Something to think about if your dealing with a premie without modern medical care.
http://smartpei.typepad.com/robert_patersons_weblog/#tpDecember 14, 2010
Kangaroo Care - Taking Attachment all the way
What started as a desperate move in the less developed world is now gaining traction everywhere. There is no better incubator than mum and no better way to gain attachment by mum too.
Another step in low tech high gain health care!
Amplify’d from opinionator.blogs.nytimes.com
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.
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.
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.
Read more at opinionator.blogs.nytimes.com
