Closa Monasterolo R, Moralejo Benéitez J, Ravés Olivé M M, Martínez Martínez M J, Gómez Papí A
Unidad Neonatal, Hospital Universitario de Tarragona Joan XXIII.
An Esp Pediatr. 1998 Nov;49(5):495-8.
More and progressively smaller preterm infants are taken out of the incubator and placed skin-to-skin (kangaroo care) on their mother's chest to promote bonding and breastfeeding. The aim of our study was to know the tolerance to kangaroo care and its security for preterm infants and their mothers, as well as its relationship to breastfeeding.
We studied 445 sessions of 38 stable preterm newborns in our Neonatal Intensive Care Unit (NICU). Their mean birth weight was 1,452 +/- 415 g and gestational age 31.5 +/- 2 weeks (mean +/- SD). The preterm infants, dressed in a diaper and cotton cap, were placed in skin-to-skin contact between their mother's breasts in an upright position and covered with a towel. The kangaroo care duration, temperature, heart rate, respiratory rate, StcO2, and the mother and infant behavioral responses were recorded. During kangaroo care, the preterm infants were nourished by their mother's milk directly by breastfeeding or by intermittent tube feeding, depending on their sucking reflex. The kangaroo care lasted 30-90 minutes, one to eight times a day depending on the availability of the mother.
During the kangaroo care, body temperatures, heart rate, respiratory rate and StcO2 remained stable. In the majority of cases, In the majority of cases, the preterm infants showed conduct patterns that indicated good tolerance toward this method, including open hand, sleeping, alert tranquility and even smiles. The breastfeeding sessions were longer than normal because the premature infants alternated short periods of sucking with longer sleep periods. Mothers participated actively looking, talking, touching, smiling and even playing with their preterm infants.
Kangaroo care is a safe and well-accepted method for preterm infants admitted to a NICU and their mothers. Intermittent kangaroo care does not allow for breastfeeding by demand, therefore with the smallest preterm infants, we are obligated to supplement feeding with the mother's milk by tube gavage.
越来越多的早产儿被抱出保温箱，与母亲进行肌肤接触（袋鼠式护理），以促进母婴情感联结和母乳喂养。我们研究的目的是了解早产儿及其母亲对袋鼠式护理的耐受性和安全性，以及它与母乳喂养的关系。
我们在新生儿重症监护病房（NICU）对38名病情稳定的早产儿进行了445次护理观察。他们的平均出生体重为1452±415克，胎龄为31.5±2周（均值±标准差）。早产儿仅穿尿布和戴棉帽，以直立姿势置于母亲双乳之间进行肌肤接触，并用毛巾覆盖。记录袋鼠式护理的时长、体温、心率、呼吸频率、经皮血氧饱和度（StcO2）以及母婴的行为反应。在袋鼠式护理期间，根据早产儿的吸吮反射情况，直接通过母乳喂养或间歇鼻饲喂养母乳。袋鼠式护理持续30至90分钟，每天进行一至八次，视母亲的时间而定。
在袋鼠式护理期间，早产儿的体温、心率、呼吸频率和经皮血氧饱和度保持稳定。在大多数情况下，早产儿表现出对这种护理方式耐受性良好的行为模式，包括张开双手、睡觉、安静警觉甚至微笑。母乳喂养时间比正常情况更长，因为早产儿短时间吸吮与较长睡眠时间交替出现。母亲们积极参与，看着、交谈着、抚摸着、微笑着，甚至与早产儿玩耍。
袋鼠式护理对于入住NICU的早产儿及其母亲来说是一种安全且广泛接受的护理方式。间歇性袋鼠式护理无法实现按需母乳喂养，因此对于最小的早产儿，我们有必要通过鼻饲补充母乳。
