The Benefits of Kangaroo Care for Your Premature Baby
Research supporting kangaroo care of pre-term infants in the NICU.
By Krisanne Larimer
Kangaroo Care has been studied in depth since 1983 when neonatologists Edgar Rey and Hector Martinez first implemented it in Bogota, Columbia. Kangaroo Care consists of placing a diaper clad premature baby in an upright position on a parent's bare chest - tummy to tummy, in between the breasts. The baby's head is turned so that the ear is above the parent's heart. Due to lack of power and reliable equipment, Kangaroo Care was found to be an inexpensive and very beneficial experience to babies in Bogota. The mortality rate fell from 70 % to 30 %.
Most studies have proven that Kangaroo Care has a major, positive impact on babies and their parents; some studies have proven there is no change; but no study has proven that Kangaroo Care has hurt either parent or baby. In this article, my goal is to inform parents, nurses, and doctors on the benefits of Kangaroo Care. I have selected one study or article in each group that best sums up all the studies done to date
Researchers have come a long way in determining the major cause of colic. The common conclusion in 1999 is that colic is caused by a baby's (whether premature or full term) inability to transition from one sleep state to another - like from an alert state into a sleep state and back again. The gas associated from colic is caused by the excess of crying during these transitions. Kangaroo Care performed in a quiet, low light environment with ANY baby has been proven to reduce crying and help the baby learn to transition from one sleep state to another. A study done by Patricia Messmer, et al (Pediatric Nursing,23 (4): 408-414) in 1997 found a significant increase in sleep time for the neonates during Kangaroo Care. I want to impress upon all that Kangaroo Care works just as well with full term infants as it does with premature infants.
Apnea, Brady, O2 Saturation, Respiration and Heart Rate
The newest studies that are being done in Sweden and other countries concentrate on full term babies in respiratory distress. They take these babies, who would normally be put on respirators, and place them on the mom's chest immediately after birth in the Kangaroo Care position. Babies stayed on mom until the respiratory distress was gone - within 48 hours for most babies. Oxygen hoods and canulas were used if needed. In preterm babies, the effects of Kangaroo Care on these functions is just as dramatic. In 1998, Susan Ludington (Acta Paediatrica,87 (6): 711-713 ) found a four-fold decrease in apnea during Kangaroo Care and mechanically ventilated babies were able to tolerate transfer and position changes without increased oxygen requirements. In 1997, GM Cleary, et al (J. American Osteopathic Assoc., 97 (8): 457-460) concluded there was no increase in bradycardia episodes during Kangaroo Care. In 1998, Gay Gale and Kathleen Vandenburg (Neonatal Network, 17 (5): 1-3) concluded that the heart rate was more regular for Kangarooed infants. All-in-all, the baby fared much better when placed in Kangaroo Care. With my own ventilated preemie (1 pound 12 ounces at birth) I noticed a 50% reduction in oxygen requirements, no apneas or bradys, more stable heart rate, and more spontaneous respiration when I held her skin-to-skin.
Body Tempature and Lactation
I believe this is truly the most amazing benefit of Kangaroo Care. In 1990, Susan Ludington (Heart and Lung, 19 (5): 445-451) concluded that mothers showed thermal synchrony with their babies. A recent study placed babies in Kangaroo Care position on the mother's chest and temperatures were taken periodically of both the mother's chest and the baby. The study concluded that when the baby got cold, the mother's body temperature would increase to 'warm' the baby up. The reverse was also true. Given a suggestion of "Your baby looks warm to me" by a nurse, the mother's chest temperature would decrease within minutes to compensate. Extra blankets and monitoring of baby's temperature might be needed when Dad or others practice Kangaroo Care, but in 1997, Karl Bauer, et al (Journal of Pediatrics, 130 (2): 240-244) concluded that one hour of skin-to-skin contact (Kangaroo Care) was no cold stress to preterm infants.
In 1998, Papi A Gomez, et al (An Esp Pediatr 1998 Jun;48 (6): 631-633 - Spanish) found infants in Kangaroo Care for > 50 minutes were 8 times more likely to breast feed spontaneously. Kangaroo Care allows for easy access to the breast, and the skin-to-skin contact increases milk let-down. A receiving blanket, strategically placed to catch extra milk is extremely helpful - especially if the baby is unable to breast feed.
Weight Gain/ Shorter Hospital Stay
Holly Richardson (Why Does it Work? International Midwife Winter. 1997.) concluded that more rapid weight gain was observed in Kangarooed infants. The NICU is a busy, noisy place. Kangaroo Care allows the baby to fall into a deep sleep, there by conserving their energy for far more important things. Left alone on a warming table, a baby cries more and sleeps less.
This increased weight gain also leads to shorter hospital stays. N Charpak, et al (Pediatrics, vol. 100 #4: Oct 1997, pg 682-689) showed a shorter hospital stay in the Kangaroo Care group; primarily in infants -/<1800 grams. Kangarooed infants can have as much as a 50% shorter hospital stay than babies who aren't Kangarooed. This in turn means less expense for the hospitals and/or parents.
In 1998, Gay Gale and Kathleen Vandenburg (Neonatal Network, 12 (6): 49-57) found an increased intimacy and attachment between baby and parent. Kangaroo Care was found to help a parent feel connected. Eye contact led to an experience of "knowing" infant.
I wish that every doctor and nurse in this country could experience Kangaroo Care themselves. As a Mom who was able to Kangaroo her little 1 1/2 pound miracle for two hours every day, I have few words to describe my experience so that others can truly understand. You can liken it to a full term delivery where the baby is immediately placed on mom's chest, kicking and screaming, then quieting to look into mom and dad's face with wonder. Holding that tiny body next to mine, feeling her little hand clutch my collar bone, feeling her drift off to sleep in my arms.... truly the most amazing experience of my life. I hope that soon, VERY soon, all parents of premature infants will be able to experience the same.