Page 304 - Encyclopedia of Nursing Research

K

Kangaroo Care Relevant theoretical paradigms include
(SKin-to-SKin ContaCt) mutual caregiving and self-regulation
(Anderson, 1977, 1989, 1999) and stress reduc-
tion (programming, inappropriate stress res-
ponsivity, and allostatic load; McEwen, 1998),
Most nurses working in an intensive care all physiological/developmental and life span
nursery have witnessed parents expressing in nature, and Fitzpatrick’s Rhythm Model,
intense need to hold their ill preterm infants. Levine’s Energy Principles, Nightingale’s
A relatively new way to address this need Model, Orem’s Self-Care Model, Rogers’
is kangaroo care (KC), a term derived from Energy Fields, and Roy’s Adaptation Model
its similarity to the way marsupials mother (Fitzpatrick & Whall, 1996).
their immature young. During KC, mothers KC has five categories, based primar-
simply hold their diaper-clad infant under- ily on how soon KC begins (Anderson,
neath their clothing, skin to skin (chest to 1995). Late KC, still most common in the
chest) and upright; if needed for warmth, a United States, begins when infants are sta-
cap and a blanket across the infant’s back ble in room air and approaching discharge.
may be added. In complete KC mothers allow Intermediate KC begins after the early inten-
self-regulatory breastfeeding. sive care phase; usually oxygen is needed
KC represents a blend of technology and some apnea and bradycardia occur. Also
and natural care. The method (also known included are infants who are stabilized with
as skin-to-skin contact) began in Bogotá, mechanical ventilation and infants who,
Colombia, is widespread in Scandinavia and although too weak to nurse, are placed at
Africa, and is proliferating elsewhere. In the breast during gavage feedings, a method
developing countries, the method is called that facilitates lactation. Early KC is for eas-
kangaroo mother care because mothers are ily stabilized infants and begins as soon as
usually the central figure responsible for stabilization occurs, usually during the first
continuous care and almost exclusive breast- week and perhaps even the first day after
feeding. Nyqvist et al. (2010a, 2010b) recom- birth. Very early KC begins in the deliv-
mends naming this continuous kangaroo ery or recovery room 15 to 60 minutes after
mother care and using the term intermit- birth. With birth KC, infants are returned to
tent kangaroo mother care for what usually their mothers immediately after birth. The
occurs in developed countries. rationale for these last two categories is that
Full-term infants also are vulnera- the mother can help to stabilize her infant
ble during the physiologically demanding (Bergman, Linley, & Fawcus, 2004).
intrauterine–extrauterine transition after Numerous important variations of KC
birth and therefore benefit from KC (Moore, have been reported as separate case stud-
Anderson, & Bergman, 2007). A Cochrane ies, mostly in MCN: The American Journal of
review protocol of KC for preterm and low– Maternal Child Nursing. Examples are twins
birth weight infants in the NICU has just and adolescent parents, triplets, an intubated
been submitted (Moore, Bergman, Anderson, preterm infant, full-term infants having
Rojas, & Chiu, 2010). breastfeeding difficulties, a near-term infant