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Kangaroo Care occurs in the NICU when a parent holds their infant in skin-to-skin contact. This consists of placing a diaper only clad baby in an upright position on a parent's bare chest - tummy to tummy. During this time, which may last 1 hour or longer, the parent is comfortably seated while holding their infant. Supportive nursing care is provided to assure the infant is tolerating the process and to assist the parent as needed with positioning.

The nursing and medical staff of the NICU will evaluate the infant’s eligibility for Kangaroo Care. Infants can be held in Kangaroo Care who are:

  • Able to tolerate traditional holding outside of the isolette
  • Still under 1000 grams of weight
  • Clinically stable but still needing some respiratory support

Some conditions preclude Kangaroo Care temporarily, these include:

  • Certain medications needed to maintain cardiovascular stability
  • Chest tubes
  • Certain types of intravenous lines
  • Open wounds or lesions, rashes, or friable skin

The procedure:

  • Parents should wear front opening, loosely fitting tops.
  • Parents should shower daily and avoid lotion or perfume on the chest.
  • Mothers should remove their bra prior to the session
  • Mother should understand her infant may suckle at the breast and that she may experience a let-down during this time. This is fine. Discuss with the nursing staff if the infant is not yet allowed to feed orally. 2 soft clothes to catch leaking milk are helpful.
  • Father should understand that the infant may attempt to suckle from his nipple, and this is fine if he does not object.
  • Parents should use the restroom prior to initiating KC, as they may be sitting for an hour or longer.
  • The nurse will assist in placing the infant on the parent’s chest.
  • The parent should support the back and buttocks with their hands, tucking the legs into flexion.
  • The nurse will cover the baby’s back with a folded receiving blanket and monitor the baby's temperature, which usually will be stable from the parent's warm chest.
  • Preterm infants should initially wear a hat.
  • After about an hour parents will need to stand up or shift positions and should ask the nurse for help before doing so.

What to expect:

  • Initial restlessness, which should subside within 10 – 15 minutes
  • Quiet alert state; increased ability to make eye contact
  • Infant falls asleep, allow to sleep uninterrupted if possible

Benefits of Kangaroo Care:

  • Increased deep sleep time resulting in decreased crying
  • Stabilization of vital signs and decreases in apnea and bradycardic episodes
  • More rapid weight gain and shorter NICU stays
  • More success with breastfeeding and milk supply
  • Increased feelings of connectedness with the baby, improved bonding

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