Sunday, January 15, 2012

Kangaroo Redefined

Millie weighs 3 lbs 1 oz and Ruby weighs 2 lbs 11 oz. The girls' are so close to being able to wear clothes and be on air temp in their condo's (incubators). Right now they are only in diapers, but the condo's are heated based on a thermometer probe that is attached to their skin. If they get cold then the condo heats up and vice versa. Once they reach a certain weight (now I can't remember what it is exactly because they told me in grams but Millie is very close), then they will turn the warmers off, and see if they can hold their own temperature. The girls were also moved up to the 8th floor (also called the "Lilly Pad") which is considered the step down unit. The Lilly Pad is where the more stable babies go that are feeding and growing. I didn't expect to be moved so soon, but they needed the space on the 7th floor for some sicker babies. It's a good thing to get moved, but it is an adjustment. The girls condos are now next to each other (if I sit between them then I can almost touch both condos where previously there was a wall between them), but we're also in a room with 4 beds total. Right now there is only one other baby in the room, but I do feel like the noise and activity level on the 8th floor is higher than our quiet area at the end of the hall on the 7th floor.

I've been doing some research on kangaroo care, and I had a chance to talk to a physician that has done a lot of research on premature infants. She told me that the two most important things I can do for the girls is to provide them breast milk and to do kangaroo care. Preemies are born with immature intestines, and they are at high risk for a condition called necrotizing enterocolitis (NEC) which can be fatal. Preemies fed breast milk are much less likely to develop NEC.  Thankfully milk production has never been a problem for me. I am spending roughly 2 1/2 hours per day pumping (split up over 7 sessions), but I can't imagine not doing this for them.

I had a long discussion with the physician I spoke to about kangaroo care. She told me that I should really be holding the girls for 3 hours at a time. The stressful part for them is getting them in and out of the condo,  but the kangaroo care itself has so many benefits. She did not recommend holding the girls at the same time, because it is hard to support their bodies in the right position for them to breathe well. I am supposed to be reclined at a 30 degree angle and to hold one hand under their bottom and the other hand at their shoulders, so that their head is angled upwards. It's all about being calm and quiet to mimic what it would be like in the womb. I should cover their eyes with a blanket so it is dark. Kangaroo care has been shown to improve brain development (more neural synapses are formed during kangaroo care) in addition to increasing growth and weight gain, decreasing stress for the baby and the Mom or Dad and improving heart rates and breathing etc. I knew all this about kangaroo care, but I had been told that I was only allowed to hold the girls for 1 hour each. I have definitely felt like the girls sleep well when we're doing kangaroo care, and it feels wrong to disturb them after only 1 hour (or really less by the time they get situated), but I thought the MD's must know best if they were telling me to only do it for 1 hour. So.....I was even more stressed out after this conversation because what she said seemed right and why was I being told to only hold them for 1 hour? And why did no one tell me to recline to 30 degrees and how many times have I talked during kangaroo care when I should have been quiet?

I talked to the girls nurse on Friday about increasing Kangaroo time, and she was very supportive and agreed that the research she had seen said that 1 hour was the minimum not the maximum. The Nurse Practitioner wrote a new order and Saturday I held Ruby for three hours straight. She did great, and we both took a nap. There is no way that I can hold both girls for three hours every day (which would be 6 hours total), but it should still benefit them if I do each one every other day. Scott actually went today and held Millie for three hours. I also asked the Nurse Practitioner if we could decrease how often we are bathing the girls. They have been getting baths every 3 days, but this is not a pleasant experience for them. The feel of the wash cloth, the cold, the stroking etc is all negative stimulation for them and once again we want to replicate what would have been going on in the womb. Babies in the womb are not clean! The NP agreed that we could decrease time between baths.

I am kicking myself for not making these changes sooner, but at least I have been doing some form of kangaroo care from the beginning. The nurses have told me that I kangaroo a lot more than most of the NICU Mom's that they see (again why? is no one giving other Mom's this research?). I plan on looking into this in the future, so I'll keep you posted (hold me to this because I think this is important).


  1. Wow, their weights are really up! Great news about moving to Lilly Pad. Don't beat yourself up about anything, Elizabeth. Every moment of Kangaroo that you've done so far (along with everything else!) with M and R has counted! They are so lucky to have you as their mama :)

  2. oh elizabeth - isn't it the lot of us mothers to forever be second guessing ourselves and feeling like we should have or could have done this or that differently or better for our kids? i know you are doing an amazing job for your girls, and on top of everything you do for your boys, i know you are a wonderful mother! i am so happy to hear that the girls are gaining weight and are doing well enough to be moved. it really is a miracle. i am very impressed that you can find the time to keep us updated on the day to day... especially with all that pumping :) haha hang in there!