Thursday, September 11, 2008
Skin-to-skin therapy used on preemies
The method, called Kangaroo Care, is described as a way to improve bonding with a parent.
JARED SOARES The Roanoke Times
Felicia Meeks holds her daughter, Kylie, during Kangaroo Care, a program at Carilion Roanoke Memorial Hospital that promotes bonding between preemies and parents.
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Felicia Meeks had never heard of Kangaroo Care before she went into labor suddenly with twins at seven months.
That quickly changed.
Meeks, 28, didn't realize she was in labor until she got to the hospital in her hometown of Princeton, W.Va., and learned her contractions were three minutes apart. That Monday night a little more than a month ago, she gave birth by Caesarean section to Kendyll and Kylie.
Employees from Carilion Roanoke Memorial Hospital came to monitor her delivery and then whisked her newborn babies away by ambulance to Roanoke Memorial for advanced care, leaving Meeks, who had to rest until she was stable enough to go to Roanoke about two days later.
"It's very scary, very hard, it's not anything anyone would want to do, to watch your babies be wheeled away with tubes out their bellies, out their noses," Meeks said.
In Roanoke, Meeks learned the value of the Kangaroo Care, or skin-to-skin therapy, as a way to be close to her babies. She described such bonding as especially important because her preemies were in incubators and on continuous positive airway pressure machines and ventilators to help with their breathing.
To do the therapy, a parent holds the diaper-clad baby directly on his or her bare chest so that the baby's head is above the heart. If the baby is small enough, the baby can be placed inside a parent's shirt or have a blanket placed on the back for warmth.
The therapy may help with breast-feeding as well as medical, emotional and psychological aspects of the parent-child relationship, proponents say.
The practice started in Bogota, Colombia, where it is called Kangaroo Mother Care, or KMC, and is more common in developing countries.
In 1983, many doctors in the Colombian capital noticed that preemies were dying largely because of unreliable equipment and power in the hospitals. So, they decided to see whether babies would fare better if their mothers held them under their shirts or in specially designed pouches. They discovered that KMC decreased mortality rates to 30 percent, from 70 percent.
Tracey Zadell, a Carilion nurse and lactation consultant, described how separation is common but abnormal and harmful. In contrast, she described the therapy as natural, adding, "It's like continuing the pregnancy."
Zadell and Julie Taylor, another nurse, encourage the practice for all babies, especially preemies and emphasize that both mothers and fathers can do the therapy.
Neonatal nurses at Carilion started encouraging the practice about 10 years ago. At the time, Sharla Cooper, a registered nurse at Carilion and former professor at Radford University, was doing research on the technique.
Lisa DiMenna, a neonatal nurse, examined 17 studies published between 1990 and 2003 that analyzed the benefits of the therapy.
DiMenna found that infants held skin-to-skin stayed warm, had regular heart rates and respirations, deeper sleep, more alert activity, less crying, no increase in infections, greater weight gain and earlier discharge. Meanwhile, mothers had longer and more productive lactation, and both parents felt closer to their infants and more confident about caring for them.
In an article titled "The Importance of Skin to Skin Contact," Dr. Jack Newman, a Canadian doctor who specializes in breast-feeding and started the Newman Breastfeeding Clinic & Institute in Toronto, writes that the practice has several benefits for babies who did the practice an hour immediately after birth.
Babies were more likely to latch on and latch on well, be less likely to cry and more likely to breast-feed exclusively longer. They also had more stable and normal skin temperatures, heart rates and blood pressures as well as higher blood sugars.
Still, Zadell emphasized that while the science of the therapy is important, it is the bonding that really excites parents.
An a recent afternoon, Meeks sat inside Roanoke Memorial's neonatal intensive care unit, amid the sounds of beeps and babies' cries. She sat in a rocking chair with Kylie, who just turned 1 month old, coddled between her bare skin and a red tank top.
