Kangaroo care involves humanized care and skin-to-skin contact; understand how it works — CMIO(Brazil)

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The Kangaroo Mother Care is a care model that starts during high-risk pregnancy and continues until the newborn is discharged. The practice consists of placing the baby in contact with the parents’ body, in a position similar to that in which the kangaroo carries its young. One of the pillars of this practice is the encouragement of breastfeeding, encouraging the constant presence of the mother with the newborn. Skin-to-skin contact, in the Kangaroo Method, begins with the parents touching the child from the first moments of hospitalization, evolving to the kangaroo position.

Studies carried out in hospitals that practice this method have shown that the daily milk volume is greater in mothers who have skin-to-skin contact with the baby. The proximity of the woman to the child allows adequate thermal control, which contributes to reducing the risk of nosocomial infection, reduces stress and pain for the newborn and increases breastfeeding rates. It is also possible to observe an improvement in the neurobehavioral and psychoaffective development of the newborn, in addition to providing a better relationship between the family and the health team.

How it works?

The low birth weight newborn is in skin-to-skin contact, in a vertical position, next to the parents’ chest and it happens in three stages:

First step

It begins in the prenatal period of high-risk pregnancies, continuing with the hospitalization of the newborn in the neonatal unit. Parents should be welcomed and given guidance on:

🇧🇷 Your child’s health conditions;
🇧🇷 The care provided;
🇧🇷 The routines;
🇧🇷 The functioning of the unit and the team that will take care of the newborn.

Parents must have free access to the unit. They also need to be encouraged to touch the baby and then put him in the kangaroo position. At this stage, the procedure must follow special care:

🇧🇷 Welcoming parents and family, supported by specialized care and later in the neonatal unit;
🇧🇷 Encourage free access to the partner or maternal companion in the necessary gestational care;
🇧🇷 Promote free and early access, as well as the permanence of parents in the neonatal unit, without time restrictions;
🇧🇷 Ensure that the parents’ first meeting is accompanied by a professional from the care team;
🇧🇷 Provide early skin-to-skin contact, respecting the clinical conditions of the newborn and the availability of approach and interaction between parents and the baby;
🇧🇷 Offer support and support for breastfeeding;
🇧🇷 Ensuring the puerperal woman stays in the hospital unit, offering the necessary assistance support;
🇧🇷 Ensure adequate chair for the mother/father to stay in the neonatal unit and to perform the kangaroo position.

Second stage

During the second stage, the baby remains continuously with the mother, who actively participates in the child’s care. This makes the woman feel safer and encouraged to remain with the baby in the kangaroo position for as long as possible. Some criteria are decisive for carrying out the method at this stage:

🇧🇷 for the newborn

Clinical stability, full enteral nutrition and minimum weight of one kilogram, two hundred and fifty grams.

🇧🇷 To Mother

Desire and availability, family support for their full-time stay in the hospital, consensus between the mother, family members and health professionals, maternal recognition of the child’s communication signals related to comfort, stress, breathing, etc. and knowledge and ability to handle the newborn in the kangaroo position.

third stage

In the third stage, the baby goes home and is accompanied, together with the family, by the Kangaroo Method Outpatient Clinic, located in the hospital of origin. They are also monitored at the Basic Health Unit (UBS) until the baby reaches a weight of 2.5 kg. At this stage, some criteria must be observed and guaranteed:

🇧🇷 The mother and father, supported by a support network in household activities, must commit to performing the kangaroo position for as long as possible;
🇧🇷 The minimum weight of the baby must be 1.6 kg;
🇧🇷 Outpatient follow-up should be ensured up to a weight of 2.5 kg;
🇧🇷 Weight gain must be adequate for three days before discharge;
🇧🇷 The baby must be exclusively breastfed or, in special situations, the family must be able to carry out the complementation;
🇧🇷 After discharge, the first appointment must be held within 48 hours at the hospital of origin. The other consultations must be alternated with the UBS and/or home visits by the community health agent;
🇧🇷 Care at the hospital unit of origin must be guaranteed until discharge from the third stage.

Among the main advantages brought by the Kangaroo Method are:

🇧🇷 Reduce the mother/father-child separation time;
🇧🇷 Favor the affective mother/father-child bond;
🇧🇷 Enable greater competence and confidence of parents in the care of their child, even after hospital discharge;
🇧🇷 Stimulate breastfeeding, allowing greater frequency, precocity and duration;
🇧🇷 Enable the newborn to have adequate thermal control;
🇧🇷 Contribute to reducing the risk of nosocomial infection;
🇧🇷 Reduce stress and pain;
🇧🇷 To provide a better relationship between the family and the health team;
🇧🇷 Provide newborns with protective sensory stimulation in relation to their integral development;
🇧🇷 Improve the quality of neuropsychomotor development.

It is in skin-to-skin contact that a large surface of the child’s body and the mother’s body meet, providing different exchanges: tactile, auditory, sensory, global, among others. Health professionals can contribute to a pleasant experience for the newborn and for everyone involved in the process.

Fran Martins
Ministry of Health



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