Introduction
Complications of preterm birth serve as one of the most important issues in neonatal medicine. The number of newborns dying each year is 2.7 million, which accounts for a total of 44% of children dying before they have chance to turn five worldwide (Chan, Labar, Wall, & Atun, 2016). A number of academic studies have demonstrated the efficacy and long-term health benefits of continuous skin-to-skin contact between a mother and her premature infant. This process is known as kangaroo mother care, or KMC.
The KMC practice was established in California in 1978 (Mekonnen, Yehualashet, & Bayleyegn, 2019). It may include kangaroo position (close skin-to-skin contact), breastfeeding, and timely discharge with supportive care. These procedures are believed to be beneficial to the health of a newborn since they create an optimal environment for the child’ adaptation.
According to Mekonnen et al. (2019), KMC plays “a significant role on infant survival, neurodevelopment, and the quality of mother-infant bonding” (para. 6). It is apparent that kangaroo care can reduce mortality and death in premature newborn if widely applied by medical professional.
Despite the efficacy of KMC, the adoption of the practice has been limited, which is why the global coverage remains low. The lack of a standardized definition of KMC makes its implementation difficult. The studies reveal that kangaroo mother care is a complex procedure, which consists of various components, including close contact, breastfeeding, early discharge, and various follow-ups (Chan et al., 2016). This review is going to focus on the incorporation of skin-to-skin contact and its effects on a newborn’s stabilization and further development.
PICO(T) Question
Preterm infants serve as the population, while the suggested intervention is kangaroo mother care. It implies prolonged skin-to-skin contact between the mother and the baby. There is going to be a comparison of KMC and a complete absence of kangaroo care. The expected outcome of the research is positive, based on the presented evidence.
When the mother is involved in providing KMC to her preterm infant, it positively affects vital signs, behavioral development, pain occurrence, and overall health of the baby. Therefore, the research is going to be centered on the following PICO question: In preterm infants (P), how does KMC (I), compared to a lack of direct skin-to-skin contact (C), affect the infant’s stabilization, behavioral development, and overall health (O)?
Purpose Statement
The purpose of this critical appraisal paper is to review primary scholarly sources in order to assess the effectiveness of kangaroo mother care. This review aims to analyze the physical and psychological impact of KMC. The studies mentioned in the paper examine the physiological functions, sleep patterns and pain management mechanisms of premature infants introduced to kangaroo care. In particular, the main objectives of the paper include:
- To analyze the effects of KMC on premature newborns’ physiological functions.
- To identify the impact of skin-to-skin contact on pain relief among preterm infants.
- To determine the effectiveness of kangaroo care on maternal stress and mother-infant attachment.
Major Concepts/Themes
The major theme of this paper is the implementation of kangaroo care into the established medical care frameworks for preterm infants. KMC can be administered at three main levels:
- Mothers, fathers, and families
- Healthcare professionals
- Medical institutions (facilities)
The key concepts discussed in the review include skin-to-skin contact, preterm infants’ sleep patterns, neonatal pain, and maternal-infant attachment. In order to critically evaluate the studies chosen for this paper, the evidence is categorized according to the table by Polit & Beck (2012).
Critique of Research
All of the studies chosen for the critical appraisal paper are random control trials (RCTs). The study conducted by Cho et al. (2016) is the only one, where participants were not randomly assigned to the groups (control vs. experiment). Therefore, it has a mixed design and cannot be considered a random control trial. Still, all of the research presented in the paper as evidence can be categorized as the second (II) level.
Support for Concept/Innovation
Kangaroo mother care may be one of the most effective and flexible nursing interventions for the care of premature infants and their mothers. KMC is beneficial for a newborn’s stabilization and further development.
Conclusion
The paper suggests that kangaroo care has numerous positive effects on the physiological functions of premature babies. Moreover, the practice of KMC can serve as an essential intervention to facilitate maternal-infant attachment and reduce the levels of stress among mothers.
References
Bastani, F., Rajai, N., Farsi, Z., & Als, H. (2016). The effects of kangaroo care on the sleep and wake states of preterm infants. Journal of Nursing Research, 25(3), 231-239. Web.
Campbell-Yeo, M., Johnston, C. C., Benoit, B., Disher, T., Caddell, K., Vincer, M., … Inglis, D. (2019). Sustained efficacy of kangaroo care for repeated painful procedures over neonatal intensive care unit hospitalization: a single-blind randomized controlled trial. The Journal of the International Association of the Study of Pain, 160(11), 2580-2588. Web.
Chan, G. J., Labar, A. S., Wall, S., & Atun, R. (2016). Kangaroo mother care: a systematic review of barriers and enablers. Bulletin of the World Health Organization, 94(2), 130-141. Web.
Cho, E.-S., Kim, S.-J., Kwon, M. S., Cho, H., Kim, E. H., Jun, E. M., & Lee, S. (2016). The effects of kangaroo care in the neonatal intensive care unit on the physiological functions of preterm infants, maternal–infant attachment, and maternal stress. Journal of Pediatric Nursing, 31(4), 430-438. Web.
Mekonnen, A. G., Yehualashet, S. S. & Bayleyegn, A. D. (2019). The effects of kangaroo mother care on the time to breastfeeding initiation among preterm and LBW infants: a meta-analysis of published studies. International Breastfeeding Journal, 14(12). Web.
Seo, Y. S., Lee, J., & Ahn, H. Y. (2016). Effects of kangaroo care on neonatal pain in South Korea. Journal of Tropical Pediatrics, 62(3), 246-249. Web.