Jazmine Rivera held her newborn son against her chest behind a privacy curtain in Cape Fear Valley Medical Center’s neonatal intensive care unit. With his tiny hand wrapped firmly around her pointer finger, the boy took sharp breaths through a breathing tube as Rivera uttered quiet words of encouragement.
It was one of many skin-to-skin care sessions, also known as kangaroo care, Rivera has done with her son, who was born prematurely a little over a week ago.
“This actually isn’t my first rodeo,” Rivera said. Her twin daughters, now 7 years old, were also born at 27 weeks, and she went through the same skin-to-skin care sessions with them.
The practice is simple. Parents hold their preterm newborns against their exposed chests for 60 to 90 minutes at a time. Benefits include decreased mortality rates and stabilized health, according to multiple studies published in peer-reviewed journals. It is recommended by the World Health Organization for preterm and low birth weight babies.
Cape Fear Valley Health Medical Center celebrated Kangaroo Care Day on May 15. This was the NICU’s second year hosting events. Dr. Mary Terrell, a neonatologist and international board-certified lactation consultant, went all out, spending her shift in a kangaroo onesie she bought on Amazon. The NICU also handed out Polaroid photos of parents during their skin-to-skin care sessions.
“It’s the most non-technological thing that we have in this NICU, yet it’s probably one of the most effective things we can do for their [preterm babies’] long-term health,” Terrell said.
Skin-to-skin care doesn’t just help preterm babies. Terrell said it improves breastfeeding rates and lowers the chances of postpartum depression for all mothers. It’s why NICU staff are integrating skin-to-skin care into all levels of pregnancy care, from prenatal counseling to post-delivery, for every family that gives birth at the medical center.
“We introduce it as something that is a normal part of our care here,” she said. “We encourage this in almost every baby.”
Helping premies and parents
Preterm babies are born before 37 weeks, while the average pregnancy lasts about 40. Besides being significantly smaller, preterm babies are often born with breathing problems and issues regulating their body temperature, landing them in the NICU for specialized care. The earlier a baby is born, the more severe their health issues and the longer their stay in the hospital can be.
Giving birth early was necessary for Rivera. While pregnant with her son, Rivera got eclampsia, a rare birth complication that causes seizures, which required an induced birth. She lost amniotic fluid, the liquid that surrounds the unborn baby, while carrying her twin daughters, and needed an emergency cesarean section.
Rivera described having a baby in the NICU as “an emotional rollercoaster.” She wants to hold her son all day, never putting him back in his incubator. While the skin-to-skin care sessions are too short to fill her need to be close to her son, she knows they have been critical to helping him thrive.
“The more skin-to-skin you do, the better for them. It not only keeps them knowing that someone’s there, but it’s also better for their health,” Rivera said, looking up at her son’s monitor. “Even now with stimulation, as far as him dropping his heart rate and picking it right back up, the more he grabs my hand and squeezes it, the better it is for him.”
Judith de Guzman, a registered nurse with the medical center’s women and children’s services, said skin-to-skin care also helps parents. She’s heard parents blame themselves for their babies being born preterm, particularly those who were pregnant with the child. De Guzman said the sessions show parents their babies can be held, and their touch will help them grow.
“They feel helpless being in that situation, so having something for them to do and be an active part of makes them feel like, ‘Yes, this is something that I can do for my baby. I am useful,’” de Guzman said.
She added how it’s especially helped fathers and other parents who didn’t give birth to bond with their babies.
Normalizing skin-to-skin
About one in every nine pregnancies in Cumberland County resulted in a preterm birth in 2023, according to data from the North Carolina Department of Health and Human Services.
Counties across North Carolina have similar statistics, with almost 11% of all pregnancies in the state resulting in preterm births. The state’s Perinatal Strategic Plan aims to decrease the number of residents giving birth preterm by over three percentage points by 2026.
A multifaceted approach addressing chronic health issues in Cumberland County is needed to bring down the county’s preterm birth rate, Jennifer Green, director of the Cumberland County Department of Public Health, previously told CityView.
While waiting for that approach, Terrell said the medical center’s NICU staff is normalizing skin-to-skin care for parents to improve the outcomes of preterm babies.
“Once they’ve done it once or twice, they come back asking for it,” Terrel said. “It really just takes one time because everybody loves it.”
Part of this normalization is celebrating Kangaroo Care Day.
After the NICU’s Kangaroo Care Day celebration in 2024, Terrell said the NICU saw about 80% of parents doing skin-to-skin care sessions for the rest of the month, a significant increase from the unit’s initial rates. That number has since dropped, hovering between 50% and 60% of parents performing the care, a baseline Terrell said the NICU wants to increase.
That will require familiarizing staff with skin-to-skin care, Terrell said. To do this, the medical center is adding the care to its skills fair this September. Terrell hopes the fair will make more physicians and nurses comfortable running skin-to-skin care sessions, particularly with preterm babies using breathing tubes and hooked up to IVs and monitors.
“We’re able to make it happen with lots of hands and lots of slowness and lots of being careful and lots of people watching,” Terrell said. “But everybody has seen that it works and is worth it. So everyone’s willing to put in the work.”
CityView Reporter Morgan Casey is a corps member with Report for America, a national service program that places journalists into local newsrooms. Morgan’s reporting focuses on health care issues in and around Cumberland County and can be supported through the News Foundation of Greater Fayetteville.
