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Kangaroo Care when a baby has lines and tubes - it can be done!

By Heather Cresswell, NP


Nothing could be more natural than a baby and parent having skin-to-skin contact. However, just because it is natural doesn’t mean it is easy if your baby is in the NICU.


Kangaroo care — holding a baby wearing only a diaper against your bare chest — is an excellent way for parents and their preemie to enjoy skin-to-skin contact. Even with wires, IV tubing, breathing, and feeding tubes, kangaroo care is possible. But you’ll need some help from your baby’s team to decide when the time is right and to help make it happen.


Why kangaroo care is such a good thing.


Here are some of the benefits of Kangaroo care for babies:

  • Improved breathing and oxygen levels;

  • Lower stress levels and less crying;

  • Better blood sugar control;

  • Decreased pain;

  • Lower risk of infection;

  • More deep sleep and rest;

  • Supports healthy brain development;

  • Faster progression to breastfeeding (when they are ready).


Let’s not forget about parents! Kangaroo care does a lot of good for them too!


No surprise that holding your baby skin-to-skin helps with parent stress levels. Not only that, but it can lower the risk of post-partum depression. Kangaroo care can help parents feel more confident in the NICU. Improved milk supply is another bonus.


When will my baby be ready for kangaroo care?

A parent can hold some babies skin-to-skin right after birth. However, some premature babies or babies with health conditions may need to wait until they are medically stable.


You can still do kangaroo care, even if your baby has lines and tubes.


Your baby’s team, including the doctor or nurse practitioner, nurse, and respiratory therapist, will help you decide when the time is right. Among other things, they will consider how much help your baby needs with breathing and if their blood pressure and oxygen levels are stable.


Getting ready for Kangaroo care


When you and your baby’s team decide the time has come, there are a few things to think about. First, decide on a time with your baby’s team, and know that plans may change depending on your baby’s health.


When the time comes, plan on settling in for a while. It is best to do Kangaroo care for as long as possible. Once your baby is comfortable on your chest, the longer you do Kangaroo care, the better. This will help both you and your baby get the full benefits.


Preparing for kangaroo care:

  • Plan a time when you can settle in for at least 2 hours

  • Use the bathroom

  • Have a water bottle handy

  • Have a snack

  • Wear comfortable clothing. Your shirt should be able to open completely at the front, or you can use a hospital gown

  • Clean your hands

  • If you want to have your phone handy for pictures, make sure it is clean and disinfected (or be prepared to use hand sanitizer after touching your phone)

  • Try out the chair before your baby is on your chest. Are you comfortable? Do you need a pillow for your back or a stool for your feet?


Your baby’s NICU team will:

  • Make sure your baby is stable enough for kangaroo care

  • Ensure all the lines and tubes are secure

  • Guide you through the process of getting your baby into position

This excellent video from St. Boniface Hospital in Winnipeg, Manitoba, shows how even tiny babies with lines or tubes can do Kangaroo care. It shows how the NICU team—parents included — prepares a baby for Kangaroo care and then transfers the baby to a parent’s chest.


Safety tips while doing kangaroo care when your baby has lines and tubes

  • Ask for help if you feel uncomfortable and need to change positions. Your baby’s team may have secured lines and tubes to your clothing or the chair, so don’t make any sudden position changes.

  • Don’t let your baby turn their head from side to side if there is a breathing tube. If your baby needs a position change, flag down your baby’s nurse or a team member.

  • Ask your baby’s nurse how to get their attention if you need help.


When a baby is not well enough to do Kangaroo care.

Holding your baby in kangaroo care is one form of skin-to-skin contact, but it’s not the only one. If your baby is too fragile for kangaroo care, there are other ways to be close.


Ask your baby’s nurse to show you how to give your baby a “hand hug.” Hand hugging uses your hands to help your baby keep their arms and legs close to their body. Think of their position inside the womb; this position will still bring them comfort.


Using your arms to make a circle around your baby is sometimes a good option if your baby has many lines and tubes that are difficult to work around. This is sometimes called “circling” or “nesting.”


You can also place your finger in your baby’s hand for them to hold. Even small amounts of skin-to-skin contact are important for babies and parents.


This video for SickKids Hospital in Toronto, Ontario, shows hand-hugging, circling, and finger-holding.


When babies are very premature or fragile, a steady touch is best. Stroking and caressing can be too much stimulation for babies at this stage, but they will love it when they are older.


Settling into a routine of daily skin-to-skin contact (or as often as possible) is an important part of your baby’s NICU care. It may seem daunting at first, but your NICU team will be there to guide you. Talk to your baby’s nurse if you have questions about how you can give your baby skin-to-skin contact and if your baby is ready for kangaroo care.


Resources


Check your hospital’s website or ask your NICU team if they have any additional resources. This list provides a few examples, but there are many more resources out there from Canadian NICUs.


Videos

· St. Boniface Hospital (Winnipeg, Manitoba). Kangaroo Care in the Neonatal Intensive Care Unit.

· Provincial Health Services Authority (British Columbia). Kangaroo Care.


Articles and websites

· Perinatal Services BC. Kangaroo Care.



Heather Cresswell is a Neonatal Nurse Practitioner and health writer. As a nursing student in 1995, Heather discovered the NICU during a clinical placement and never looked back. She has spent her entire nursing career (more than 25 years and counting) caring for NICU patients (premature babies are her favourite!). When not caring for her tiny patients, Heather is also a health writer and is happy to contribute to the Canadian Premature Babies Foundation.

Heather lives with her family in Burlington, Ontario, and is a proud mom to one son.


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