The Zaky ZAK for Delivery, OR, and Postpartum.

Some background

The Zaky ZAK is the only device for skin to skin and kangaroo care that applies engineering and ergonomics principles and best practices for the safety and comfort of the baby and parent.  It was developed by Yamile Jackson, a native of Colombia, PhD in ergonomics engineering, risk management professional, and gave birth prematurely to Zachary who weighed less than 2 lbs. in 2001. She started holding him skin to skin from the second day and for 5+ hrs. each day in the NICU in Houston, TX. Zachary now is in his last year of high school and aspires to be an automotive engineer.

Why Kangaroo Care and Skin to Skin Contact?

When a flood shut-down the power of the hospital along with the incubators when Z was only 3 weeks old, Yamile joined to save Zach's life by holding him skin to skin to keep him warm (and her husband, Larry, received a crash course on how to "bag" him and took turns with the NICU staff).  Watch Oprah's video about their story in our homepage and Our true story: the science of a transformative promise

Her personal and professional mission is to work on Zachary's behalf to provide a round-the-clock nurturing, healing, and more humane world to babies from birth regardless of their size, gestational age, or medical condition.  In 2001, she founded Nurtured by Design, a disruptive, family-owned engineering organization where scientific knowledge, nurturing and humane care lead the way™

Why The Zaky ZAK? 

After developing The Zaky HUG,  Yamile realized that moms didn't hold babies as much as she did, or at all.  She decided to improve skin to skin contact rates to give every parent the opportunity to safely and comfortably hold the baby for as long as they want and in any hospital unit. 

She embarked in a 3.5-year project to understand the needs around kangaroo care, became certified as a Kangaroo Caregiver, traveled to different Kangaroo Care Sites in Colombia, India, and Africa, and decided to develop The Zaky ZAK. Since 2010 it provides safety, easy and immediate access, containment, warmth, and comfort for adult and baby for prolonged holding. 

She also founded the International Kangaroo Care Awareness Day (celebrated globally on May 15th, Zachary's birthday) to raise education, awareness, and a sense of community. She also developed a poster about the Science Behind Kangaroo Care and a checklist to evaluate a Kangaroo Care/Skin to Skin Contact Device and received a grant from the Bill and Melinda Gates Foundation to advance Kangaroo Care/Skin to Skin Contact implementation and practice. 

The Zaky ZAK is the result of 3.5 years of development using engineering and ergonomics principles and best practices.  It is designed to assist the mother in providing the newborn with the safest, most comfortable, ergonomic and loving transition from womb to world, from birth to up to 3 months after due date. 

INSTRUCTIONS

• BEFORE ARRIVAL OR MOVING THE BABY: When possible, wear the ZAK before welcoming or moving the baby to be held. It is easier than trying to hold the baby and go around the mom to close it when the baby is in place - Transfers are stressful for the baby and the transfer time must be done with intention - quick, respectfully, and ensuring proper positioning. 

• VAGINAL DELIVERY - The Zaky ZAK may be worn by the mom before the delivery using the zipper in the size that is comfortable for her. Many moms choose to only wear The Zaky ZAK to cover their torso and breasts.  After birth, lower the ZAK (or partially open the zipper) to expose the chest of the mom and place the baby (after dried) on skin to skin and loosely cover the baby with The Zaky ZAK without closing the zipper all the way to allow the baby to move and find the breast. 

• C-SECTION - The Zaky ZAK is worn by the mom before going to the OR, covering the breasts but not the abdomen and leaving the zipper partially open.  When the baby is born, place him/her diagonal higher than the breast and cover with the ZAK.  Cover and secure the baby by closing the zipper for full containment before transferring mom with her baby from the table to the stretcher.

• GOLDEN HOUR(S): One hour is the norm, however, according to Dr. Ludington, 2 hours of skin to skin after birth virtually guarantees success with breastfeeding. 

  With The Zaky ZAK, the zipper can be partially open to the selected point, so during the Golden Hour(s), the baby is covered but also allowed to move and find the breast to feed.  If the size of the ZAK needs to be adjusted, the nurse can assist in opening the quiet zipper and easily closing it in the appropriate size.  

• SAFE TRANSPORT: When the mother needs to be moved (i.e., after C-section, or moved to another room or another bed whether holding the baby) close the zipper to keep the baby snug, covering the baby up to the neck to give proper containment/safety while mom moves.  Never cover the head or face of the baby.  If the baby goes to NICU, the mom likes the privacy and light compression of the Zaky ZAK. 

• SAFETY IN POSTPARTUM:  After birth, the mom is recovering from birth and mom and dad are tired, but they also want to hold the baby if they know it is kept safe with the Zaky ZAK.  Other family members may hold the baby in skin to skin position but while clothed, in kangaroo care position secured with The Zaky ZAK.

How tight should the Zaky ZAK be worn?

Moms wear the baby closing the zipper in the size that is comfortable for them (wear bigger size for multiples): not too loose because the baby could slide, and not too tight because it could restrict breathing. During delivery, partially open the zipper to give opportunity to the baby to move and find the breast. When finished close the zipper to secure the baby from the neck to the toes.

Can the parent rest/sleep during skin to skin contact?

This is a frequently asked question.

There is no contraindication in the literature for parents to sleep during kangaroo care, however, there is a significant risk of injury or death if the parent's hands AND attention are the sole source of safety for the babies, and the parent falls asleep. 

Nurses educate the moms about the benefits of skin to skin and usually give verbal commands to the already sleep- deprived moms, to "rest and enjoy" skin to skin contact but not relax too much and fall asleep.  Parents also may lose attention towards the baby while using phones, watching movies, reading, writing on their journal, talking with family, sleeping, resting, etc., and the risk of injuries caused by accidental drops, sliding, or losing the proper posture increases significantly.

As part of their risk management plan, hospitals provide The Zaky ZAK to every baby, and train the adults on its use, sizing and safety features. 

Hospitals are reclaiming the ability to provide safety to every newborn in every hospital unit that is being held in skin to skin (or clothed), and not rely solely on the caregiver's ability to stay awake and attentive.

We support the parent's right to rest/sleep/use hands to use the phone or other activities (i.e., watching a movie is worth 2 hours of skin to skin!), ONLY IF the baby is properly secured with The Zaky ZAK.  Also, the person holding is reclined (not horizontal to avoid rollovers), and with an adult monitoring the skin to skin session.  

Nurtured by Design supports every hospital's' policies regarding sleep during kangaroo care/skin to skin.  The Zaky ZAK's job is to keep the baby safe in the case that the parent falls asleep or is not paying attention.  

Not all kangaroo care / skin to skin care devices are equal.

Click here for assistance on how to evaluate a Kangaroo Care Device and do your homework before purchasing.  Learn why zippers were selected for The Zaky ZAK and why is the preferred device of hospitals.  The stakes are high and it is a matter of life, injury, or death.

We know of a case of a mom in postpartum that was wearing a competitor's wrap and she fell asleep, waking up to her baby breastfeeding under the wrap.  The baby was probably safe from accidentally dropping to the floor, however, the fabric was slippery, didn't provide the proper containment, and the baby slid under the wrap - she could have suffocated. Please beware.

The Zaky ZAK is for everyone with green light to kangaroo, in any hospital unit, then at home.

• DADS/FAMILY MEMBERS/ADOPTING PARENTS/FOSTER PARENTS/VOLUNTEERS:  During Golden Hour(s) the father holds if the mother does not. 

  Everyone can wear the ZAK over the clothes to hold the baby in skin to skin position, however, only in skin to skin contact those that have the explicit permission by the baby's parents.

• BABIES IN WITHDRAWAL: The Zaky ZAK along with The Zaky HUG, is particularly beneficial to promote maternal-infant bonding.  They support infants receiving the Eat, Sleep, Console (ESC) Model of Care (or any model) for NAS symptoms. It facilitates 24/7 ergonomic, evidence-based, non-pharmacologic, and nurturing care for babies and parents.

• KANGAROO CARE IN THE NICU, PICU, or other hospital unit: The Zaky ZAK has been the leader in kangaroo care in hospitals since 2010 and was originally designed to hold fragile babies in critical care.  Any baby and parent that have green light to be skin to skin can do it with The Zaky ZAK.

• SKIN TO SKIN CONTACT WHEN THE PARENT SEEMS UNABLE.   Dr. Jackson is a breast cancer survivor and met many new moms undergoing cancer treatment.  They could not hold the babies because their own arms were weak.  Seeing their faces as they held their babies skin to skin with the Zaky ZAK is something she will never forget.  Same applies for parents with problems with their arms, amputees, etc.

Materials and features

The Zaky ZAK is cotton because it washes cleaner than other fibers and often doesn’t need to be dry-cleaned.  It uses zippers (zippers are quiet, reliable, it opens fully and can be partially opened, they are easy to use, easy to adjust, can be used in any setting, and the parents may put them on and off with or without help).  It is also tagless and free of embroidery that can bother the naked skin of the baby or parent.

The Zaky ZAK provides consistent boundaries from the baby's neck to toes. 

PRIVACY:  The Zaky ZAK is made with heavy cotton that keeps modesty by covering the breasts and nipples, and a touch of spandex.  Cotton is antiallergenic, breathable, keeps baby warm, wash/dry nicely)Fabric is thick, comfortable, and can be worn without anything else if it is hot, or with a sweater, hospital gown, or any garment that opens in the front. 

LENGTH: The ZAK is long, to prevent air drafts from below, and to secure the baby from sliding down.

CLEAN WASH/DRY: To prevent stretching or tangling during the wash/dry, we recommend using the washing bag that comes with The Zaky ZAK.   Follow the same protocol of clothing of babies - in up to 60 degrees, 20+ times, and can be used 3-5 sessions between washes.

EASY TO USE: everyone can use a zipper with or without assistance. Because the zipper opens completely, the ZAK can be worn when the mom is laying down (place it open under the mom and close when she lays down for OR, sitting down, reclined, or standing. 

WARMTH:  Cotton is warmed by the parent's skin and helps keep the baby warm.  Beware of fabrics containing nylon, polyester, or any material that is designed to keep the body cool (designed for yoga, workouts, etc.)

ACCESSIBLE: Access the baby from the top, the bottom, and by partially opening the zipper

UNISEX: Anyone can use The Zaky ZAK, if they have the green light to hold the baby.

PERFECT FIT CONSISTENTLY:  Zippers have 3 zippers that are placed 2 inches apart and we have 3 sizes, so The Zaky ZAK will fit perfectly and consistently from 3XS to 3XL.  They are also color coordinated, so by the color the staff can know the size. 

SOFT AND COMFORTABLE:  The Zaky ZAK is made with heavy cotton and a touch of spandex (cotton is antiallergenic, breathable, keeps baby warm, wash/dry nicely).  It safely holds babies up to 12-15 lbs. Also, the fabric is of light colors to clearly see if the baby is bleeding if any medical equipment is leaking, or if the baby is not positioned correctly to quickly take corrective action.   

Why is important to partially open The Zaky ZAK?

The zipper can be left partially open for ease of placing the baby, access the baby, by only closing the amount needed to allow the baby to move to the breast safely, and not restrain the movement completely for the entire time the baby is skin to skin.  This allows parents to hold for longer sessions.

• During feeding in skin to skin.  The zipper can be partially opened to reposition the baby for breastfeeding, and leave it partially open while the mom is feeding her baby.   If the baby can breastfeed without opening the kangaroo care device, it means that the baby is either too contained to eat comfortably, or it is too loose where the baby is not contained enough.  The best situation is to open the zipper partially to give more room for the baby to move while eating. 
• After each sleep cycle.  Babies wake up about every hour, and the zipper is partially opened to give the baby space to move on the chest of the mom and explore (unless the baby is intubated and must remain still).
• For Shots and evaluations.  Open the zipper partially to provide the vitamin K shot, or any interventions that can be done in skin to skin. 

What about cost?

The Zaky ZAK is the "ultimate skin to skin care device" taking care of the needs of the baby /parents /volunteers/ staff/ hospital admin to provide the best value by improving healthcare outcomes, increase everyone's satisfaction, and lower cost of healthcare

The Zaky ZAK is designed to be an effective device that works consistently and reliably in all hospitals settings (delivery, OR, post-partum, NICU, PICU, high and low tech settings, and at every unit with babies up to 3 months after due date) and then at home. 

This means that the hospital only needs to purchase one device that works with every baby that is hospitalized. All the supply chain is streamlined:
inventory: count how many by color you have, since each color indicates one size
training and quality control: everyone in the hospital that facilitates kangaroo care 
ordering/procurement: a few sizes fit most of the population 

It washed 20-30 times in water of up to 60 degrees Celsius, following the same laundry protocol of clothing of babies and blankets. They can be worn for days between washes (unless soiled) and can be sent home with baby after proper training.  That means it costs only pennies per session, and saves lives.