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In Response: Why Do We Recommend Kangaroo Care to New Mothers?

In Monday’s post from the blog site, Expecting Words, came this suggestion, following the description of a friend of hers who had recently been encouraged to have her baby room in and conduct skin-to-skin newborn care rather than have the baby cared for in the hospital nursery:

…I am shocked at this likely cost-cutting scenario billed as natural mothering.  This was her second birth at this major NYC hospital.  The first time, they had a nursery and she could have some rest.  I can only imagine what a first-time mother feels as she endures her two days in the hospital believing that the nurses must be right and that any time her baby is crying it’s because she hasn’t done enough skin-to-skin contact.  What a set-up for baby blues and postpartum depression.

Wow.  I am sad to think of the women who might read this and believe that their local hospital, in an effort to do something right for moms and babies would be motivated only by budgetary cost-cutting.

Skin-to-skin care, otherwise known as kangaroo care, fosters so much more than relief of work on the hospital nursing staff.  Babies kept skin-to-skin remain more stable in terms of body temperature, heart rate and stress hormone levels.

Studies also repeatedly show that newborns attended to via kangaroo care cry less and breastfeed with greater success.  Not only do infants held skin-to-skin frequently benefit, but mothers do too.   Women utilizing kangaroo care are generally calmer and more relaxed during their interactions with their babies, and report less depressive symptoms than women who do not employ kangaroo care.

My guess is, the hospital mentioned in Expecting Words’ post may have either been working on, or recently achieved Baby Friendly Designation from the  Baby Friendly Hospital Initiative, USA (a program sponsored by both the World Health Organization and UNICEF)  and possibly the Mother-Friendly Childbirth Initiative endorsement from the Coalition for Improving Maternity  Services.  These initiatives are ALL ABOUT improving care and the overall childbearing and early parenting experiences of not only the baby, but the mother as well.  Common sense tells us that a well cared for, well educated woman, in terms of immediate postpartum self care and newborn care, will more likely translate into a calmer, happier, more successful mother.  And a happier baby, to boot.  That’s what kangaroo care is about.  That’s what the initiatives described above are about.  And, I’m guessing, that’s what the woman’s experience described in this post was all about.

I, for one, am thankful for the hospitals which are beginning to look seriously at these issues, and move forward to implement practices and policies that are both mother and baby friendly.

And on that note…Happy Thanksgiving to all!

Practice Guidelines, Science & Sensibility , , , , , , ,

  1. November 24th, 2010 at 08:36 | #1

    Hello! This is Laurie, the blogger who wrote the original post you are commenting on. I want to make sure my words are not misinterpreted, so let me clarify.

    The mother was not encouraged to keep her baby in the room, she was required. No choice because the hospital does have a well-baby nursery. However, the mother was in a shared room and not permitted to have anyone stay the night. Plus the bed is a standard hospital bed, not made for sleeping with a baby. Also, she was not aware of the hospital’s pure rooming in policy until she was already there.

    So, overall, I think it is fair to say that if the hospital intends to fulfill the mission of the initiatives you mentioned, that there would be other factors that must change as well. And, the decision should be very public so people who want to sleep from 3am to 6am with the baby in the nursery, have that choice.

    I’m all for skin-to-skin contact, but it should be encouraged in a way that is reasonable and helpful, not authoritarian.

  2. November 24th, 2010 at 08:36 | #2

    Oops, I meant does “not” have a well-baby nursery.

  3. November 24th, 2010 at 09:08 | #3

    @ Laurie: I think you’re hitting on an important point here: for hospitals which aim to incorporate Mother Friendly & Baby Friendly practices (again, I’m postulating here that that is what was going on in the anecdote you shared) patient education is crucial. It would truthfully take very little time for a staff member to explain to mothers why they are encouraging rooming in (see reasons mentioned in my post) so that women do not leave feeling as though they were “forced” to do something against their will. Exacting good health and well-being-promoting practices only goes so far as the education that accompanies those practices. “Forcing” a baby to remain in-room with the mother without teaching kangaroo care, responding to the infant’s early hunger cues, etc., etc. is simply falling short of educational opportunity.

  4. November 24th, 2010 at 10:10 | #4

    I’m glad Laurie commented back to clarify, her position makes more sense. Still, I think non-optimal rooming-in is better than the alternative. And I love that the things that make the most sense often result in reducing costs; if that’s what motivates hospitals in the end, fine.

  5. November 24th, 2010 at 16:44 | #5

    I also get what Laurie is saying – that 1) it should be a choice, and 2) this hospital was not exactly mama friendly if partners could not stay the night to help.
    Several of the worst hours of my life occurred on that night of my son’s birth when he was in the NICU and we were forced to leave him there alone – there is no way on this Earth that I would have let him out of my sight otherwise, he would have stayed with me every moment.

    This smacks of a lack of patient education. Hospitals and healthcare providers should do more to educate women about the many benefits of natural birth, kangaroo care, exclusive breastfeeding – these things should be the norm, and women should know exactly what they are opting out of when they choose to do otherwise.
    The sentence about “natural mothering is being ‘forced’” on someone made me very sad, because really, consider the choices we are making in the alternative – and often those choices are made without full information. (For example – it is one thing to thoughtfully choose formula after knowing all of the facts and risks, or after having made attempts and being unable to breastfeed; it is another to refuse to even consider/learn about breastfeeding or even worse, to never have anyone present you with information pertinent to the decision.)

    Personally, I think the real problem in the US today is that needless interventions and non-optimal parenting choices are being “forced” on women by providers who are too busy to educate, by a lack of well-trained LC’s, and by the bottom line being money over preventative healthcare.
    But again, let me reiterate – parenting choices shouldn’t be forced, I agree with the author of the original post. There should, however, be more education so that all possible alternatives are actually *choices.*

  6. November 24th, 2010 at 16:58 | #6

    Laurie, I’m so glad you wrote in to clarify what was going on. Mothers have a reputation as getting into wars over parenting styles, and it’s so easy to see how a miscommunication here would make people think the mother was unconcerned and didn’t want to spend time with her newborn child. When you give the full scenario, I can imagine how uncomfortable it would be to stay in a shared room for two nights with a stranger, without support from your loved ones, and feel isolated while taking care of your new child.

    I’m an advocate for natural parenting methods and agree with the post that spending time with your new baby produces calming hormones that reduce the incidence of depression, dealing with that setup would be very stressful and trying. All maternity caregivers should look at the whole picture to provide a supportive environment for mothers and babies.

  7. avatar
    Indie
    November 24th, 2010 at 22:06 | #7

    And patients like that mother should be educated on the studies that show that sending your baby to the nursery does not actually increase sleep for mom. The quote implies that sending the baby away is the way to get some rest, but the studies don’t really bear that out. I’ve found that moms that actually keep their babies with them begin to learn to care for their babies while they still have a little button they can push for help. They can either do it then or do it when they get home where unfortunately they are often on their own.

  8. avatar
    Cherie
    November 25th, 2010 at 11:52 | #8

    I am saddened that any mom wouldn’t naturally want their baby with them… not alone in a nursery….

  9. avatar
    Erin
    November 28th, 2010 at 09:56 | #9

    To me the biggest problem with the story in question is that the hospital doesn’t permit a partner to stay the night. I never let my babies leave my room postpartum & don’t like nurseries, but it is actually kind of cruel to make all postpartum women act as sole caretakers of new babies immediately after giving birth, regardless of their physical condition. Some women have Csections or significant tearing that can make caretaking the baby VERY painful. This isn’t about a mom who just didn’t want to be around her baby! Mother-baby friendly initiatives need to support mothers by making sure they have access to support people whenever possible. Birth is exhausting and taking care of a brand new baby can be really difficult.

  10. November 29th, 2010 at 14:23 | #10

    Promoting kangaroo care is wonderful — I fully believe in the power of skin-to-skin contact. I am against, however, not offering any options for new mothers who want a little time away from their newborns, as was the case with the hospital in Laurie’s story.

    You should consider the voluminous comments I received when I wrote about Laurie’s piece here: http://www.postpartumprogress.com/weblog/2010/11/should-new-moms-be-required-to-keep-babies-in-hospital-room.html

    Without any doubt, it was one of the most powerful reader responses I received all year (and the comments you see don’t even include all of the add’l comments on Facebook). Women who’ve had perinatal mood and anxiety disorders know that each mother is different, and may have different needs. Fulfilling a new mother’s needs, even if that includes some time away from her baby for her own mental health, can be as important to the long-term health of that baby as it is to the health of the mother.

  11. November 29th, 2010 at 14:28 | #11

    @Indie
    I’m not sure that the only reason mothers send their babies to the nursery is for full-on sleep, which is what the studies mention looked at. Some mothers just need rest in terms of some quiet time, or alone time, or a mental break.

    I don’t think that just because some studies found that moms get better sleep with their babies in the room we can then make the leap to the concept that therefore hospitals don’t need nurseries.

  12. avatar
    Roberta Scaer
    December 10th, 2010 at 14:20 | #12

    I believe it is a good thing when hospitals make normality the default setting for birth and postpartum care. Newborns need their mothers’ bodies for nourishment, comfort and temperature regulation. Choice would come in if a women needed/wanted a diferent arrangement. She would then request it during her stay.

    Roberta M. Scaer
    co-author, A Good Birth, A Safe Birth

  1. December 16th, 2010 at 15:35 | #1