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Improving Infant Health

Raouth Kostandy advances use of ‘Kangaroo Care” in neonatal medicine

Cleveland State University nursing professor Dr. Raouth Kostandy is helping to advance health and well-being for some of our most vulnerable medical patients: infants. She is collaborating with Case Western Reserve University faculty and local hospitals to increase the use of Kangaroo Care (KC) to improve outcomes for babies suffering from a range of illnesses and complications, with the goal of improving ultimate health for patients.

Kangaroo Care involves the use of regular, round the clock, skin-to-skin contact for infants with a parent to reduce anxiety, improve breathing, regulate body temperature and increase microbe transfer from mother to child. Originally developed in Cleveland in the 1970s and popularized by Colombian physicians in the 1980’s, Kangaroo Care, as an element of care, has been shown to improve development in premature and term infants and assist in treatment for a wide variety of conditions and illnesses.

“By utilizing the natural connection between the infant and the parent, both mother and father, KC reduces stress, enhances the development of regular sleeping patterns and improves response to various treatments as well as providing needed therapy. For example, a baby who is having spells in which breathing stops experiences a 75% reduction in those spells when being held in Kangaroo Care,” Kostandy says. “Through the research that is being conducted, I hope to further opportunities to utilize Kangaroo Care in neonatal medicine and nursing and develop state of the art metrics to document its wide effectiveness.”

Kostandy and her research partner, Dr. Susan Ludington-Hoe, the Carl W. and Margaret Davis Walters Endowed Chair of Pediatric Nursing at Case Western Reserve University’s Frances Payne Bolton School of Nursing, are currently working with Metro Health Medical Center to improve treatment for infants suffering from neonatal abstinence syndrome. This illness often is found in babies born to drug addicted mothers and can cause serious birth defects and even death. Kostandy, Ludington-Hoe, and their Metro Health collaborators are working with a group of newborn infants and their mothers in the Mother-Baby Unit to specifically evaluate Kangaroo Care’s effectiveness as a technique for pain management and to reduce the severity of withdrawal symptoms.

“Infants suffering from this illness experience significant pain and agitation during withdrawal and obviously can only be given restricted pain killers,” Kostandy adds. “It is our hope that Kangaroo Care will serve a natural painkiller and anxiolytic to reduce withdrawal suffering in these infants.”

Kostandy and Ludington-Hoe also recently served as editors for a special issue of the journal Birth Defects Research, the official journal of the Society for Birth Defects Research and Prevention. It featured national and international experts on Kangaroo Care and highlighted its growing use as a non-pharmacologic neonatal therapy for many newborn problems. Kostandy hopes the continued research on the topic and further dissemination of its effectiveness will lead to increased adoption in hospitals dealing with newborn drug withdrawal across the country.

“KC has seen significant adoption in Latin America and Europe but has not been as widely used in the U.S., due to in large part to bureaucratic and cultural factors” she says. “It is my distinct hope that a broader understanding of the tremendous positive impacts of Kangaroo Care will help break down these barriers and increase its use as a means for improving infant health in the United States.”