How Kangaroo Care Gives the Smallest Babies the Best Chance

A natural and simple, yet surprisingly powerful approach

Kangaroo Care, also known as skin-to-skin, helps give even the smallest of premature babies a better chance at life. This is why.

It’s something that no expectant parent can prepare for. Most parents won’t even let themselves think it could happen to them and their baby-to-be. Luckily, most will never know how it feels to have a premature baby in the Neonatal Intensive Care Unit (NICU). Most mothers will never give birth to a micro preemie born at the cusp of viability. Most people will never know what it's like to have their baby born too soon, but for many parents it will become a reality.

Premature birth is a global issue and the numbers are alarming. Worldwide, an estimated 15 million babies are born preterm every year. That is more than 1 in 10 babies. The numbers are similar in Canada where currently, 1 out of every 12 babies is born prematurely.

The good news is that treatment and care for premature infants continue to improve. Neonatal intensive care units across the country have adopted new standards of care that have resulted in better survival rates. The simple power of touch is proving to be one of the most effective methods.

The power of touch

What could be more natural than a mother holding her ‪‎newborn baby skin-to-skin close to her chest? As a neonatal nurse, I have been fortunate to help facilitate this moment hundreds of times. Known as Kangaroo Care for premature infants, this powerful interaction of mother and child benefits babies in more ways than we think. Holding your baby skin-to-skin during the first moments of life is an opportunity to shape your baby's overall health, and it is one of the most beneficial things that a mother can do for her newborn baby.

Why is touch so vitally important? Touch is one of the first senses to develop while the baby is still in the womb (between 7-8 weeks gestation). From their earliest weeks, babies depend on touch for exploring their world. There are many medical benefits too.

Benefits for baby

Research on Kangaroo Care shows that it helps babies in the NICU regulate their heart rate, breathing and temperature, improve head circumference, growth and weight gain. It also helps stabilize baby’s organ function and self-regulation abilities, experience less pain and less crying, facilitate better sleep patterns and improves breastfeeding outcomes. Research shows that skin-to-skin time with parents is calming, which positively impacts their brain and emotional development, and it can even shorten a preterm baby’s hospital stay.

Can I really do skin-to-skin with my tiny premature baby?

Depending on your baby’s condition, Kangaroo Care can begin immediately after delivery or start once your baby is more stable. Even very small babies with major health issues can benefit from short sessions. Once baby is stabilized, sessions should be at least an hour (NICU policies vary). Your baby’s health care team will give advice about when your baby is ready for Kangaroo Care and will help you prepare.

How will skin-to-skin contact help me with breastfeeding?

Holding your baby skin-to-skin can help trigger the release of the hormones that can help to increase your breastmilk supply. During skin-to-skin contact your baby is close to his food. He can see and smell your skin and nipple/areola and this encourages him when it’s time to start breastfeeding.

Practicing safe skin-to-skin

Here are a few tips I use to help parents safely practice skin-to-skin holding while in the NICU and after they go home. These can also be adapted for a full term baby.

  1. Find a comfortable place to sit. Kangaroo Care requires a comfortable chair with several pillows for support to help position the baby. Mom should be in a reclined and relaxed position. Being inclined helps to ensure that baby’s airway stays open so breathing is not affected. 
  2. Undress your baby down to the diaper and place him directly on your bare chest, vertically between your breasts. In the NICU babies are often cared for in a warm incubator so they are already undressed and ready for skin-to-skin! Your nurse will help you carefully position wires and tubes.
  3. Cover baby with a blanket or consider using a wrap like SleepBelt for added support. In our NICU we now provide a SleepBelt for parents during skin-to-skin holding sessions, which helps securely position your baby on your belly, while also maintaining warmth and privacy. SleepBelt has a soft, stretchy fabric that mimics the womb, so even the smallest of babies can be comfortable and secure. It doesn’t have complicated buckles, knots or straps and doesn’t interfere with medical tubing or wires, and has been used in NICU’s on babies as small as 1000g. SleepBelt can also be a terrific hospital bag item for parents with full-term babies because it enables a hands-free, and safer skin-to-skin experience (I used one myself!).
  4. Practice skin-to-skin for as long as possible and as frequently as possible during the post-partum period. You can enjoy skin-to-skin contact as soon as the NICU staff feel it is safe. I encourage families to practice skin-to-skin for an uninterrupted 60 minutes, as much and as often as possible, during the first 12 weeks and beyond; even once they are able to take their babies home. 
  5. Get dad involved too. Kangaroo Care can empower dads so they also feel like a significant person in their infant’s life. Babies love skin-to-skin holding with Dads and partners too!

Parents often tell me how helpless they feel while their baby is in the NICU. I always tell them that participating in Kangaroo Care means they are giving their baby the best care possible.

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Angela Grant Buechner, BA, BScN, RN, IBCLC, is a Registered Nurse and an International Board Certified Lactation Consultant who has spent over 15 years working in one of the largest Neonatal Intensive Care Units in North America.  She is the mother of three children, is a Birth Doula, and also runs her own private lactation practice, Nutmeg Consulting, in Toronto, helping new moms achieve better breastfeeding outcomes.