Note the baby hug “kangaroo care” immediately after birth
“Kangaroo care” where a mother holds a newborn baby. It is said to have the effect of strengthening the bond between mother and child and facilitating breastfeeding, but we must take care because the baby’s physical function is unstable. Sometimes, the condition suddenly changed during care, and a lawsuit was filed for the remaining disability. It required the maternity facility to give due consideration to safety, such as observing the state of care.
Birth Care for Newborns – Kangaroo Care
Kangaroo care is a childcare method in which a mother holds her baby in her chest and brings her skin into contact with each other. They named it because its appearance is reminiscent of kangaroo parenting. It started in Colombia, South America, which suffers from a shortage of incubators in the 1970s, and was first implemented in Japan in 1995 at a hospital in Yokohama.
It is said that kinship has the effect of stabilizing the baby’s breathing and maintaining body temperature, and strengthening the bond between mother and child promotes breastfeeding. Initially targeted for babies who are born small because of premature birth and enter the neonatal intensive care unit (NICU), the World Health Organization (WHO) applies it to babies who have a term birth (37-41 weeks gestation) in 1996.
Instability of body function
Is kangaroo care safe? Many experts say that the care itself is not dangerous, and that “babies are unstable in their physical function. Care requires careful observation by the institution.”
According to Takahiko Kubo, Deputy chairperson of the Japanese Society of Perinatal and Neonatal Medicine and Director of Obstetrics at the National Center for Growth Medicine (Setagaya, Tokyo), the time when the baby adapts to sudden changes outside the womb immediately after birth. It is said that about 10 out of 10,000 people have serious cases such as being unable to breathe on their own.
According to a survey conducted by Dr. Kubo and others from 585 facilities nationwide in 2010, 65.4% provided kangaroo care. Twenty-one of the 138,534 babies was in a sudden change during care. When converted to about 1.5 people per 10,000 people, Dr. Kubo says, “It cannot be said that sudden changes in physical condition are likely to occur due to care.”
The survey also revealed deficiencies such as facility safety measures. Healthcare workers were stationed at 74.8% of the facilities during care, but the monitoring implementation rate for coping with sudden changes was only 49.9%. 30.7% of the facilities have manuals, and 39.9% set the criteria for suspension / cancellation. Before the implementation, the percentage of pregnant women who explained in advance and got their consent was 48.2%, which was less than half.
Dr. Kubo said, “Care itself is safe and there is no problem, but the facility must know the condition of newborn babies changes suddenly. It is necessary to have sufficient observation and management system in place.”
In August of this year, the Japanese Perinatal and Neonatal Medical Society put together a proposal to change the term kangaroo care for term-born babies to “early mother-child contact.” The reason is that the image of “safety” is walking alone from that feeling. It also points out points to keep in mind when implementing it, and plans to propose it to production facilities nationwide with the consent of related organizations and academic societies.
According to the Society, postnatal care is different for babies who enter the NICU because of premature birth and for term babies. The academic society proposal distinguishes the former by calling it kangaroo care and the latter as early mother-child contact.
Points to keep in mind for early mother-child contact are: ▽ Explain in advance ▽ Confirm the intention of implementation with the mother ▽ The person in charge will accompany you to check the respiratory condition, etc. It also shows the posture of mother and child to interact with each other and the criteria for discontinuation.
Besides these points, the facility side needs to provide care based on each situation. Around 2000, the Katsushika Red Cross Maternity Hospital (Katsushika, Tokyo) created its own manual that shows detailed procedures, such as setting the room to 25-27 degrees and making sure that the baby’s nose and mouth are not blocked. Deputy Director Shunji Suzuki said, “It is desirable that doctors, nurses, and midwives work together to create this so that we can share firmly it in the field.”