From the Guidelines
No, there is no substantial research indicating that skin-to-skin care (SSC) or kangaroo care increases intraventricular hemorrhage (IVH) in preterm infants. In fact, the available evidence suggests that these practices are generally safe and beneficial for preterm infants when implemented appropriately, as seen in studies such as 1. Skin-to-skin care involves placing the infant directly on the parent's bare chest, promoting physiological stability through temperature regulation, improved cardiorespiratory stability, and enhanced parent-infant bonding. For preterm infants, SSC should be initiated when the infant is hemodynamically stable, typically with careful monitoring of vital signs during the transition to and throughout the SSC session.
The physiological benefits of SSC include:
- Improved thermoregulation
- More stable heart and respiratory rates
- Better oxygen saturation
- Reduced stress responses These stabilizing effects may actually be protective against complications like IVH, which is more commonly associated with physiological instability, fluctuations in blood pressure, and stress. According to 1, maintaining normothermia is crucial, and SSC or kangaroo mother care can be a reasonable approach to achieve this in resource-limited settings.
When implementing SSC with very preterm or medically fragile infants, healthcare providers should ensure:
- Careful transfer techniques
- Continuous monitoring
- Appropriate timing based on the infant's clinical status to maximize safety and benefits, as suggested by 1. Overall, the current evidence supports the use of SSC or kangaroo care in preterm infants, without increasing the risk of IVH, and highlights the importance of careful implementation and monitoring.
From the Research
Research on SSC and Kangaroo Care in Preterm Infants
- There is no evidence to suggest that SSC or kangaroo care increases IVH in preterm infants 2.
- In fact, a study found that implementation of multidimensional, multidisciplinary interventions for reducing barriers to early SSC in extremely preterm infants resulted in rapid adoption of SSC in the first 72 hours of life without increasing severe IVH in this high-risk population 2.
- Another study found that SSC improves short-term cardiorespiratory stress outcomes compared with incubator care, and reduces cortisol and increases oxytocin levels in preterm infants, with no mention of an increase in IVH 3.
- A study on the safety and effectiveness of SSC in the NICU to support neurodevelopment in vulnerable preterm infants found that SSC seems safe and effective even in ventilated VPIs, with no increase in IVH reported 4.
- Overall, the available evidence suggests that SSC and kangaroo care do not increase the risk of IVH in preterm infants, and may even have beneficial effects on their physiological and neurodevelopmental outcomes 2, 3, 4.