• Change in Perceived Maternal Stress After Kangaroo Holding. [ Time Frame: Baseline and 5-7 days later ] [ Designated as safety issue: No ]
  Change in maternal stress was evaluated utilizing both physiologic and self-report measures. Maternal self-reported stress was measured using a modified version of the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS:NICU). This is an 11 item questionnaire that focuses on topics of parental role alteration and the parental relationship with their baby. Each item is scored on a 5-point likert scale.
  
  

• Change in Blood Pressure Pre- and Post-kangaroo Holding [ Time Frame: Baseline and 5-7 days later ] [ Designated as safety issue: No ]
  Change in maternal stress was evaluated utilizing both physiologic and self-report measures. Maternal blood pressure was used as one of two physiologic measures of stress.
  
  
• Change in Heart Rate Pre- and Post-kangaroo Holding [ Time Frame: Baseline and 5-7 days later ] [ Designated as safety issue: No ]
  Change in maternal stress was evaluated utilizing both physiologic and self-report measures. Maternal heart rate was used as one of two physiologic measures of stress.
  
  

This study builds on known observations by previous researchers that the birth and hospitalization of premature infants creates stressful events in the lives of parents (Shields-Poe & Pinelli, 1997). The challenge for health care workers is to provide for the physical and psychological needs of infants within a highly technological setting such as the SCN. It is necessary to facilitate effective bonding between parents and infants. Effective bonding is linked with successful parenting role development. Stress can alter the development of a positive parental role.

Kangaroo holding, or skin-to-skin holding, involves placing a diaper clad infant vertical and prone between a mother's breasts (Affonso, 1993). As evidenced by the literature, stress can have an altering effect on the maternal attachment role psychologically and place physical demands on the cardiovascular system. Kangaroo care is one variable that may change the perception of maternal stress during preterm hospitalization by assisting mothers to gain control of the parental role, permitting maternal bonding and reducing maternal separation as well as potentially decreasing the allostatic load as associated with physiologic stress.

This study will compare maternal perceived stress levels before and after kangaroo holding during the first week of life. Mothers who are enrolled in this study will be asked to Kangaroo hold their infants at least two times during the first week of life. The first kangaroo hold will take place with the first 48 hours of life. The second kangaroo hold will take place between day of life five and seven. Mothers may kangaroo hold their infants more than two times, however this study will only examine the kangaroo holding sessions that take place at the two times specified above. This study includes both physiologic and psychologic measurements. Mothers will have their blood pressure and heart rate measured before and after each of the two kangaroo holding sessions. These mothers will also be asked to complete a self-report stress inventory scale prior to the first kangaroo holding session (first 48 hours of infant's life) and again after the second kangaroo holding session (infant's day of life five to seven).