Jane, I doubt anyone would dispute that birth at less than 24 weeks
gestation is an extreme situation. Mortality and severe morbidities are high
among this population even when cared for in the "civilized" NICU
environment. Since the majority of preterm infants are born after 24 weeks,
it may be that you are thinking oranges while most of us are thinking
apples... I also doubt that most of us who work with health professionals
caring for the smallest and earliest of our human family would dispute their
good intentions, but good intentions are not always evidence-based ones and,
as they say, "The road to hell is paved with good intentions."
Unfortunately, there still are many NICU or SCN where Kangaroo Care
(KC) is an afterthought (or something a parent must
"push") vs. an evidence-based strategy focused on creating that more
womb-like environment and also enhancing keeping the baby
alive with as few negative sequelae -- physiological and psychosocial
- as possible.
Although 24/7 KC may not be feasible, Ludington-Hoe lectured last year at
OLCA that the person doing the KC with baby, which doesn't always have to be
the mother, should commit to 1 hour so baby gets through a normal sleep
cycle.

There has been some research and some anecdotal reports on kangarooing with
preterm infants of 24 weeks and older. Some of the lit conflicts and, as
always, it's important to read the individual infant -- not just the
reports... For those interested, you may want to check:

Ludington-Hoe SM. Ferreira C, Swinth J & Ceccardi JJ (2003). Safe criteria
and procedure for kangaroo care with intubated preterm infants. *JOGNN, 32*(5),
579-588. Abstract accessed
http://www3.interscience.wiley.com/journal/118885120/abstract on 7/2/10.

Black K (2005). Kangaroo care and the ventilated neonate. *Infant, 1*(4),
127-132. Accessed http://www.infantgrapevine.co.uk/pdf/inf_004_tev.pdf on
7/2/10.

*Newborn Services Clinical Guideline: Early Preterm Infant
(24 to 27 Weeks
Gestation* (see last bullet re: “Nursing Implications” - then link to
guidelines re: *Kangaroo Care*)
http://www.adhb.govt.nz/newborn/guidelines/developmental/DevCare24-27.htm

By a mother who kangarooed her premie from the baby’s birth at 24 wks:
http://www.babylinq.com/kangaroocare-preemiearticle-krisannecollard.aspx

Looks at kangarooing from birth at 27 wks
http://journals.lww.com/mcnjournal/Abstract/2002/07000/Kangaroo_Care_for_Adoptive_Parents_and_Their.7.aspx



> I work in a hospital with a level 3+ nursery.  Right now we have several
> tiny babies born at 22-24 weeks gestation.  These babies have special beds
> for them, are on ventilators and other life support systems.  They are
> barely alive.  Please show me the evidence-based information that shows that
> these babies will survive placed on mom.  And let's be realistic, if indeed
> it is BETTER for these babes to be on mother (which I think it might be),
> what mom can sit in a chair 24/7 without a need to pee and eat and sleep?
>  Plus pump for her baby.  The research done has been on babies 32 weeks and
> above, I believe.  And these are small studies.  We can't forget that in the
> "wild" these babies WOULD NOT SURVIVE outside of the womb.  All of our
> technology is trying to create an environment that is womb-like in it's
> ability to provide warmth, nourishment and protection in hope of helping a
> baby survive.  And hospital personnel, including doctors, are not trying to
> harm the mother-child bond, they are just focused on keeping the baby alive
> and as healthy as possible with as few sequelae as possible.  We have a
> heavy emphasis on getting moms pumping, getting the colostrum and milk to
> the babies ASAP, touching and being with baby as much as possible.  Let's
> advocate for mom and baby but can we do it in a way that recognizes that
> most doctors and nurses CHOOSE to do what they are doing and have no ill
> will towards their clients.  I would challenge anyone who works with
> breastfeeding moms who have preemies to (if they have opportunity) tour a
> local NICU and see really tiny babies and hear the miracle stories.  The
> first lactation course I took as an aspiring consultant was with Marsha
> Walker and Jeannie Driscoll back in the age of dinosaurs.  It was so
> eye-opening to move beyond what I was familiar with (normal newborns) into
> the world of the long-term pumping mom.  This was before kangaroo care was
> attempted and Susan Luddington's work.  Things have advanced a long way in
> the years since.
>
>
-- 
Karen Gromada
www.karengromada.com/

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome