Rachel Myr posted:
> Men's chests don't regulate temperature the same way ours do, I have
> learned somewhere (where? I'm that old now that I don't even care enough to
> go find the source). Mothers warm babies up and their chests get less warm
> in response to an overheated baby. Fathers just keep the heat on, so they
> need to keep track of the baby's temperature if the baby can't complain on
> its own.
I once heard Susan Luddington-Hoe speak about the mother's skin warming up to keep the kangaroo-care baby at the ideal temperature, and then cooling down if the baby got too warm. Dads doing kangaroo care, she said, had their skin temperature rise, but when baby became overly warm the father's skin temperature did not go down. Instead, she said, the father would get a bit ansty, and say "I can't sit and hold this baby like this all day, I have a lot of other stuff I have to et done."
Her book with Susan K. Golant, "Kangaroo Care: The Best You Can Do to Help Your Preterm Infant" was published in 1993.
She discusses temperature effects of kangaroo care in an article written with kathy Morgan and Amel Abouelfettoh that can be accessed at http://www.neoforcegroup.org/downloads/Kangaroo_Guidelines.pdf
It is titled, "A Clinical Guideline for Implementation of Kangaroo Care with Premature Infants of 30 or More Weeks Postmenstrual Age," Advances in Neonatal Care, Vol. 8, No. 3S, May 21, 2008.
From the article:
> The effect of KC on infant body temperature has been studied extensively, with the same outcome: when healthy preterm infants are placed in KC, infant body temperature rises.5,11,14,27,35,43–49 Infant warming during KC has been confirmed by meta-analyses,19,29,50–52 no matter how the body temperature has been measured. Temperature measurements have been axillary, tympanic, rectal, central artery, forehead, back, abdominal, foot/toe, and thigh, and still the areas under measurement increase during KC. Only one pretest–test–posttest study38 found infant temperature was lower (but still within clinically acceptable limits) during KC than during incubator care. Infant temperature has remained within clinically acceptable limits and within each infant’s neutral thermal zone when provided by the mother. Infant temperature can exceed 37.5°C when provided by fathers in tropical, un-air conditioned units.48 Infant thermoregulation occurs by maternal control over the amount of breast heat that is conducted to the infant.14,53,54 Infants of more than 32 weeks’ postmenstrual age have demonstrated the ability to thermoregulate their body temperature during KC by sticking an arm or foot out from under the covering blanket.48 Regardless of providers (mothers, fathers, and surrogates [adoptive parents, healthcare staff]), infant temperature remains stable or increases.
I like the part about the overheated infant sticking his arm or leg out from under the blanket!
Regarding kangaroo care following C-section birth, I learned of a webinar presented April 11, 2013 by Isis Parenting of Boston, MA and titled, "Family Centered Cesarean Birth." The speaker was Dr. William Camann, Director of Obstetric Anesthesia at The Brigham and Women's Hospital in Boston, and an Associate Professor of Anesthesia at Harvard Medical School.
The lecture was recorded and is archived at the Isis web site. Try this address to find it: http://www.isisparenting.com/page/results?q=Family%20Centered%20Cesarian%20Birth
It was free, but you had to register.
Here is a description of it:
> Currently more than 30% of births in the US are cesarean delivery. A c/section is a major surgical procedure but also a momentous and miraculous event in the life of a family.
>
> The Family-Centered Cesarean (also called “Gentle”, “Natural” or “Women-Centered” cesarean birth) refocuses the standard and routine clinical processes at cesarean delivery to enhance early maternal-infant bonding and improve the mother’s experience of the surgical birth of her baby.
>
> In contrast to a standard c/section, the Family-Centered Cesarean may include:
> • Surgical drapes adjusted to allow mother and partner the ability to see their baby’s head and body be delivered.
> • Slower delivery of baby’s body to allow the physiologic squeeze.
> • Mother with dominant arm free of IVs and monitors, and EKG leads positioned away from mother’s chest, for immediate Skin-to-Skin contact after delivery.
> • Breastfeeding initiated in the OR during the procedure.
> • Additional support person (professional doula) permitted in OR.
> • Delay separation of newborn for routine care until first breastfeeding has been completed.
I was very impressed with the presentation. I also listened to another from Isis on "Optimal Cord Clamping." That also was very good. These lectures can be listened to by parents as well. I really wanted to share them with local hospital staff.
Anne Altshuler, RN, MS, IBCLC, La Leche League Leader
Madison, WI
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