In a nutshell, Kangaroo Care and skin-to-skin contact are the same things. In most instances, Kangaroo Care does refer to contact with your premature baby, while skin-to-skin implies contact with your full term baby.
However, the guidelines for Kangaroo Care and skin-to-skin contact are the same. The process is the same. The benefits are the same. The joy you will experience is the same.
If your baby is born prematurely, your Kangaroo Care experience might be a little different. That is because your baby will likely be admitted to a Neonatal Intensive Care Unit (NICU).
“In current day, skin-to-skin is typically a term used for full-term infants, describing how much of the first hours and days of the infant’s life are spent against the mother’s chest, promoting both bonding and breast milk production. Kangaroo care is more often used when referring to the care a pre-term baby in the NICU receives.”
This article will focus more on Kangaroo Care and your NICU experience.
WHAT IS KANGAROO CARE?
Then I wondered “Why would anyone want to have a pet kangaroo?” Their boxing skills are well documented. I would likely get the crap knocked out of me while trying to feed my new pet. But who knows? People these days have monster lizards and boa constrictors for pets.
Kangaroo Care started in Bogota, Columbia during the late 1970’s. It began out of necessity. Nurseries were over-crowded. There was a dire shortage of warming equipment. Premature babies were not being attended to. Infections were rampant. The premature infant mortality rate was actually 70%. This is not a typo – 70% death rate.
In desperation, care-givers began to ask mothers to hold their their naked newborns against their naked chests. The results were staggering. Newborn premature babies not only survived, but they actually thrived. Fatality rates plummeted.
Kangaroo Care was born, and the good word spread very quickly. Today holding your baby skin to skin is commonly practiced everywhere worldwide. It has been discovered that Kangaroo Care benefits not only preemies, but full-term babies as well.
KANGAROO CARE FOR PREMATURE BABIES
The Kangaroo Care process is quite simple:
- Remove your bra. Wear a shirt or hospital gown that opens in the front.
- Place your baby directly on your bare chest. The baby will be only wearing a diaper.
- Your baby should be in an upright or 45 degree position.
- Cover your baby with your shirt or a blanket.
- Relax and enjoy your wonderful bonding experience.
Nothing to it. Try to make your Kangaroo Care sessions last for at least 1 hour. You can be in a hospital bed or sitting in a comfortable chair.
At some point, your baby will probably fall asleep. This is a good thing. But you should stay awake. Mom falling asleep during Kangaroo Care is very definitely NOT a good thing.
It is a great idea to continue Kangaroo Care after your hospital stay is over. Many parents continue skin to skin for many months after delivery.
“Aim to provide kangaroo care for an hour or so, once daily. You may even be able to work up to a longer sessions of three to four hours — but know that your baby benefits from even just a few minutes of kangaroo care.”
Dads can get in the act as well. In fact dad’s participation is strongly encouraged. All fathers will benefit greatly from these bonding periods. And let’s give mom a break. She just went through labor and delivery, for crying out loud.
This Kangaroo Care process for preemies is very similar (if not identical) to skin to skin contact procedures for full term babies. We examine the “How To’s” much more thoroughly in our post “How to do Skin to Skin Contact.” I hope you will have a closer look.
KANGAROO CARE BENEFITS
Why bother with Kangaroo Care? For one thing, it’s flat out fun. What a joyful experience. Holding your naked newborn against your bare chest provides such contentment. It’s just – well, pure joy. I don’t know how else to describe it.
Perhaps more importantly, Kangaroo care is potent medicine. When your baby feels your skin, his or her brain produces a hormone called oxytocin.
“ A recent interesting study found that skin-to-skin care increased oxytocin not only in mothers but fathers and infants, as well.”
I certainly am not much in the science department. But oxytocin is often referred to as the “love hormone.” It actually helps your baby to feel safe and protected. It promotes calm and reduces stress. Studies have shown increased oxytocin levels in parents and babies during Kangaroo Care sessions.
Here are some direct Kangaroo Care benefits for your baby.
Regulate Baby’s Body Temperature: Mom (or Dad) actually pass along warmth to the baby during skin to skin contact. This requires your newborn to use fewer calories to keep warm. Newborns (especially preemies) have very little body fat and can’t produce enough calories to regulate their body temperature.
Moms are a little more effective in helping your baby regulate his or her body temperature. This is because mom’s breasts will naturally get warmer or cooler, depending on baby’s needs. As baby starts to lose warmth, mom’s breasts will heat up – as much as 2 degrees in 2 minutes.
Regulate Baby’s Heartbeat and Breathing: Newborns tend to have irregular and chaotic heartbeats and respiratory patterns. They have to breathe on their own for the first time. This takes some getting used to.
Skin to skin contact is a significant way to regulate baby’s heartbeat and breathing patterns. And the improvement is practically immediate. Baby’s oxygen saturation rate will also show immediate improvement.
Better Breastfeeding: Kangaroo Care babies almost always breastfeed more quickly and more effectively. There is a distinct odor emitted from mom’s breast. Babies sense this odor and clearly are attracted to it. Holding your newborn skin to skin on your chest allows baby to speed up this process.
It is amazing to see babies start to suckle and search for mom’s breast almost immediately after delivery. After all, your newborn has just been through a whirlwind called birth. Hunger is an understatement. Sorry Dads. This one is not for you.
Better Sleep: One wonderful benefit of Kangaroo Care is that baby will sleep better. This is a direct result of regulated body temperature and heartbeats mentioned above. Your baby will sleep longer and more deeply.
It won’t take long for baby to fall asleep after your Kangaroo care session has started. Better sleep helps your newborn to conserve much needed energy. This will result in increased overall growth and faster weight gain.
Less Pain: Skin to skin sessions help your baby to relax. This allows your newborn to feel less pain, especially during required medical procedures that premature babies are subject to. Blood draws is a good example.
Less pain means less crying. We like this one a lot. Nothing else needs to said.
Kangaroo Care babies have shown clear tendencies to be able to avoid infections. This is great news. Also, they tend to be discharged from the NICU much sooner. Even better news.
Kangaroo Care also benefits moms and dads, too. Here is a short summary.
Provides comfort for parents: Moms have just endured labor and delivery. This is truly a stressful experience. Providing Kangaroo Care for your newborn is a wonderful way to take a breath and relax. Phew!!
Provides confidence: You are actually doing something that results in real benefits for your baby. Think of your baby benefitting with regulated body temperature and heartbeats. This happens because of you. Nobody else can do this. Only you.
Special bonding with your newborn: Think about the wonders of Kangaroo Care. Your baby is intimately close to you. Practically immediate breastfeeding. Your baby makes eye contact with you. Your baby sleeps on your chest. All of this is the beginning of the special love and bonding you will develop for your new baby.
Greater Breast milk production: That’s right, moms. Kangaroo Care actually does result in more milk for junior.
Decreased risk of postpartum depression: There is lots of verified data that suggests Kangaroo Care does actually diminish the possibility that you will suffer from postpartum depression.
KANGAROO CARE GUIDELINES FOR PREMIES
Here is a terrific video showing guidelines and benefits of Kangaroo Care for your premature baby
Kangaroo Care guidelines for premies are very straightforward and simple. Here is a summary.
- You can lie in a bed or sit in a comfortable chair. Be sure to wear a top that opens in the front. Remove your bra.
- Place your baby directly onto your chest. Your can position your baby vertically or at at 45 degree angle. The baby should be naked, except for a diaper.
- Cover your baby with a blanket. That’s all there is to it.
- Try to make your sessions last for at least 1 hour. Also, initiate as many Kangaroo Care sessions as you can. More is better.
Our post about the benefits of skin to skin contact goes into greater detail about the benefits and techniques of Kangaroo Care (or skin to skin contact). If you are interested in learning more, have a look.
Let’s take a closer look at the NICU to see what it’s like.
REASONS FOR BABY BEING ADMITTED TO THE NICU
First of all, why would your baby be admitted to the neonatal intensive care unit (NICU)? The most common reason is prematurity. Since this article talks mostly about Kangaroo Care and premature babies, this one is especially relevant.
Your baby will likely be sent to the NICU if he or she is born in less than 37 full weeks of pregnancy. Premature babies are less physically developed. They may have a more difficult time adjusting to the outside world. Their body temperature and vital signs are often less stable. They may exhibit more significant weight loss.
Sometimes, your baby may be placed in an incubator to help regulate body temperature. Also, your baby might be given food that is higher in calories or IV hydration.
There are other situations that may require your newborn to be sent to the NICU. It might be helpful to be aware of the other reasons, as they are often related to premature birth.
Respiratory Distress Syndrome (RDS): RDS is fairly common in newborns, especially preemies. Babies may show breathing problems. This is usually because their lungs are immature and haven’t developed.
Typically, RDS is treated with a machine that pushes additional oxygen into the baby through a mask. More severe cases might require the use of a breathing tube or ventilator.
Infection: Sometimes called sepsis, infections can be quite serious and dangerous. Babies born with sepsis are more common with premature births, and their immune systems need help fighting off infections. Sepsis is generally treated with antibiotics.
Low Blood Sugar: This is called hypoglycemia and is sometimes seen in premature babies. Low blood sugar may also occur if mom is diabetic or if the baby has an infection.
Perinatal Depression: This is when your baby has experienced decreased blood flow and/or oxygen deprivation. The cause of this condition is usually a traumatic delivery or other problems during birth.
There is a new treatment for babies born with perinatal depression. Care givers have found that body cooling for your baby is often very effective in decreasing the risk of brain injury due to decreased blood flow.
Maternal Chorioamnionitis: This has to do with mom’s health, usually a placenta or umbilical chord infection. The result is a higher risk for baby to develop sepsis as well. As is the case with other infections, baby is treated with antibiotics.
WHAT DOES THE NICU LOOK LIKE?
Your first look inside the NICU can be a scary experience. You will see all kinds of sophisticated equipment, machines, monitors, alarm systems, and who knows what else. What is all of this stuff?
I think you might find it helpful to have a brief and general introduction to NICU equipment and what it does. Try not to be overwhelmed. NICU staff members are very knowledgable and caring. They will explain everything to you.
We can separate this equipment into broader functions as follows:
This equipment will vary some depending on your NICU. But monitoring machines will be measuring the following:
- Heart rate
- Respiratory rate
- Blood pressure
- Body temperature
Sometimes a pulse oximeter is used. This measures oxygen levels in your baby’s blood.
There will all kinds of sticky pads or cuffs attached to your baby’s body. This is nothing to worry about. The attached wires go to the various monitors that track all of the stuff outlined above. The monitors typically look like a TV screen displaying a variety of charts and numbers. The NICU care givers can explain what these displays mean.
You will also hear a regular annoying screech. These are periodic alarms. An alarm does NOT necessarily mean there is a problem. More likely, these sounds are merely routine periodic checks. Again, nothing to be concerned about.
Here is a question for you. Why is it that hospitals seem to always be filled with machines that make the most annoying sounds imaginable? I have no answer to this.
Sometimes, your baby may need a little help breathing regularly. Normally, your Kangaroo Care sessions will help baby develop breathing patterns. The following equipment will give your newborn a little extra assistance, if required.
Endotracheal Tube: Placed down your baby’s windpipe. Provides humidified air and oxygen.
Ventilator (or Respirator): This is a breathing machine connected to the endotracheal tube. It monitors breathing patterns and oxygen.
Continuous Positive Airway Pressure (or C-PAP): Used when babies are capable of breathing unassisted, but need a little help getting air into their lungs.
Oxygen hood: Sort of a clear plastic tent. It placed around your baby’s head and pumps oxygen.
Intravenous Lines: Delivers nutrition directly into the baby’s blood. Can be used when baby is having difficulty sucking or swallowing. Can also help to develop an immature digestive system. The lines are usually an IV that is placed on the scalp, arm, or leg.
Umbilical Catheter: This method requires surgery to place a tube into the umbilical cord vessel (belly button). It is painless, but does carry the risk od infection or blood clots. This method is only used in critical cases where baby will require feeding assistance for a longer period of time.
Oral and Nasal Feeding Tubes: These are small flexible tubes inserted into your baby’s nose or mouth. It is a good option for babies who are ready to digest breast milk, but are yet able to coordinate sucking, swallowing, and breathing.
Central Line (PICC Line): This is an IV inserted into larger veins. It is intended to provide nutrients and medications that might irritate smaller veins.
Incubator: This is a clear plastic crib that helps protect your baby from germs and infections.
Bili Lights: A blue fluorescent light placed over the incubator to help treat jaundice.
THE NICU STAFF
This is a good time to mention what to expect from your NICU staff. You might meet respiratory therapists, occupational therapists, dietitians, social workers, or other specialists. You will surely run into a neonatologist, a pediatrician with special training in the care of premature babies.
It is a good idea to get to know your NICU staff members. They are professional and extremely caring experts. These pros know what they are doing, and will provide you with the highest level of care and assistance possible.
Here is an excellent video to watch about NICU activities. It includes sort of a sales pitch for some hospital in Idaho, but the video will provide a good overview of what goes on in a typical NICU
YOUR NICU EXPERIENCE
We have already taken a look at the NICU and what it is like there. What about the experience that moms and dads can expect?
First, try to prepare for a stressful time. After all, your baby is premature and in intensive care. At the same time, understand that the chances of your baby being in danger are extremely low. In fact, most babies admitted to the NICU are sent home within 48-72 hours.
I feel a little foolish suggesting that you try to stay calm and not panic. I have been lucky. My two sons were born full term and very healthy. All 9 grandkids also. So I can’t possibly relate to parents whose newborn baby is admitted to the NICU.
But I can pass along expert advice from experienced and caring professionals who work regularly in the NICU. The most important thing to remember is this – Don’t panic, and stay calm. It is extremely likely that your baby is going to be just fine.
Here are some other things to be aware of during your NICU stay.
KANGAROO CARE IS MORE IMPORTANT THAN EVER
When your baby is born prematurely, practicing kangaroo care is more important than ever. Your baby will be less developed that a full term newborn. Therefore, he or she might be more susceptible to germs and illness.
We have touched on the kangaroo care benefits already. Wonderful results like regulating baby’s heart rate and body temperature are conclusively documented. Skin to skin contact will also provide your premature baby with the additional crucial benefits:
- Kangaroo care helps develop your baby’s immune system.
- It will help mom produce breast milk that is best for providing nourishment and protection for your baby.
- Kangaroo care will help build antibodies to help your baby fight off threatening germs.
“All infants benefit from skin-to-skin contact, breastfeeding, shared sleep and so forth, but some babies very seriously need kangaroo care. They include premature infants, infants with low muscle tone or disabilities, high-needs infants, those with intrauterine growth retardation or those who have a hard time gaining weight.”
There is one primary difference in practicing Kangaroo care if your baby is in the NICU. Parents will have to go to the NICU to hold their baby. And mom will sit in a chair during skin to skin contact sessions instead of lying in bed. Other that that Kangaroo care is very much the same as we discussed in the previous section. The NICU care givers will certainly help you to make any necessary adjustments.
YOU MAY BE SEPARATED MORE
The NICU will be like a temporary new home for parents. You will be able to come and go in the NICU pretty much as often as you like.
But you will not be able to be in the NICU 24 hours a day. There will some separation from your baby. This can be a difficult emotional experience for parents. Try to remember that your baby needs time for necessary treatment and rest. Also, moms need to rest and recover from delivery as well.
HOW TO PARTICIPATE IN NICU
Here are a few suggestions:
- Touch your baby as often as you can. You can try some light massage motions or just a very gentle touch.
- Talk to your newborn. It will be surprising to see how quickly your baby recognizes your voice. If it were me, I wouldn’t have a clue about what to say. But you can read a story or try singing a song. Just the sound of your voice will truly comfort your baby.
- Change your baby’s diaper. What can I say? Get used to it.
- Help give your baby a bath. The NICU staff will help by providing recommended supplies for this.
- Take your baby’s temperature.
These are simple tasks that are very helpful in caring for your newborn. They provide a wonderful opportunity for you to assist. Don’t be afraid to ask the NICU staff if there is anything else you can do. They will surely have other suggestions.
WHEN YOUR BABY COMES HOME
As we have discussed, you will be encouraged to provide as much Kangaroo Care as possible during your stay in the NICU. It is so helpful to your baby’s health and development. What about when you bring your baby home?
The best suggestion is to “Keep On Kangarooing.” This is especially a great idea if your baby was born prematurely. Your preemie is a little behind in physical development. Continued Kangaroo Care does help your baby feed more effectively and gain weight. Skin to skin contact also will help baby sleep better and cry less.
You can provide Kangaroo Care when breast feeding or bottle feeding. Kangaroo Care can also be used as a relaxation exercise after bathing.
Why not give your baby Kangaroo Care during the day? Carry your baby around with you while performing your normal daily activities. There are all kinds of slings and carriers available that make this very easy and safe.
Cleveland Clinic: Kangaroo Care
Hand to Hold: Benefits of Kangaroo Care
La Leche League: Premies: Kangaroo Care and Skin to Skin
La Leche League: Skin to Skin Contact
What To Expect: Kangaroo Care
Baby Centre: How to Do Kangaroo Care Premature Baby
American Pregnancy: Care For the Premature Baby
Evidence Based Birth: Skin to Skin After Caesarian
Midwifery Today: Kangaroo Care: Why Does It Work?
Pixabay: Baby in Incubator
US Air Force: Endotracheal Tube
Wikapedia (Brian Hall): NICU C-PAP
Wikapedia (ceejayoz): Ventilator
Flickr: Oxygen Hood
US Air Force: Feeding Tube
Unsplash (Jair Lazaro): Monitor
Wikimedia Commons: Umbilical Catheter
Shutterstock: Rob Hainer
US Air Force: Newborn Transport
Shutterstock: Khoroshunova Olga
EIRMC: NICU Tour
Nationwide Childrens: How to Kangaroo Care With Your Baby