title: Kangaroo care with twins: a case study in which one infant did not respond as expected.
abstract: OBJECTIVE
  The purposes were to relate responses (including unacceptable ones) of twins to shared kangaroo care (KC), to provide explanations for the unexpected responses, and to offer suggestions for safe nursing practice.
  
  
  METHODS
  A descriptive, evaluative case study was conducted. Both twins received KC while their vital signs and maternal breast temperatures were manually recorded every 30 seconds. Descriptive statistics were computed.
  
  
  METHODS
  Identical twins, born to a 19-year-old African-American primigravada, were 34 3/7 weeks postconceptional age with weights of 1,760 and 1,480 g, respectively, when tested. Preterm labor resulted in spontaneous vaginal birth at 30 weeks gestation.
  
  
  METHODS
  Infant heart and respiratory rates, oxygen saturations, abdominal temperatures, and maternal breast temperatures.
  
  
  RESULTS
  Infant A's vital signs exceeded acceptable clinical limits during shared KC; vital signs returned to normal range once Infant A was returned to the incubator. Infant B's vital signs approximated clinically acceptable ranges throughout the session. Breast temperatures did not differ. Individuality mandates vigilant assessment of infant responses to shared KC.
authors.affiliation: Case Western Reserve University, Bolton School of Nursing, Cleveland, OH 44106-4904, USA.
authors.forename: Julia R
authors.initials: JR
authors.lastname: Jarrell
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ludington-Hoe
authors.forename: Amel
authors.initials: A
authors.lastname: Abouelfettoh
mesh_terms: D000328:Adult; D001831:Body Temperature; D015400:Clinical Nursing Research; D005260:Female; D005330:Fetofetal Transfusion / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007224:Infant Care / Q000379:methods*; D007230:Infant, Low Birth Weight / Q000502:physiology; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000502:physiology; D015931:Intensive Care, Neonatal; D008297:Male; D008991:Monitoring, Physiologic / Q000451:nursing; D017283:Neonatal Nursing; D009730:Nursing Assessment; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D012119:Respiration; D014430:Twins, Monozygotic / Q000502:physiology*
chemical_list: D010100:Oxygen