Purpose for the program: For eligible mother-infant dyads, does implementation of birth KC increase breastfeeding rates as compared to retrospective breastfeeding rates?

Proposed change: Kangaroo Care (KC) or skin-to-skin contact began in 1979 in Bogota, Columbia as a way to keep infants warm and provide optimal nutrition following birth. Research has shown that KC has many benefits for mothers and babies, including increased breast milk supply and greater breastfeeding success. AAP recommends skin-to-skin contact as a strategy to increase breastfeeding success. In 2007, implementation of a KC program began for healthy infants and their mothers at University of Louisville Hospital (ULH). However, the philosophy was not adopted as a standard of care until 2010. Strategies were developed to hardwire the process and facilitate a change in practice which supported the use of KC.

Implementation, outcomes and evaluation: Current literature was examined, policies were revised, and staff expectations for participation were established. KC Champions were identified and assisted other staff with completion of KC competencies; also three staff members received certification in KC. Documentation was improved to facilitate accurate data collection. Breastfeeding and KC progress was shared monthly with staff. Breastfeeding initiation rates increased from 51% in July 2010 to 74% in July 2011.  During this time the percentage of eligible infants who were placed in birth KC increased from 60% to 73%. The percentage of mothers and infants documented as participating in KC on the Mother/Baby unit also increased from 35% to 51%. Ninety percent of the Labor/Delivery and Mother/Baby staff completed KC Competency Assessment in the twelve months following July 2010.

Implications for nursing practice: Implementation of the KC initiative improved breastfeeding rates in the population served by University of Louisville Hospital. It is essential that all levels of leadership support and monitor standard of care practice at the bedside. In addition, accurate data collection and a comprehensive educational program are vital to support the initiative. Staff accountability is crucial to any successful change in practice. Our journey continues with further education and improved practices. This quality initiative is being shared with fifty-seven birthing hospitals throughout Kentucky.

Keywords: kangaroo care, skin-to-skin contact, breastfeeding, barriers to kangaroo care