The Benefits of Kangaroo Care for Your Premature Baby

The photos above and below show my daughter being held in a "Kangaroo Cuddle” - more formally known as Kangaroo Care. The mother or father sits down wearing a loose shirt. The baby - wires and tubes still attached - is placed in an upright position inside the parent’s shirt. The parent then holds the baby and supports her head. The baby wears a nappy (diaper) and her head rests against the parent’s chest. This skin-to-skin contact is reassuring for the baby, and the position means she can feel the parent’s heart beat. It is the closest the premature baby gets to being back in the womb, and the closest the mother gets to completing her pregnancy. In the past premature babies had all their physical needs met in intensive care, but the stress of the experience often remained with them, sometimes leading to aggressive behaviour. The close contact of Kangaroo Care, along with other techniques such as baby-massage, heals the emotional damage.

Although statistics vary by country, around 8 - 12% of babies are born premature - before the 37th week - but far fewer are born as early as my daughter was. If you have had a very pre term baby, or know someone who has, please be reassured that feelings of guilt and distress are normal, and that Kangaroo Care can help ease those feelings. You may feel afraid to hold your extremely small baby, believing that you might harm her or him in some way. Those fears are normal, but unfounded; the nurses will show you how to do it, and your baby will be safe with you.

Kangaroo care is so called because of the similarities to how the kangaroo carries her extremely small baby. Its origins are in Bogota, Columbia in 1979, where it was introduced by Doctors Edgar Rey and Hector Martinez. Its introduction was partly due to lack of incubators and partly an extension of a recently introduced policy allowing mothers access into intensive care to breast-feed babies. Before this, the mothers did not see their babies until discharged, and babies were often abandoned.

The new practices led to fewer deaths and illnesses among the babies, and abandonment became rare. Rey and Martinez published these results, and worldwide interest in Kangaroo care began. Numerous studies have since found that kangaroo cuddled babies gain weight better, get home sooner and cry less than premature babies who don’t receive kangaroo care.

As long ago as 1907 a Dr Budin noticed that mothers who were not allowed to see or care for their premature babies often abandoned them. He developed glass walled incubators and encouraged mothers to visit, breastfeed and take part in their babies care.

The first night I held my daughter I knew none of this, only that holding that tiny baby against my chest felt right. I wanted to stay like that, feeling her warmth against me, feeling her tiny movements. I felt an intense need to protect my baby, and not being able to do it I felt lost and confused. Being separated from your baby goes against the most basic, powerful mother instinct and makes bonding hard.

As I sat there, Theresa, the nurse who had arranged the Kangaroo Care, told me the monitor showed the oxygen saturation had gone up, a sign that my baby was calmer. It was a surprise to realise that I could make a difference, but this is exactly what happens. Research has even shown that the mother’s body temperature will vary according to her baby’s - if the baby gets too hot she cools down and vice versa. Just being able to hold my baby help me feel that I was being looked after, and understood. Theresa had stayed behind after her shift finished to settle us into that kangaroo cuddle. She cared about my baby’s emotional needs, she seemed to understand how much that mattered to me. The Newborn Unit, with all its baffling monitors seemed less alien, less terrifying.

There is some variation in hospital policies for allowing Kangaroo Care, and some used to consider it suitable only if the baby is over 30 weeks gestation and breathing independently. Nowadays most are more flexible, and you should be able to hold your baby as long as she is stable. I held Lolo* for the first time when she was 39 hours old and she was born at 26 weeks. When Lolo was a week old she became seriously ill with a lung infection and for the next week we couldn’t do Kangaroo care. The photograph above was taken during the first cuddle when her condition had returned to stable, although as you can see from the tubes she was still on a ventilator.

My purpose in writing this post is to share my experiences and - I hope - to encourage mothers who have an early baby to feel a little less afraid and more able to cope. Giving birth early is a shock, and the intensive care unit can be bewildering. Each time a monitor emits a long tone it can feel terrifying, but the most likely explanation is because the probe, which measures oxygen and is on the baby’s foot, has come loose. This is all the more likely to happen during Kangaroo Care as the baby has been moved around.

How long you continue to Kangaroo Cuddle your baby will depend on her or him. When Lolo came home from hospital she was easily overstimulated and sometimes undressing her caused more distress than the Kangaroo Care relieved, so I didn’t undress her. That might not be the classic version, but it was what my baby needed, and I’d advise anyone in the same position to simply do what your baby indicates they need, rather than what you think you ‘should’ do. It’s far too easy for any parent to think they should follow rules instead of intuition, and that’s particularly true when you have a premature baby. In our case, when Lolo was just past her due-date she was seriously ill and back in intensive care so cuddles stopped for a while. As she recovered, when I held her on my chest she began to wriggle down till she could see my face. She was letting me know she had grown out of Kangaroo Care, that she was a full term baby now. We had moments of quiet bliss then, moments when I was amazed that she was our baby, amazed that she had survived to lie in my arms quietly watching as I moved a finger for her to follow.

* Name has been changed.