In 2009, the Lakewood Hospital Birthing Center embarked on the journey to obtain Baby Friendly, USA designation.  It was identified that a key component for a successful journey was the implementation of Kangaroo Care (KC) or skin-to-skin care in the immediate post birth period.  In the fall of 2009, the Birthing Center began training for the nurses in KC and implementation soon followed

Proposed change:

Our goal was that all appropriate infants would be placed in KC shortly after birth and would remain with their mother or the mother’s support person for 60 to 90 minutes.  The time in KC with the mother would facilitate transition to extrauterine life and allow the infant to self latch at the breast.

Implementation, outcomes and evaluation:

Nursing leadership worked with a nationally recognized expert on KC to provide education to the nurses.  A four hour program on KC was developed and included discussion of the benefits, infant placement and ongoing care of the infant including assessment.   There was a re-demonstration of placing the infant in KC to validate understanding.  The electronic health record was modified to include documentation of time in and out of KC and with whom the infant was in KC.   Patient education included handouts on KC for distribution during prenatal appointments, prepared childbirth classes and breastfeeding classes.  Kangaroo Care is also discussed during tours of the Birthing Center.  Pediatric, midwifery, obstetric, and anesthesia providers were educated about KC and the Birthing Center’s change in the model of care immediately following birth.  As barriers were identified, nursing leadership worked on the issues to minimize interruptions of KC. 

            The percentage of appropriate infants in KC following birth is reviewed monthly.  Between 90%-98% of appropriate infants are placed in KC.   Infants are also placed in KC shortly after a Cesarean birth while the mother remained in the operating room.  Anecdotally, Lactation Consultants report decrease incidence of delayed latch and breastfeeding problems. Families have reported increased satisfaction with their birthing experience. 

Implications for nursing practice:

Kangaroo Care assists the infant with transition and facilitates initial breastfeeding.  KC is beneficial to infant, mother and family.  KC is utilized throughout the hospital stay.  Families are encouraged to continue KC at home especially in conjunction with breastfeeding.   The use of KC is truly a nursing intervention. This nursing intervention quickly became a model of care for the Birthing Center. 

Keywords: Kangaroo Care, Infant, Childbirth, Breastfeeding