As I think about Father’s Day and the process of becoming a father, I can’t help but wonder about whether we do enough in the neonatal intensive care unit to promote and build the basis for a strong, emotional, and lasting relationship between our fragile babies and their dads. Frederick Douglass said “It is easier to build strong children than to repair broken men”. Douglass’ forward-looking quote reminds us that we can’t turn back the clock for many babies in the NICU, but much can be done to give them the best chance moving forward. What single act is available to every father, in every NICU, almost every day that can change the outcome of a child? The answer is simple, it doesn’t cost a dime and no medical training is required. The powerful act of holding the baby skin-to-skin (STS), also known as kangaroo care, can literally change the neurophysiological maturation of a baby’s brain.
Kangaroo care is believed to have been developed in Bogota, Columbia in the late 1970s as a response to lack of caregivers and hospital resources. Parents essentially held their child continually to provide warmth and frequent access to breastfeeding. The results were decreased deaths, decreased infections, and improved growth. Since that time, kangaroo care has spread to become fairly common in developed countries as well.
But really, why does this matter? Hospitalized newborns are unique relative to other hospitalized patients because their time in the NICU coincides with crucial periods of brain development. The brain triples in weight during the third trimester, and connectivity between various regions of the brain is initiated and in some cases completed during this time period. The brain regions involved in fear, anxiety and impulsive responses may overproduce neural connections, while those areas dedicated to reasoning, planning and behavior control may produce fewer connections. For some of our babies, this entire process takes place during their birth hospitalization. Interference with this process can yield lifelong consequences. Many babies born at or below three pounds are at risk for school difficulties, have issues with motor coordination, and have difficulties with language, spatial relationships, and social immaturity.
The good news is that neural circuits for dealing with stress are particularly malleable during fetal and early childhood periods. That is why family presence, consistent parental care-giving, and skin-to-skin care improve long-term neurodevelopmental outcomes.
The medical benefits of skin-to-skin care are well documented in the medical literature. Some of the most well known benefits include: enhanced bonding and parental attachment, decreased postpartum depression, decrease pain perception, and increased breast feeding. More recently, kangaroo care has been demonstrated to actually accelerate neurophysiological maturation.
Why is this such a big deal to the dads who have a child in intensive care? For one thing, it is a way to take action. Having an ill child can leave parents and other family members feeling literally helpless. Yet, the touch of the parent can ONLY be provided by a parent, not the medical staff. Parents, moms and dads, are essential ingredients in the health of their child. A father providing kangaroo care is a concrete way to make sure that the health of the baby is a team activity, and the team expands beyond the birth mom and the medical staff.
“The journey to get our son home after 93 hospital days and a couple surgeries was a long one. As hard as that time was, it became part of what has bonded our family together. Being a dad to a child who had gone through so much, and shown so much strength in his journey, gives me a feeling of pride that is hard to explain. My life as a dad is different from what I ever thought it would be, and it could not be better.” Eric.