The effects of kangaroo mother care in a sample of preterm, preschool aged children
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Submission date: 2014-03-06
Final revision date: 2014-03-27
Acceptance date: 2014-03-27
Online publication date: 2014-08-06
Publication date: 2014-08-08
Health Psychology Report 2014;2(3):208–217
The research has shown that kangaroo mother care has a protective impact both on health and future cognitive skills of prematurely born babies. The aim of this study was to investigate the relation between the early skin-to-skin contact and the cognitive and emotional-social functioning of preschool aged preterm babies.

Participants and procedure
The study group included 99 preterm babies. The children participated in a psychological examination conducted using the Columbia Mental Maturity Scale and the Terman-Merrill Test. The data concerning the skin-to-skin contact during the child’s hospitalisation were acquired during interviews with mothers. The emotional development was assessed on the basis of interviews with mothers, conducted using the Rescorla DSM-IV Orientation Scale (2005).

The study showed no relation between kangaroo mother care and cognitive development. Nevertheless the early skin-to-skin contact turned out to be connected with the emotional functioning of the subjects. Preterm babies who used to experience kangaroo mother care experienced fewer anxiety and depressive disorders than those who did not. In addition it was revealed that the children who suffered from early damage to the brain in the forms of intraventricular and periventricular haemorrhages and experienced kangaroo mother care demonstrated less intense depressive symptoms than those who did not.

The obtained results, combined with the review of the foreign literature of the subject, indicate the usefulness of introducing kangaroo mother care to neonatal wards and encouraging parents to care about their prematurely born babies in such a way.
Anand, K. J., & Scalzo, F. M. (2000). Can adverse neonatal experiences alter brain development and subsequent behavior? Biology of Neonate, 77, 69-82.
Barker, D., & Rutter, N. (1995). Exposure to invasive procedures in NICU admissions. Journal of Archives of Disabled Children: Fetal Neonatal Education, 55, 1877-1884.
Barratt, M. S., Roach, M. A., & Leavitt, L. A. (1992). Early channels of mother-infant communication: preterm and term infants. Journal of Child Psychology & Psychiatry, 33, 1193-1204.
Brooten, D., Gennaro, S., Brown, L. P., Butts, P., Gibbons, A. L., Bakewell-Sachs, S., & Kumar, S. P. (1988). Anxiety, depression, and hostility in mothers of preterm infants. Nursing Research, 37, 213-216.
Beckwith, L., & Parmelee, A. (1986). EEG patterns of preterm infants, home environment and later IQ. Child Development, 57, 777-789.
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. J. (2002). Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. The Journal of American Medical Association, 288, 728-737.
Bidzan, M., & Bieleninik, Ł. (2013). Psychomotor development of preterm babies in the context of biomedical predictors in Polish sample. Health Psychology Report, 1, 18-33. doi: 10.5114/hpr.2013.40466.
Bidzan, M., Bieleninik, Ł., & Lipowska, M. (2013). The development of speech in early childhood in children from twin pregnancies with twin-twin transfusion syndrome. Polish Psychological Bulletin, 44, 9-20. doi: 10.2478/ppb-2013-002.
Blencowe, H., Cousens, S., Chou, D., Oestergaard, M., Say, L., Moller, A. B., Kinney, M., & Lawn, J. (2013). Born too soon: global epidemiology of 15 million preterm births. Reproductive Health, 10 (Suppl 1): S2. doi: 10.1186/1742-4755-10-S1-S2.
Brisch, K., et al. (2005). Attachment Quality in Very Low-Birthweight Premature Infants in Relation to Maternal Attachment Representations and Neurological Development. Parenting: Science and Practice, 5, 311-331.
Brouhton, E. I., Gomez, I., Sanchez, N., & Vindell, C. (2013). The cost-savings of implementing kangaroo mother care in Nicaragua. Revista Panamericana de Salud Publica, 34, 176-182.
Champion, P. (2005). The at-risk infant – approaches to intervention. The Champion Centre Model. In: Carpenter, B. & Egerton, J. (eds.), Early Childhood Intervention. International Perspectives, National Initiatives and Regional Practice (pp. 39-52). Wielka Brytania: West Midlands Sen Regional Partnership.
Chrzan-Dętkoś, M. (2012). Wcześniaki. Rozwój psychoruchowy w pierwszych latach życia [The preterm child. Psychomotor development in the first years of life]. Gdańsk: Harmonia Universalis.
Chrzan-Dętkoś, M., Dyduch-Maroszek, A., Humięcka, A., & Karasiewicz, K. (2012). Uwarunkowania i konsekwencje depresji poporodowej – badania pilotażowe [Psychological background of post-partum depression and it’s consequences]. Psychoterapia, 161, 55-63.
Chrzan-Dętkoś, M., & Bogdanowicz, M. (2009). Rozwój poznawczy i emocjonalno-społeczny wcześniaków w wieku przedszkolnym [Cognitive and socio-emotional development of preschool-aged preterm children]. Pediatria Polska, 84, 517-523.
Ciechanowicz, A. (1990). Skala Dojrzałości Umysłowej Columbia [Columbia Mental Maturity Scale]. Warszawa: Pracowania Testów Psychologicznych PTP.
Cox, S., Hopkins, J., & Hans, S. (2000). Attachment in preterm infants and their Mothers: neonatal risk status and Maternal representations. Infant Mental Health Journal, 21, 464-480.
Engmann, C., Wall, S., Darmstadt, G., Valsangkar, B., & Claeso, M. Participants of the Istanbul KMC Acceleration Meeting (2013). Consensus on kangaroo mother care acceleration. The Lancet, 382; 26-27. doi: 10.1016/S0140-6736(13)62293-X.
Feldman, R., Rosenthal, Z., Eidelman, A. (2014). Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biological Psychiatry, 75, 56-64 doi: 10.1016/j.biopsych.2013.08.012.
Feldman, R., Weller, A., Sirota, L., & Eidelman, A. I. (2002). Skin-to-skin contact (Kangaroo Care) promotes self-regulation in premature infants: Sleep-wake cyclicity, arousal modulation, and sustained exploration. Developmental Psychology, 38, 194-207.
Galler, J. R., Harrison, R. H., Ramsey, F., Forde, V., & Butler, S. C. (2000). Maternal depressive symptoms affect infant cognitive development in Barbados. Journal of Child Psychology and Psychiatry, 41, 747-757.
Garcia-Coll, C., Emmons, L., & Vohr, B. R. (1988). Behavioural responsiveness in preterm infants with intraventricular hemmorrhage. Pediatrics, 81, 412-418.
Gerhardt, S. (2010). Znaczenie miłości. Jak uczucia wpływają na rozwój mózgu [Why love matters: how affection shapes a baby’s brain]. Kraków: Wydawnictwo Uniwersytetu Jagiellońskiego.
Glover, V., Miles, R., Matta, S., Modi, N., & Stevenson J. (2005). Glucocorticoid exposure in preterm babies predicts saliva cortisol response to immunisation at 4 months. Pediatric Research, 58, 1233-1237.
Grunau, R. E., Tu, M. T., Whitfield, M., Oberlander, T., Weinberg, J., Yu, W., Thiessen, P., Gosse, G., & Scheifele, D. (2010). Cortisol, behavior, and heart rate reactivity to immunization pain at 4 months corrected age in infants born very preterm. The Clinical Journal of Pain, 26, 698-704.
Helwich, E. (ed.). (2002). Wcześniak [The preterm infants]. Warszawa: PZWL.
Hofer, M. A. (1987). Early social relationships: a psychobiologist’s view. Child Development, 58, 633-647.
Hofer, M. A., & Shair, H. (1982). Control of sleep-wake states in the infant rat by features of the mother-infant relationship. Developmental Psychobiology, 15, 229-243.
Johnston, C. C., Stevens, B., Pinelli, J., Gibbins, S., Filion, F., Jack, A., Steele, S., Boyer, K., & Veilleux, A. (2003). Kangaroo care is effective in diminishing pain response in preterm neonates. Archives of Pediatrics & Adolescent Medicine, 157, 1084-1088.
Johnston, C. C., Filion, F., Campbell-Yeo, M., Goulet, C., Bell, L., McNaughton, K., & Byron J. (2009). Enhanced kangaroo mother care for heel lance in preterm neonates: a crossover trial. Journal of Perinatology, 29, 51-56.
Johnston, C. C., Filion, F., Campbell-Yeo, M., Goulet, C., Bell, L., McNaughton, K., Byron, J., Aita, M., Finley, G. A., & Walker, C. D. (2008). Kangaroo mother care diminishes pain from heel lance in very preterm neonates: a crossover trial. BMC Pediatrics, 8, 13. doi: 10.1186/1471-2431-8-13.
Jones, J. A., Field, T., Fox, N. A., Davalos, M., Lundy, B., & Hart, S. (1998). Newborns of mothers with depressive symptoms are physiologically less developed. Infant Behavior & Development, 21, 537-541.
Kmita, G. (2003). Trauma przedwczesnych narodzin: Procesy radzenia sobie rodziców a rozwój dziecka. Wybrane aspekty metodologiczne i statystyczne pracy doktorskiej. Materiały z konferencji: Zastosowanie metod statystycznych w badaniach naukowych [The trauma of premature birth. Coping processes in parents and the child’s development.Selected aspects of the methodological and statistical doctoral dissertation. Materials from the conference: Application statistical methods in research]. Statsoft Polska.
Nyqvist, K. H., Anderson, G. C., Bergman, N., Cattaneo, A., Charpak, N., Davanzo, R., Ewald, U., Ibe, O., Ludington-Hoe, S., Mendoza, S., Pallás- Allonso, C., Ruiz Peláez, J. G., Sizun, J., & Widström, A. M. (2010). Towards universal Kangaroo Mother Care: recommendations and report from the First European conference and Seventh International Workshop on Kangaroo Mother Care. Acta Pćdiatrica, 99, 820-826. doi: 10.1111/j.1651-2227.2010.01787.x.
Pisula, E. (2003). Autyzm i przywiązanie. Studia nad interakcjami dzieci z autyzmem i ich matek [Autism and attachment, mothers and children with autism interactions studies]. Gdańsk: Gdańskie Wydawnictwo Psychologiczne.
Rescorla, L. (2005). Assessment of young children using the achenbach system of empirically based assessment (ASEBA). Mental Retardation and Developmental Disabilities Reaserch Reviewes, 11, 226-237.
Szychowiak, B. (2004). Możliwości i ograniczenia wynikające z zastosowania skali Dojrzałości Umysłowej Columbia do badania dzieci z głębszą niepełnosprawnością intelektualną [The possibilities and limitations of the application of the Columbia Mental Maturity Scale in the assessment of children with profound intellectual disabilities]. Wczesna diagnoza i terapia dzieci z utrudnieniami rozwoju. Interdyscyplinarne problemy [Early diagnosis and therapy of children with developmental difficulties. The interdisciplinary problems]. Wrocław: Dolnośląska Szkoła Wyższa Edukacji Towarzystwa Wiedzy Powszechnej.
Tallandini, M. A., & Scalembra, Ch. (2006). Kangaroo mother care and mother-premature infant dyadic interaction. Infant Mental Health Journal, 27, 251-275. doi: 10.1002/imhj.20091.
Terman, L. M., & Merrill, M. A. (1959). Skala Inteligencji [The Intelligence Scale]. Warszawa: Ministerstwo Oświaty.
Tessier, R., Cristo, M. B., Velez, S., Giron, M., Nadeau, L., Figueroa de Calume, Z., Ruiz-Paláez, J., & Charpak, N. (2003). Kangaroo mother care: A method for protecting high-risk low-birth-weight and premature infants against developmental delay. Infant Behavior and Development, 26, 304-397.
Worku, B., & Kassie, A. (2005). Kangaroo mother care: a randomized controlled trial on effectiveness of early kangaroo mother care for the low birthweight infants in Addis Ababa, Ethiopia. Journal of Tropical Pediatrics, 51, 93-97. doi: 10.1093/tropej/fmh085.
Van Ijzendoorn, M. H., Goldberg, S., Kroonenberg, P. M., & Frenkel, O. J. (1992). The relative effects of maternal and child problems on the quality of attachment: A meta-analysis of attachment in clinical samples. Child Development, 63, 840-885.