EVENING. Health.

`Kangaroo' Care

April 15, 1997|By Juanita Westaby, The Grand Rapid Press.

Eleven-day-old Caden Burrows started to make a fuss. But with his head and shoulders tucked between his mother's breasts, skin to skin, he just couldn't do it. The warmth, the rhythm of her breathing, the cadence of her heartbeat soothed and relaxed him.

Caden, a tiny patient at St. Mary's Hospital, Grand Rapids, Mich., hadn't gone home yet but, to him, it felt like he had.

"This is wonderful," said his mother Kimberlie, who until recently made daily trips from Cedar Springs to the hospital to visit her son. He has since been sent home.

"I can't tell you how heart-wrenching it was to go home by myself," she said.

Caden developed pneumonia shortly after birth and was whisked away from his parents for the next six days. Then nurses introduced Kimberlie Burrows to the best form of medicine she could offer: kangaroo care.

This low-tech, skin-to-skin technique for premature and sick infants helps them gain weight, recover faster and leave the hospital sooner than those isolated from touch in hospital incubators.

Named after the pouch nursing used by kangaroos for their babies, kangaroo care was created in Colombia and introduced in the United States eight years ago by nurse-midwife Susan Ludington and nurse Gene Anderson.

Ludington, who has researched the technique's effectiveness for the National Institute of Health, has been asked by the World Health Organization to develop an educational and training center for kangaroo care. Roughly 200 of the nation's 500 neonatal intensive care units have the program, she said.

In Grand Rapids, Butterworth Hospital infant developmental specialist Mary DeWys was one of the first people the Ludington-Anderson team convinced to try the intervention.

Butterworth used skin-to-skin care "minimally" before 1992, but by 1994 had expanded the program and written medical protocols for its use, DeWys said.

Kangaroo care was introduced at St. Mary's Hospital last year, at the same time the hospital was given permission to begin caring for premature babies, said Lynette Johnson, outreach educator for the special care nursery.

Typically, babies born prematurely--at 37 weeks or younger--are placed in incubators to control their temperature. Their contact with other humans is limited because of studies which show touching increased their levels of stress. Ludington's studies, however, show that kangaroo care allows premature and sick infants to fall into the deep sleep they need to be able to breathe easier, gain weight and go home sooner.

"The babies in the incubator are much more active and agitated than those in kangaroo care," she said.

"In the incubator, they only fall into deep sleep for 5 to 20 seconds at a time. In kangaroo care, they get up to 2 1/2 times as much deep sleep and up to 26 minutes at a time of regular sleep," she said. This helps conserve energy, which makes babies gain weight faster.

Rebecca Wildebore of Kent City didn't count the minutes her son slept when she buttoned him into her blouse while sitting in the St. Mary's nursery. But, she said: "It was a hard sleep. He didn't wiggle or make a peep."

The experience gave Wildebore something she thought she had lost: a chance to bond with her newborn. She held him for about 15 minutes after delivery before passing him on to relatives for the rest of a celebratory night. She woke the next morning to the news she could not hold him again for a long time because he had developed breathing difficulties.

For six days, she could only stroke his feet in the incubator.

"I really felt cheated. He wasn't my baby yet. He was (the hospital's) baby," she recalled.

There came a moment during kangaroo care when Benjamin suddenly became her own baby.

"I was by myself, it was very quiet in the nursery and dark, and it was just him and me."

DeWys said that's a major benefit of kangaroo care, which was developed in Bogota, Colombia, where a majority of the population would literally abandon a sick, baby in the absence of any maternal bonding.

"Bonding prevents abandonment," DeWys said simply. With kangaroo care, "they reduced the abandonment rate to near zero."

In the U.S., kangaroo care gives worried parents some control in an often overwhelming situation. "Most mothers are thrilled with the opportunity to do something for their babies that nobody else can do," said DeWys. "This is a gift that only parents can give, that cannot be duplicated."

A mother's breasts actually will change temperature to help regulate the temperature of her baby's body, a process called "maternal neonatal thermal synchrony," Ludington said.

"The mother's breast temperature makes four times as many adjustments to the baby's temperature as the incubator will."