Mother-newborn contact in a randomized trial of kangaroo (skin-to-skin) care

OBJECTIVE: To describe the type and percent time of contact 0-48 hours postbirth for mother-preterm newborn (infant) dyads given kangaroo care (skin-to-skin) or standard care (controls). DESIGN: Randomized controlled trial with assignment by computerized minimization to kangaroo care (n = 48) or control (n = 43). SETTING: Postpartum units and neonatal intensive-care units (NICU). PARTICIPANTS: Preterm infants 32 to less than 37 weeks gestation and their mothers. INTERVENTION: Kangaroo (skin-to-skin, SS) care (KC). MAIN OUTCOME MEASURES: Type and percent time of mother-infant contact (SS versus holding wrapped in blankets). RESULTS: Analyses were based on four groups: assignment for infants in each group to postpartum or NICU. For KC dyads, SS postpartum was 22.0%; SS NICU was 7.5%. KC wrapped holding postpartum was 11.6%; NICU was 1.8%. For control dyads, wrapped holding postpartum was 13.9%; NICU was 6.1%. CONCLUSION: Amount of SS was much less than expected. Reasons include unavailability of infants or mothers and hospital staff interrupting contact. However, KC postpartum dyads were held wrapped almost as often as control postpartum dyads. Total contact time for KC dyads (SS plus wrapped) was more than double that of controls. These data suggest that hospital and social supports for families are needed to facilitate early initiation of SS, prolonged periods of mother-infant SS contact, and reduction of maternal stress.