IWK among 48 Canadian hospitals rallying to increase skin-to-skin care in NICUs

A baby receives skin-to-skin care. (Courtesy of Joeyband)

In May, 48 hospitals across Canada launched the country’s first national “Kangaroo-A-Thon,” a co-ordinated effort to increase and track skin-to-skin care for premature and medically fragile infants in neonatal intensive care units (NICU).

Kangaroo care, or skin-to-skin, refers to the upright holding of a baby typically wearing only a diaper, on a parent’s bare chest.

The launch coincides with Kangaroo Care Awareness Day and is led by the Canadian Premature Babies Foundation (CPBF).

Results from participating hospitals are expected after the campaign ends.

“Skin-to-skin care is beneficial for every baby that’s born,” says Gail MacRae, a clinical nurse specialist in the NICU at the IWK Health Centre in Halifax, which began its Kangaroo-A-Thon campaign Friday.

Babies born in the NICU are still in the process of developing, and skin-to-skin with parents has evidence-backed benefits for them.

Regulating blood sugar, temperature, exposure to flora that helps develop their microbiome, facilitating attachment, and physiological stability are some of the perks MacRae lists.

“It actually optimizes the development of the brain,” she says. “There’s been studies done on pre-term infants who’ve done skin-to-skin contact and those who haven’t and in MRIs, the parts of their brain that control decision-making and mobility and cognition are actually better developed than those who didn’t get skin-to-skin.”

Dr. Marsha Campbell-Yeo, a certified neonatal nurse practitioner at the IWK and professor of nursing at Dalhousie University, has provided clinical care to premature and sick babies for over three decades.

She adds skin-to-skin can help stable babies’ heart rates, reduce incidents of infection, and help with breastfeeding success.

“What the national Kangaroo-A-Thon does is provide a way to turn evidence into action. It creates a national movement where hospitals, clinicians, and families work together to ensure babies are held earlier, longer, and more consistently,” she says in an email statement to CTV News.

The WHO recommends eight to 24 hours a day of skin-to-skin for pre-term infants.

“There’s no limit, there’s also no minimum,” MacRae says.

“It’s so beneficial, do whatever you absolutely can. If you’ve got 30 minutes, if you’ve got 15 minutes, if you’ve got eight hours, then let’s do that,” she tells parents.

For babies in the NICU, there can be a lot of equipment, wires, IVs and tubes in the room, and parents can be intimidated.

Campbell-Yeo has experienced this.

“The NICU can be overwhelming. Parents often feel like observers instead of caregivers. Kangaroo care changes that. It gives parents an active role, builds confidence, strengthens attachment, and reduces stress,” she says.

MacRae adds, in the NICU, they have a lot more discussion about why skin-to-skin is important and the many benefits of it.

“There’s some babies, it requires seven people to get them out in skin-to-skin because of the type of ventilator they’re on, but we do it because we know the evidence and we know the associated outcomes for their brain development, so it’s all hands on deck,” she says.

She emphasizes that anyone can do skin-to-skin.

“You can do skin-to-skin with just a blanket over you, if you have a robe on, you can wrap the robe around the baby,” explains MacRae.

Parents should always be able to see the baby’s face and have them in a position that doesn’t obstruct their airway, she adds.

While gadgets aren’t required to do skin-to-skin, NICUs across the country, including top-ranked hospitals, have employed the use of Joeybands.

Joeyband is a skin-to-skin support device founded by three Canadian women, including Nova Scotian Sarah-Almaza Cox.

Three weeks after they released the device for retail, Cox says they heard from several hospitals saying they’ve been needing a device just like it.

“It was pretty surreal,” she says.

Cox says, in preparation of C-section deliveries, some hospitals will have Joeybands laid out with the linens so the mother can do skin-to-skin contact right away, even as her body is healing.

She says in NICUs and challenging environments, like having twins, triplets or babies on ventilators, skin-to-skin historically wasn’t prioritized.

“This is critical care practice, it’s no longer ‘nice to have,’” she says. “It’s now considered unethical to withhold this practice… it’s lifesaving.”

Joeyband donated 110 devices to NICUs across the country as a part of the Kangaroo Care initiative.

Despite strong clinical evidence, the adoption of skin-to-skin care remains inconsistent across institutions, according to a news release from the CBPF.

“Many hospitals are doing excellent work, but implementation is not always consistent. We know that there are still wide variations in practice,” explains Campbell-Yeo.

MacRae suggests the adoption of skin-to-skin care is increasing, though.

“Families are coming, having babies much more informed than ever before,” she says. “One of the number one things they ask me is, ‘When and how often can I do skin-to-skin?’”

It’s beneficial for both parents to do it, too. And while the health benefits are substantial, the health-care professionals say it also feels good.

MacRae says that release of oxytocin is what makes a baby’s brain develop, as opposed to having cortisol imprint on the brain.

She has seen skin-to-skin in practice and read studies exploring the sensation, and says there’s one quote that never left her.

“It was a dad who’d said, ‘Now I feel like a father,’ when he finally got to hold his baby in skin-to-skin,” she says. “He spent all this time watching his baby through an incubator and seeing procedures be done, and when he finally got to put the baby on his chest he was like, ‘Now I feel like a father.’”

The family impact of skin-to-skin proximity resonates with Campbell-Yeo, too. She calls it biologic medicine delivered through a parent’s chest.

“What continues to inspire me is that some of the most sophisticated science in neonatal care points us back to something profoundly human: keeping families together,” she says.

“There’s a science behind it and it’s really cool,” adds MacRae. “Parents are magic to their children and they offer something really special and unique that we can’t as health-care providers.”

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