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Skin to Skin Contact Saves Preemies

post #1 of 11
Thread Starter 

By Laura Grace Weldon

 

We know how perfectly a newborn's body curls against a mother's body. We know close contact with the mother's breathing, heartbeat, and temperature helps to stabilize the baby's vitals through age-old sympathetic biological responses. We know skin-to-skin closeness reduces stress and builds emotional warmth.

 

It also saves lives, particularly of preemies in the developing world. There's plenty of evidence that what's called "kangaroo care" is as good or better than incubators. In poorly staffed and equipped hospitals, it makes all the difference when preemies are held against their mother's (or father's!) bodies. As Tina Rosenberg, author of Join the Club: How Peer Pressure Can Transform the World, explains in a New York Times article,

 

 

Kangaroo care has been widely studied. A trial in a Bogota hospital of 746 low birth weight babies randomly assigned to either kangaroo or conventional incubator care found that the kangaroo babies had shorter hospital stays, better growth of head circumference and fewer severe infections. They had slightly better rates of survival, but the difference was not statistically significant. Other studies have found fewer differences between kangaroo and conventional methods. A conservative summary of the evidence to date is that kangaroo care is at least as good as conventional treatment — and perhaps better.

In much of the world, however, whether a mother’s chest is better or worse than an incubator is not the point. Hospitals have no incubators, or have only a few. ..

 

The Manama Mission Hospital in southwest Zimbabwe, for example, had available only antibiotics and piped oxygen in its neonatal unit. Survival rates for babies born under 1500 grams (3.3 lbs.) improved from 10 percent to 50 percent when kangaroo care was started in the 1980s. In 2003, the World Health Organization put kangaroo care on its list of endorsed practices.

 

And of course, we know skin-to-skin contact helps full-term babies as well. They're less stressed, sleep longer, and even in hospitals, noticeably more peaceful.

 

In my experience, it's nearly impossible to bend hospital regulations when a preemie or seriously ill infant is in an incubator. I could have used the data in these articles to argue my case. I fought for every minute I could hold my daughter against me. What's your experience?

 

 

 

 

 

Laura Grace Weldon is the author of Free Range Learning: How Homeschooling Changes Everything. She lives on a small farm with her family where they raise bees, cows, chickens, and the occasional ruckus. Laura writes about learning, sustainability, and peace. Connect with her at http://lauragraceweldon.com/blog-2/

 

 

 

 

 

 

 

 

 

 

 

post #2 of 11

Thanks for sharing it is so obvious that skin to skin contact is healing. I wonder how hospital regulations could start to change?

post #3 of 11
I had a healthy, full term infant and *still* had to fight to be with him. They knew we were breastfeeding, constantly insisted he had to go back to the nursery after a mere 30 minutes, and I had to go retrieve him for the next feeding, only to see him screaming, unattended. It was horrible!

Yes. We need to change hospital regulations. How?
post #4 of 11
Quote:
Originally Posted by pek64 View Post

I had a healthy, full term infant and *still* had to fight to be with him. They knew we were breastfeeding, constantly insisted he had to go back to the nursery after a mere 30 minutes, and I had to go retrieve him for the next feeding, only to see him screaming, unattended. It was horrible!

Yes. We need to change hospital regulations. How?

Wow, I am lucky I had my son(c-section too) at a hospital that knows the benefits. Literally as soon as he was out he was on my chest.

post #5 of 11
Thread Starter 

It was utter hell advocating for my baby's need to be held rather than isolated in an incubator with 24 hour lights. Doctors and nurses had no problem coming back with lines like, "Well, if you don't care about your baby's survival..." and "Your emotional issues shouldn't obstruct our medical care." 

post #6 of 11
You deserve a medal for staying tough in the face of their criticism and scare tactics!
post #7 of 11
Thread Starter 

Thanks Pek64. At the time I felt mostly anger, shame, and the burning desire to grab my baby to escape. 

post #8 of 11

My experience with my premature baby was that it just wasn't as simple as "skin to skin contact saves preemies" or "hospital regulations," and that an article about care options in Zimbabwe in 1994 (in a unit the abstract describes as having nothing but antibiotics and piped oxygen) was sure as hell not going to move the opinions of a neonatal care team in Boston in 2009.

 

I think kangaroo care is great for families, but I think it's presented to parents, at a hugely stressful time in their lives, as the one answer.  Which it's not.  It's not the highest possible standard of care for babies in developed nations, and it's not always the most appropriate care, but I frequently see preemie moms beating themselves up for not holding their babies enough, and arguing with the NICU team.

 

My daughter was born at 32w gestation.  She needed three doses of lung surfactant to get through her first 24 hours.  She needed IV fluids, parenteral nutrition, and gavage feeding.  She needed phototherapy for jaundice.  She needed CPAP support.  While all this was going on, I was coming off of morphine from the emergency c-section, dragging myself to the NICU, and demonstrating to the nurses that I was a risk for dropping the baby.  Because I was completely focused on kangaroo care, I was busy freaking out that they wouldn't let me hold her.  Of course they wouldn't let me hold her!  I was too shaky from blood loss to walk straight!  Within three days, they were happy to have her in my arms as much as I could stand.

 

I think parents of premature infants would be better served by a broader discussion of treatment needs, and by some encouragement towards self-care, then they are served by the way kangaroo care dominates the conversation.

post #9 of 11
Thread Starter 

Excellent points MeepyCat. The medical needs of the preemie are critical and must come first. But at least in rural mid-western hospitals in my area, kangaroo care doesn't dominate the conversation. It still seems unheard of, with "progressive" policies allowing a parent to touch a baby while he/she is in the incubator or to hold the infant for short periods each day, tightly swaddled with no skin contact at all. All I wanted was that skin contact for a few hours a day, and maybe a comfortable chair where a recovering and often very stressed mom could lean back and relax with her baby. These things change incrementally, usually due to demands by well-informed parents. 

post #10 of 11
Quote:
Originally Posted by Laura Grace Weldon View Post

These things change incrementally, usually due to demands by well-informed parents. 

 

Yes, absolutely.  The articles you link, unfortunately, do not make parents in developed nations well-informed.  They just make neonatalogists crazy.  Why should a doctor in a NICU with a survival rate upwards of 90% care how a hospital in Africa got a survival rate up to 50%?  That 50% is a totally unacceptable survival rate for a NICU in the U.S.  And that number is what the doctor is going to see, first and foremost.  You need better supporting arguments.

 

The changes I'd like to see in NICU care are:

- A standard ratio of one recliner chair per patient bed.

- A standard ratio of one functioning, hospital grade breast pump per at least every two patient beds.

- More holistic care for the mother/infant dyad, with post-partum nursing staff available to preemie moms in the NICU (so that moms can stay near their babies while recovering from illness or surgery when possible).

- Better maternity leave policies, so that parents don't have to choose between being with their premature infants in the NICU and preserving leave time for when their children come home.

- More NICUs, more widely geographically distributed, so that more parents have quality care options close to home.

- Post-partum childcare services for the older children in a family considered as a medical expense (tax deductible, and possibly reimbursable by insurance) when a family has a baby in the NICU, so that parents of preemies aren't stretched as thin.

post #11 of 11
Thread Starter 

You are entirely right MeepyCat. 

 

I heartily concur with the changes you'd like to see. 

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