Kangaroo Care in the USA

dawngloves, BSN, RN · Sep 13, 2004

Mods, could you move this to the NICU forum?

Home Health Columnist / Guide · Sep 13, 2004

Moved thread.

From my experience as a mom in NICU with premature child, was able to hold infant for about 30 min 1-2x a day.

Each unit is different. Not practical for 24/7 due to care/sleep needs.

TiffyRN, BSN, PhD · Sep 13, 2004

We don't use kangaroo care as much as we should. The ideal candidate for kangaroo care in our unit is a baby over 1000 grams (need an order if baby is smaller) who doesn't have umbilical lines. Obviously needs to be stable. We routinely kangaroo infants on vents though it scares me for fear of tube dislodgement (quite rare). KC is generally limited to 1 hour once or twice a day if the infant is smaller. We rarely kangaroo an infant who is over 1500 grams, we should. . . Sometimes moms resist KC because they want to look at the infant. We will bring in a big mirror we have so they can see the baby if they are concerned about that.

I personally haven't noticed a great benefit or harm to infants. I generally have to increase an infant's FiO2 when they are on the vent due to desats. I usually work with slightly larger infants so I don't do very much KC. I do believe it's good for the infant's bonding and I know it does a world of good for the parents. They just glow when they get to be skin-to-skin especially the first few times.

prmenrs, RN · Sep 13, 2004

Our FAMILIES can visit 23/7. We need 30 min 2x/d for report (confidentiality). Mothers and fathers can hold baby skin to skin as long as they like, providing the baby tolerates it (per monitors) and is in stable enough condition. Usually when the baby is out of the ICU area, they can.

It has been proven that mom will automatically adjust her own temperature to keep baby's temp perfectly. (author of the study is Mellien, A; try JOGYN ? Apr 2001) I don't know if the study was repeated for dads, but I don't see why it wouldn't.

The baby is, of course, monitored (including temp) fully for heart, resp and O2 sat. Even tho it's a pleasant thing for both parent and child, the baby can tire, showing avoidance cues like hand salutes and finger splays. Then Mom and Dad let the nurse know it's time to go back to the incubator.

Sometimes, if baby is interested, they can non-nutritive suck on either parent. Can be very helpful in maintaining milk supply, and even beginning to breast feed. Just make sure Mom pumps very well so baby doesn't get a mouthful of milk s/he doesn't know what to do with. And watch out for hairy chested dads--baby can get a mouth full of hair, too. Blechh.

fergus51 · Sep 13, 2004

I haven't seen it done in my unit at all. They are very reluctant to allow parents to hold infants under 1500 g. My old unit used it pretty often and babies were allowed to be out as long as they tolerated it.

dawngloves, BSN, RN · Sep 14, 2004

As long as a patient is stable and has no A-line and is not on a HFV I let the parents Kangaroo for as long as the parents want or the baby tolerates it. Unless the baby needs labs drawn or an xray they can sit all day if they can!

I encourage it a lot. It is a big hassle if they are vented, but I've only had one pt extubate that way and he went right to CPAP from there anyway.

I love to see the baby all cuddled up and warm on a parents chest doing skin to skin. It does them both so much good! :)

LauraF, RN, ASN, CNA, LPN, RN · Sep 14, 2004

I am a Mom of a former NICU patient. She was 560gr when she was born. We did skin to skin once they got rid of her umbilical lines. We did it as long as she tolerated it. If she started desats or bradys we would put her back. She really thrived on this. We continued this after she came home. We also did it as often as possible in the hospital, but I also had a 7 month old. It was difficult to juggle both during the days of NICU. Feel free to PM me if you have specific questions.

BittyBabyGrower, MSN, RN · Sep 14, 2004

Around a kilo, no umbilical lines, can be intubated, but stable. We have the mom's wear a button up shirt, pop baby in her shirt and button it up :) Sometimes we initally have to turn the oxygen up, but wean it back down...don't want any fried eyeballs! If they need increased fio2, then they aren't tolerating it and have to go back and try again. It is for at least 30 minutes...longer if baby tolerates it. As long as we have one good assessment a shift, baby can stay on mom.

The kids that usually tolerate nothing usually do well with kangaroo once we get them settled. Good for baby, good for mom :)

gwenith, BSN, RN · Sep 14, 2004

Sorry but when I hear the words "kangaroo care" this comes to mind

dawngloves, BSN, RN · Sep 14, 2004

That's it in a nutshell, Gwenith! :chuckle

debblynn13 · Sep 15, 2004

Thanks everyone for your input. From what I understand KC is being used in various forms and more in some hospitals than others.

Thanks again,

Debblynn