DISCUSSION
This review of the literature suggests that admission to the neonatal intensive care unit restricts the natural process of attachment and that many mothers struggle to get connected with their infant. This study also concludes that nurses who encourage mother‑infant interaction through kangaroo care (KC), breastfeeding, participation in routine care, alongside mother‑nurse interaction through psychosocial support and effective communication, are central to helping the vital connections between the mother and her infant.
KC has a positive, multidimensional impact on mother‑infant interaction and attachment, infant development and self regulation as well as the mother’s mood and behaviour. However, there were also expressed concerns related to infant safety (dislodging of equipment), time restraints and nursing shortage to supervise the technique (Chia and Sellick 2005 p25). Because KC has been acknowledged in promoting mother‑infant attachment and parental confidence, nurses are in a unique position to initiate such practices and facilitate this important mother‑infant acquaintance. However, Hunt (2008 p48) states that KC is not a standard practice in every hospital. Therefore, effective practice policies need to be identified and implemented.
Major barriers have been highlighted with the practice of KC, such as infant safety, nursing staff reluctance, nurses’ fear of something going wrong, minimal staff and time constraints (Chia and Sellick 2005 p25; Engler et al 2002 p150). A national survey of the United States of America indicated that a lack of guidelines, experience and information were major barriers towards the use of KC (Engler et al 2002 p150). Engler et al (2002 p151) suggests that ‘nurses need educational offerings highlighting the knowledge and skills needed to provide KC safely and effectively’. Nurses need further experience, support, evidenced‑based policies and procedures from knowledgeable practitioners and educational offerings that emphasise the value of KC to the mother and infant (Engler et al 2002 p151).