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College of Human and Health Sciences, Swansea University

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Multiple Births
http://www.bliss.org.uk/multiple-births

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The importance of skin to skin contact for prem babies

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Mothering Like a Marsupial

Krisanne delivered Kaia Michelle at 24 weeks at 1 pound, 12 ounces. Immediately, Krisanne was separated from her daughter, who was taken an hour away to a special neonatal unit.

The next time Krisanne saw her baby, Kaia was hooked up to monitors and breathing tubes. Krisanne was terrified to hold her, but the nurses encouraged it. Krisanne was instructed to remove her shirt and bra, and the nurses then placed Kaia in her arms.

Krisanne watched Kaia squirm but to Krisanne's astonishment, Kaia fell into a deep, peaceful sleep. "She made me feel like a mom for the first time. I knew at that moment she was going to live," she says.

Lifesaving Efforts

The skin-to-skin contact Krisanne gave her daughter was first used in 1979 in Bogota, Colombia, in neonatal wards that had a shortage of incubators for babies with severe hospital infections. Neonatologists Edgar Rey and Hector Martinez turned to nature-specifically kangaroos, which hold their young as soon as they are born.

They sent mothers home with the instruction to hold their infants diapered but bare-chested between their breasts in an upright position as often as possible, feeding them only breast milk.

What the doctors-who coined the term "Kangaroo Care"-found was that this skin-to-skin contact not only allowed mothers to leave the hospitals (which decreased overcrowding) but it also decreased their babies' dependency on incubators. And the most astounding? The doctors watched as mortality rates plunged from 70 percent to 30 percent.

Benefits for Baby

Today, doctors across the United States, South America, South Africa, and other countries recommend Kangaroo Care-sometimes referred to as Kangaroo Mother Care-to new moms of both premature and full-term infants. Doctors recommend that this bonding last from 60 minutes to 24 hours a day and can be performed by fathers as well.

"The more skin-to-skin [contact] the better. It should ideally start at birth, but is helpful any time," says Dr. Nils Bergman, senior medical superintendent of Mowbray Maternity Hospital in Cape Town, Africa, where doctors deliver 7,000 children a year.

"Physiology and research provide overwhelming evidence that Kangaroo Mother Care is not only safe but superior to the use of technology such as incubators," Bergman adds. "Depriving babies of skin-to-skin makes alternative stress pathways in the brain, which can lead to ADD, colic, sleep disorders, among other things."

No published studies have found any harmful effects of Kangaroo Care-only its benefits. Consider these:

Healthier heart rates and respiration. Babies who suffered from respiratory distress and stayed in Kangaroo Care positions were relieved within 48 hours without respirators. One study concluded that heart rates for infants given Kangaroo Care were more regular than babies not given it.

Increased breastfeedings. A study found that infants held for more than 50 minutes were 8 times more likely to breastfeed spontaneously. Skin-to-skin contact also increases milk let-down.

Improved immunity. "Premature [babies] seem to have poor immune systems-[they're] susceptible to allergies, infections, feeding problems. Early skin-to-skin contact dramatically reduces these problems," says Bergman.

Increased weight gain. A study concluded that infants given Kangaroo Care gained weight more quickly than babies not given it; weight gain can often lead to shorter hospital stays.

Regulated body temperature. "Mothers are able to control the infant's temperature better than an incubator," Bergman says. "Core temperature can rise by two degrees centigrade if baby is cold and fall 1 degree if baby is hot."

Kangaroo Care: How to Get Started

How to Get Started

Parents should be seated comfortably in a quiet, dimly lit room with some privacy.

Position the baby, dressed in diaper (and cap for warmth if needed) on your bare chest for a minimum of 20 minutes.

This bonding time can be experienced by both mother and father. If Kangaroo Care is performed around feedings, place the baby with dad after mom has breastfed.

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

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Kangaroo Care: The Importance of a Parent's Touch

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Krisanne delivered Kaia Michelle at 24 weeks at 1 pound, 12 ounces. Immediately, Krisanne was separated from her daughter, who was taken an hour away to a special neonatal unit. The next time Krisanne saw her baby, Kaia was hooked up to monitors and breathing tubes.

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Breastfeeding your premature baby

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Deciding whether to breastfeed

Your baby being in a neonatal unit may have come as an enormous shock to you, but the good news is that you can still do many of the things you planned, including breastfeeding. Even if you have decided against breastfeeding, you could express your breast milk for a little while.

Mothers transfer protective antibodies to their babies through the placenta during the last three months of pregnancy. This process is broken when the baby is born prematurely. For this reason, premature babies are especially vulnerable to infection. The good news is that mothers also give their babies antibodies in breast milk. By providing breast milk, you give your baby an extra line of defence.

Advantages of breast milk

Breast milk provides antibodies that protect your baby against bacteria and viruses.

It boosts your baby's immune system and protects against infections, such as stomach and chest infections.

It provides nutrients, growth factors and hormones that help your baby grow and develop during the vital early months after birth.

It is very easy to digest and is absorbed more easily than formula milks.

It allows you to have skin-to-skin contact with your baby. Research has shown that this is very beneficial, especially for premature babies and it has been observed that babies spend less time crying and more time in deep sleep as a result of skin-to-skin contact with their parents.

Breastfeeding is good for your health too. It can help you regain your pre-pregnancy figure, since any extra fat stored by the body during pregnancy is used to produce breast milk. There is also some evidence that breastfeeding reduces your risk of breast and ovarian cancer.

First milk

The first milk mothers produce is called colostrum. Colostrum is thicker and more yellow in colour than breastmilk. It contains a rich mix of proteins, including antibodies that can help protect against infections.

Your baby may not be ready to feed straight from your breast, so you can provide milk from your breast by using a technique called expressing. Expressing breast milk is a skill that can take a time to learn, and the staff looking after your baby will give you positive support and practical help with this.

If you choose to breastfeed, you should express your milk as soon as possible. Breast milk can be frozen and stored until your baby is ready to feed. As with all newborn babies, some find breastfeeding easier than others. This can depend on factors such as the baby's age, maturity and his or her medical condition. It may take slightly longer to establish breastfeeding with premature babies, or require extra support from the staff on your unit. At birth, breastfeeding may have to be delayed so feeding is provided by tube feeding where a tiny tube is passed through the nose into your baby's stomach.

Giving breastmilk is something best done by you and it may help you to feel closer to your baby, but you must feel happy with whatever you decide to do.

For more information on breastfeeding contact The Breastfeeding Network on 0300 100 0212.

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If you choose to, you can breastfeed your baby on the neonatal unit. Find out more about how to do this in this section.

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Multiple babies

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Feeding multiple babies