Kangaroo Care Helps Preemies And Full Term Babies, Too

Jan 23, 2017
Originally published on January 23, 2017 7:56 am

When Ali Andrew Li was born on Jan. 7, he was gently placed on his mother's chest, where doctors cleaned and examined him and covered him with a warm blanket.

"I just loved it," his mother, Salma Shabaik, a family physician who lives in Los Angeles, says. "It was really nice to have the baby right there beneath my eyes where I could feel him, touch him, kiss him."

That was different than the birth of her son Elias two years ago; he was whisked away to a bassinet to be examined. And unlike Elias, who cried a lot after delivery, Shabaik says Ali stopped crying "within seconds" after being placed on her chest.

Kangaroo mother care has been widely used worldwide to care for premature babies, and it's gaining popularity in caring for healthy full term babies like Ali as well. It is as it sounds: Like a kangaroo's pouch, mothers hold their naked newborns on their bare chest for the first few hours of life.

At Ronald Reagan UCLA Medical Center where Ali was born, the technique is routinely practiced for healthy mothers and newborns. The baby gets to know their mother immediately, says Dr. Larry Gray, behavioral and developmental pediatrician at Comer Children's Hospital, University of Chicago Medicine. "The baby gets landed in a trusting environment," he says, reassuring them that life outside the womb can also be "soft, comfortable and warm."

The benefits are many, according to Dr. Lydia Kyung-Min Lee, an ob-gyn at UCLA. Not only is the baby happier, she says, but his or her vitals are more stable. Body temperature, heart and breathing rate normalize more quickly. The close contact also allows the baby to be exposed to the same bacteria as the mother, which can protect against allergies and infection in the future. Infants who receive kangaroo care breast feed more easily, Lee says, and their mothers tend to breast feed for longer periods of time, which is "all good."

Babies also seem to suffer less pain. Almost 20 years ago, Gray studied how babies respond to a heel prick to draw blood, a procedure that screens newborns for genetic disorders. He found that when healthy newborns had kangaroo care, there was less facial grimacing and crying suggesting pain, compared to babies who had been swaddled and had the procedure in their bassinets, "sort of alone."

One of the first places to show how this technique can help preemies was Colombia in the 1990s. There, hospitals with no access to incubators and other equipment often sent home preemies with no expectation that they would live. But doctors were surprised to see that babies whose mothers carried them close, skin to skin, not only survived but thrived.

This was a "serendipitous magical finding," says Gray, suggesting that skin-to-skin contact acted something like a "natural incubator."

Gray also points to the work of Myron Hofer, a psychiatrist with Columbia University Medical Center who studies attachment between mother and infants. Hofer coined the term "hidden regulators" that pass between mother and baby. It's not just that mother and baby are together, Gray says, but also that the mother is in some way "programming the baby, the breathing, temperature and heart rate."

That "magic" can also happen between baby and father, too, says Gray, if there's skin-to-skin contact. And if mothers or babies are very sick and have to be isolated, Gray suggests mothers take any opportunity to hold their infant skin to skin. Even a little bit of kangaroo contact, he says, can be beneficial.

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

RACHEL MARTIN, HOST:

Kangaroo mother care, it's a technique for mothers to bond with their newborns immediately after delivery. And the name kind of gives away what this is all about. Naked newborns are placed on their mother's bare chest, a little like a baby kangaroo in its mother pouch.

STEVE INSKEEP, HOST:

Aw, that sounds kind of sweet.

MARTIN: Yeah.

INSKEEP: Did you do that as a new mom?

MARTIN: I did.

INSKEEP: Of course.

MARTIN: In fact, I should note though, my husband did it, too.

INSKEEP: Oh, very nice - and people do encourage fathers to kind of bond with the child that way. This is common practice, especially for children who were born prematurely. And it's growing popular for healthy full-term babies, too. Here's NPR's Patti Neighmond.

SALMA SHABAIK: Do you want to say something?

ALI: (Cooing).

PATTI NEIGHMOND, BYLINE: Salma Shabaik nuzzles her newborn little boy, Ali.

SHABAIK: Hello? I think you want to tell us that you just want to sleep (laughter).

NEIGHMOND: Ali was born just two weeks ago - 8 pounds, 3 ounces, 20 inches long - with a full head of shiny black hair. He was delivered at Ronald Reagan UCLA Medical Center, where kangaroo mother care is routinely practiced.

SHABAIK: After he delivered. Immediately after, he was on my chest. Cleaning him off, like, rubbing him, all that happening while he was on my chest. I don't know if it was a pediatrician or a nurse practitioner, but whoever was examining the baby examined him also while he was on my chest - so listening with the stethoscope and looking at him and whatnot, everything happening while he was laying on my chest.

NEIGHMOND: Which was different than her firstborn son, who was whisked away to a warming crib and weighed, measured and examined there. He cried a lot, she says. But within seconds of being placed on her chest, Ali stopped crying.

SHABAIK: I loved it. It was really nice to kind of have baby right there with you, rather than watching, trying to see what they're doing, you know, from the bed. When he's right there and I could feel him and touch him and kiss him and all of that - so I think it just added more depth to the delivery.

NEIGHMOND: And there are clear physical benefits for the baby. UCLA OB-GYN, Dr. Lydia Lee.

LYDIA LEE: It improves body temperature, so the baby doesn't cool off. It seems to lower the heartrate of the baby, stabilize the blood pressure. They seem to cry less and not grimace as much.

NEIGHMOND: When babies receive kangaroo mother care, they're better able to breast-feed. And mothers tend to breast-feed for a longer period of time. All good, says Lee, because breast-feeding is well known to keep babies healthy and avoid illness.

At UCLA and at hospitals nationwide, Lee says there's another growing practice aimed at naturalizing the birth experience - delaying cutting the umbilical cord. After the baby is put on the mother's chest, the cord is left attached for about one minute.

LEE: And that allows some of the blood from the placenta to continue going to the baby. And that increases the iron store in the baby.

NEIGHMOND: Allowing not only iron but also other nutrients to continue flowing from mother to baby even after delivery. Pediatrician and researcher Dr. Larry Gray with the Comer Children's Hospital at University of Chicago Medicine did a study that shows kangaroo mother care also seems to mediate pain.

He looked at how babies respond to a heel prick to draw blood - a procedure to screen newborns for diseases that can be identified in the first day of life. Gray found babies cuddled with their mom in kangaroo care seemed to feel less pain.

LARRY GRAY: There was essentially no evidence of the rise in heartrate to suggest that the baby felt pain, compared to the babies who had been swaddled and had that blood procedure in their bassinets sort of alone.

NEIGHMOND: The first place to document how this technique works with premature babies was in Bogota, Colombia. In poor areas where there was no access to incubators and other high-tech equipment, preemies were often sent home with no expectation they would live. But doctors were surprised to see babies whose mothers carried them close, skin to skin, not only survived but thrived. Gray says one likely reason, so-called hidden regulators, which cement the attachment between mom and newborn.

GRAY: It's not just that the mother and the baby are being held together but that the mother in some ways is programming the baby - programming the baby's breathing, programming the baby's temperature, learning the baby's cues. And so there's some magic that happens.

NEIGHMOND: That magic can happen between a baby and a father too, he says, if there's skin-to-skin contact. Now, if mothers or babies are sick and need to be isolated, Gray says just take any opportunity you can to hold your infant skin to skin. Even a little bit of kangaroo mother care, he says, can help. Patti Neighmond, NPR News. Transcript provided by NPR, Copyright NPR.