By Clare Bratten
NASHVILLE, TN — May 15th is Kangaroo Care Day at St. Thomas Hospital – a day rewarding new mothers for holding their babies against their skin for extended periods. Most babies in the US begin their lives in a hospital lying in a plastic bassinet. Premature babies are cared for in incubators. But St. Thomas hospitals (Midtown and Rutherford County) are asking new mothers to spend cuddle time or ‘kangaroo care’ with skin to skin contact with their tiny newborns–even premature babies –until the babies turn six months old.
Almost evangelical in her fervor, Brooke Miller, RN, BSN, IBCLC (lactation consultant) who helped bring Kangaroo Care for newborns and premature infants in the St. Thomas NICU (Neonatal Intensive Care Unit) wants to change the way mothers and infants interact. It’s called kangaroo care because it mimics the close connection mother kangaroos have with their “joeys.” It basically means the mother places the infant on her chest and belly (with no clothing in the way). The infant lies chest-to-chest and belly-to-belly in skin to skin contact with its mother at least an hour a day.
“What actually happens when you are skin to skin–it connects a set of nerve pathways between the mom and baby. It has to be chest to chest/belly to belly (bra off so nothing in between those nerve pathways) – it can’t be side to side. That is where all these benefits are going to last. These nerve pathways between the infant and child start ‘talking’ to each other,” said Miller.
The practice is probably is as old as humanity, but the knowledge and benefits were lost in modern times until, according to Miller, a hospital in Colombia (South America) did not have enough money for the incubators they needed. In desperation, the staff put tiny premature infants on their mothers’ bellies and found the infants improved faster than the “preemies” in incubators. These benefits were documented by Dr. Susan Ludington and, since then, research has confirmed that kangaroo care in the first six months of life has long term health and emotional benefits even into adulthood.
Miller wants every family to know that kangaroo care even at home benefits both baby and mother until the baby is six months of age. “It literally can affect how that baby develops to be … an adult. The babies here in the NICU actually develop up to three times faster if they are kangarooed every single day compared to those who are just cared for in the incubators. And the moms tend to have lower rates of depression,” said Miller.
Kangaroo care is “actually going to shut down the side of brain (of the baby) that houses all of the feelings of fear, aggression, stress and anxiety and it opens up that love channel, that love hormone and that’s where all of a sudden they feel safe, they feel secure and they are at peace,” said Miller.
“The baby’s heart rate becomes more stable, they have less episodes of apnea (where they hold their breath for a minute), their oxygen levels stabilize. This is my most favorite benefit for the NICU babies – they have faster brain maturation. That is huge in a neonate, because once a preterm baby is born, that level of their growth stops from when they are in utero so everything is going to start slowing down. So, these babies that are skin-to-skin — it helps their brain develop and mature faster. They have better brain function and development, they sleep better, they gain weight quicker, they develop up to three times faster when they’ve been in kangaroo care every day.” According to Miller, a NICU baby can gain up to 10-15 grams more than the babies cared for in the incubators.
Other benefits of kangaroo care that Miller mentioned: The mother can actually thermoregulate a preterm or newborn better than an incubator can. This means her body can adjust its temperature to warm the baby – even for more than one baby–if a mother has as many as four babies, her body will change temperature at the site of each baby on her body to stabilize the temperature of each baby.
Kangaroo care encourages breast feeding in a natural way. Most premature babies receiving kangaroo care can leave the hospital as much as two weeks earlier than those cared for in incubators only. Babies receive some of their mother’s immunities to disease or infection.
However, Miller cautions that during kangaroo care, mothers often also feel sleepy and this is where other family members or fathers or the mother herself need to be monitoring the infant and be vigilant. “If the Mom is going to fall asleep, someone needs to be sitting right next to her. If you are at home doing skin to skin and you start falling asleep you need to put the baby up.”
Miller credits St. Thomas with being willing to implement the protocol after she and a colleague attended a conference on kangaroo care and convinced St. Thomas to invite Dr. Susan Ludington to come to talk to medical professionals there. Dr. Ludington conducted the first research study of the method in the United State and was funded by the National Institutes of Health to conduct randomized controlled trials of Kangaroo Care and establish the evidence base for Kangaroo Care effects on infant physiology and development. Ludington’s work won her membership in the International Nurse Researcher Hall of Fame, the Audrey Hepburn Award for Global Contributions to the Health of Children and Excellence in Research from the Association of Women’s Health, Obstetric and Neonatal Nurses.