765 - Understanding Caregiver Perspectives on Kangaroo Care in the NICU

Kangaroo care (KC) is the practice of skin-to-skin holding between a caregiver and an infant. Research has demonstrated that KC leads to improved breastfeeding rates, infant sleep organization, procedural pain, and infant-parent bonding. Additionally, it can be safely performed in critically ill infants without adverse outcomes. Despite being both beneficial and safe, rates in our Neonatal Intensive Care Unit (NICU) remain low.

Objective:

To explore caregiver experiences with and perspectives on KC with the goal of improving rates of KC in our NICU.

Design/Methods:

As part of a quality improvement initiative to increase KC in our NICU, we developed a survey to assess caregiver perspectives on and barriers to provision of KC. Surveys were completed by caregivers whose infants were  ≥ 7 days old from October 19, 2021 until October 26, 2022 and were limited to one caregiver per family. Survey questions with Likert-type scale responses were analyzed using descriptive statistics. Free-text responses were coded by theme by two writers and analyzed with descriptive statistics.

Results: A total of 62 caregivers completed surveys, the majority being mothers of white race with a bachelor’s degree (Table 1). Infants had a mean birth weight of 1.9 ± 0.7 kg and a mean gestational age of 32.8 ± 3.4 weeks. Although 95% of caregivers reported participating in KC, 73% reported a desire to hold more often. Ninety-seven percent of caregivers reported feeling comfortable performing KC, despite some misconceptions related to line and tube displacement, vital sign instability, and temperature instability (Figure 1). Based on the results from qualitative analysis, 58% of caregivers reported the most valued aspects of KC were bonding with their infants, while concern for their infant’s medical status made them fearful to hold.  Parent time, staff/unit issues, and their infant’s medical status hindered them from holding more often (Table 2). 

Conclusion(s):

Despite a desire to provide KC, survey results demonstrate misconceptions among parents of the risks of KC, which may hinder willingness and frequency. Therefore, to effectively increase KC rates efforts should focus on providing caregiver education and increasing staff support, which could help improve neonatal outcomes and parental bonding.