Question: My first baby was born in hospital. After he was born they took him away to the newborn nursery, and I was allowed to have him only at feeding times. We did have about half-an-hour together after he was born and I sneaked into the nursery to see him whenever I could. But it felt like we were separated from each other too soon, and I never really felt bonded with him. It was hard getting breastfeeding started and after we got home I tried to get my baby to sleep alone in his own room, and even tried to “sleep train” him — something I now regret. I am pregnant with my second son, and I have heard about something called Kangaroo Mother Care where you have the baby with you all the time in hospital, and also when you get back home. Could you explain to me how it works please? I want to do things very differently this time.
Answer: I am sorry that you had that unhappy experience. It’s often easier with the second baby. You know more now and can choose how and where you would like him to be born (a baby-friendly hospital, birthing centre, or at home). You also have time to tell the person who will be delivering your baby — doctor or midwife — how you would like the birth to be handled if all goes well, which mostly it does if we do not interfere with the birth process. It’s good to have a doula or support person with you who can support you too, as well as a “back-up plan” in case there are complications, because even C-sections can be done KMC style. I hope your next birth is everything you want it to be for you and your baby. I am going to give general information below, which will hopefully answer your questions, as well as the questions of other mothers who may have different circumstances.
Numerous studies over about three decades have shown that what is now known as Kangaroo Mother Care (KMC or KC), is best for both full-term and premature babies in every way. When separated from their mothers, babies’ vital signs show that they are in distress — breathing, heart rate, temperature, etc. become irregular and there is an increase in stress hormones. When reunited with their mothers, babies’ vital signs normalise, their stress hormones drop and they begin to thrive. See article on Kangaroo Mother Care: The Magic of a Mother’s Touch.
All healthy newborns — including premature babies above 2.5lbs (1,200 grams) should be place skin-to-skin on the mother’s naked chest and kept there permanently, or as much as is possible, especially immediately after birth. Pediatric examinations or resuscitation can be done on the mother’s chest if needed. Mother and baby can be covered by a warm blanket if the room is cold. When a newborn is place skin-to-skin with the mother, the temperature on her chest will increase up to two degrees to warm a cold baby and drop by one degree to cool an overheated baby, which means babies stabilise much better on their mother’s chests than if they are placed in an incubator.
If medical assistance is needed, it can be given on the mother’s chest. Babies can be tube fed, on IV drips and on ventilators while on the mother’s chest, and babies’ vital signs stabilise better in their natural habitat (skin-to-skin with their mother) than if they are placed in incubators or heated cots. If removed from their mothers, newborns make high levels of cortisol (a stress hormone that can, in high doses, cause brain damage). When returned to their mother’s chest, their hormones normalise.
Breastfeeding should be initiated within the first hour of life if the baby is mature enough to be able to suck, and should continue on cue nursing from then on. In the case of undrugged, full term babies, it is best to place them on their mother’s chest, with the baby’s head between her breasts. Using his sense of smell and the grasp reflex (along with “head bobbing”) the baby will self-attach to the breast, and is more likely to get the correct latch-on position, than if baby were held and assisted in finding the breast. (Drugged or premature babies may need assistance, and very tiny babies can be tube-fed their mother’s milk till they are big enough to be able to breastfeed).
On discharge from the hospital, the mother should be encouraged to wear her baby, skin-to-skin in a kangaroo carrier, or other carrier where the mother wraps her baby on her chest, throughout the day. Most babies sleep, wake and nurse happily through the day if they are worn in a sling. At night the baby should sleep close to his mother or within arms reach. The baby can be in bed with the mother or either on a safe sleeping surface or side-crib attached to the mother’s bed. Mom should be able to touch her baby at all times, and baby’s vitals signs (heart beat, blood pressure, body temperature and hormones) will be regulated by being close to his mother. In this environment, a baby is also reassured by the sound of his mother’s breathing, heartbeat, touch and smell. Breastfeeding should continue on cue whenever the baby is hungry.
As you have probably guessed by now, Kangaroo Mother Care is very much like Attachment Parenting, which also emphasises breastfeeding on demand, keeping the mother and baby together during the first months of life and always responding immediately if the baby cries at any time of the day or night. The only difference is that with KMC, we start right after birth, placing the baby on the mother’s body as soon as he is born, and keeping him there unless he is very ill and needs to be in the NICU (intensive care).
In the case of very tiny, or ill babies, they may need incubator care, but if this is necessary, the mother should be encouraged to be with her baby as much as possible, with her hand in the incubator, touching her baby, reassuring her baby of her presence. Through touch and the sound of her voice, a baby’s stress hormones decrease and vital signs regulate. If the mother is ill as well and unable to be with her baby, her baby should be wrapped skin-to-skin on the father’s chest. If the baby is in an incubator, the father should be with the baby, touching and talking to the baby as much as possible. The baby will recognise his father’s voice which he has heard from before he was born, and be reassured by his presence. Babies tube fed in the NICU should receive their mother’s pumped milk if possible. An exclusive diet of human milk benefits premature babies, and the sicker a newborn is, the more desperately he needs this healing “liquid gold”.
In the case of very ill babies, they should still be held skin-to-skin on their mother’s chest for as many hours per day as is possible, and the mother can sit in a comfortable reclining chair in the NICU nursery to do so. Normal Kangaroo Mother Care should be instituted as soon as possible. If very tiny premature twins are born needing incubator care, they should be placed together in the same incubator. Twin babies who can feel each other’s presence physically survive better in the same incubator than if they are separated.
Babies born with conditions that are incompatible with life, should be kept on their mother’s chest so that they are not distressed during their short lives. Having held her dying baby will also help the mother to grieve and let go. Very tiny babies, believed to be dead, should also be placed skin-to-skin on the mother. There are numerous documented cases of these babies “miraculously reviving” from the warmth of their mother’s body and the reassuring sound of her heartbeat.
Kangaroo Mother Care is summed up well with this simple lesson: Never separate a mother and her newborn unless it is absolutely unavoidable. All young babies should be kept close to their mother’s body in her arms or in a sling during the day, and sleep close to her at night. The brain is a psychosocial organ, and babies brains grow as their mothers interact with them in loving and gentle ways. This is how they learn the basis of having healthy relationships with their own partners and children one day.
Kangaroo Mother Care Notes
Staying in physical contact with their babies it is a practice that almost all mammals participate in naturally. The great apes, who are the animals genetically closest to us, carry their babies in their arms and the babies are born able to hold onto mother’s fur when she needs her hands free. Our hunter gatherer ancestors carried their babies in their arms, or in a sling made of animal skin when they needed to have their hands free. So our babies are born expecting to be held close to their mothers too and Kangaroo Mother Care benefits all human babies, premature or full term, in many ways.
- KMC babies stabilize faster with skin-to-skin care than in an incubator (very few newborns stabilize well within an incubator during the first fragile hours of life).
- KMC babies have stable oxygen rates and breathing thanks to the steady regulation of mother’s respiration.
- A KMC baby’s heart rate is stable (mother’s heartbeat regulates baby’s heartbeat).
- A baby’s temperature is most stable on his mother – in skin-to-skin care mother’s chest automatically warms up to warm a cold baby, while her core temperature drops if baby is too warm and needs to be cooled.
- Sleeping within an arm’s reach of baby (as long as a parent does not smoke) also regulates all of his physiological needs in the same way ~ they are kept steady thanks to Mom’s warm, even-paced body. We lose fewer babies due to complications after birth when KMC is used.
- Baies are less likely to die of SIDS if they sleep close to their mothers, because her breathing stimulates theirs.
Read more about the importance of skin-to-skin contact for all babies at http://www.Kangaroomothercare.com
If you live in the USA you can get local information from http://www.kangaroocareusa.org
- “Kangaroo Babies: A Different Way of Mothering”, by Nathalie Charpak (Souvenir Press, USA, 2006)
- “Kangaroo Care: The Best You Can do to Help Your Preterm Infant”, by Susan Ludington-Hoe (Bantam Books, USA, 1993)
- “Hold your Premie”, by Jill Bergman (New Voices Publishing, SA, 2010)
Written by Pat Törngren © 2013