Today's guest blogger is Diane L. Spatz, PhD, RN-BC, FAAN, professor of perinatal nursing & Helen M. Shearer professor of nutrition, and faculty advisor to Student Nurses at PENN at the University of Pennsylvania School of Nursing, and nurse researcher - lactation at The Children's Hospital of Philadelphia.
The hospital is a high-tech world with many things that can separate you from your baby, especially if your child is born preterm or ill. One way parents can bond with their newborns, even if they require a ventilator, is holding the baby in a special way called kangaroo mother care (KMC).
In developing countries, mothers hold their babies in KMC continuously from birth. KMC involves the baby being in continuous skin to skin contact with his mother from the time of birth. In the United States, a version of KMC is practiced: skin to skin care. Skin to skin contact is when the mother or father holds the infant on their chest, with the infant clad only in a diaper.
At The Children’s Hospital of Philadelphia, we have encouraged our parents to participate in skin to skin contact with their infants for over a decade. Skin to skin contact may seem simple, but it is one of the best ways a parent can help a baby become more stable and grow. Skin-to-skin care can be done with both preterm and full term infants.
It gets its name from the way a mother kangaroo carries her baby in her pouch. Kangaroo care was developed in South America as a way to keep premature infants warm so that they could be released early from overcrowded hospitals. Mothers were instructed to hold their diaper-clad premature infants beneath their clothing, skin-to-skin, snuggled between their warm breasts.
Recently, Save the Children in its annual State of the World’s Mothers report highlighted how KMC is now being used to improve newborn survival outcomes and support parent-child bonding not only in developing countries, but in richer countries for newborn care. In the United States and at CHOP, mothers may not be able to hold their infant continuously from birth due to the critical nature of some infants. However, at CHOP we encourage early and often skin to skin even with ventilated infants.
Moms can wear a hospital gown open in the front or a zip-up hoodie that she can use to cover up the baby, once her infant is tucked in between her breasts. For a Dad, the baby rests on his chest. Parents sit in a comfortable chair allowing them to relax. It’s really about the baby having as much skin contact with the parents as possible. For the mom, skin to skin contact helps with milk production and will help prepare the baby to feed at the breast once he/she is ready.
Skin to skin care is a low tech intervention that results in significant improvements for the baby. Research has shown many benefits for babies and parents, including:
- Preterm babies gain weight faster
- Babies cry less and sleep better
- Babies’ heart rates, breathing patterns, and temperature become more stable
- Preterm babies come out of incubators and into cribs sooner
- Babies feed earlier and more successfully
- Skin to skin care promotes breastfeeding
- Milk production is increased in breastfeeding moms
- Skin to skin care helps infant/parent bonding
- Parents become more confident in caring for their baby
- Parents feel more important in their baby’s care
For parents of critically ill babies in our Neonatal Intensive Care Unit, they’re often concerned the baby is too small and too sick, they could hurt the baby, or the baby could lose its ventilator tube. Just as long as the baby is physically stable, it can be safely transferred to a parent.
Once parents experience skin to skin, these fears go away once they realize that it’s the most fabulous feeling in the world because they see the baby’s response to it. The baby’s oxygen levels and temperature will improve once he or she is resting on a parent.
The first time that a mother or father holds their baby, it’s a magical and transformative experience. It’s like the first time that the baby is theirs.
We’ve created a DVD featuring parents who have participated in skin to skin care to address fears parents may have about it, including how a nurse will help transfer the baby in a thoughtful step by step process.
For healthy term babies, they can go from being delivered to skin to skin uninterrupted until the first breast feed. Even if your hospital doesn’t routinely practice skin to skin, you should ask your nurse to help you do skin to skin care with your baby. The more skin to skin contact you can have with your child the better.
All babies benefit from skin to skin contact! Be your own advocate! Be informed! You can make a difference for your baby by educating hospital staff on the wonders of skin to skin contact!
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