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Subject:
From:
Deanne Francis <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 28 Jan 2000 20:08:31 -0700
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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

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