Uppsala University, Uppsala, Sweden.
Acta Paediatr. 2010 Jun;99(6):820-6. doi: 10.1111/j.1651-2227.2010.01787.x. Epub 2010 Mar 6.
The hallmark of Kangaroo Mother Care (KMC) is the kangaroo position: the infant is cared for skin-to-skin vertically between the mother's breasts and below her clothes, 24 h/day, with father/substitute(s) participating as KMC providers. Intermittent KMC (for short periods once or a few times per day, for a variable number of days) is commonly employed in high-tech neonatal intensive care units. These two modalities should be regarded as a progressive adaptation of the mother-infant dyad, ideally towards continuous KMC, starting gradually and progressively with intermittent KMC. The other components in KMC are exclusive breastfeeding (ideally) and early discharge in kangaroo position with strict follow-up. Current evidence allows the following general statements about KMC in affluent and low-income settings: KMC enhances bonding and attachment; reduces maternal postpartum depression symptoms; enhances infant physiologic stability and reduces pain, increases parental sensitivity to infant cues; contributes to the establishment and longer duration of breastfeeding and has positive effects on infant development and infant/parent interaction. Therefore, intrapartum and postnatal care in all types of settings should adhere to a paradigm of nonseparation of infants and their mothers/families. Preterm/low-birth-weight infants should be regarded as extero-gestational foetuses needing skin-to-skin contact to promote maturation.
Kangaroo Mother Care should begin as soon as possible after birth, be applied as continuous skin-to-skin contact to the extent that this is possible and appropriate and continue for as long as appropriate.
袋鼠式护理(KMC)的特点是袋鼠式姿势:婴儿在母亲的乳房之间和衣服下方进行皮肤对皮肤的垂直护理,每天 24 小时,父亲/替代者(s)作为 KMC 提供者参与。间歇性 KMC(每天短时间一次或几次,持续数天)在高科技新生儿重症监护病房中很常见。这两种方式应被视为母婴二元体的渐进适应,理想情况下是逐渐向连续 KMC 过渡,从间歇性 KMC 开始逐渐进行。KMC 的其他组成部分是纯母乳喂养(理想情况下)和以袋鼠式姿势早期出院,并进行严格的随访。目前的证据允许对富裕和低收入环境中的 KMC 做出以下一般陈述:KMC 增强了亲子关系和依恋;减少了产妇产后抑郁症状;增强了婴儿的生理稳定性,减轻了疼痛,增加了父母对婴儿暗示的敏感性;有助于建立和延长母乳喂养时间,并对婴儿发育和母婴互动产生积极影响。因此,所有类型的环境中的分娩中和产后护理都应遵循婴儿及其母亲/家庭不分离的范例。早产儿/低出生体重婴儿应被视为需要皮肤接触以促进成熟的外生胎儿。
KMC 应在出生后尽快开始,尽可能适当地应用连续的皮肤对皮肤接触,并持续适当的时间。