Key words: low birth weight infants; Kangaroo care; research progress
Kangaroo nursing method, which originated in 1980s, lacks treatment facilities such as incubator. It imitates the way marsupials are raised and puts premature babies in their mothers' arms. It is found that it has a remarkable effect on stabilizing mood and vital signs, and has a great influence on mother and baby. In this regard, on the basis of neonatal ICU nursing, the introduction of kangaroo nursing has great clinical application value. But the clinical application has not been popularized in China. In this regard, medical staff should bear the brunt, strengthen health education, standardize nursing, and push China into the era of kangaroo nursing mode.
Kangaroo nursing concept
Kangaroo nursing is an effective and low-cost intervention method to improve the success rate of premature infants. Who defines kangaroo care, which is divided into three parts: kangaroo posture, nutrition and excretion. One is kangaroo posture (also known as skin care), in which family members touch the baby's skin. The second is kangaroo nutrition, which is mainly breast-fed with extra support. Third, kangaroo discharge, premature infants discharged in time, parents need to closely cooperate with follow-up while basic nursing. The advantages of kangaroo nursing are mainly embodied in maintaining body temperature, stabilizing vital signs, improving sleep quality, relieving pain and promoting the development of nervous system.
Kangaroo nursing practice
Prepare the ward separately, reduce noise and strong light stimulation, keep soft light, which is conducive to the baby's rest. It is equipped with various support systems, such as rescue equipment and ECG monitoring instruments. Mothers who practice kangaroo care should strictly implement hand hygiene standards. Reasonable control of ward temperature (24-26℃) and humidity (55-65%) requires soft sofa cushions and blankets with moderate thickness. In practice, soothing music can be played to stabilize the mood of mother and child, and the mother is sitting on the sofa with a body of 60 degrees. The baby lies prone on his mother's bare chest, with his head raised 30 degrees and tilted to one side to ensure smooth breathing and facilitate observation of complexion changes. The mother holds the baby's hip with one hand, and the other hand is fixed on the baby's back, so as to ensure the maximum skin contact surface. Attention should be paid to the following points in the implementation: First, low-birth-weight infants have weak resistance, and the probability of complications such as sepsis is high. Nursing practitioners are required to be physically and mentally healthy without infectious or respiratory diseases, so as to ensure that they can start nursing regularly. Yin Ting et al. [1] found that the incidence of pneumonia, sepsis, feeding intolerance and NEC complications in kangaroo nursing group was lower than that in conventional nursing group, with statistical differences, which directly led to the growth retardation and quality of life decline of low birth weight infants, and even buried hidden diseases in adulthood. Second, pay attention to the timing of intervention, implement it when the baby is emotionally stable and full, and stop crying in time. Parents voluntarily provide kangaroo care for their children every afternoon 1h or more. The third is to observe the baby's vital signs. If there is cyanosis or shortness of breath, stop the operation. Fourth, if the mother is unwell or in a state of fatigue, she can be replaced by her father, which is beneficial to her recovery.
Influence of Kangaroo Nursing on Low Birth Weight Infants
temperature
Premature infants have weak body temperature center function, limited muscle activity, low skin heat dissipation and heat production ability, and are often in a low temperature state, with the temperature < 35℃, and the incidence of scleredema increases. Through incubator and kangaroo nursing, the body temperature recovered quickly, but the latter had more obvious influence.
weight
Premature low birth weight infants (birth weight
yearn for
A series of medical operations in neonatal ICU have a great influence on low birth weight infants, especially invasive operations, which will promote their breathing and heart rate levels to increase, blood oxygen saturation to decrease and physiological changes to be obvious. Considering the physiological particularity of newborns, it is unrealistic to use drugs to relieve pain, and a series of interventions are needed to reduce the pain response of infants.
Neurobehavior
The newborn's environment after birth is different from the uterus, and the brain nerve is not fully developed, which is affected by related factors such as premature delivery. During neonatal ICU treatment, the ward environment is embarrassing, which is not conducive to brain development. In nursing intervention, skin contact stimulation can be transmitted from skin receptors to cerebral cortex, which can relieve nervous tension and improve the sensitivity of external perception. Zhang Yanmei et al. [3] found that the neurological function score of premature infants who implemented kangaroo nursing intervention was better than that of routine nursing group, and the difference between groups was obvious. In terms of physical development, the growth value of premature infants in kangaroo nursing group is10.022.11cm, and the weight gain value is 2.04±0.35kg, which is higher than that in conventional nursing group (5.5710.68 cm and10.29).
Life characteristics
Kangaroo nursing can stimulate newborn's hearing and touch, improve oxygenation, stabilize vital signs and avoid adverse phenomena such as apnea.
Mother's side
Kangaroo nursing can reduce postpartum depression and relieve negative psychology and emotions. Distract attention, relieve postpartum pain, promote uterine contraction, stimulate pituitary gland, secrete more oxytocin and improve breastfeeding conditions. Skin contact improves mother's happiness, which is more conducive to domestic application prospects.
Kangaroo nursing mode is relatively mature. WHO practical nursing guidelines and the formulation of International Kangaroo Nursing Awareness Day provide valuable reference for clinical application. The medical level in foreign countries is advanced, even if infants are treated with auxiliary ventilation, kangaroo nursing can be implemented. China's medical level lags behind, nursing propaganda is not in place, and the application of kangaroo nursing is still in the exploratory stage. There is still much room for improvement in the implementation conditions, nursing staff training, health education and follow-up system of kangaroo nursing. In nursing intervention, it is suggested to implement continuous nursing, communicate in time through WeChat group after discharge, answer questions for caregivers, provide information consulting services, and ensure the results of nursing intervention. Lin Chunyuan and others believe that kangaroo nursing can promote the growth and development of low birth weight infants more than conventional nursing intervention on the premise of improving the quality of routine nursing such as improving posture and feeding intervention, non-nutritive sucking and keeping feces normal. On this basis, the effect of kangaroo nursing intervention is more significant.
Summary:
Kangaroo nursing has played a positive role in promoting the growth and development of low birth weight infants and improving the relationship between family and nurses and patients. Medical staff should strengthen communication with intervention implementers, so that caregivers can master nursing intervention methods and ensure nursing effect. Pregnant women who find the risk factors of premature delivery before delivery should inform the baby of routine nursing measures and give full guidance to improve the success rate of treatment of premature and low birth weight infants.