Kangaroo care for preterm infant and family Flashcards
What is kangaroo care
It is the practice of skin to skin contact between an infant and parent
What are the benefits of kangaroo care (big picture) (4)
Evidence says:
- it reduces mortality at discharge
- decreases severe illnesses (such as NEC) and infections (nosocomial)
- improves maternal bonding, breast feeding and maternal satisfaction
- improved growth
- decrease LOS
Apart from skin to skin, what else is involved in kangaroo care to ensure safety
- for temperature stability: baby has a diaper and cap on and is covered by clothing/blanket
- positioning: remains in the upright prone position
- monitoring: cardiorespiratory and temperature monitor in place
How long is each session of kangaroo care
1-3 hours
How do we know it is safe
There are no reported detrimental effects on physiological stability in neonates as young as 26 wks GA, including those ventilated.
Meta-analysis re safety of kangaroo care found:
- increase in body temperature 0.22 celcius
- no change in HR
- statistically but not clinically significant change in saturation by 0.6%
Are safety parameters affected by prematurity
no
Who should you avoid or be cautious with re kangaroo care
5
- less than 27 weeks GA
- neonates that need high humidification
- abdominal wall or neuro tubular defects taht should be kept sterile pre surgery
- newly post-operative
- hemodynamic instability (BP swings, bradycardia, apnea, desaturation with handling)
NB these are not hard and fast rules
What are the thoughts around the benefits of kangaroo care for the development of preterm infants
being born premature disrupts the smooth and integrated neurobehavioural development
→ disorganization of the nervous system: disturbances in physiological function, stress and behaviour.
During kangaroo: decreased arousal and more mature sleep organisation. They seem more normally alert and responsive and less irritable and fussy
Long term: maybe better neurodevelopmental outcomes in follow up
What is the evidence with kangaroo care and breast feeding
3
improved volumes of EBM
longer duration of breast feeding
more babies being exclusively breast fed
Why is there decreased incidence of nosocomial infections
because the neonate has an increased chance to be colonized with maternal flora rather than the flora of the nursery (which includes Abx-resistant bugs)
What do mothers say about kangaroo care
it gives them as sensation of being needed
it increases their confidence
it gives them a sense of their role
Does Kangaroo care have any impact on pain management
Not a ton of evidence, but some to suggest that the gentle stimulation of sensory systems may modulate the perception of pain
