These Standards were released during the Gravens' Conference, March 2020.
The Developmental Care Standards for Infants in Intensive Care is the Report of the First Consensus Conference on Standards, Competencies and Best Practices for Infant and Family-Centered Developmental Care in the Intensive Care Unit. It includes:
"Infant Family Centered Developmental Care (IFCDC):
Recommendations for Skin-to-Skin Contact
with Intimate Family Members
Two different competencies mention the use of a kangaroo care wrap/device:
Standard 1: Parents shall be encouraged and supported in early, frequent, and prolonged skin‐to‐skin contact (SSC) with their babies.
Competency 1.5: Parents should be provided with comfort including:
a) safe and comfortable seating or reclining accommodations that are readily available at baby's bedside;
b) support pillows;
c) secure wraps to support baby;
d) a mirror to see baby’s face;
e) hydration and nutrition for parents as needed;
f) privacy, if desired (in private rooms or by privacy screens); and
g) a quiet, therapeutic environment for being with their baby.
Competency 1.10: Parents should be allowed to fall asleep during SSC or Kangaroo Care (KC) when safety measures are in place that include:
a) parent and baby are in a non-rocking, reclining chair or bed;
b) baby is well secured by an appropriate wrap to parent's chest;
c) baby is electronically monitored, if indicated; and
d) an appropriate healthcare provider is immediately available.
During the presentation "Skin to Skin Contact with Intimate Family Members" by
Raylene Phillips, MD, MA, FABM, FAAP, IBCLC Joy Browne, PhD, PCNS‐BC, IMH‐E(IV)
a photo of a mom sleeping using The Zaky ZAK was shown. The Zaky ZAK is by Nurtured by Design.
One Frequently Asked Question is:
What makes a kangaroo care wrap/device "appropriate" for securing the baby and allow parents to safely fall asleep during skin to skin contact?
Answer: A Kangaroo Care Devices that, even without the hands and attention of the adult doing kangaroo care, the baby remains safe, supported, and well positioned. It must not need the hands of the parents to:
- consistently, reliably and appropriately support the baby's weight so that the baby does not slide
- keep the proper Kangaroo Care position and proper alignment of the baby
- provide a consistent containment, cover, and boundaries from neck to toes.
In addition, for hospital use with babies in intensive care units:
- it allows instant and quiet access to the baby at all times for interventions (breastfeeding, abdominal ultrasounds, heel sticks, massage therapy, etc.) with minimal disruption, and
- supports sitting and standing transfer.
Please note that if the KC device is too loose around the torso, then the baby may slide and dislodge or worse, s/he may slide under the wrap (or fall). If it the wrap is too tight, then the baby's breathing may be compromised. It is always a good idea to ask the manufacturer of the kangaroo care wrap/device if they recommend parents sleeping during kangaroo care.
During the 3 year design of The Zaky ZAK we tried all closing mechanisms (snaps, hooks, velcro, ties, etc.) and zippers were the only one that could protect the baby consistently, reliably, quietly for every parent/baby. When our instructions are followed, the baby will remain safe even without the use of the parents' hands.
Yamile slept with Zachary during Kangaroo Care in the NICU, and she vowed to design The Zaky ZAK so that other parents could do the same. It was that special!
The Zaky ZAK is ergonomically engineered to support the baby even if the parents fall asleep during kangaroo care when these instructions are clearly followed for the safety of the baby, the comfort of the parent, and the peace of mind of the staff:
- The zipper of The Zaky ZAK allows to select the perfect fit consistently and reliably
- Parent wears and closes the zipper of The Zaky ZAK at the appropriate size that fits around the torso BEFORE transferring the baby (the fabric will stretch to accomodate the size of the baby)
- The baby is in correct kangaroo care position (vertical and mid-aligned between cleavage, top of the head close enough to kiss without stretching the parent's neck).
- The zipper is fully closed and The Zaky ZAK covers the baby from neck to toes. (The baby is only considered safe for parents sleeping or parents using the hands for an activity when the Zaky ZAK covers the baby up to the neck and the zipper is fully closed).
- Parent is reclined, never horizontal to avoid rolling-over.
- Parent/baby are always supervised/monitored by another adult.