by Karen Gromada
October 06, 2010
My newest granddaughter, and first child for my son, Joe, and his wife, Mia, is asleep after a recent breastfeeding. She seems blissfully unaware that she and her Daddy made a bit of history within minutes of her birth last month. Because she was a first baby and she remained in a breech position, Alice arrived via surgical (cesarean) delivery. Mia had planned for an unmedicated birth and, after reading about the many benefits of Kangaroo Mother Care (KMC) for the full-term newborn, she was determined to initiate skin-to-skin contact with her baby immediately after the birth. A cesarean birth meant Mia would be medicated, and it also meant Alice would have to wait 30 to 60 minutes before she and her mother could enjoy KMC.
KMC was recently in the news for saving the life of a preterm twin. This was not the first time KMC was reported to have such an impact on a baby (and mother). Benefits of KMC for preterm infants have been well-documented in studies completed over the last decade or two. Researchers have begun to study KMC with full-term, healthy newborns in the period immediately after birth. Most recently, researchers in Sweden found that babies born surgically and placed skin-to-skin with either parent immediately after birth responded to a parent’s voice by crying or whining, sooner than babies placed nearby but not skin-to-skin.
Benefits of skin-to-skin contact
The high-touch, low-tech skin-to-skin contact of KMC helps stabilize a newborn’s body temperature, heart and breathing rates, and blood sugar levels as well or better than high-tech interventions, such as radiant heat warmers. Plus, only KMC lowers the stress hormone, cortisol, and causes the release of oxytocin and beta-endorphins, hormones which have a calming effect in both mothers and babies.
As a proponent of KMC for full-term babies immediately after birth, I was thrilled that Mia’s birth plan included KMC and I shared her disappointment that it would have to be delayed. However, I remembered reading a small study that found father-baby skin contact—or as I call it, Kangaroo Daddy Care—provided a newborn with many of the same benefits experienced through mother-baby skin contact. In this study, the babies who were placed skin-to-skin on their fathers’ chests immediately after birth calmed sooner, cried less, and were more likely to show an interest in breastfeeding. After sharing the study with my daughter-in-law she decided that my son (her husband) would be the provider of skin-to-skin contact as soon as Alice was born.
Making a case for Kangaroo Daddy Care
Since Kangaroo Daddy Care after delivery seemed to have only benefits and no risks for any member of this new family, telling her obstetrical care providers that she and my son wanted to change the birth plan to allow immediate father-daughter skin contact should have been a slam-dunk; but Mia was told no. The reason? Kangaroo Daddy Care wouldn’t be possible in an operating room since they couldn’t allow a father to be shirtless in the operating room (OR). Later, the labor and delivery nurse reminded us that there would be no skin-to-skin contact in the OR. I was with Mia during the admitting process, so I asked, “For what reason should they deprive a newborn of the physical and emotional benefits of immediate Kangaroo Daddy Care?” The nurse said other staff would be concerned about sterility, at which point, as a former labor and delivery room nurse and wife of an obstetrician, I had to laugh. I knew that very little of an OR is sterile! I mentioned that it would be much safer for this newborn to get bacteria from her Dad’s chest than from the other items in the room. I also suggested my son could wear a patient or surgical gown backwards, which could be tied in the front so toplessness would not be an issue.
My persistence paid off. After a few minutes the nurse offered an alternative: once Alice was delivered and her mother had had a chance to see her, the baby, my son, and the nurse could go to the “recovery” room to do Kangaroo Daddy Care until my daughter-in-law could join them. However, once my son and their baby left the OR, neither would be able to re-enter. We all looked to Mia, whose mind was already made up; she wanted her baby to have skin-to-skin contact with a parent as soon as possible after her birth. I left for the waiting room feeling satisfied with the compromise.
And then, things just got better.
Upon delivery, my son was allowed to initiate skin-to-skin contact in the delivery room. The nurse asked my son to tear the front of his paper scrub suit top down the middle and little Alice was placed skin-to-skin on his chest. He also wore a paper surgical gown backwards, which he closed around both of them. He held her while sitting in a chair in sight and touch of Mia. Once Mia was moved from the OR to a hospital bed, about 30 minutes after birth, Alice was placed skin-to-skin with her mother. From birth to discharge (and once home), much of little Alice’s first week has been spent skin-to-skin with a parent.
History was made
Upon discharge, we learned that Alice and her daddy made history at the hospital—a hospital that has more than 10,000 births each year. Joe and Alice were the first to do Kangaroo Daddy Care during a surgical birth—but we’re hopeful they won’t be the last. No newborn should miss out on kangaroo parent care due to surgical births or other birthing complications. For newborn safety and stabilization, kangaroo parent care in the OR is not a strategy that should be allowed only if parents (or grandparents) ask (or in my case, insist). Parent-newborn skin contact immediately after birth should be encouraged and needs to be considered a standard practice in newborn care.
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