A mother’s bond with a child is eternal and is set up in the first few days of birth itself. You must have heard many opinions on how to handle the first few days. One such, common approach is Kangaroo Care, which is specifically useful for providing care to preterm infants.

What is Kangaroo Care?

Also known as kangaroo mother care, it is a method of holding your baby close to your chest with the baby wearing only a diaper and maybe a hat and socks to keep it warm. The infant rests on your bare chest, allowing skin-to-skin contact. This is a unique way to bond with your child. Additionally, it has a range of medical benefits too, which we will explore later in the article.

That’s not all! Kangaroo care is not meant for the mother only, even the father can provide it and strengthen their bond with the infant.

Kangaroo care helps the baby recognise the mother’s heartbeat while lying on her chest, which helps the baby to calm down and feel safe. Kangaroo care is usually done in the hospital. You may be required to provide it in the neonatal intensive care unit (NICU). It can also be given at home. The length of each session will depend on your infant’s condition, medical needs and the guidance provided by your doctor.

You’ll receive step-by-step support from your baby’s healthcare team on how and when to do kangaroo care. They will carefully assess your baby’s medical status, especially if your baby is connected to IVs or other machines, to make sure it’s safe. Consulting with your baby’s medical team before starting kangaroo care is strongly advised.

Immediate Kangaroo Care

WHO recommends starting kangaroo care almost immediately after birth. This is known as immediate kangaroo care, which can be initiated as soon as the infant is clinically stable. This helps to avoid unnecessary separation of the mother and the newborn. However, if the newborn is unstable after birth or needs mechanical ventilation or any other kind of treatment, then immediate kangaroo care may not be started.

In cases where the mother is unable to perform immediate kangaroo care due to her condition, the father or another family member may be asked to help.

According to a study conducted by WHO, infants who received immediate kangaroo care had reduced mortality rates, decreased occurrence of hypothermia at discharge, and fewer cases of sepsis.

Immediate kangarooing has been identified as an important powerful intervention tool which with time would become a routine infant care procedure.

Why Is Kangaroo Care Important in the NICU?

Kangaroo care, commonly known as kangarooing, is good for the baby, mom and dad in many ways.

Benefits of Kangaroo Care for the Baby

• The baby stays warmer because their body temperature is better regulated.
• Baby’s weight improves.
• Their vital signs such as heart rate and breathing rate increase.
• Their sleep improves leading to more regular and longer sleep cycles.
• The baby has a decreased risk of infection and pain, especially if your baby has had a medical procedure.
• Kangaroo care helps reduce the baby’s stress, leading to less crying. It also soothes both the baby and parents during or after medical procedures.
• The brain and overall physique of the baby improve.
• Lower the risk of hypothermia and serious infections.
• Helps the baby access their mother’s breasts easily, so breastfeeding gets easier.
• Kangaroo care can also reduce distress in babies during vaccination.

Benefits of Kangaroo Care for Parents

One of the foremost kangaroo care benefits is the increased bonding between the baby and the parents. Through kangaroo care, parents feel more confident in their ability to take care of their babies and respond to their needs more effectively. It has also been proven that kangaroo care aids the mother to make more milk, which increases the chance of breastfeeding.

Overall, both parents feel less stressed and anxious about handling a baby, especially a premature baby by providing regular kangaroo care.

The Science Behind Kangaroo Care

Let’s understand the science behind this whole process. Kangaroo care can lead to the following chemical reactions in the mother and the child:

Prolonged skin-to-skin contact and breastfeeding stimulate a surge of oxytocin in the mother’s body. This leads to an overall feeling of well-being, which leads to an increased supply of breastmilk that supports exclusive breastfeeding. This enhances the bond between the infant and the mother.

The baby’s body also releases oxytocin due to skin-to-skin contact and breast milk production. This boosts their immune system leading to the production of T-cells and suppresses inflammatory cytokines.

Kangaroo care immediately after birth decreases cortisol levels which leads to the release of oxytocin, which in turn, reduces stress in both the infant and the parent. The infant’s heart rate also stabilises.

Through skin-to-skin contact, the baby receives protective microbiota from the mother’s skin, which plays an important role in building their immunity.

Providing kangaroo care as early as possible activates mesocorticolimbic dopamine and the body’s opioid systems. Mesocorticolimbic dopamine plays a crucial role in developing neural circuits responsible for social cognition.

How to do Kangaroo Care?

As a new mother or father, it might feel daunting to start kangaroo care for an infant. This is why it is better to start in the presence of a trained nurse, which shouldn’t be an issue if you are starting it in the hospital. However, if you’re starting it at home, then hiring a nurse from a homecare provider can be a good option. You can also consult your baby’s care team to know how long you should do it and how often.

We’ll cover a few essential tips to get you going.

Your comfort matters most

The most important thing to remember is to stay relaxed-when you’re calm, your baby will feel calm too. Wear something comfortable that opens easily in the front, so your baby can rest directly on your bare chest. You will have to remove the bra if you are wearing one. Keep one or two pillows handy before starting to kangaroo. Visit the toilet before starting kangaroo care because you will not be able to move for an hour or two once you start it. Keep a drink handy that can help you relax.

Hold your baby against your chest

Place your baby in an upright position with the head resting on your chest. Ensure the baby is wearing a diaper, socks and hat so that it is sufficiently warm.

Wrap your baby in a blanket or drape a cloth over them

With your baby settled on you, ensure they’re properly covered to keep them snug and comfortable. You can also use a wrap to secure the baby to your chest.

Unwind and enjoy the time together

Relax as you hold your baby. Breathe normally, which will relax your baby too. Slowly your baby will snuggle and fall asleep. Avoid doing anything that may rouse their attention. Pay attention to the cues and signals your baby gives out. It will help you understand if the infant is comfortable.

Have several sessions

Usually, several sessions of kangaroo care in a day are good for the baby. You can consult your baby’s medical team to know how often you should do it.

Finally, don’t forget to ask your doctor whatever questions you have in your mind. We know there will be several and the doctor or the medical team will help you get answers to all of them.

How to Provide Kangaroo Care while Holding an Infant with a Breathing Tube

The process of providing kangaroo care to a baby with a breathing tube can be slightly different. While the breathing tube is essential for your baby to heal, kangaroo care can be beneficial in improving their overall health. Moving or removing the breathing tube can lead to breathing issues.

Here are some tips for you:

• Always seek assistance from your nurse before holding your baby or returning them to the bed. Only a nurse or respiratory therapist should handle the baby’s removal.
• If you need to change the holding position or feel uncomfortable during kangaroo care, call the nurse for help. Ensure the calling button is close to you before you hold the baby.
• As you hold your baby during kangaroo care, the nurse may check the breathing tube occasionally. This is a normal part of keeping your baby safe and comfortable.
• Avoid placing your baby back in bed or adjusting their position on your own.

What Not to Do During Kangaroo Care

Now that we know what to do during kangaroo care, let us also discuss what not to do.

• Use phone or other electronic devices: Avoid using electronic devices while providing kangaroo care since it can distract you. This is a bonding time, make the most of it. Also being attentive can help you keep your baby safe while you hold them.
• Ensure you don’t have any health issues when you hold your baby: Ensure you don’t have any cold sores, open cuts or rash on your skin. Clean your skin beforehand and do not apply any lotions or perfumes. Also ensure you don’t have a fever, cold or flu when you provide kangaroo care.
• An infant’s immune system is not fully mature until they are two to three months old. During these early weeks, your baby’s exposure to germs must be as low as possible. If you’re sick, take the help of another caregiver until you feel better. Ask your medical team if you can provide kangaroo care wearing a face mask.
• Don’t smoke: Smoking before and during kangaroo care is a complete no-no as second-hand smoke can lead to health issues in your baby.

When Should You Start Kangaroo Care?

The first step to starting kangaroo care is to consult your baby’s medical team, especially if your baby is in the NICU. Kangaroo care typically takes place once or twice daily to begin with. While the longer you hold your baby, the better, but in general you can start with about an hour each time or as long as your baby can tolerate it. There’s no hard and fast rule on how long each session should last.

Try to keep kangaroo time as silent as possible, when you enjoy bonding with your baby. Hence, avoid doing other things such as watching TV, talking on the phone or rocking the infant. You can sing a lullaby or read a book to your baby during kangaroo care as these activities help your baby’s brain grow.

Sources:

• https://www.efcni.org/activities/efcni-academy/kmc/
• https://www.pregnancybirthbaby.org.au/what-is-kangaroo-care#benefit
• https://www.who.int/publications/i/item/9241590351
• https://my.clevelandclinic.org/health/treatments/12578-kangaroo-care
• https://www.nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/kangaroo-care-for-your-infant
• https://www.marchofdimes.org/find-support/topics/neonatal-intensive-care-unit-nicu/touching-and-holding-your-baby-nicu