Kangaroo Care


Reviewed by Charge Nurse Newborn
December 2007
Clinical Guidelines Back Newborn Services Home Page
Definition Criteria Benefits Steps & Preparation
Stable Infant on CPAP Stable Ventilated Infant Criteria for return Infant in cot/INC
  Other Related Document References  

Kangaroo Care (KC)

Kangaroo care (KC) is defined as a method of holding a diaper-clad infant in skin-to-skin contact, prone and upright on the chest of the parent. The infant is enclosed in the parentís clothing in order to maintain temperature stability. It is recommended that KC should be employed regularly and consistently with medically stable premature infants and their parents due to its beneficial effects.

Criteria for Administering Kangaroo Care

        Exclusion Criteria

Benefits of Kangaroo Care

Infant Outcomes

  • Decreased variation in heart and respiratory rates, improved oxygenation, less bradycardia, fewer and shorter apnoeic episodes.
  • Maintains skin and core temperatures through conduction of heat from the parent.
  • Promotes optimal infant growth and development.
  • Beneficial effects on the sleep-awake state organisation in infants.

Maternal Outcomes

  • Improves parent-infant bonding process.
  • Increases motherís milk production ( an oxytocin-releasing agent) and unlimited access to breast.
  • Enhances parental emotional and psychological wellness.
  • Promotes parent/infant attachment.

Steps and Preparation

All Infants



1 Ensure baby and parent are prepared:
  • Offer parent information on KC (link to info?)
  • Provide a quiet, calm environment
  • Offer screen and handheld mirror
2 Parent Preparation:
  • Plan with parents a suitable time for kangaroo care (as infantís condition allows).
  • Advise to bring a drink, go to the toilet prior to kangaroo cuddle and express breasts prior to kangaroo cuddle.
  • Offer to change top clothes with a hospital gown (with its opening in front)
3 Infant preparation:
  • Check infantís temperature. Secure skin temperature
    probe to monitor infantís temperature if appropriate.
  • Suction if necessary.
  • Remove infantís clothing except for the diaper
4 Ideally, allow infant to remain on KC for at least 1 hour (or longer) if physiologically stable and parent comfortable.
5 Document infants intolerance of KC

Stable Infant in Cot or Incubator



1 Wrap the infant with a cloth nappy or leave the infant in a snuggle- up
2 Mother/father picks infant up and places infant on the chest, with legs and arms in a flexed position and head to one side
3 Nurse assists with taking out IV fluids lines and/ ECG leads
4 Parent reclines back on the lazy boy chair/ breastfeeding chair with a foot stool
5 Cover infant with blanket and apply hat to maintain body temperature
6 If the baby is >30 wks gestation and requiring no ventilatory support, allow baby to nuzzle at the breast while up, as this is a step towards initiating lactation and breastfeeding

Stable Infants on Hudson CPAP



1 Wrap the infant with a cloth nappy or leave the infant in a snuggle- up
2 Parent sits in lazy boy chair/breastfeeding chair (Or consider standing transfer)
3 Disconnect CPAP tubing (blue & white) from infant, reconnect tubing through the side port hole of incubator. Check water is cleared from CPAP tubing
4 Nurse assists transfer by holding baby in one hand and CPAP tubing in the other hand
5 Position infant comfortably with legs and arms flexed and head on the side once placed on parentís chest
6 Cover infant with a blanket and cover head with a hat and close motherís gown around baby
7 Secure CPAP tubing to parentís clothing at shoulder height to prevent disconnection

Stable Ventilated Baby



1 Wrap the infant with a cloth nappy or leave the infant in a snuggle- up
2 Parent sits in lazy boy chair/breastfeeding chair (Or consider standing transfer)
3 Briefly disconnect from ventilation for more stable infants where appropriate. Check and clear ventilator tubes of water
4 One nurse holds baby (wrapped/ in snuggle up). Another nurse supports ETT tubes/ lines/ cardio/respiratory leads
5 Both nurses transfer infant and connections at the same time. Place infant vertically on the mother/fatherís chest. Secure ventilator tubings at parentís clothing at shoulder height using tape. Monitor cardio-respiratory throughout transfer
6 Position infant comfortably with legs and arms flexed and head on the side once placed on parentís chest
7 Cover infant with a blanket and cover head with a hat and close motherís gown around baby
8 Inform parents how to recognise changes in colour
9 Assess stability of infant as to length of time up for cuddle



Click images to enlarge

Criteria for Returning Infant to the Incubator

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