Kangaroo Care Reducing Infant Mortality & Improving the care of infants

The transition from Fetal to Neonatal life represents one of the most dynamic & potentially hazardas events in the human life cycle. The initial postnatal period is characterized by high levels of stress, as exemplified by levels of catecholamines & cortisol secretion & comparatively labile neurobehavioral regulation. Therefore methods that enhance stabilization of neural, behavioral, & state regulation & facilitate the adaption of the infant to the outside worldmight be clinically useful. The current study was designed to test the effect of a behavioral method known as skin-to-skin contact (kangaroo care), used as post delivery facilitation of the neurobehavioral self-regulatory responses of the term infant.

The term "self regulation" is widely used to identify infant adaption to various internal & external stimuli & to unstable situations. The development of infant self regulation involves the regulation of physiologic systems, information processes, & the formation of attachment bonds & ultimately determines hoe the infant responds cognitively & social-effectively to the environment. Self regulation develops in the newborn within the womb & throughout the birth process, & it is especially challenged during the 1st hours & days after delivery.

Skin-to-skin contact, the normal mammalian postnatal condition, has been found to improve infant state organization, thermal regulation, respiration, & oxygen saturation, reduce apnea, bradycardia, increase milk production, accelerate weight gain, & quicken hospital discharge.
For more informatin please visit: www.pediatrics.org The effect of skin-to-skin contact
(kangaroo care).

***Traditional hospital care of premature & small newborns:

In many western cultures, the birth process has become a medical procedure. Once a baby is delivered, he or she is tended to by healthcare professionals who provide medical care for the baby apart from the mother & for the mother apart from her baby.

Often, infants are removed from the motherto be washed, weighed, measured, & sometimes given artificial nourishment (Londan, Ladewig, Ball & Bindler, 2006). This is physiologically & emotionally disruptive to a baby who has been securely positioned for months in the womb, in constant contact with the mother & her familiar rhythms.

When the newborn is premature or small in size, there are additional concerns & stressors. Neonatal intensive care nurseries (NICU) have developed to provide specialized, direct care in an environment that is noisy, & bright, & totally unfamiiliar. Incubators with thermostats are used to keep the baby warm & visible. The people around the infant have foreign voices. the pace of the environment is remarkably different from that of the uterus & physiologically the newborn exhibits increased responses to the dramatic change that has taken place.
The Neonatal attachment has been essentially interrupted. Artificial temperature regulation, feeding, & lack of physical contact can have significant deleterious effects on even normal, term newborns. For the premature infant, the effects are compounded!

Kangaroo Care seeks to provide restored closeness of the newborn with mother &/or father by placing the infant in direct skin-to-skin contact with one of them. This ensures Physiological & Psychological warmth & bonding. The kangaroo care position provides ready access to nourishment. The mother's body responds to the needs of the infant directly, helping regulate temperature more smoothely than an incubator, her milk adjusts to the nutritional & imunological needs of her fragile infant, & the baby sleeps more soundly.

Benefits for Preterm & low birth weight infants:
*Normal temp, heart rate, respiratory rate
*Breast milk readily available & strengthens infants immune system
*The maternal contact causes a calming effect with decreased stress & rapid quiescence
*Reduce physiological & behavioral pain responses
*Increased weight gain
*Enahnced mother-infant bonding (positive effects on infant's cognitive development)
*Less nosocomial infection severe illness, lower respiratory tract disease
*Restful sleep
*Earlier discharge
*possible reduced risk of sudden infant death
*Normalized infant growth of premature infants
*May be good intervention for colic
*Possible positive effects in motor development

Benefits for Mom:
*Enhanced attachment & bonding
*Increased milk volume, doubled rates of succesful breastfeeding & increased duration of breastfeeding
*Resilience & feelings of confidence, competence & satisfaction regarding baby care

More information on Kangaroo Care is available at the March of Dimes website: www.marchofdimes.com/prematurity/5430_6074.asp