Quote from WeeBabyRN
We allow skin to skin also. I am very uncomfortable getting the babies out for skin to skin, I am very slow and the parents staring makes me more nervous. If a baby goes out to Kangaroo, the parents have to hold for at least an hour.
WeeBabyRN, I know it's scary the first few times you get a baby out. I found if I get all of my lines in position first and get everything set with mom or dad first, then I seem speedier in getting them up. We will usually disconnect them from the vent and inline suction before we move them over to the waiting parent, and in that cast, you can't be very slow. If the baby doesn't like being disconnected or has a high PEEP, then it goes a bit slower .
We encourage kangarooing, stable babies without umbi lines can
kangaroo daily. They must be held for an absolute minimum of one hour, we prefer at least 90 mins. They go back when they start exhibiting signs they are getting stressed with their situation (as listed above by Prmenrs). I've had parents kangaroo for four hours. We have recliners and use the nursing stools that Prmenrs posted the picture of. If a parent decides to recline, then they get completely into position before the RT (in the case of an intubated baby) and I place the baby on their chest, and they stay reclined while we put the baby back when the session is over. We clip the vent tubing to the parents' gown or shirt in two places and check on the position of the baby and parent frequently (but quietly) to make sure they are not moving too much. We discourage talking at all during the kangaroo time, the whole point is for it to be very peaceful and I've seen babies get very upset if the parent speaks. I don't know if it is the reverberation or what, but many don't seem to like it. Also when most people talk, they have a tendency to move their arms or hands to express themsleves, it's an unconscious thing and then, whoops! There goes the ETT.
All of these things (parent in place first, clipping tubing in two places, checking on them frequently, discouraging talking) have helped decrease our unplanned extubations during kangarooing
Quote from WeeBabyRN
I have noticed that a downfall is that some parent's don't realize the seriousness of their babies condition if they are allowed to kanagaroo.
I'm confused by this comment. This statement implies to me that your unit does not kangaroo unless the baby is really really sick? Or are you saying that you've found that when a parent is allowed to hold/kangaroo they have trouble grasping the fact their baby is a sick infant in an ICU and can still get very ill and possibly die. If the latter is the case, I kind of get what you are saying. It's like trying to tell a parent that just because the baby (possibly a 25 weeker) is here doesn't mean it is fine to hold and touch and stroke and give them a bottle right away. But I've found that if you educate the parents correctly about the concepts behind kangaroo care and it's benefits for ill babies, generally they don't seem to have unrealistic expectations. There are always those exceptions who think that no matter what or how sick the baby is, they should be able to hold.