Imagine a place where you feel secure, joyous, protected – a place where you are enveloped by the warmth of those who love you the most dearly, and whom you love in the same capacity. This is your safe space, your happy place. For a newborn, the world in which we all find our happy places is blindingly bright, cold, and filled with loud, frightful noises. It is anything but comforting, and is in direct conflict with the warm, nurturing, quiet, dark space of his/her mother’s womb in which the infant found its’ first happy place. So why is it that the routine birthing practice in the United States is to whisk the Baby away from his/her parents into this intimidating and confusing environment? Doesn’t it make more sense to place the baby in an environment that is most reflective of his/hers first nine months or so of life and also most beneficial to the baby’s initial adaptation and adjustment? That is where kangaroo care, also known as skin-to-skin contact comes in.

Kangaroo care was first developed in 1979 in Bogotá, Colombia by neonatologists, Dr. Edgar Rey and Dr. Hector Martinez when they were faced with a shortage of incubators to care for all of the premature Babies in their hospital. Dr. Rey and Martinez decided to place the babies directly on their mother’s chests, skin-to-skin, and found that the babies flourished. Their temperatures regulated and were maintained more quickly, they were more apt to breastfeeding, and they were able to be discharged to begin life at home more quickly as compared to babies that were placed in incubators rather than skin-to-skin. After this initial observation and the apparent benefits of skin-to-skin contact, research began to take place and subsequently the inception of kangaroo care.

Nils Bergman, a physician and researcher in South Africa, explains the essential nature of kangaroo care for all babies in that, the development of their brains is contingent upon the positive stimulation of their senses. “At birth, the sensations that tell the brain ‘I am safe’ are the mother’s smell, her movements and skin-to-skin contact.” A mother’s voice can also trigger these positive stimulation, but this is not always present. Think of a time when you were scared or felt threatened or in danger. Your fight-or-flight response most likely intuitively took over in order to protect you. If a baby’s brain does not receive these stimulation, the baby experiences feelings of fear and danger in much the same way that we do throughout our entire lives. A baby that does not receive this positive stimulation will enter into a self-defense response, meaning he/she is instinctively reacting in order to stay alive. Babies will continue breathing, eating, and digesting, but their brain development and emotional and social connections will be put on hold. However, when a baby experiences kangaroo care, “It stimulates a specific part of the newborn brain, so that two things happen. The baby will move to the breast, self-attach and feed; and secondly, the baby will open his eyes and gaze at his mother.” This exemplifies the vital nature of skin-to-skin contact in order to foster not only the baby’s physical development through feeding and obtaining nutrients through mother’s milk, but also emotional and social development created through a positive, nurturing attachment between infant and parents. Skin-to-skin contact is the happy place for infants, it is the natural place for them to be and where they intuitively know they must be in order to survive and develop fruitfully.

Mothers and fathers should begin skin-to-skin contact as soon after the baby’s arrival as possible and continue without interruption for the first two hours after birth. This provides for ease of the baby’s transition into the world and allows them to most fully reap the benefits that researchers have found kangaroo care to offer, according to Dr. Susan Ludington, the director of the United States Institute for Kangaroo Care. However, the continuation of kangaroo care after these initial two hours is incredibly important for secure attachment and the continuation of a healthy development process. In terms of development, this is especially true for babies that were born prematurely, since they typically have low birth weights and are unable to regulate and maintain their own temperatures. Skin-to-skin contact not only has the potential to be a life-saving method of care, but it also provides solace and a sense of normalcy to new mothers and fathers that otherwise feel helpless. Imagine having a high-risk pregnancy in which you or your partner had a premature delivery. The fear and helplessness that overcomes is palpable, and you feel frozen – suspended in your ability to nurture and protect your baby. Now further complicate and intensify the trepidation felt and place yourself in the same scenario, this time with twins, and you have the birth story of Laura and Josh Brewer’s babies. Even with immense feelings of helplessness and personally being able to do so little to protect, nurture, and care for their babies, Laura and Josh were not paralyzed by fear. Instead, they listened to their medical team and the research they had conducted that pointed to kangaroo care as being the best way to care for their twins while they were in the NICU. This simple method of care turned feelings of fear into those of excitement, as Laura was able to care for her babies and begin her role of mother for the first time. She and Josh were able to directly see the impacts of skin-to-skin contact and Laura describes how, “gratifying to hold them and watch their monitors calm down a little as they slept and think about the fact helping them sleep calmly would help them grow and develop.”

Any complications during pregnancy or delivery that affect the health of the children or mothers are simply terrifying and deeply saddening. As Laura describes, it is not something she would wish upon anyone. Since her babies were in the NICU, when Laura and Josh first left the hospital they left as a couple and not as the family they had just recently become. They did not get to share pictures immediately after delivery of their little miracles, and they did not get to experience the initial newborn phase of becoming parents as their babies drew their first breaths. As blurred and heart-wrenching as the lack of these experiences were, skin-to-skin contact was able to provide a sense of normalcy in the story of becoming a family, as well as crucial care and nurturing that the Brewer babies needed in order to grow and develop. When Laura thinks back to this time three and a half years later with two healthy, beautiful children she remembers that she “could sit in a chair for a few hours, holding my babies close and smelling their heads. Skin to skin was the number one thing that helped me feel like a mom and feel calm when my twins were in the NICU.” Skin-to-skin contact is a simple way to care for newborns, with benefits that can be life altering and even life saving to infants and parents. Dr. Bergman states that as a whole, “the more skin-to-skin contact the better. It should ideally start at birth, but is helpful at any time, and will immediately sooth and calm the baby.”

When thinking about the natural processes of our bodies that allow us to survive and flourish, the magnitude of benefits provided through skin-to-skin contact are no wonder.

There are four overarching benefits of kangaroo care with each having numerous additional advantages falling under them. The four major benefits are: adaptation and regulation, the calming affects of being held and cuddled, making the breastfeeding process easier, and bonding and attachment.

Adaptation and Regulation

• Helps babies to regulate their temperatures. In fact, mother’s bodies are naturally designed to aid in this process. The temperature of a mother’s chest will rise two degrees in order to warm a cold baby, and will conversely fall one degree in order to cool a hot baby. Once babies’ temperatures stabilize they are typically able to maintain this on their own.
• Boosts baby’s mental development through stabilizing heart rate, oxygenation, and improving sleep.
• Promotes healthy weight because when babies’ temperatures are regulated they can use energy to grow rather than to regulate their body temperature.

Calming Affects of being Cuddled

• Reduces baby’s stress and pain because skin-to-skin contact decreases babies’ levels of the stress hormone cortisol and increases levels of the “cuddle” feel-good hormone oxytocin. This stimulates the parasympathetic nervous system to make babies feel calm and safe.
• Less stress means more sleep. Babies held skin-to-skin sleep more deeply and wake up less frequently.

Making the Process of Breastfeeding Easier

• “Newborns instinctively have a heightened sense of smell, so placing your baby skin-to-skin helps her seek out the nipple and begin breastfeeding, says Katie Dunning, R.N., clinical coordinator of labor and delivery at Mount Sinai Hospital.
• Skin-to-skin contact actually helps mothers make milk because when mom and baby are together, the hormones that regulate lactation balance, and this aids in the production of more milk.

Bonding and Attachment

• Decreases the mother’s risk for experiencing postpartum depression
  • Skin-to-skin contact releases oxytocin in both the mother and baby and subsequently decreases anxiety that comes with being a mom (especially a new mom) and promotes attachment, which reduces the risk for postpartum depression
  • During birth, activity in the mother’s adrenal axis pathway is negative, but research has been done that suggests that skin-to-skin may reactivate these pathways, aiding in minimizing the risk of depression.
• Parents become empowered and more confident because they realize they know how to and are made to care for their baby.
• Father-child snuggling calms babies and skin-to-skin time with dad helps them bond
  • Babies recognize the voices of their fathers from when they were in their mother’s wombs and as a result, kangaroo care between fathers and infants provides a safe, happy place for the baby.
  • Fathers tend to be a little warmer than mothers, but are still able to stabilize their babies well.

Birth is one of the elemental, continuing processes of nature (Gaskin, Birth matters: a midwife’s manifesta). The action of birth is fundamental to a woman’s composition and is something that comes as second nature because of the design of a woman’s body. It is no wonder then that kangaroo care, an act and method of care as simple as placing one’s baby skin-to-skin with its mother or father (or both) provides countless benefits in development, nurturing, and attachment for both infants and parents alike.

Meet the author:

Grace O’Hara is studying International Business coupled with a minor in Human Service Studies at Elon University in North Carolina, and is currently a partner in research for a micro finance company. She has spent the summer interning for Shannon Miller Lifestyle (SML) to expand her horizons and broaden her professional skill set to include experiences outside of the direct business world. While at SML, she has taken the time to gain an interest in researching and writing journal articles, while simultaneously challenging her comfort zone by taking on articles focused on motherhood and parenting. In her free time she enjoys staying active through running, yoga, & hiking, traveling & adventuring to new places, and coming home to Florida to feel the sand beneath her feet & relax with family.

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