“Kangaroula” care – a novel perinatal family support service around the time of birth.
How would you as parents like to have someone walk beside you supporting you through the actual delivery of your baby? This is what the doula does, contact one! But after that: what is the best thing to do with your tiny newborn, how do you handle it, how do you get breastfeeding started? This is the kangaroula function! The kangaroula helps to start this early parenting and make the change from life inside mum into the open world as smooth as possible for the newborn baby. How do you know what to do if you have not had a baby before? And if you have maybe you want help to cope with your older child as well as the new baby. The KangaroulaSM support consists of providing care focused on the newborn baby and its brain in the first hours of life, based on the most recent findings from developmental neuroscience.
Our care does most closely resemble that of the “doula”; however while the doula supports the mother through the labour to birth, the “kangaroula” (kangaroo + doula) continues that support to the baby and mother dyad from birth to bonding.
This is done by:
Support in full term birth, which can be in labour ward or in theatre for Caesarean section,
Support in preterm infants, starting from birth through to discharge and beyond as needed.
The Kangaroula concept is prompted partly by requests from parents, who are well-informed and up to date with these modern trends. This state of the art thinking is practised in Sweden in the Karolinska Institute, where the term “family-centred care” is used, the March of Dimes in the USA is promoting very similar care; and the NIDCAP movement has developed this understanding of the neuroscience specifically in the context of prematurity.
The Kangaroula applies the neuroscience, with awareness that the newborn brain is highly plastic, and adapts very rapidly to the earliest environment it experiences. The baby’s brain is expecting familiar sensations of smell, touch and soothing voice, only provided by the mother. When there is skin-to-skin contact, the autonomic nervous system of the mothers and baby are connected, and physiological regulation takes place in the baby. But more significantly it is now clear that emotional and social intelligence begins through skin-to-skin contact in this first hour also. Very early breastfeeding plays a major role in both these processes. The mother’s emotional experience powerfully influences her own physiology and her perception of care. Optimal birth experience for the whole family is the key.
Our modern obstetric and neonatal care is of the highest technological quality, and ensures survival of mothers and babies. In the process, specialization has resulted in this care being fragmented, separating mothers and babies. This separation is experienced negatively by parents, but also has harmful effects on newborn development. Our Kangaroula service would provide a holistic and integrated support that spans all departments in which the mother and baby find themselves, with the objective of avoiding or minimizing separation.
It is the quality of the parental experience , and the quality of their baby’s brain development which our proposed service will improve. Our service would not duplicate or replicate any current care, but would support the timing and delivery of this in such a way as to focus on optimal birth experience.
Jill works closely with the staff but does not interfere on the medical care side of things, but does “translate” for the parents what the nursing staff are doing and saying about their baby, explaining if things are a problem, and supports both mum and baby being together, bonding, attachment and early breastfeeding.
The environment of the Neonatal ICU can be very strange, overwhelming and scary for parents of prematures, and that is why Jill and Nils have written the book Hold Your Prem.