Close skin-to-skin contact (or Kangaroo Mother Care) with parents gives babies a healthy start

April 15, 2016
Most parents cherish the minutes after giving birth when they meet their baby for the first time. These are also precious minutes for the caregivers in the Birthing Program at BC Women's.

When the baby is well, the focus is on ensuring that mom and baby have "skin-to-skin" time. Baby is placed on mom's chest as soon as possible after birth. As well as beginning the bonding process for new parents, skin-to-skin care is healthy for both baby and mom, especially when it comes to establishing breastfeeding.

Pictured is Cindy Ghashghaee with baby Darius in BC Women's Newborn ICU early 2015.  "With all the tubes and equipment it was quite a task to move Darius into my arms, but it was after this first cuddle that he started to be more responsive.  They knew Darius needed to be skin to skin with me."

For babies who need immediate support in the Neonatal Intensive Care Unit (NICU), skin-to-skin care comes into its own later on. When the baby is stable enough to be held for the first time, the nurses help parents start daily skin-to-skin contact. In the NICU, skin-to-skin is also known as kangaroo care, and neonatal research demonstrates that it has far-reaching benefits for the baby's health and development.

Whether you call it skin-to-skin or kangaroo care, this well-researched philosophy of care is a priority at BC Women's. We asked two experts - registered nurses caring for families in the Birthing Program and the NICU - to provide some insights on why it's so important for babies and parents.

Skin-to-skin in the Birthing Program

Brianne Robb, a registered nurse in the Birthing Program, explains that skin-to-skin is a priority for well babies. Whether born vaginally or by Caesarean section, the baby is placed skin-to-skin with mom as soon as possible, and for as long as possible:  "We strongly support uninterrupted skin-to-skin for at least one hour of life or until after the first feed."

As a designated Baby Friendly Hospital under the World Health Organization/UNICEF worldwide Baby Friendly Initiative, BC Women's focuses on providing women with the supports they need for breastfeeding. One of these is initiating skin to skin immediately after birth.

During the first hours and days, skin-to-skin contact also helps to maintain the baby's temperature and promote bonding. Babies also feel less pain during skin-to-skin. For mom, some research has demonstrated hat practising skin-to-skin care can reduce symptoms of depression in the postpartum period.

Because of this proven value for families, newborn care in the Birthing Program is designed to support skin-to-skin.

"It's very much ingrained in our practice," Robb notes. For example, if the baby needs a blood sugar test or injection, it's given while the baby is skin-to-skin to minimize discomfort. When possible, routine assessments of mom or baby are delayed until an hour after delivery or after the first feed. If mom is tired or ill, dads or partners are also encouraged to hold the baby skin-to-skin.

At BC Women's, caregivers encourage skin-to-skin before each feed, especially if mom is having difficulty breastfeeding. The benefits include stimulating milk production, as well as helping moms relax, get to know their baby's behaviour, and recognize the important cues that baby is ready to feed. Placing the baby skin-to-skin is also the first thing that the nurses recommend if the baby's temperature drops.

Robb explains that parents are encouraged to continue skin-to-skin contact after they go home: "We always tell them that there is never a time when skin-to-skin does not benefit baby, as well as mom and her partner."

Some women are now noting their desire for skin-to-skin care in their birth plans. They are happy to hear that it's a priority at BC Women's.

Kangaroo Care in the Neonatal Intensive Care Unit

When you think of the Neonatal Intensive Care Unit (NICU), chances are you picture a tiny baby in an incubator attached to multiple drips and machines. Although babies in the NICU need the most technologically advanced care, they also benefit from long periods snuggled skin-to-skin with mom or dad.

Kangaroo care (skin-to-skin) is recommended by the Canadian Pediatric Society because of the measurable impact on sick babies. For example, it has been shown to help stabilize premature babies' vital signs, including heart rate and respirations. Kangaroo care also impacts their response to pain; helps them to sleep more deeply; and stimulates their brain and other neurological development. Babies can ultimately gain weight faster and go home sooner.

In more than 20 years' experience as a nurse in the NICU, Cheryl Podgornik has cared for hundreds of babies. She explains that one of the biggest benefits of kangaroo care is the ability to re-establish the bond between mom and baby, helping her to feel that she is contributing to the care for her newborn.

Wearing only a diaper, the baby is carefully positioned directly on mom's chest with an ear close to her heart. Baby gets the benefit of hearing her heartbeat and absorbing the warmth of her body.

For parents of multiples, more than one baby can receive skin-to-skin at the same time, reuniting siblings separated at birth to receive intensive care.

Podgornik explains that kangaroo care gives the baby an opportunity to rest, fostering growth and development. "If they are getting good deep sleeps, they are able to put their energy towards gaining weight."

For moms learning to breastfeed a sick baby or expressing breast milk, the skin-to-skin contact is also invaluable for decreasing their own stress and helping to boost milk production. Both parents benefit from additional bonding with the baby.

In the NICU, parents are encouraged to practice kangaroo care every day. The day's care is planned around the opportunity to get mom settled with the baby for an optimal period of one to four hours. It's not unusual to see partners coming in after work to have their own skin-to-skin time.

When you consider that the BC Women's NICU has the province's sickest babies, it's not surprising that many parents are nervous about touching or holding their baby for the first time, but kangaroo care reassures them. "As soon as they are able to do skin-to-skin, their whole outlook changes," Podgornik says. "You should see the faces of parents after they have done skin-to-skin, they are so peaceful and calm."


BC Women's Being Baby Friendly

WHO/UNICEF Baby Friendly Hospital Initiative

Healthy Families BC - video on breastfeeding and skin-to-skin

BC Women's Neonatal Intensive Care Unit

Kangaroo Care - Canadian Premature Babies Foundation

This article was written by Anne McLaughlin with information provided by BC Women's Labour + Delivery nurse Brianne Robb, and Neonatal Intensive Care Unit nurse Cheryl Podgornik


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