Uppsala University, Uppsala, Sweden.
Acta Paediatr. 2010 Jun;99(6):812-9. doi: 10.1111/j.1651-2227.2010.01794.x. Epub 2010 Mar 8.
Since Kangaroo Mother Care (KMC) was developed in Colombia in the 1970s, two trends in clinical application emerged. In low income settings, the original KMC model is implemented. This consists of continuous (24 h/day, 7 days/week) and prolonged mother/parent-infant skin-to-skin contact; early discharge with the infant in the kangaroo position; (ideally) exclusive breastfeeding; and, adequate follow-up. In affluent settings, intermittent KMC with sessions of one or a few hours skin-to-skin contact for a limited period is common. As a result of the increasing evidence of the benefits of KMC for both infants and families in all intensive care settings, KMC in a high-tech environment was chosen as the topic for the first European Conference on KMC, and the clinical implementation of the KMC model in all types of settings was discussed at the 7th International Workshop on KMC. Kangaroo Mother Care protocols in high-tech Neonatal Intensive Care Units (NICU) should specify criteria for initiation, kangaroo position, transfer to/from KMC, transport in kangaroo position, kangaroo nutrition, parents' role, modification of the NICU environment, performance of care in KMC, and KMC in case of infant instability.
Implementation of the original KMC method, with continuous skin-to-skin contact whenever possible, is recommended for application in high-tech environments, although scientific evaluation should continue.
自 20 世纪 70 年代袋鼠式护理(KMC)在哥伦比亚发展以来,临床应用出现了两种趋势。在低收入环境中,实施了原始的 KMC 模式。这包括持续(每天 24 小时,每周 7 天)和延长母婴皮肤接触;婴儿采用袋鼠式体位及早出院;(理想情况下)纯母乳喂养;以及充分的随访。在富裕环境中,间歇性 KMC 较为常见,即母婴皮肤接触 1 或几个小时,持续时间有限。由于越来越多的证据表明 KMC 对所有强化护理环境中的婴儿和家庭都有益,因此选择在高科技环境中进行 KMC 作为第一届欧洲 KMC 会议的主题,并在第 7 届 KMC 国际研讨会上讨论了在所有类型的环境中实施 KMC 模式的问题。高科技新生儿重症监护病房(NICU)中的袋鼠式护理方案应规定启动、袋鼠式体位、转移至/离开 KMC、袋鼠式体位转运、袋鼠式营养、父母角色、NICU 环境调整、KMC 中的护理操作以及婴儿不稳定时的 KMC 等方面的标准。
建议在高科技环境中实施原始的 KMC 方法,尽可能保持持续的皮肤接触,尽管应继续进行科学评估。