This is another brilliant article about skin to skin kangaroo care.  Sometimes we need to questions advanced technology and step back in time to simpler methods- basic methods that answer both the baby's needs and the needs of his mother.

The Human Incubator

By TINA ROSENBERG

Bullit Marquez/Associated PressA mother in the Philippines used the warmth of her body to nurture her prematurely born daughter.

Sometimes, the best way to progress isn’t to advance — to step up with more money, more technology, more modernity. It’s to retreat.
Towards the end of the 1970s, the Mother and Child Institute in Bogota, Colombia, was in deep trouble. The institute was the city’s obstetrical reference hospital, where most of the city’s poor women went to give birth. Nurses and doctors were in short supply. In the newly created neonatal intensive care unit, there were so few incubators that premature babies had to share them — sometimes three to an incubator. The crowded conditions spread infections, which are particularly dangerous for preemies. The death rate was high.
Dr. Edgar Rey, the chief of the pediatrics department, could have attempted to do what many other hospital officials would have done: wage a political fight for more money, more incubators and more staff.

He would likely have lost. What was happening at the Mother and Child Institute was not unusual. Conditions were much better, in fact, than at most public hospitals in the third world. Hospitals that mainly serve the poor have very little political clout, which means that conditions in their wards sometimes seem to have been staged by Hieronymous Bosch. They have too much disease, too few nurses and sometimes no doctors at all. They can be so crowded that patients sleep on the floor and so broke that people must bring their own surgical gloves and thread. I recently visited a hospital in Ethiopia that didn’t even have water — the nurses washed their hands after they got home at night.

Proof that more money and more technology isn’t always the answer.

Rey thought about the basics. What is the purpose of an incubator? It is to keep a baby warm, oxygenated and nourished — to simulate as closely as possible the conditions of the womb. There is another mechanism for accomplishing these goals, Rey reasoned, the same one that cared for the baby during its months of gestation. Rey also felt, something that probably all mothers feel intuitively: that one reason babies in incubators did so poorly was that they were separated from their mothers. Was there a way to avoid the incubator by employing the baby’s mother instead?
What he came up with is an idea now known as kangaroo care. Aspects of kangaroo care are now in use even in wealthy countries — most hospitals in the United States, for example, have adopted some kangaroo care practices. But its real impact has been felt in poor countries, where it has saved countless preemies’ lives and helped others to survive with fewer problems.

Agence France-Presse A mother and child in Colombia, where the “kangaroo care” method was first used in the late 1970s.

In Rey’s system, a mother of a preemie puts the baby on her exposed chest, dressed only in a diaper and sometimes a cap, in an upright or semi-upright position. The baby is strapped in by a scarf or other cloth sling supporting its bottom, and all but its head is covered by mom’s shirt. The mother keeps the baby like that, skin-to-skin, as much as possible, even sleeping in a reclining chair. Fathers and other relatives or friends can wear the baby as well to give the mother a break. Even very premature infants can go home with their families (with regular follow-up visits) once they are stable and their mothers are given training.
The babies stay warm, their own temperature regulated by the sympathetic biological responses that occur when mother and infant are in close physical contact. The mother’s breasts, in fact, heat up or cool down depending on what the baby needs. The upright position helps prevent reflux and apnea. Feeling the mother’s breathing and heartbeat helps the babies to stabilize their own heart and respiratory rates. They sleep more. They can breastfeed at will, and the constant contact encourages the mother to produce more milk. Babies breastfeed earlier and gain more weight.
The physical closeness encourages emotional closeness, which leads to lower rates of abandonment of premature infants. This was a serious problem among the patients of Rey’s hospital; without being able to hold and bond with their babies, some mothers had little attachment to counter their feelings of being overwhelmed with the burdens of having a preemie. But kangaroo care also had enormous benefits for parents. Every parent, I think, can understand the importance of holding a baby instead of gazing at him in an incubator. With kangaroo care, parents and baby go through less stress. Nurses who practice kangaroo care also report that mothers also feel more confident and effective because they are the heroes in their babies’ care, instead of passive bystanders watching a mysterious process from a distance.
The hospitals were the third beneficiaries. Kangaroo care freed up incubators. Getting preemies home as soon as they were stable also lessened overcrowding and allowed nurses and doctors to concentrate on the patients who needed them most.
Kangaroo care has been widely studied. A trial in a Bogota hospital of 746 low birth weight babies randomly assigned to either kangaroo or conventional incubator care found that the kangaroo babies had shorter hospital stays, better growth of head circumference and fewer severe infections. They had slightly better rates of survival, but the difference was not statistically significant. Other studies have found fewer differences between kangaroo and conventional methods. A conservative summary of the evidence to date is that kangaroo care is at least as good as conventional treatment — and perhaps better.

HERE to read the entire article in the NYTimes

UK study on Kangaroo Care for preemie babies

More and more good news in the world of baby wearing!!  A new study done in Kent UK shows that premature babies gain weight faster and get home sooner with the use of Kangaroo Care to keep the babies close to their mother, skin to skin.

As I wrote back in May 2010, 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. All of which are vital for babies born  too early.

YAY for Baby Wearing!!!!

Babies gain from 'kangaroo' care study at Kent hospital

By Nigel Thompson BBC South East health correspondent

Carianne Hamilton said she jumped at the chance to try the new method

The first minutes and hours after a baby is born are precious - it is the chance for a mother to bond with her child after months of expectation and the pressure of giving birth.

Now midwives in Kent are studying the use of a device which it is claimed can help babies born prematurely to put on weight and develop far quicker than if they were to stay in an incubator.
A simple sling, used to cradle the child as close to the mother's skin as possible, has been tested at the Pembury maternity unit near Tunbridge Wells since November.
About 90 mothers have made use of the sling, which is part of a method called Kangaroo Care, and the progress of their children has been monitored under a study looking at how particularly premature babies develop. The study will conclude next month.
So far the signs are that the scheme is bringing beneficial results.
Humphrey Hamilton was born on 28 December, six weeks before he was due.
His mother Carianne elected to use the sling in those early weeks.
"It was great to feel so close to him," she said.
"When it was offered to me to try I jumped at the chance."
Jean Meadows, a consultant midwife at Maidstone and Tunbridge Wells NHS Trust, said: "Normally we'd expect a child like Humphrey to spend several weeks with us... he went home within days."
It is also claimed that the sling encourages mothers to continue breastfeeding.
"There's been a lot of research elsewhere into Kangaroo Care for premature babies which shows that it can lead to a shorter hospital stay, more successful breastfeeding, less crying and more quiet sleep," consultant midwife Sarah Gregson said.
The hospital has established links with Craftaid, a Fairtrade charity based in Mauritius which makes the slings.
The plan now is that the Maidstone trust will act as a hub for the rest of the NHS and be able to commission more of the slings from the charity.

 

HERE to read the entire article on the BBC

A glorious HBAC birth story from Gloria Lemay

I read this post on Gloria's blog this morning while drinking my coffee in the peace of a sleeping house...and it brought tears to my eyes.  Gloria's article is written by a mother who had two terrible Caesarean Section birth with her first two children- both born prematurely due to doctors being convinced by ultra sounds that they were full term when they were NOT.  This woman's story is a powerful victory over fear and the medical machine. One that should enlighten, empower and encourage women every where to take back their births.

Third births: finally getting it right

This came in as a comment on my blog post “What’s a Poor Midwife to Do?” but I think it should have it’s own blog space. Gloria
Gloria, this jumped off the page for me: “Something to notice is that for many women, it takes two screwed up births to get the third birth somewhat acceptable.”
This is me. I had two coerced c/s without labour and thereby two premature babies, the first of which was so premature that his skull would mold to my hands while I breastfed him and from sleeping so that I spent weeks gently re-forming his skull manually. He had breathing problems until 6 months pp, and his skin was so soft that I couldn’t even feel it under my fingertips.
I look at pictures of him now and see how obviously premature he was. He was my first and a c/s because otherwise, “if I [went] into labour, he could [have] die[d]” from his frank breech position. His brother was also a no-labour c/s for the very same positioning ‘reason.’
For my third baby, I saw an OB in my 1st trimester (midwives wouldn’t even talk to me seriously- I’d had ’shared care’ for the first two pregnancies after breech was indicated in the 3rd trimester) but left his office and never returned.
I freebirthed the next baby with my first labour- at 46+3, a 9 hour painless birth. It was GLORIOUS! He was 10lbs 3oz, strong and beautiful.
I then freebirthed another boy at 42+3 at the tail end of a flu that my whole family had. It was a precipitous labour- 3 minutes long, and he was 10lbs 8oz. Also beautifully formed and strong.
Now I am 45 weeks tomorrow with our fifth baby....

HERE to read the entire Blog on Gloria Lemay's site