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Skin-to-skin (STS, also known as kangaroo care) is the practice of holding an infant, naked (except for a nappy and hat), in an upright position against the bare parents’ chest.
Skin-to-skin care is widely recognised as an integral component of neonatal care, improving developmental, physiological and psychological outcomes. Evidence demonstrates that neonates who receive STS care frequently experience improved weight gain, reduced risk of infection, and greater haemodynamic stability, including thermoregulation and blood sugar stability. Parents and neonates experience an increase in oxytocin release during STS care, leading to decreased stress and the promotion of bonding.
The benefits of STS for the parents include increased confidence in providing care for their hospitalised newborn, and reduced levels of anxiety and depression. Parents engaging in STS care frequently in the hospital environment are more confident in interpreting their newborn’s cues and responding appropriately. Mothers’ experience an increase in milk production during STS , resulting in increased breastfeeding rates upon discharge. Utilising a mirror during STS further promotes the bonding experience and can help to take focus away from monitors that can often become a stressor for parents in the NICU environment. In addition, enabling parents to provide STS care is an effective non-pharmacological comfort measure assists in reducing parental and neonatal stress with painful procedures and enhancing the parental bond.
The aim of this guideline is to provide all clinical staff with the benefits, criteria and procedure to promote and provide skin-to-skin care to infants and parents during admission effectively and safely.
Continuous Positive Airway Pressure (CPAP): may be delivered via Single Nasal Prong, Bi-Nasal Prong, or Nasal Mask
ETT: Endotracheal Tube
JET ventilation: A mode of ventilation which utilises an additional JET box to deliver pulsated ventilation at a high frequency.
Neopuff: Device used to administer air or oxygen flow with PEEP +/- PIP to neonates in an emergency.
Normothermia: An axillary temperature 36.5°C – 37.5°C
Skin-to-Skin (STS): Also known as kangaroo care refers to the method of holding an infant in an upright and prone position, skin-to-skin, on the parent’s chest for a period of time. Clothing or blankets are wrapped around the infant to provide a secure kangaroo-like pouch.
Skin-to-skin care should be promoted and provided to all haemodynamically stable infants, as well as to families of infants redirecting to palliative care.
The evidence table for this guideline can be viewed here.
Please remember to read the
The review of this nursing guideline was coordinated by Sarah Gardner, Associate Nurse Unit Manager, Butterfly Ward, and approved by the Nursing Clinical Effectiveness Committee. Updated February 2023.