Ludington-Hoe, S. M, Lewis, T., Morgan, K., Cong, X., Anderson, L., & Reese, S. (2006). Journal of Obstetric, Gynecologic, and Neonatal Nursing, 35(2), 223-231.

With well documented evidence regarding efficacy and safety, most neonatal nurses today feel comfortable with and routinely encourageing kangaroo care (KC) for singleton births. Little research, however, has been reported about outcomes for multiple-birth infants simultaneously experiencing KC.

This study used a case approach with two sets of premature twins. Rigorous and consistent guidelines were followed for temperature measurement of maternal breast and infant abdominal temperature. The twins were held in shared KC for 1.5 hours.

Both sets of twins remained stable and were able to remain in shared KC for 1.5 hours without any compromise to thermal stability. All four infants had temperatures above 36.5 [degrees]C during KC. It is interesting and important to note that when infant temperatures decreased below 36.9 [degrees]C, breast temperatures increased. Concomitantly, when infant temperatures increased, breast temperatures decreased.

The findings indicated that breast temperatures increased and decreased independently of each other but not independently of the infant on the breast. These data suggest a condition of thermal stability that is supported and clearly explained as physiologically grounded. Although this study is limited in its generalizability because of a case-study approach, it is exciting in that it suggests the value, efficacy, and safety of shared KC with twins. Further research with a randomized-controlled trial is now warranted. In the meantime, nurses can feel comfortable initiating shared KC while maintaining close observation of infant thermal stability.

Judy Beal