The national indications of the Italian Society of Neonatology, on the occasion of the world day of Kangaroo care which is celebrated on May 15
For those who became a parent in the 90s, the experience of rooming in (the practice that provides for the stay of the child in the same room as the mother immediately after delivery) and that of the Kangaroo Care (skin-to-skin contact between mom or dad and newborn, which has been introduced since 1978)
seemed like a real revolution. Perhaps more for dads, since that unique feeling of first contact with the newborn baby was more common for mothers. Promoted by both the World Health Organization (WHO) and Unicef, both models have become common heritage of Neonatology.
The importance of shared protocols in Neonatology
The benefits of the therapy have been certified by international studies. On the occasion of the World Kangaroo Care Day, which has been celebrated on May 15th since 2011the Italian Society of Neonatology (SIN), emphasizes the extreme importance of shared protocols for KC within the birth pointsstructural elements that allow this activity to be carried out in the best possible way and the need for refresher courses regularly repeated over time for all health professionals. The Sin Neonatal Care Study Group, which for several years has been carrying out a widespread promotion of KC, recently conducted a survey among the Italian neonatal intensive care units.
The analysis of the collected data allowed the realizationin collaboration with a multidisciplinary working group, made up of doctors, nurses, physiotherapists and representatives of the national coordination of parents’ associations, from
indications national specifics on Kangaroo Careaimed at the care of all newborns hospitalized in Neonatology and NICU and at the disposal of all operators.
The many positive effects
Kangaroo carefundamental for the correct development of premature babies, represents a real therapy, which, compatibly with the clinical conditions of mother and newborn, must be implemented immediately explains Dr. Paola Cavicchioli, secretary of the Care study group. Skin-to-skin contact, in fact, facilitates adaptation and stabilization of the baby at birth, reduces procedural pain response, helps thermoregulation of the newborn, improves oxygenation, heart rate variability and stabilizes respiratory activity. , moreover, able to reduce stress in the newborn and to promote the organization of sleep-wake states and also has neuro-protective, social and behavioral benefit effectsfound up to 20 years after birth.
A stepping stone to breastfeeding
Kangaroo Care represents a real springboard towards breastfeeding, thanks to an early approach to the breast, increasing this important practice even after discharge and in the following months. Due to the health emergency from Covid-19, many Italian hospitals have put in place health care routines that hinder access to neonatal intensive care units and therefore also the parent-child relationship and Kangaroo Care.
Intensive care still off-limits to parents
Unfortunately, although the epidemic situation has changed, in some structures there are still limitations today. My personal appeal, as a neonatologist and Sin president, goes to the medical managers of the maternal-infant area and then to the health directors, says Dr. Luigi Orfeo. a priority is to review the current procedures within many departments, re-establishing the presence of parents 24 hours a day and all those practices aimed at facilitating the relationship of the mother-father-newborn triad, such as skin to skin, direct attachment to the breast and rooming-in. We must not forget that parents are an integral part of caring for premature babies and therefore their contribution is necessary for the psycho-physical well-being of the newborn.
The online event on May 13th
To find out everything about the world of Kangaroo Care, on Friday 13 May, the Italian Society of Neonatology e Living Onlus they organized a free online event entitled Reflections on proximity: the value of contactfrom 17 to 19. The President of SIN Luigi Orfeo, Paola Cavicchioli, Secretary of the Study Care Group, Martina Bruscagnin and Monica Ceccatelli of Vivere Onlus will speak, together with other experts (to register https://bit.ly/3yhrRDH).
The national indications of the SIN
The KC indicated in all stable newborns, in the absence of absolute contraindications and in all newborns with relative contraindications, after medical evaluation. It can be performed in NICU, subintensive and in neonatal pathology. The baby may be in an incubator, heated open bed or cot. Skin-to-skin contact is also recommended for hospitalized full-term infants. The Kangaroo Care it can be offered by all healthcare professionals and by the parent himself. The preparation and accompaniment of the family must not be neglected, valuing their skills, not forgetting that the time that the operators dedicate to relationships and communication is also a time of care. KC should be continued until dischargewith sessions repeated several times a day and lasting more than 60 minutes, to have an advantageous cost / benefit ratio.
The KC it must be able to take place in absolute tranquility without time constraints. It takes time for the child to adapt to the mother or father and vice versa, for this it is necessary that free access to the ward for parents 24 hours a day must be allowed and offered. Early approach to the breast requires timely and well-coordinated interventions. The newborn can be helped progressively to approach the breast to receive pleasant sensory experiences and to be able to latch onto the breast with effective sucking over the days. it is always good to consider the sleeping state of the newborn and possibly protect the quiet sleep, implementing the most careful handling possible to avoid waking up.
Taking care of the macro-environment (temperature, noises, lights) helps to make the KC session place calm and comfortable. In the same way, the methods of transfer from the incubator / thermal cot to the parent’s chest and vice versa are fundamental. At the end of the session, it is advisable to discuss with the parentencouraging and supporting his commitment, without forgetting to answer his questions. The KC in all respects is a therapy and as such it is important that it be reported in the filespecifying all useful information, including the start and end times of each session.
May 13, 2022 (change May 13, 2022 | 15:31)
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