The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial

Abstract

Background. The method of skin-to-skin contact (kangaroo care [KC]) has shown physiologic, cognitive, and emotional gains for preterm infants; however, KC has not been studied adequately in term newborns. Aims. To evaluate the effect of KC, used shortly after delivery, on the neurobehavioral responses of the healthy newborn. Study Design. A randomized, controlled trial using a table of random numbers. After consent, the mothers were assigned to 1 of 2 groups: KC shortly after delivery or a no-treatment standard care (control group). Subjects. Included were 47 healthy mother-infant pairs. KC began at 15 to 20 minutes after delivery and lasted for 1 hour. Control infants and KC infants were brought to the nursery 15 to 20 and 75 to 80 minutes after birth, respectively. Results. During a 1-hour-long observation, starting at 4 hours postnatally, the KC infants slept longer, were mostly in a quiet sleep state, exhibited more flexor movements and postures, and showed less extensor movements. Conclusions. KC seems to influence state organization and motor system modulation of the newborn infant shortly after delivery. The significance of our findings for supportive transition from the womb to the extrauterine environment is discussed. Medical and nursing staff may be well advised to provide this kind of care shortly after birth.

Examining the role of endogenous opioids in learned odor–stroke associations in infant rats

“…Such treatment in nondeprived rats significantly alters hormones (particularly those involved in stress responses) and gene expression, and in deprived pups is sufficient to reverse many of the neural and behavioral severities generated by maternal separation (Jutapakdeegul, Casalotti, Govitrapong, & Kotchabhakdi, 2003;Lucion, Pereira, Winkelman, Sanvitto & AnselmoFranci, 2003;Schanberg & Field, 1987;van Oers et al, 1998). In humans, stroking and skin-to skin contact causes positive changes in the neonate's physiology and behavior, especially in preterm or low-birth weight infants (Anisfeld, Casper, Nozyce, & Cunningham, 1990;Bystrova et al, 2003;Ferber & Makhoul, 2004;Pelaez-Nogueras, Field, Hossain, & Pickens, 1996;Schanberg & Field, 1987;Vickers, Ohlsson, Lacy, & Horsley, 2000). Overall, these studies demonstrate the importance of maternal tactile stimulation in normal infant development.…”

The development of potentially better practices to support the neurodevelopment of infants in the NICU

“…209,210 There has been early concern that spontaneously breathing premature infants might be at higher risk for physiologic instability. 211 However, extensive evidence has established its safety for use in premature infants as an intervention that promotes neurobehavioral development, [212][213][214][215] with recommendations for implementation in physiologically stable newborns or greater than 33 weeks gestation. 216 A systematic review has demonstrated a decrease in clinical morbidity and improved weight gain, although criticisms of study design still do not allow for a recommendation for implementation.…”

“…212 Kangaroo care/skin to skin contact improves newborn state organization, and perceptual-cognitive and motor development. 214,[217][218][219] It may improve physiologic stability, 216,[220][221][222] with lower infant activity level and diminished signs of discomfort, pain or stress, although salivary cortisol as a marker of stress suggested variable infant stress response. [222][223][224] Infants demonstrate more mature sleep patterns with decreased periods of arousal and longer periods of QS and less AS, 214,217,218,222,225 and significantly decreased periods of arousal during QS There have been conflicting reports of improved weight gain and decreased length of stay 226 as well as no demonstrable difference.…”

“…214,[217][218][219] It may improve physiologic stability, 216,[220][221][222] with lower infant activity level and diminished signs of discomfort, pain or stress, although salivary cortisol as a marker of stress suggested variable infant stress response. [222][223][224] Infants demonstrate more mature sleep patterns with decreased periods of arousal and longer periods of QS and less AS, 214,217,218,222,225 and significantly decreased periods of arousal during QS There have been conflicting reports of improved weight gain and decreased length of stay 226 as well as no demonstrable difference. 220,222,227 Maternal benefits include improved parental infant attachment, improved maternal mood including feelings of self-confidence and less stress, 219,220,223,228 increased knowledge and comfort with their infant, increased maternal milk production and breast feeding.…”

Family-Centered, Evidence-Based Phototherapy Delivery

“…Multiple studies have shown that skin-to-skin contact provides thermoregulation to infants. 14,15 In term infants it helps with neurobehavioral adaptation and has a beneficial effect on the neurophysiologic organization of the developing brain; kangaroo care infants spend more time in quiet sleep states and less time in fussy or crying states. 15 Kangaroo care reduces morbidity and mortality, and at 6 months' corrected age, the infants scored higher on the Bayley Mental Developmental Index.…”