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How
Kangaroo Care Came To America
By Steve Clark
This
is the story my wife was supposed to write; only she couldn't.
Not that she didn't try. She's a fine writer, that wasn't
the problem. The problem is that she couldn't do the story
justice because she's way too modest. So I'm going to write
it for her, write it the way that it must be written, a
true-life story of valor and sacrifice. A story of a heroine.
(And I'm going to make sure she won't see this until it's
printed, too late for her to protest).
First,
the scenario: Chris is pregnant with our fourth child. At
22 weeks, her waters burst, and under a moon-lit sky, she
begins to wail. She is sure she is going to miscarriage.
The sheets are changed, the doctor is called, and prayers
are made. We grieve as we prepare for the inevitable, knowing
that premature babies can sometimes be saved at 24 weeks
gestation, but not at 22.
Our
oldest son suggests we should pray not for strength but
for a miracle. He is told that in a situation like this,
there really isn't much hope. "But that's what miracles
are!" he reminds us.
He
was right, of course. And the miracle did happen and the
little trooper hung in there, working feverishly for several
weeks to patch up the broken sac—with Chris during
her part by going on strict bed rest.
Still, she could sense it was only a matter of time. She
readied herself by reading everything she could about giving
birth to a premature child. She even called an author to
find out how to reach a professor who had done research
on "kangaroo care." The professor, Dr. Gene Cranston
Anderson, did not hesitate to federal express to her all
the pertinent documents. The timing was impeccable.
The
"patch" didn't hold up, and now she was losing
blood along with the amniotic fluids. Her due date was still
10 weeks away. I called the ambulance.
Now
Chris is an interesting blend of paradoxical traits: Unlike
her husband, she can be perfectly relaxed in a hospital
setting, even though she would rather be tending her herbal
garden. Trained in western medicine (as a respiratory therapist)
she eschews its reductionistic, human as a machine mentality,
but has never let those sentiments interfere with her faith
in the "mechanics" working on those human machines.
And while she wants desperately to please others and just
get along -- if she knows something is right, she will fight,
and never stop fighting until the issue is resolved. Especially
when it concerns one of her children.
As it
turns out, that mix of comfort and skepticism, peacemaker
and resolute fighter, was just what little Danny needed
in a mother so that he could become the first premie in
the United States within a new born intensive care unit
to be granted kangaroo care.
What
is kangaroo care? Well, consider the joey - an infant kangaroo.
A joey is actually born quite undeveloped, staying warm
in the pouch of its mother. Kangaroo care for premature
infants is based on the observation that all babies, even
one as fragile as Danny, will stay warm if protected and
cuddled, (skin to skin), by a healthy human being. Not only
will Danny stay warm, argued my wife, "but he will
do better in my arms and on my chest, than if he was left
alone in that stark incubator".
It took
three full days for my wife's gentle but persistent arguments
to sway the medical staff. It helped that we had a video
about its successful implementation in a Dutch hospital,
and solid research from Bogota, Columbia, where it all started
(due to a lack of incubators).
So on
day four the neonatologist announced that on Danny's seventh
day the grand experiment could begin. For the first time,
Chris would be able to hold her 2 lb, 12 oz. baby boy.
When
the time came, there were no less than seven suited professionals
within an arm's reach from mother and child. They were so
sure an intervention would be necessary, so sure the machines
helping him breathe would sound off the alarms, that they
didn't want a moment to be wasted. They were prepared to
snatch Danny from his mother at the first sign of trouble.
While
this was hardly reassuring to me, it didn't seem to phase
Chris. If she was nervous at all, she didn't show it. Lack
of privacy aside, if kangaroo care was as good as we thought
it would be, having all those witnesses might not be such
a bad thing!
Once
Danny settled in, all his vital signs improved. In fact,
though the tube feeding oxygen to his nose became inadvertently
disconnected, his oxygen saturation rates stayed high! He
had no apnea spells and his body temperature actually climbed
above normal until the number of blankets covering him was
reduced to just a single thin sheet. The staff allowed Chris
only a half-hour that first session, but all agreed it was
a success. But that didn't make the conflict go away.
Each
day, Chris advocated for the right to hold Danny a little
bit longer than the day before. And each day Chris was faced
with the difficult task of putting him back in the incubator.
The reality was once he was skin to skin with either mom
or dad (yes, I participated in this radical experiment,
too) he didn't want it to stop. Had he had the strength
for a temper tantrum perhaps what was obvious to us would
have been more obvious to the medical staff. But he couldn't
even whimper—yet, it was obvious.
When
Chris wasn't lobbying for or doing KC, she was either pumping
(to ensure Danny got only breastmilk, fed to him through
a special tube) or she was just there sitting next to his
incubator, hand placed through the hole, gently stroking
him, often humming, singing or talking to him.
Finally,
in the sixth week, the day of reckoning came. By this time,
Danny was out of the intensive care unit, but still in his
incubator. Chris, as always, pushed for more time. A nurse
who seemed from the beginning to play the devil's advocate
(and here I use the term quite literally) suggested that
less KC was in order, as Danny was not showing adequate
weight gain. A neonatologist who was back after a 3 week
break, looked at the charts and said to the nurse: "Why
are we starving this baby?" Red in the face, she had
no explanation. The doctor then turned to Chris and said,
"Mrs. Clark, you can hold Danny as much as you want!"
When
Chris called to tell me the news, I could see the tears
rolling down her face. I wonder if the good doctor had any
idea what his words meant to my wife. I don't think any
of the staff knew just how much kangaroo care Chris was
capable of. They hadn't seen anything yet!.
The
combination of unlimited skin-to-skin contact and increased
feedings (now they were finally using all the milk Chris
could pump out), resulted in rapid gains. The day finally
came when Danny was deemed healthy enough to leave his incubator
even without being held by Chris, and shortly thereafter,
mother and child were free to leave the hospital.
Here's
the deal: Danny's first 9 weeks of life outside the womb,
even with the kangaroo care, could not have been very pleasant.
He had just about every problem a premie can have, undergoing
blood transfusions, double hernia surgery, and a number
of other complicated procedures. He often would forget to
breathe, or his heart would just stop. It was often quite
terrifying and we could easily see why many parents stay
far away from the intensive care unit (some completely abandoning
their babies). The only thing that made it even barely tolerable
for us was the kangaroo care. And we believe the same is
true for Danny, only more so. We can't prove it, but it
may have been the one thing that kept him going. Indeed,
whenever he was held the alarms were silent, vital signs
normal, and he seemed completely at peace.
Despite
these undeniable clinical improvements, the majority of
the high tech staff seemed at best aloof, and more often,
darn right resistant to our "high touch" approach.
Chris told me later that if it hadn't been for her strong
convictions (based on solid information and her own heart
and soul) and the steady support of two wonderful nurses
(who would, on occasion, tell the rest of the staff to be
open-minded) , she would not have succeeded.
Today,
St. Paul Children's Hospital actively encourages parents
to do kangaroo care, and recently announced that 95 percent
of the parents now participate in the program! A few months
ago Chris stopped in and her favorite nurse exclaimed, "We
owe so much to you. Kangaroo Care is the best thing that
has ever happened to this hospital and it's all because
a parent wasn't afraid to challenge the current thinking."
Danny,
now 12 and as healthy and happy as could be, couldn't agree
more. Me too.
