In answer to Merilee's question about how to do Kangaroo Care in a modern NICU, let me say that we kangaroo stable premies beginning at 750 gms as long as they are on conventional ventilation support and not high frequency, are not on vasopressors, and are not immediately post-op. If the baby has an arterial line, a doctor's order is required. Important: We have the mother, or father go to the bathroom first (it's awful to make the transfer to the parent with all the tubes and wires and ten minutes later, the parent says "I gotta go!") The parent who will be doing kangaroo care, wears a shirt that opens in the front . We are working on a tie-on 'pouch' like they use in Indonesia, but for now are just using a pillow on the mom's lap for support. The parent sits in a recliner or rocker ready to receive the baby. Two staff members, usually a respiratory therapist and a nurse, make the transfer. If the baby is on a ventilator, two staff members are mandatory. The nurse puts the baby in the position which will be used for kangarooing, with the head turned to the appropriate side (closest to the ventilator) , gathers all the tubes and wires into one spot, so they all come out near the baby's feet. With the therapist monitoring the ventilator tubing and the nurse moving the flexed-up, contained baby, the transfer is made smoothly. It can be done with everything gathered up in a snuggly, also. The baby goes upright between the mothers breasts, or on the father's chest. so the baby is skin-to-skin, and the shirt is closed over the baby. The ventilator tubing is clipped to the parents shirt at the shoulder. We put a hat on the baby, so the head remains warm, and cover both parent and baby with a light blanket. If the parent has chosen a recliner over a rocker, the chair is reclined slowly, watching the IV's, etc. The usual length of time to do skin-to-skin holding is an hour, to an hour and a half. It is really interesting to watch the baby's oxygen needs decrease, and a fussy baby settle when placed on the parent's skin. Hope that helps. And no, we haven't had any problems with this in a level III NICU. Have a nice day Deanne, R.N. IBCLC NICU Utah Valley Regional Medical Center *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html