“Retrovation” – Innovation By Looking Back: “Kangaroo” Care for Preemies
“By Shlomo Maital
“Kangaroo” care of preemie, with Daddy
Two key innovation principles joined together, to save the lives of prematurely-born babies in developing countries. One is the desperation of having no money – leading to superheated inventiveness and creativity. The second is the wisdom of looking back to old ideas, rather than constantly seeking technology-intensive expensive new ones, which I call “retrovation”.
Here is the story. Dr. Edgar Rey, chief of pediatrics at Mother & Child Institute, Bogota, Colombia, was desperate. Toward the end of the 1970s, Dr. Rey had a desperate shortage of incubators for premature babies. At times, three babies were crowded into one incubator, spreading infection. Even when alone, “preemies” tend to do poorly in incubators. One reason, Dr. Rey felt, was that preemies were separated from their mothers when in incubators.
Let’s be creative, he reasoned. Incubators keep babies warm, oxygenated and nourished. Just like the womb. What else can do this job, without costly equipment? How about – mothers? Dr. Rey invented “kangaroo care” – here is how it works.
A mother of a preemie puts the baby on her exposed chest, dressed only in a diaper and a cap, upright or semi-upright, strapped in by a scarf or other cloth sling supporting its bottom, all but its head covered by mom’s shirt. The mother keeps the baby like that, skin-to-skin, even when sleeping in a reclining chair. Fathers can wear the baby too, to give Mom a break. The babies stay warm, their own temperature regulated by the sympathetic biological responses that occur when mother and infant are in close contact. The mother’s breasts heat up or cool down, depending on what the baby needs. Feeling the mother’s breathing and heartbeat helps babies stabilize their own heart and respiratory rates. They sleep more. They can breastfeed at will. Preemies simply do better with “kangaroo”, according to randomized clinical research.
“Kangaroo” is basically how mothers care for babies in “poor” countries that cannot afford technology, and how mothers cared for babies through history. By looking “backward”, both in terms of history and in terms of technological sophistication, a major breakthrough was achieved.
One of the careful clinical trials of “kangaroo” was conducted here in Israel, at Nahariya Hospital.
 Tina Rosenberg, “The human incubator”, Global New York Times, Friday Dec. 17, 2010, p. 6.