Kangaroo Treatment or Kangaroo mother care (KMC) , sometimes called skin-to-skin care , is a newborn care technique in which babies are kept skin-to-skin with parents, usually their mothers. It is most commonly used for premature infants with low birth weight, who are more likely to suffer from hypothermia, while being treated in a neonatal unit to keep babies warm and support early breastfeeding.
Kangaroo treatments, named for the similarity with how certain marsupials bring their child, were originally developed in 1970 to care for premature babies in countries where incubators are unavailable or unreliable. There is evidence that it is effective in reducing both infant mortality and the risk of hospital-acquired infections, and improves breastfeeding and weight gain rates.
Skin-to-skin care is also used to describe the technique of short-term newborn placement shortly after birth on the naked breast of their mother or father. It also increases breastfeeding rates and can improve cardiac stability and respiratory rates.
Video Kangaroo care
Description
Kangaroo care seeks to restore the familiarity of newborns with family members by placing the baby in direct skin contact to the skin with one of them. This ensures warmth and physiological and psychological bonding. A stable parent body temperature helps regulate the neonate temperature more smoothly than the incubator, and allows for easy breastfeeding when the mother holds the baby in this way.
While this infant care model is substantially different from Western neonatal intensive care procedures (NICU), the two are not mutually exclusive, and it is estimated that more than 200 neonatal intensive care units perform kangaroo treatments today. A recent survey found that 82 percent of neonatal intensive care units use kangaroo treatments in the United States today.
Maps Kangaroo care
Terminology
Kangaroos Treatment is probably the most widely used term in the United States for skin-to-skin contact. Gene Cranston Anderson was probably the first to emulate the term Kangaroo Care in the US. However, the decisive feature is for skin-to-skin contact, commonly abbreviated as SSC, as well as STS. It is used synonymously with "skin-to-skin care". Dr Nils Bergman, co-founder of the Kangaroo Care Movement, argues that since skin-to-skin contact is a place of care, not the type of treatment itself, skin-to-skin contact should be the preferred term.
Kangaroo Mother Care is a wider treatment package defined by the World Health Organization. Kangaroo Mother Care was originally intended only to treat low birth weight and premature infants, and was defined as a treatment strategy including three major components: kangaroo positions, kangaroo nutrition and kangaroo discharge. The kangaroo position means skin-to-skin direct contact between mother and baby, but may include fathers, other family members or surrogates. The baby should be erect in the chest, and the airway is safe with a safe technique. (The term Kangaroo Mother Care is generally used to mean skin-to-skin, although the definition of WHO includes a wider strategy). Nutrition kangaroos implies exclusive breastfeeding, with additional support as needed but with the aim of achieving exclusive breastfeeding. The kangaroo disposal requires that the baby be sent home early, meaning immediately after the mother is breastfeeding and able to provide all of her own basic care. In Colombia in 1985 this occurred at a weight of about 1000g, with oxygen cylinders for home use; the reason is that the density in their hospital means that three infants in the incubator will produce a potentially lethal cross infection. An important part of this is close follow-up, and access to daily visits.
History
Peter de Chateau in Sweden first described the study of "early contact" with mothers and babies at birth in 1976, the articles do not specifically describe this as skin-to-skin contact. Klaus and Kennell do a very similar job in the US, better known in the context of mother-baby bonding early. The first reported use of the term "skin-to-skin contact" was by Thomson in 1979 and quoted de Chateau's work in his thought. It is contemporary or even precedes the origin of Kangaroo Mother Care in Bogota, Colombia. But the latter makes this concept more widely known.
In 1978, due to increased morbidity and mortality rates at the Instituto Materno Infantil NICU in BogotÃÆ'¡, Colombia, Dr. Edgar Rey Sanabria, Professor of Neonatology at the Department of Pediatrics - Universidad Nacional de Colombia, introduced methods to reduce caregiver shortages and lack of resources. She suggests that mothers have continuous skin-to-skin contact with their low birth weight babies to keep them warm and provide exclusive breastfeeding as needed. This frees up the overcrowded incubator chamber and caregiver.
Another feature of kangaroo care is the early release in kangaroo positions despite prematurity. It has been proven successful in improving the survival rate of premature and low birth weight infants and in reducing the risk of nosocomial infections, severe illness, and lower respiratory tract disease. It also enhances exclusive breastfeeding and for longer duration and improves maternal satisfaction and trust.
Dr Rey and Dr Martinez published their results in 1979 in Spanish, and used the term Mother Kangaroo Method. This was brought to the attention of English-language health professionals in an article by Whitelaw and Sleath in 1985. Gene Cranston Anderson and Susan Ludington were instrumental in introducing this to North America.
"Kangaroo Mother Care" as a term first defined at a meeting of about 30 interested researchers, attended a meeting hosted by Dr Adriano Cattaneo and colleagues in November 1996 in Trieste, Italy, along with WHO represented by Dr. Jelka Zupan.
The International Network of Kangaroo Mother Care (INK) is held at the Trieste meeting and has overseen workshops and conferences every two years. After Trieste, the meetings were held in Bogota Colombia 1998, Yogyakarta Indonesia 2000, Cape Town South Africa 2002, Rio de Janeiro Brazil 2004, Cleveland USA 2006, Uppsala Sweden 2008, Quebec Canada 2010, Ahmedabad India 2012, and Kigali Rwanda 2014; meeting in 2016 is planned for Trieste Italy.
An informal steering committee coordinates these meetings: (alphabetically, at present) Nils Bergman, Adriano Cattaneo, Nathalie Charpak, Kerstin Hedberg-Nyqvist, Ochi Ibe, Susan Ludington, Socorro Mendoza, Mantoa Mokrachane, Juan Gabriel Ruiz, RÃÆ'Ã… © jean Tessier, Rekha Udani.
Susan Ludington maintains "KC BIB" (bibliography) on behalf of INK, endeavoring to be a complete inventory of any and all publications relevant to Kangaroo Mother Care. This is also broken down in an analysis of 120 diagrams, in which specific results are collected.
International Kangaroo Care Awareness Day has been celebrated worldwide on May 15th since 2011. This is a day to raise awareness to improve Kangaroo Practice practice in NICUS, Postpartum, Delivery and Delivery, and any hospital unit that has babies up to 3 years. month of age.
Scientific thinking
In primates, early skin-to-skin contact is part of universal reproductive behavior, and initial separation is used as a research modality to test for the harmful effects of early development. Research shows that for all mammals, the mother's environment (or place of care) is the main requirement for the regulation of all physiological needs (homeostasis), maternal absence causes dysregulation and adaptation to adversity.
In the main clinical treatment, Kangaroo Mother Care is used as an adjunct to advanced technology that requires separation of the baby's mother. However, skin-to-skin contact may have better scientific reasons than an incubator. All other support technologies can be given as part of the treatment for very low birth weight babies during skin-to-skin contact, and appear to produce a better effect.
Based on scientific thought, it has been suggested that skin-to-skin contact should begin immediately, to avoid the harmful effects of separation (Bergman Curationis). In terms of proper classification and determination for research purposes, the following aspects that categorize and define skin-to-skin contact have been proposed:
- Initiation time, (minutes, hours from birth), ideal is zero separation.
- Skin-to-skin skin dose, (hours per day, or as a percentage of days), ideal & gt; 90%.
- Duration, (measured in days or weeks of birth), ideally until the baby declines.
A safe technique should ensure that obstructive apnea can not occur. Because the mother should be able to sleep to provide adequate doses, this requires that the airway remains safely open, and cover the bare breast caught with clothing, some of which are described in the WHO guidelines.
Mother should be the main provider of skin-to-skin contact, because only she can breastfeed. However, it is almost always necessary that the father should also provide skin-to-skin contact to achieve an adequate dose; other family members can also be used. Since skin-to-skin contact is the basis for early bonding and attachment, it may not be performed by hospital staff and other surrogates.
Clinical evidence
In 2016 Cochrane's review, "Kangaroo mother's care to reduce morbidity and mortality in low birth weight babies", was published by collecting data from 21 studies including 3042 low birth weight babies (less than 1,500 grams (53 oz) at birth). This review shows that infants given kangaroo mother care have a reduced risk of death, hospital-acquired infections, and low body temperature (hypothermia); this is also associated with weight gain, long growth, and breastfeeding rates.
A Cochrane review on "Early skin-to-skin contact for mothers and their healthy babies", updated in 2015, provides clinical support for scientific reasons but sees evidence for early skin-to-skin contact for healthy infants. Available evidence suggests that early skin-to-skin contact is associated with increased breastfeeding rates, and some evidence of increased physiological outcomes (early stability of heart rate and breathing) for infants.
A randomized controlled trial published in 2004 reported that babies born between 1200 and 2200g became physiologically stable in skin-to-skin contact starting from birth, compared to the same infants in the incubator. In another randomized controlled trial conducted in Ethiopia, survival increases when skin-to-skin contact begins before the age of 6 hours.
Although Kangaroo Mother Care generally implements low birth weight and premature babies, skin-to-skin contact should be considered normal and basic for all newborns. Original research by Thomson showed an increase in breastfeeding rates when skin-to-skin contact begins at birth, and when breastfeeding is recommended every two hours. Currently, the impact of skin-to-skin contact on breastfeeding is a scientific reason for Step 4 of the Baby Friendly Initiative Initiative (BFHI), which requires assistance to "start breastfeeding within an hour after birth".
Feasibility criteria
Initially infants who qualify for kangaroo treatments include premature babies weighing less than 1,500 grams (3.3 pounds), and breathing independently. Cardiopulmonary monitoring, oximetry, supplemental or nasal oxygen (continuous positive airway ventilation), intravenous infusion, and monitor leads do not prevent kangaroo treatment. In fact, infants residing in kangaroo care tend to be less susceptible to apnea and bradycardia and have a stabilization of oxygen demand.
During the early 1990s, this concept was advocated in North America for premature infants in the NICU and later for term infants. Research has been conducted in developed countries but there is a lag in the implementation of kangaroo care because of access to incubators and ready technology.
Restrictions for the feasibility of receiving skin-to-skin contact are becoming less and less, the main obstacle may be the self-esteem and caregiver experience.
Technique
In kangaroo care, babies wear only small diapers and hats and are placed in a position of flexion (fetus) with maximum skin-to-skin contact on the parent's chest. These babies are secured by a wrap around the adult naked body, providing babies with proper support and positioning (keeping flexion), constant detention without pressure or wrinkle points, and protecting from air draft (thermoregulation). If it's cold, parents can wear a shirt or hospital gown by opening forwards and blankets over the wrapper for the baby.
Strong bundling is enough to stimulate the baby: vestibular stimulation of the parent's breathing and chest movements, auditory stimulation of the parent's voice and the natural sound of breathing and heartbeat, parental skin touch, wrap, and natural tendencies. to hold the baby. All of these stimuli are important for infant development.
"Birth Kangaroo Care" places the baby in kangaroo care with the mother within a minute of birth and until the first feeding. The American Academy of Pediatrics recommends this practice, with minimal disruption to infants who do not require life support. The baby's head should be dried immediately after birth and then the baby is placed with a cap on the mother's chest. Measurements, etc. Done after the first feeding. According to the US Kangaroo Institute of Care, healthy infants should maintain a skin-to-skin contact method for about 3 months so that infants and mothers are established in breastfeeding and have achieved physiological recovery from the birth process.
For premature infants, this method can be used continuously over time or for sessions not less than one hour in duration (the duration of a full sleep cycle.) It can start immediately after the baby is stabilized, so it may be at birth or within hours, days , or weeks after birth.
Kangaroo treatments differ from babywearing practices. In kangaroo care, adults and infants are skinned to the skin and chest to the chest, securing the position of the baby with a stretchy wrap, and practiced to provide developmental care for premature infants for 6 months and full - term newborns for 3 months. In babywearing adults and children fully clothed, the child may be in front or behind an adult, can be done with different types of carriers and slings, and is generally practiced with infants and toddlers.
Benefits
For pain control
Skin-to-skin contact is effective in reducing infant pain during painful procedures. There seems to be no difference between mothers and others who provide skin-to-skin contact during medical care.
For parents
Kangaroo treatments benefit the elderly as they increase attachment and bonding, boost parents' confidence, and help promote increased milk production and breastfeeding success.
A new study found that the psychological benefits of kangaroo care for parents of preterm infants are quite extensive. Research shows that the use of kangaroo treatments is associated with lower parental anxiety levels. The number of parents' anxiety is related to the age of parents, family income, and socioeconomic status. Older parents may have additional life experiences or endurance, which causes decreased anxiety. Higher socioeconomic status can lead to less anxiety as well. These factors can cause lower baseline anxiety levels, and therefore a further decline of anxiety after kangaroo treatment. Factors such as gestational age, gender of the elderly, and marital status do not seem to affect the anxiety of the parents. Kangaroo treatments are shown to decrease anxiety scores on mothers and fathers, also unrelated to parental marital status.
Kangaroo care also leads to greater confidence in parenting skills. Parents who use kangaroo treatments show greater confidence in their ability to care for their child. Kangaroo treatments have been shown to have a positive impact on breastfeeding too, with mothers producing larger amounts of milk for longer periods of time. Overall, kangaroo care has many important benefits for both parents and infants.
For father
Both premature infants and infants are full of benefits from skin to skin contact during the first few weeks of life with the baby's father as well. The new baby is familiar with the voice of the father and it is believed that contact with the father helps the baby to stabilize and promote the bonding of the father to the baby. If the baby's mother has a caesarean birth, the father can hold their baby in skin-to-skin contact while the mother recovers from anesthesia.
For premature and low birth-weight babies
Kangaroo treatments offer practically the most benefits for premature babies and low-birth-weight babies, who experience more normalized temperatures, heart rates, and respiratory rate, weight gain, and fewer hospital-acquired infections. In addition, studies have shown that preterm infants who experience kangaroo care have improved cognitive development, decreased stress levels, reduced pain response, normal growth, and positive effects on motor development. Kangaroo treatments also help improve infant sleep patterns, and may be a good intervention for colic. Early discharge from the hospital is also a possible outcome Finally, kangaroo care helps to promote breastfeeding regularly, and can improve mother-infant bonding. Evidence from recent systematic reviews supports the use of kangaroo mother care as a substitute for conventional neonatal care in settings where resources are limited. "
Increase more successful breastfeeding
According to some authorities there is increasing evidence showing that early mother-to-skin skin contacts stimulate breastfeeding behavior in infants. Newborns that are immediately placed on their mother's skin have a natural instinct to stick to the breast and start breastfeeding, usually within an hour of birth. It is thought that direct skin-to-skin contact provides a form of printing that makes subsequent feeding significantly easier. The World Health Organization reports that in addition to more successful breast-feeding, skin-to-skin contact between mother and newborn soon after delivery also reduces crying, improves mother-to-baby interactions, and keeps the baby warm. According to a study cited by UNICEF, babies have been observed naturally following a unique process leading to first breastfeeding. After birth, babies placed skin onto the skin on their mother's breast will:
- Initially the baby cries for a while - a very distinctive birth scream
- Then they will enter the relaxation stage, recovering from birth
- Then the baby will begin to wake up
- Then start moving, initially a small movement, perhaps from arm, shoulder and head
- As these movements increase the baby will actually start crawling toward the breast
- After the baby finds the breasts and therefore the source of food, there is a period of rest. Often this can be wrong because the baby is not hungry or wants to feed
- After resting, the baby will explore and get used to the breast, perhaps by nuzzling, kissing and licking before installing
Provided there is no interruption, all babies are said to be following this process and it is advisable to try to rush the process or interrupt such as removing a baby to weigh or measure is counter-productive and may cause problems with subsequent breastfeeding.
For mothers with low milk supply, increased skin-to-skin contact is recommended, as it promotes more frequent feeding and stimulates milk expenditure reflexes, encouraging the body to produce more milk.
For institutions
Kangaroo treatments often result in reduced hospital admissions, reduced need for expensive health care technologies, increased parental involvement and teaching opportunities, and better use of health dollars.
For community
Overall, kangaroo care helps reduce morbidity and mortality, improves parental satisfaction, provides opportunities for teaching during postpartum follow-up visits, and reduces hospital-related costs.
Controversy
Kangaroo Treatment "is an effective and safe alternative to conventional neonatal care for LBW infants, especially in resource-limited countries." Kangaroo Mother Care reduces mortality, as well as morbidity in resource-limited settings, although more research is needed.
The main controversy among supporters of Kangaroo Mother Care relates to the feasibility of starting a kangaroo position: in Rey & amp; The Martinez model and as described in the WHO guidelines, infants should be stable to "tolerate skin-to-skin contact". From the perspective of biology and neuroscience, others argue that it is the separation of the mother that causes instability,
Regarding 'kangaroo nutrition' there is little controversy, by collecting evidence for such breastfeeding benefits, and evidence that even premature babies can breastfeed exclusively.
Further controversy concerns the 'early release', which was defended by Fundación Canguro, in Bogota, Colombia, and reported in evidence from Cochrane's review. I
Society and culture
Kangaroo International Awareness Day is celebrated on May 15th from 2011. It is a day to raise awareness, education and celebrations to improve global practice of kangaroo care. Health professionals, parents, volunteers around the world show their support, in their own way, to improve Kangaroo Care practices to benefit babies, parents, and society at large.
See also
- Baby Clothes
- Baby massage
- Lampin
References
External links
- "Kangaroo Care Benefits" from Prematurity.org
- http://www.motherfriendly.org
- http://who.int./reproductive-health/publications/kmc/text.pdf
- http://home.mweb.co.za/to/torngren/eng-berg.html
- http://www.ninobirth.org
- http://www.kangaroocareusa.org
- http://kangaroo.care
Source of the article : Wikipedia
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