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A Clinical Guideline for Implementation of Kangaroo Care With Premature Infants of 30 or More Weeks' Postmenstrual Age

Ludington-Hoe, Susan M. PhD, CNM, FAAN1; Morgan, Kathy BSN, CNNP, RN2; Abouelfettoh, Amel PhD, RN1

doi: 10.1097/01.ANC.0000324330.25734.b6

As part of the National Association of Neonatal Nurses (NANN) clinical reference series, a clinical guideline for kangaroo care (KC) with stable premature infants, usually those who are 30 or more weeks' postmenstrual age, is presented. The guideline begins with the evidence base regarding physiologic (heart rate, respiratory rate, apnea, periodic breathing, oxygen saturation level and desaturation events, temperature, weight gain, infection, and hypoglycemia), behavioral (crying, sleep, pain, and breastfeeding behaviors), and psychosocial (parental feelings, attachment, and interactions) outcomes of KC. The presented evidence is rated to guide adoption. Following summations of the evidence, criteria for assessing infant, parental, and institutional readiness for KC are provided along with recommendations for monitoring and documenting KC experiences. A sample protocol/policy that can be modified for specific unit use is provided to facilitate adoption of KC as a positive, potent nursing intervention, as is a list of the Ten Steps to Successful Kangaroo Care.

1Bolton School of Nursing, Case Western Reserve University; and 2Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center (Ms Morgan), Cleveland, Ohio.

Address correspondence to Susan M. Ludington-Hoe, PhD, CNM, FAAN, Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106;

© 2008 National Association of Neonatal Nurses