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Saturday, June 5, 2010

In the Pouch

In the Pouch: Kangaroo care for newborns

  (originally posted on Natural Mothering)
His first cradle is the warm cozy womb that sways to and fro, gently rocking him as his mother walks through the park or dances in the the living room with his big brother.

His first lullaby is the sound of the beat and swoosh of his mothers heart, mommy's beautiful voice talking to his daddy, laughing with a friend, singing and reading to his big sister.

He is protected by the warm wet cocoon inside his mothers belly. He receives his food and oxygen directly from his mothers body.

They are not two. They are One.

His birth is a momentous occasion, both exciting and scary. Hormones flood into him to prepare him for his grand entry into this shocking world- so cold, bright and loud. All of a sudden he is no longer lulled to sleep by the sound of his mothers heartbeat. He is no longer gently rocking in his warm safe cocoon. He has been separated and cries out in fear- bereft, stranded, solitary and unattached...

Then suddenly he is enveloped in warmth, laying wet and slippery on his mothers chest. He hears it- the beating of his mothers heart. He hears her voice, so clearly for the first time. He knows what he needs and he seeks out that attachment, the physical bond to tie them back together. Little toes flex and dig into his mother soft belly as he wiggles and squirms forward, his little mouth open and questing. The sound of her voice draws him forward. Her arms support him in his journey. In a feat of strength and coordination that is truly amazing he reaches his goal and re-establishes their physical bond. As he suckles her nipple, drops of liquid gold land on his tongue. Food yes, but so much more. Each drops reattaches him to his "self", brings him back to his core being. He lays on his mothers chest drinking the precious drops, listening to her heart beat and her voice, hearing it both from within and without. Her arms around him holding him close, warming him with her body. He relaxes. He breathes in and out and his breath calms. His heart beats in a steady rhythm. He is soothed.

Though this new world is so big, and a bit frightening in its brightness and noise, He is secure and calm. He is with his other self, who protects him with her loving arms, warms him with her skin, comforts him with her steady heart beat and voice, and nurtures him with her breasts.

He is content.

Kangaroo care is a way of nurturing a baby, to enhance skin-to-skin contact between the baby and the parent. The baby, wearing only a diaper, is held upright against the parent’s bare chest. The term kangaroo care is used because the method is similar to how a baby kangaroo is nurtured by its mother - from the safe environment of the womb to the safe environment of the pouch where further maturation of the baby occurs. Skin-to-skin contact promotes more consistent heart and respiratory rates; it stabilizes oxygen needs; it aids in stabilizing blood sugar levels; it regulates body temperature; and improves weight gain and helps increase breast milk supply.

The Father of modern Kangaroo care is Dr. Nils Bergman. Dr Bergman worked in South Africa, Ciskei and Sweden, before working seven years as Medical Superintendent and District Medical Officer at Manama Mission, Zimbabwe. It was in Zimbabwe that he developed and implemented Kangaroo Mother Care (KMC) for premature infants right from birth. This resulted in a five-fold improvement in survival of Very Low Birth Weight babies raising the survival rate of these tiny preterm infants from 10% to 50%.

But Kangaroo Care isn't just for preemies. Skin to Skin contact is vitally important for all infants.

"The very best environment for a baby to grow and thrive, is the mother's body," says Dr Nils Bergman, "When placed skin-to-skin on the mother's chest, the baby receives warmth, protection and food, and its brain can develop optimally. Not feeding the baby often enough and leaving it to sleep alone after a feed can result in the baby getting colic", he adds. "The mother's skin is the baby's natural environment, and both physically and emotionally the healthiest place for the baby to be".

Failure to be kept in contact with the mothers skin, maintains Bergman, is not only a negative behaviour but also creates a state of pathophysiological stress. When the baby is separated from his mother he tries intensely to re-establish contact with its correct environment, usually by crying.If that fails, the baby becomes exhausted and lapses into a state of despair and becomes withdrawn in order to conserve energy and concentrate on survival. This results in lower body temperatures and heartbeat, and increases levels of stress hormones: because a baby separated from its mother, is in fact stressed.

In the first 8 weeks of life, skin-to-skin contact is the most important stimulant for the development of the brain. Dr. Bergman says this continuous physical contact is an essential requirement if the fundamental structures of the brain are to be developed in a healthy way. After this requirement, the most important stimuli that the brain needs for normal development are eye contact, and the physical need to be carried by the parents.

"Only in the last century we have abandoned our three million year-old pattern of caring for children. We have replaced continuous carrying of the child, co-sleeping with the parents, and breastfeeding on immediate demand with leaving the child to lie alone, ignoring its crying, and feeding it every four hours with formula", he adds.

Kangaroo care is also very important in establishing breastfeeding. Dr. Jack Newman, world renown Doctor in the field of Breastfeeding and lactation, firmly contends that skin to skin contact is vital to building a strong breastfeeding relationship between mother and baby. Babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without any help and they are more likely to latch on well. A baby who latches on well, gets milk more easily than a baby who latches on improperly. When a baby latches on well, the mother is less likely to be sore, and her milk supply is balanced to the needs of her baby.

According to Dr. Newman, skin to skin contact immediately after birth, which lasts for at least an hour (and should continue for as many hours as possible throughout the day and night for the first number of weeks) has the following positive effects on the baby:

  • Is more likely to latch on well
  • Is more stable and has normal skin temperature
  • Is more stable and has a normal heart rate and blood pressure
  • Has higher blood sugar
  • Is less likely to cry
  • Is more likely to breastfeed exclusively longer
  • Will self wake when hungry

But Kangaroo care is not just limited to mothers or even to biological mothers. Babies can benefit from skin to skin contact with their fathers, and adoptive/foster parents. Many times we hear from mothers that they want to introduce a bottle to their new born baby because the father wishes to "bond" with baby too. The use of bottles is completely unnecessary to create a nurturing bond between father and baby. Once baby has nursed and has a contentedly full belly, daddy can easily spend important bonding time being skin to skin with baby. Many fathers enjoy this special time with baby, and baby is able to get close and personal with daddy- breathing in daddy's own unique scent, hearing his heart beat and listening to the voice that he may well remember from being in the womb. This also gives mom some time to herself- for a nice hot shower, or even a few moments to play tea party with baby's older sister!!

When all of babies physical and emotional needs are taken care of and they are warm and content, their energy is focused on growing and developing their brains and bonding with their parents. And really, what could be more wonderful than spending time cuddling with your beautiful new baby?! So slow down and enjoy your baby moon. Lock the doors, take the phone off the hook and spend a few days in bed, just mommy, daddy, baby (and siblings). Visits, and cleaning, and laundry can be taken care of next week. Just cuddle.

Dr Jack Newman The Importance of Skin to Skin Contact