By Melissa Nelson
Kangaroo Care is an evidence-based practice in which a preterm infant, wearing only a diaper, is held skin-to-skin against their parent's chest.
This developmental care practice originated in Bogota, Columbia in the 1970s, where preterm and low birth-weight infants were dying of infections and hypothermia.
Without incubators to support the infants, a pediatrician asked parents and caregivers to ‘wear’ their infants, similar to how marsupials such as kangaroos carry their young.
Kangaroo Care has three components: the kangaroo position (skin-to-skin contact), kangaroo nutrition (human milk and chestfeeding), and early discharge home (using the kangaroo position 24/7 at home with follow-ups in a clinic). In Columbia, these practices were found to decrease deaths in preterm and low birth-weight infants, and Kangaroo Care is now used as a best practice around the world.
BC Women’s Hospital neonatal intensive care unit (NICU) has been practicing Kangaroo Care for a number of years.
Over the last three years, a team affiliated with the NICU, the Women’s Health Research Institute, Perinatal Services BC, and the BC Women’s Health Foundation partnered with the regional health authorities to research how the practice of Kangaroo Care can be strengthened for infants throughout the province. The project was funded by the Ministry of Child and Family Development.
The team is working with 11 of the NICUs in B.C. to understand how to support healthcare providers, clinicians, and parents to practice Kangaroo Care.
Findings from the first phase of the study suggested that preterm infants in B.C. receive variable Kangaroo Care practice, depending on when, where, and by whom they are cared for, despite Kangaroo Care having been identified as a best practice.
“A ‘one-size-fits-all’ approach cannot be identified to guide Kangaroo Care implementation as it is a complex intervention, and each NICU presents unique barriers and enablers to its uptake,” says Alix Woldring, Kangaroo Care coordinator at Perinatal Services BC and a member of the study team.
“Support for improving parental presence, shifting healthcare provider beliefs, identifying creative solutions to NICU design and space constraints, and the development of a provincial guideline for Kangaroo Care in NICUs may together provide the impetus to change practice and reduce barriers to KC for healthcare providers, families, and administrators at local and system levels,” Alix says.
The Sandra Schmirler Foundation has provided a grant to the BC Women’s Health Foundation to continue supporting Perinatal Services BC to sustain the project. The funds will enable the team to provide bandeau-style Kangaroo Care wraps to families for an additional year.
The team’s first publication, What's stopping us: An implementation science study of kangaroo care in BC neonatal intensive care units, describes healthcare providers’ perspectives of the barriers and enablers to Kangaroo Care in the eleven NICUs that participated in the study. Read the study or learn more about the project by listening to the latest episode of @WomensResearch.