Kangaroo Mother Care?

Specialties NICU

Published

Specializes in NICU, Med/Surg.

I´m a big believer in KMC and was wondering how much it´s being used in other countries? I work in a level 3 nicu (with full capacity of 17 icu beds, 10 private rooms and 6 high dependency beds).

Do you have a specific criteria for letting parents and babies use it? Can the babies be ventilator dependent, unstable, have umbilical lines, any gestational age or weight? Who decides if it´s appropriate, doctor or nurse?

We use it on almost any type of baby regardless of size and condition. Parents are encouraged to do it as much as they can.

For babies that doesn´t have umbilical lines, ventilator or cpap we now try to use kmc 24/7. They stay with their parents (on their chest) in private rooms (with monitoring if appropriate). We have had preterm babies as small as 30 weeks that were never separated from parents, and 32 weeks on full breastfeeding leaving the hospital!

(In sweden both parents are entitled to staying with their baby and recieve 80% pay of their normal salary, indefinately).

Anna, RN

We do use Kangaroo care in our unit but unfortunately not as much as in your unit. I have seen the wonders it can do for both mother and child but it is under the nurses descretion and whether it be because of inconvinience or because they don't feel comfortable because a baby is unstable it is not offered much. New parents don't know to ask to hold their baby until the first nurse introduces them to the concept. It is standard however that unless the baby is extremely ill and not expected to make it kangaroo care is not done when a baby has umbilical lines or chest tubes or is on an oscillator. We also are not blessed with private rooms so kangaroo care can be a breech of privacy for a modest mom. General rules are once a 12 hr shift but as long as the baby handles it and maintains his/her temp the parent may continue to hold.

When my son was in the NICU I was PUSHED to do kangaroo care. I just didn't want to be the type of mommy that was alway pushing my baby to do somthing that he wasn't ready to do Their policy was any condition any time as long as no physical intervention was needed such as bagging through a brady or desat also as long as their temp is stable.

Specializes in NICU, Infection Control.

Danianne--Did you do it and how was the experience for both of you?

Yes I did finally do kangaroo care. my son was born at 27/1 he weighed 950grams about 2lbs. he was VERY unstable in the beginning so I took me 2 agonizing weeks for me to feel he was okay and ready to start kangaroo care. the first time is did kangaroo care with him the baby behind us coded and the nurse that was responsible for jacob he was 1:1 at the time HAD to help the other nurse so I ebded up holding him for 2 1/2 hours the frist time. he had 0 desats and 0 bradys his temp stayed absolutly perfect. I ended up going home for one week because he was "doing SO well" he was off the osscilator and on to CPAP on 21%O2 had no infections and then exactly at 0600 (the time I usually came in to touch him) the first day I was gone I go a call we need you to come back NOW (I was 900 MILES away at the time) they thought that he had NEC and he also had bacteremia (MRSA) and Pnumonia. I had been gone fron Vancouver for a total of 6 1/2 hours. He KNEW I was not there. As soon as I got back he got better.

Specializes in Med-surg; OB/Well baby; pulmonology; RTS.

I'm not a NICU nurse but wanted to say that the NICU where my daughter stayed after her birth allowed us to do kangaroo care. We waited until she was in the progessive unit to start KC because I was pretty ill for several days after her birth (I had severe pre-eclampsia/HELLP Syndrome) and they wanted to make sure she didn't need to go back on CPAP.

Alyssa had a peripheral IV and O2 via nasal cannula and if her temp was stable, we kangaroo'd for an hour or so. We would try to coordinate KC with her feedings and before I would pump. Her HR and sats were always excellent when she was with me and even her daddy (my husband watched me do KC for a couple of times and then said he wanted to do it too!). We only got to do KC about once a day. The NICU had privacy screens that they would place around us while we were snuggling. As far as I know, we were the only ones doing KC in that NICU at the time.

I absolutely loved KC and I regret that I didn't ask to do KC with our first child. You could tell Alyssa loved it too-she would sleep for hours and be as still as a mouse after KC. Even after we brought her home, if she was having trouble going to sleep or very fussy, I would pop her under my shirt and have some KC time and she would calm down in a matter of minutes.

I did this with both of my preemies (680 grams and 970 grams born 3 yrs apart) and they did WONDERFUL during these sessions. My son was the least stable of the two (5 major surgeries before leaving NICU)...I was afraid to do it at first, and the docs only required him to be stable (I held him while on a vent)...but he usually wasn't stable! He was one of the sickest babies up there, so it was frustrating. I did it as long as my bladder could stand it and would have stayed with him longer if it weren't for having to get up to go tinkle...lol. I spent upwards of 15 hours a day with both my kids when they were in NICU. They are thriving 8 and 11 yr olds now. =)

I think it is great your unit promotes that much KC and that babies are doing so well with it...wonderful to hear!

~J

We do KC. Our policy requires the infant to be stable, and supposedly over 1000g, though many nurses ignore that. The baby can be intubated, but it only seems to be done with the kids who are intubated for a LONG time, otherwise we just wait till they are on VT. I have seen it do wonders for some babies. Unfortunately, I've also seen kids who just can't tolerate it and it is so upsetting for the parents. They need a lot of reassurance that it doesn't mean anything negative about them.

KC is not really pushed at our hospital and I admit, my shift is a lot easier if holding is limited to a few hours at a time rather than 8 hours at a time. The reason is the unit is just not set up for it. The bedspaces are ridiculously small, to the point that if one mom is doing KC I sometimes can't get into their neighbour's bedspace without pulling the isolette out into the walkway area. It is litterally impossible to have two babies doing KC next to eachother.

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