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#200 - 🦘 Tech Tuesday - The Science and Heart of Kangaroo Care (ft Yamile Jackson)






Hello Friends 👋

In this episode of the Tech Tuesday podcast, Dr. Yamile C. Jackson, CEO of Nurtured by Design, shares her journey from an engineer to an innovator in the neonatal care space, inspired by her son Zach's premature birth and the challenges she faced in the NICU. Focused on improving the NICU experience for both infants and their families, Yamile developed the Zaky Hug and Zaki Zak, tools designed to provide comfort, support, and safety to hospitalized infants. The conversation dives deep into the concept of kangaroo care, its benefits for premature babies, and how Yamile’s products facilitate this essential practice. By blending personal narrative with practical innovation, the episode illuminates the power of parental touch and involvement in neonatal care, underscoring the need for hospitals to adopt more family-centered approaches. This inspiring story not only showcases Yamile's commitment to enhancing neonatal care but also encourages healthcare professionals to recognize the profound impact of integrating human elements into medical care.

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Short Bio: Yamile C. Jackson, Ph.D., PE, PMP, CEO of Nurtured by Design in Sugar Land, TX, shifted her career path from risk management to neonatal care innovation after her son, Zachary, survived a premature birth during a hospital blackout in 2001. Her experience led her to create The Zaky® brand, offering ergonomically designed solutions like The Zaky HUG® and The Zaky ZAK® to improve safety, family involvement, and healthcare outcomes in NICUs and PICUs. Dr. Jackson is recognized as an award-winning innovator and motivational speaker. She founded International Kangaroo Care Awareness Day and recently launched The Zaky APP to enhance kangaroo care practices, underscoring her dedication to improving healthcare.

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Learn more about the Zaky ZAK





Find out more about the Zaky ZAK (for professionals): https://thezaky.com/pages/useful-links-for-the-zaky-zak





The article mentioned on the show can be found below:

Hatch LD 3rd, Scott TA, Slaughter JC, Xu M, Smith AH, Stark AR, Patrick SW, Ely EW.Pediatrics. 2020 Jun;145(6):e20192819. doi: 10.1542/peds.2019-2819. Epub 2020 May 6.PMID: 32376726 Free PMC article.


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The transcript of today's episode can be found below 👇


Daphna Barbeau (00:01.847)

Good morning, everybody. We've got another episode of Tech Tuesday today. And today we're so honored to be joined by Dr. Yamil C. Jackson, the CEO of Nurtured by Design. Thank you so much for joining us today.

 

Yamile (00:17.322)

I'm so excited to be here. Thank you so much for inviting me.

 

Daphna Barbeau (00:21.767)

We're just so pleased to have you just a month out from Kangaroo Care Day and you'll be able to tell us all why that's so important. But I'll let people know a little bit about you if they don't know you yet, though you are well involved in so many things that involve in NICU parents. You're totally ingrained in the community. Just in case people don't know who you are, Dr. Jackson, I told you he's the CEO of Nurtured by Design in Sugar Land, Texas.

 

An engineer by training has a distinguished background in Fortune 100 companies specializing in risk management. She was inspired by her son, Zach's premature birth in 2001 and remarkable survival during a hospital blackout caused by a flood. She embarked on a mission to transform NICUs into nurturing intensive care units. Through her brand, The Zaki, she engineers evidence-based solutions like The Zaki Hug, The Zaki Zak, improving safety, satisfaction, and healthcare outcomes while reducing risks, errors, and...

 

cost. Other accomplishments include founding International Kangaroo Care Awareness Day and introducing the Zaki app for Kangaroo Care Analytics. You can learn more at www.thezaki.com and www.kangaroo.care. You can follow her on Instagram and Facebook at The Zaki and at Kangaroo Care Day. Well.

 

I'd love if you can tell us a little bit about your story and a little bit about your son Zach.

 

Yamile (01:56.594)

Yes, so I am originally Colombian and I came to the U.S. to pursue a Ph.D. in engineering. I ended up going to four different degrees in engineering and my concentration is in ergonomics and human factors and I do risk and safety as well. And in 2001, I...

 

Daphna Barbeau (02:16.256)

Amazing.

 

Yamile (02:23.982)

gave birth to Zach. He was 28 weeks and almost 23 years ago, that was little. And I didn't know the Nikkyo existed. I didn't know, you know, from the time that Zachary was, from the time that somebody told me that I could have a preemie to the time that I had a preemie was two and a half hours. So I didn't have any time to prepare. It was

 

It was very traumatic and three weeks after Zach was born, we had a flood in Houston that shut down the hospital. And we had to keep him alive by touch, by hand for nine hours until he was evacuated. My husband and I were able to get to the hospital in about hour number five or six. And I held him skin to skin.

 

Daphna Barbeau (03:10.431)

Wow.

 

Yamile (03:23.106)

to give him warmth and Larry received a crash course on how to bag him. So he will take turns with the staff on bagging him until he was evacuated. In those very dark moments, I promised Zach that he's pain and struggle to survive or not in vain, and I would dedicate my life to helping babies like him and families like ours. So.

 

Daphna Barbeau (03:30.349)

Mmm.

 

Daphna Barbeau (03:43.317)

Mm.

 

Yamile (03:51.346)

going to a different hospital make me realize that not all the hospitals are the same, not all have the same culture, not all have the same type of care, not all have the same involvement of, you know, inviting parents to come be part of the team that takes care of the baby. And I.

 

Daphna Barbeau (04:04.119)

So true.

 

Yamile (04:19.398)

When Zachary was in the NICU, it was very, very difficult for me and for every mom that goes through those doors to leave without your baby after you give birth. So I wanted to, I ask a lot of questions. I'm an engineer. I want to solve problems. One of the problems that we had was that the nurses kept saying,

 

And they say it every day, the baby feels the way you feel. So one of the things that I could do was to calm myself. And one of the ways that I knew I could calm myself was to do something, you know, try to solve a problem, right? One of the questions that I asked Anaraj was.

 

Daphna Barbeau (05:01.323)

Mm-hmm.

 

Daphna Barbeau (05:08.896)

Mm-hmm.

 

Yamile (05:15.078)

very, very soon after Zachary was born was what is a common denominator of these babies when they were born, when they grow. And she said without any hesitation, she says they don't like to be touched. And I was Hispanic, we touch, like, and, you know, touch has been very important in my life, in my culture. And I couldn't imagine not touching Zach.

 

Daphna Barbeau (05:29.623)

Mm-hmm. Sure.

 

Yamile (05:40.966)

or even worse, giving Zach a life where he wouldn't enjoy human touch. That would be a very isolating life, I thought. So I asked the nurse, is it because they don't develop that sense because they're so little or is it because they learn by association and every time we touch him, it hurts? And she says, well, we don't know. There is no way to research it.

 

You know, it's not a topic that we can research. And so I was like, I need evidence of one. Yeah, I need evidence of my son to see if we can, you know, avoid that risk, I mean, that risk of being aversion to touch. So I touched him a lot. The nurses taught me how to touch him, how to hold my hands over him. And.

 

Daphna Barbeau (06:14.719)

You're like, that's not good enough for me. Yeah, that's right.

 

Yamile (06:37.954)

I, we held him in skin to skin. Like I said, I'm Colombian, so I've heard about kangaroo care when I was in Colombia. Not that I was a junk, a news junkie at 11, but you know, we only had two channels. So, so I, I wanted to simulate my hands that stayed with Zach because I was like, how does he know that I love him? Because I love him.

 

Daphna Barbeau (06:43.415)

Sure.

 

Yamile (07:07.794)

And my husband loves him and nurses love him. But how does he know if I leave him every day, he doesn't know that I have to go, but I abandoned him every day. The nurses didn't let me stay or there was not a place for me to stay. And I would allow people to hurt him and I wouldn't stop them.

 

And he doesn't know that these people are actually trying to save his life. And then when he's the sickest, I don't touch him. And he doesn't know that I'm not allowed to touch him. And I always thought, I wonder if he feels that I am mad at him, that he's sick. Right. So for those moments that I couldn't touch him, I used this little glove filled with beads that would simulate my hands.

 

And the nurses saw immediately how it helped them. It, you know, he was connected to every monitor. What they couldn't see was how it helped me, being able to leave something of me with Zach. I didn't know, and I believe the research was not out on babies learning, knowing the scent of the mom, you know, in 2001, so I would.

 

Daphna Barbeau (08:18.175)

Mmm.

 

Yamile (08:33.238)

put it on my skin and my husband's and I would leave it with him. I wanted to make sure that he knew who his mother was and that I was there every day. I was very fortunate that I could take a leave of absence from my work to be there every day. And so we went to different hospital, then we went back to the first hospital because of complications.

 

Daphna Barbeau (08:37.483)

Mm-hmm.

 

Yamile (09:01.362)

And then once we got home, I asked my husband, what can we do to help babies? What can I do? And about three weeks after we got home, a nurse called me from the hospital and she says, you know the little gloves that you made for Zach? Can you make them for the rest of the unit? So, yeah, so I was like, you know, it clicked. Exactly, right?

 

Daphna Barbeau (09:06.807)

Hmm.

 

Daphna Barbeau (09:20.651)

I love that.

 

Daphna Barbeau (09:25.271)

That was your proof of concept right there, right? When the nurses were asking for more.

 

Yamile (09:32.014)

And I also had, I said, you know, there are many things that I had in the NICU that I, you know, that I learned that I didn't like, right? So for example, using so many items to position Zachary, right? I always felt that every time you move him and you touch him, you pretty much wake him up.

 

Daphna Barbeau (09:43.319)

Mm-hmm.

 

Daphna Barbeau (09:59.36)

Mm-hmm.

 

Yamile (09:59.626)

Right? It's like, it's like if I am sleeping and I want to roll over and somebody changes my pillow and my blanket and even my mattress, it's going to be very difficult for me to fall asleep right away. Then if you leave everything the same, but you, I roll over. Right. Which is I do that every night. Um, and I keep sleeping. I don't wake up to roll over and then wait 30 minutes to see if I can, you know,

 

Daphna Barbeau (10:06.891)

Mm-hmm.

 

Yamile (10:29.21)

go back to sleep. So I asked the nurse, I said, you know, the ones that I made were handmade, homemade. They had risks, which I could take risks for my baby, but I cannot take them for somebody else. So I said, let's do a full blown project to develop what I would consider the ultimate developmental care tool.

 

Daphna Barbeau (10:42.327)

That's right.

 

Yamile (10:58.158)

and replace everything that we're using. Because, you know, just because I want to position a baby sideline, I don't have to use a specific one for sideline. I can use the same one to do all the things that you need for developmental care. So, it took us three and a half years. Things that I wanted to achieve was that I didn't want to make different sizes.

 

We were talking about developing a product that was being, is going to be used by babies that were one, weighing a little bit less than a pound, maybe 25 pounds. We were not developing something for a 300 pound person. So, I wanted to do one product, you know, one size that it could be used by everyone in the NICU.

 

I didn't want to say the baby has X condition, they can't use it. That it would take the place of all the tools on the bed. So all positioners, nesters, soothing items, dissenting items for the parents, containment boundaries, and positioning for all positions like, you know, supine, prone, sideline. And,

 

And so it took us three and a half years to have the design that we have, which is called the Zaki hug. And I wanted to give it to someone else to sell it so I could go back to doing my consulting work in oil and gas. But it didn't work that way because at that time that product was like family centered care was not a thing, you know, like.

 

Why do we want moms involved, right? So I was facing with a decision, do I do it on my own or do I let it die? And I couldn't let it die. So the only company that could sell the product at the time, which was the supplier of the items that Zachary used.

 

Daphna Barbeau (12:58.647)

Mm-hmm, mm-hmm.

 

Yamile (13:24.818)

They loved it, except the one that was making the decision said that it would replace one of the items of their suite of products. What he didn't know was that we actually replaced them all, virtually replaced them all. You can use one or two or three to do everything that you need to do, you know, for developmental care. So.

 

Daphna Barbeau (13:36.235)

Hmm.

 

Daphna Barbeau (13:42.473)

hahahaha

 

Yamile (13:55.67)

When I was doing that work, I started getting calls from different hospitals and I'm like, how do you know about us? Because we don't do advertising. We don't have any budget for that. I mean, no way. And they were like, well, you know, we hired a neonatologist that was in that hospital doing residency or fellowship or something. And, you know, traveling nurses that.

 

They used the product when they were in this hospital. And so that's how we started growing. Then I saw that by going to different NICUs, we were not doing kangaroo care. And it was like in the second hospital that I went, like I say, can I hold my baby? And they would say, well, you need a doctor's order. And I'm like, okay, can you go get it? And then she would come with a 15 minute of kangaroo care.

 

Daphna Barbeau (14:35.762)

Mm-hmm.

 

Daphna Barbeau (14:46.224)

Mm-hmm. Okay.

 

Yamile (14:50.986)

when in the other hospital I was doing 45 hours of kangaroo care. So I did a study, I wanted to know what were the roadblocks of kangaroo care in the United States. And we did, you know, it's a pretty big survey on interviews. And I wanted to find out, like it was a lot of things that happened to me, right? So for example, I wanted to find out.

 

Daphna Barbeau (14:54.24)

Mm-hmm.

 

Yamile (15:20.582)

why some nurses would allow and promote kangaroo care and some nurses in the same unit with the same information with the same baby would not want to do it, right? I also wanted to know what keeps us from doing kangaroo care and I could place all the answers into two big buckets.

 

Daphna Barbeau (15:28.808)

Mm-hmm.

 

Yamile (15:50.346)

One was education and training. There is no education in the curriculum. And even now, it's not, you know, they mention it. They might mention it in their college, but they don't dive into it, right? So, every nurse comes to the NICU not knowing what it is. So, if you don't know it, you're not going to suggest it, right?

 

Daphna Barbeau (15:52.179)

Mm-hmm.

 

Yamile (16:17.87)

Many of the answers were, if the parent asks, we'll do it. And then I was like, how would the parent know if we don't tell them? And then, what are the benefits, how to do it, who can do it for how long? All these like awareness and education. So to try to solve that, I started Kangaroo Care Day.

 

which was a day that the mission was to just what it says, is awareness, improve awareness, give a day in a year to allow for education to be disseminated and without any judgment. Like if you know it, you can, you know, you.

 

You review it, but if you don't know it, you learn it without having to say, I don't know. Right. Um, and, um, I needed a date for the kangaroo care day. So I selected Zachary's birthday. And, uh, which is May 15. And, uh, so the second big bucket, and it has been an amazing day. It is already a global event. Uh, every.

 

Daphna Barbeau (17:28.828)

I love that.

 

Daphna Barbeau (17:38.487)

Hmm?

 

Yamile (17:42.518)

Nikyu does their own activities and celebration. And it is amazing to see that in every Nikyu, there is at least one person that is absolutely creative. And they do so many great things. We have the website kangaroo.care that we provide free resources. Like.

 

Daphna Barbeau (18:00.052)

Mm-hmm.

 

Yamile (18:10.922)

you know, a little page that says, what are the benefits of kangaroo care to print and give it to the parents? There are cards. There are, we have a lot of resources that are, that are free for, for that. The reason that, that we started doing that and they having the website and offering all these was because we talked to every nurse and they all said, we don't have a budget. And I'm like, you know, we can do it for free. You know, if you do it.

 

Daphna Barbeau (18:16.603)

Yeah, lots of resources for that day. Yeah, you guys offer, absolutely.

 

Daphna Barbeau (18:35.487)

Mm-hmm.

 

Yamile (18:40.062)

We can support you, just get some printing and start with, you know, like giving every person, every bed, the benefits of kangaroo care. So hospitals started doing kangarooathons and kangarooathons are, they select to, you know, a period of time where they basically do analytics on kangaroo care. They count.

 

How many babies were kangarooed? Who, you know, for how long? How long was the unit having kangaroo, you know, kangaroo care in that, let's say two weeks. They involve the staff as well. So, they also, you know, give incentives to, or bragging rights to either the baby that held the longest or the parent, the staff that helped the most.

 

Um, we always recommend to, um, To give like incentives to everyone, like our, or a raffle instead of only the one that won the most because we want to. You know, we want to make sure that everybody's has incentive to do it. Even if they are not, you know, if the mom is not there all day kangarooing for eight hours. So the.

 

Daphna Barbeau (19:47.295)

Yeah.

 

Daphna Barbeau (20:01.215)

Mm-hmm.

 

Daphna Barbeau (20:04.844)

It's kind of the theory that some kangaroo care is better than no kangaroo care, right? Yeah.

 

Yamile (20:08.998)

Exactly, exactly. However, WHO recommends eight to 24 hours of kangaroo care for preemies. So I want to see when every day is Kangaroo Care Day. My goal is when every day is every day is Kangaroo Care Day. The other big bucket was safety.

 

Daphna Barbeau (20:22.963)

So that's your goal. That's your ultimate goal that globally, that's right. I love.

 

Yamile (20:37.55)

transfers, we have to put the baby back because we need to do interventions. So if we know that we're going to do a heel stick in 15 minutes, then let's wait the 15 minutes to do the heel stick and then we do kangaroo care. But then after the heel stick, we need to, you know, there is, you know, abdominal ultrasound coming exactly. So that all those interventions were keeping us from doing it.

 

Daphna Barbeau (20:58.475)

Something always comes up. Yeah, something always.

 

Yamile (21:06.79)

Um, the, the fact that we give parents the most comfortable chairs that we can, we know that their adrenaline is down when, and that happened to me. I mean, your adrenaline goes to zero when you're holding your baby and the monitors are quiet because the baby is stable. You're sleep deprived. You're producing oxytocin and a nurse tells you don't fall asleep.

 

Well, that is what keeps also kangaroo care to 30 to 40 minutes to an hour, because that's how long the parent can fall asleep. I mean, stay awake. And we usually say, you know, I've heard from nurses that the parents don't want to hold. Well, we don't want to hold because you told me I can't sleep and I'm sleepy. And I don't want to put my baby in danger. So I think you need to put the baby back.

 

Daphna Barbeau (21:42.679)

That's right.

 

Yamile (22:08.334)

Um, so I fell asleep with Zach and when I woke up, I still remember the feeling of waking up with Zach and I wanted every parent to experience that. So I started a project, um, to see if anything that is in the market we could use in the NICU to hold the babies on skin to skin now.

 

Daphna Barbeau (22:25.451)

Beautiful.

 

Yamile (22:37.206)

Do you need something to hold the babies? If you're gonna do it for 30 minutes or an hour or two hours at a time, I mean, it's stressful, right? So, you know, we don't have to go to school walking. You know, we could, but we don't have to. So, you know, having a kangaroo care device is actually recommended in the standards

 

Daphna Barbeau (22:49.237)

Mm-hmm.

 

Yamile (23:06.942)

neonatal care because we know that we found the solution for all of these problems that we've had on all the roadblocks, most of the roadblocks that either keeps the baby putting them back or not doing kangaroo care. One of the things that was very, very interesting for me was to find out why some nurses like it and some nurses didn't offer it.

 

Other than, you know, some of them were like, you know, I don't know enough to offer it. So I don't want to be put in a position that I don't know the answer. So I just avoided. But many, when we talked about the safety, I wanted to know because it was a lot. It was some nurses, you know, were more averse to doing it. And what I found, I concluded from all the interviews.

 

was that when the babies are on the bed, the nurse has control of the safety of these baby as much as possible. The nurse knows that the baby's not going to fall to the floor. Chances of extubation is lower on the bed than it is when the mom is holding.

 

Daphna Barbeau (24:14.383)

Mm-hmm.

 

Yamile (24:32.382)

So they have the responsibility and the control of the safety of this baby when they're on the bed. Once they put this baby on the chest of the mom, you give the control to the mom, but you keep the responsibility. So it is very difficult to ask someone to do that. And so what we wanted to do was, how do we give that control back to the nurse?

 

Daphna Barbeau (24:48.48)

That's right.

 

Yamile (25:02.102)

where the nurse is not worried that the mom is moving, the mom is closing her eyes, the mom is reaching for the phone, the mom is reaching for drinks.

 

Daphna Barbeau (25:12.171)

Mm-hmm.

 

Yamile (25:15.926)

The parents, when they don't use a kangaroo care device, they are responsible for the safety of this baby.

 

Daphna Barbeau (25:23.345)

Mm-hmm.

 

Yamile (25:25.138)

Some, if something happens, they are responsible because they're responsible for the safety of this baby. So if you ask a father, specifically a father, fathers are super risk averse. If the babies are intubated and you tell the father, you can hold your baby. But if you don't do these, and these, the baby can extubate. The immediate response is let my wife do it. Right.

 

Daphna Barbeau (25:37.879)

Hehehe

 

Daphna Barbeau (25:46.795)

Mm-hmm.

 

Daphna Barbeau (25:50.815)

They just won't do it. Yeah. Yeah, right now.

 

Yamile (25:55.542)

They don't want to do it. So by these, we're moving kangaroo care two weeks, three weeks, four weeks until the baby is extubated, right? I mean, and we can't do that. Fathers need to be involved right away.

 

Daphna Barbeau (26:10.641)

Yeah.

 

Daphna Barbeau (26:14.559)

Well, and I just want to highlight something that you said that was just so poetic, I think, that by having parents do kangaroo care, you're giving them control back, right? And that's all parents are looking for. It's just like a little bit of control in this chaos and feeling like a parent. And just that is why kangaroo care is so powerful, I think, from a parent perspective.

 

Yamile (26:42.003)

Yes.

 

Daphna Barbeau (26:42.688)

in addition to the obvious benefits to the baby.

 

Yamile (26:46.002)

Yeah. So kangaroo care gives the control to the parents and gives them the ability to heal their babies. Because that's what basically kangaroo care is. The kangaroo care device gives a safety control to the nurse. Because we want the nurse to know that when she walks away, the device is going to keep that baby safe.

 

Daphna Barbeau (26:55.04)

Mm-hmm.

 

Daphna Barbeau (27:03.795)

Yeah, I love that.

 

Daphna Barbeau (27:14.365)

Yeah.

 

Yamile (27:14.79)

or else she can't do anything else other than, and that's what, you know, that's what, it was so interesting to me because they keep saying, and it's not one, I mean, so many of them said, it's more work for me. And when I asked, why is it more work for you if the parent is the one doing the holding? And then that's when they said, you know, the baby can do all these things. They can, you know,

 

Daphna Barbeau (27:29.419)

Mm-hmm.

 

Yamile (27:43.766)

the positioning of the baby, the mom can do all this, it's just, I get nervous when the mom moves and the baby's intubated because I know, and there is research now, which he was not, when we did the study, that an unplanned extubation in the NICU costs the hospital between 30 and $50,000. Plus the baby goes through a very traumatic intubation again.

 

It is in the nurses watch and the respiratory therapies, they have to intubate again. And the parent, when you ask a parent whose baby has been extubated during kangaroo care, what they say is I had one job and I couldn't do it. Absolutely. Which is not their fault because we have now a device that

 

Daphna Barbeau (28:32.119)

Mm-hmm. Yeah, there's a lot of guilt associated with that, right? Yeah. Right.

 

solutions.

 

Yamile (28:43.25)

that will prevent as much as possible. Obviously, we can, you know, eliminate the risks, but we significantly, you know, reduce the risk of extubation. We, so I made what is called the ZakiZak, which is the device that I would have loved to have when I held my baby.

 

Daphna Barbeau (29:04.215)

Mm-hmm. And the Zachy Zach for people who haven't seen it is almost like a binder, like a stretchy binder that goes over the chest and the baby is tucked into the pocket, really like a kangaroo, which is delightful. That's right.

 

Yamile (29:11.815)

Is that yeah.

 

Yamile (29:17.078)

Yes, it's a strapless top that closes with a zipper. And we have four sizes and each size adjusts to three different sizes. So we actually get 12 sizes into four devices. And it's unisex, it has zippers.

 

And the reason for zippers is because everybody knows how to use a zipper. And everybody knows when the zipper is not working. Everybody, you know, you, and then we have us, you know, a set of steps. Remember I'm an engineer, so I'm in processes. So you, you know, you put the Zachy Zach first to make sure, and the nurse makes sure that he's in the right size. The zippers are working. And then, you know, it, it fits perfectly to the body of the bait or the

 

Daphna Barbeau (30:13.867)

Mm-hmm.

 

Yamile (30:13.998)

parent without the baby, once we have that size, then we move the baby, either sitting or standing transfer. And then you can access by moving the Zachy Sack. You fold it up, you fold it down, you open the zipper a little bit. You don't open all the zipper all the way until you're removing the baby from kangaroo care. It was very, always very...

 

in my head that we were using the Zachy, Zach in an intensive care unit, whether it's NICU, PQ, any unit with babies up to 15 pounds. And that kept us from doing loops and hoops and holes to put any of the leads. Because we...

 

we want to be able to get the baby out in an instant in an emergency. So I was in a very unique position to be able to make like the ultimate canker care device, right?

 

Daphna Barbeau (31:28.215)

device. Yeah. What I love about your story is, I mean, obviously you had a background in engineering, obviously. So it was kind of serendipitous that you found yourself in a NICU. But what I hear in your story is just this perseverance. Like this is something that babies need and they deserve it and families need it. And I'm just going to go do it. And I think that's such a message for the community because we all in our own units, we're like

 

You know, if we just had this simple, really simple intervention, like it could potentially change outcomes for babies. Right. So that is just so powerful. And I hope people really get that from listening to you that like, we can just go out and do things and create things. And maybe we need to partner with an engineer and we need to go through the safety steps, but it's possible. And you've done quite a lot in just, I mean, two, two decades, give or take.

 

Yamile (32:10.838)

Thank you.

 

Yamile (32:25.87)

two decades.

 

Daphna Barbeau (32:26.139)

Um, since, since you, since you started, which I think is incredible. And I'd actually like to share with you how the Zachy impacted my career a little bit, and I don't think I've ever told you that story, but I was a resident when I went to my first Gravens conference here in Clearwater Beach, Florida, um, which if you people have not been there is a conference that centers around NICU design, developmental care and family centered care. And it was really, it was really.

 

Yamile (32:29.675)

Mm-hmm.

 

Yamile (32:34.726)

Yeah. No, tell me.

 

Yamile (32:43.305)

Yeah?

 

Yamile (32:50.84)

Right. Yeah.

 

Daphna Barbeau (32:54.463)

before its time, now is really gaining a lot of popularity. And you were there as a quote unquote vendor. Obviously you have such a presence at the Gravens Conference. But I was a resident and I had not quite yet found my space, I think in medicine. And when I went to the Gravens Conference and I learned about the Zacchi, I said, you know, like, this is it. Like this is what I think I want to do with my life. And that's really...

 

Yamile (32:56.404)

Yeah.

 

Yamile (33:04.654)

Thank you. Yeah.

 

Yamile (33:12.299)

Yeah?

 

Daphna Barbeau (33:23.167)

change how babies feel safe in the unit by making sure that parents are really centered as the team, you know, as a major part of the team, the biggest part of the team, because that's what babies and parents are looking for. And so my entire career trajectory was, I think, built on my first Gravance Conference. Yeah. And seeing

 

Yamile (33:26.901)

Yeah.

 

Yamile (33:36.941)

Yeah.

 

Yamile (33:41.178)

Oh my god! I had no idea!

 

Daphna Barbeau (33:48.551)

Um, seeing things like the Zachian saying like, these are my people, people who get it that like the NICU, despite our technological advances is really a place about human relationships. And, um, how can we, how can we focus on that? So thank you for setting my career trajectory.

 

Yamile (33:51.916)

Yeah.

 

Yamile (34:05.906)

Oh my goodness, no, I am honored. Thank you so much for sharing that. That's amazing. And what you say is so, so true. Like, you know, when you get that not everything has to have a medication attached to it, you know, our products are non-pharmacologic, but how do you calm a baby, right? Parents can calm their babies. And when the babies are not there, let's simulate their hands.

 

Daphna Barbeau (34:11.973)

Yeah.

 

Daphna Barbeau (34:20.267)

That's right. Yeah.

 

Daphna Barbeau (34:28.491)

Mm-hmm.

 

Yamile (34:34.934)

that stay with them. And we know that, like when you get a flu shot, the technician tells you, well, relax, because if you relax, you will hurt less. In the NICU, I was like asking everyone that would listen to me, like, how do you relax a baby? You can't tell them relax because it's gonna hurt. And then by calming them, there is actually evidence that when using the Zaki hugs, babies show less

 

Daphna Barbeau (34:35.031)

Mm-hmm. I love that.

 

Daphna Barbeau (34:44.322)

Mm-hmm.

 

Daphna Barbeau (34:52.267)

That's right.

 

Yamile (35:05.07)

pain indicators, you know, and when the babies can sleep, they can eat better, they can, you know, they develop better, they grow better. So we want them to sleep even, especially because Dr. Graven that started that conference, his research shows that babies develop the brain when they're sleeping. And it's not just the IQ. I mean, it's every type of development, you know.

 

Daphna Barbeau (35:06.411)

Mm-hmm.

 

Daphna Barbeau (35:26.717)

Mm-hmm.

 

Yamile (35:33.046)

communications and relationships and everything develops when they're sleeping. When I took my kangaroo care certification with Dr. Luttington, she said babies in the womb go through 22 sleep cycles. Every hour is a sleep cycle. So what I recommend the nurses.

 

Daphna Barbeau (35:55.745)

Mm-hmm.

 

That's right.

 

Yamile (36:02.722)

to tell the parents is if the baby were in the womb, they would get fit 22 hours, 22 cycles of kangaroo care. How many sleep cycles can you give them today? So they understand that one hour is a bare minimum, right? I always equate the kangaroo care sessions

 

Daphna Barbeau (36:16.267)

I love that.

 

Daphna Barbeau (36:22.935)

Mm-hmm.

 

Yamile (36:31.746)

to an airplane ride. If you go in a 30 minute airplane ride from one city to the next city, you go to the restroom before, you don't get any service for drinks, you don't get up, you don't open the phone because you can't even watch a movie. You know, it's like up and down and that's it. But when you go from the US to Europe, you get...

 

Daphna Barbeau (36:44.148)

You don't settle in.

 

Yamile (37:00.674)

food and you get all these things that keep your mind occupied. Because if it's a six-hour flight, you don't want it to feel like it's a 10-hour flight. And the way that we do that is allowing the parents to do something, to read, to work in their phones. Working on their phones is not a problem unless they're...

 

removing the hands from giving safety to the baby. So by having the Zachy sack, the Zachy sack is the one giving that support that the parents don't have to worry that am I doing it right? Am I positioning the baby correctly? Am I doing, which is what stresses us, right? Am I doing it okay?

 

Many of the moms say I don't want to hold him. And that's what I had. When the first day I saw Sack, which he was the second day of life. A nurse asked me, do you want to hold him? And I said, no. But I said, why? I said, I don't want to hurt him anymore. And I felt that by giving him, you know, by not giving him a healthy start, I had already hurt him too much.

 

So I didn't want to hurt him anymore. And the nurse said, you will hurt him more if you don't hold him. I always think, imagine if she would have said something else. If she would have said, oh, it's okay. Or whenever you're ready or yeah, the baby's sleeping. Any other question answer that she would have given to me would have

 

Daphna Barbeau (38:37.608)

Yeah.

 

Daphna Barbeau (38:43.399)

Yeah, disagreed with you. Yeah.

 

Yamile (38:57.618)

not putting me in the path of Sakri being healthy today and being in college and having a relationship with a beautiful girl. So yeah, it is amazing. So now that we improve kangaroo care, I, in 2017, about, you know, when we started doing kangarooathons and hosting kangarooathons,

 

I was curious of why it was so important and what did the nurses get from the kangaroo athons. And it was basically analytics. They can see how long we are holding the babies. And I always thought kangaroo care, we measure everything on the NICU, right? We measure every drop of milk, every drop of formula, medications.

 

Daphna Barbeau (39:49.448)

Mm-hmm.

 

Yamile (39:56.722)

the millimeter of growth of the baby, the weight. So basically we count everything that counts, right? Everything that is important. But we're not counting cangery care. And what the message that we're providing, we're giving to parents and staff is that is not that important. We're not even charting it.

 

Daphna Barbeau (40:19.823)

Mm-hmm. That's right.

 

Yamile (40:21.886)

If you chart it, in some hospitals, there might be a kangaroo care there, but it's one more thing for the nurse. And that's one.

 

Daphna Barbeau (40:31.947)

Well, and the nurse is recognized too. If I chart it, but nobody follows it, then what am I even doing it for, right? Yeah.

 

Yamile (40:37.31)

Yeah, exactly. Unless it's consistent, then it's not good. One of the things that I learned in the NICU by being there for five months is to get an appreciation of the amount of work the nurses have. And

 

What I wanted to do was to not give them one more thing to do. When we do kangarooathons that last either one day or two weeks, the people that do the kangarooathons are basically volunteers. They don't get paid anymore, and they still have to do the work that they have to do. So.

 

It is good for two weeks, but it's impossible to ask for them to do these manually for the entire year. So I said, I want to make an app. Not knowing anything about apps.

 

Daphna Barbeau (41:54.571)

but you figured it out.

 

Yamile (41:56.178)

I figured out. Um, and we got, um, very, you know, the, the push that we needed, which was a grant from the Gates Foundation to make an app to, uh, improve kangaroo care. So we selected to make an app to do analytics of kangaroo care. And we, because I am a parent, I felt that parents needed to be involved.

 

And parents needed a very important piece of this app. So what we did was the, it has two different apps, basically the mobile app is for parents and the parents are the ones that track kangaroo care. When we asked parents, when we started developing the app in our conceptual phase, we asked parents, would you use a kangaroo care app?

 

And the answer was yes, but not if kangaroo care is the only thing that I can do in the app. So we added feeding. So we have breastfeeding, pumping, gavage, because we know we're in the NICU, solid, solid food, because, you know, we wanted to make it up to about two, three years. We have sleep and we.

 

We talked to pediatricians and the pediatricians requested that we put sleep and awake, but in the awake, we wanted just really awake and calm or awake and fussy. And the reason was because, which was really interesting to me, it says, many of the moms come to my practice and say, my baby cries so much. And so...

 

to be able to say, okay, you count how long because, you know, it might seem a lot, but it's not that much, right? It's just that you're so stressed out that it feels like the baby's crying a long time. So we got that, we got growth, obviously. And then the change of diapers and other activities and then journal and the ability to join a team for a kangarooathon.

 

Yamile (44:18.646)

or for analytics for a team like the NICU, for example. So in the web app, we have a portal, which is for the staff. We call them coaches because we, you know, can get our care coaches because it can be, you know, not everybody's a staff, not everybody's a nurse, not everybody is a respiratory therapist. So we just call them all coaches and it can be anybody that helps parents can grow care.

 

lactation consultants, peer parents, volunteers, anybody. And one of the persons of the team is a team leader and they get all the kangaroo care information from all the babies. So the app does the average of kangaroo care for the team for today or for the day.

 

if you are in a contest for the entire contest, we call it contest because kangaroo I thought it was too long. Um, we also measure, uh, also when they, when the parent logs, the kangaroo care sessions on their phone, they have an opportunity to, to pick one of the coaches to give the same amount of the duration of the, of the app, of the session, and that's how we get.

 

coaches also to participate is to help the parents so they can pick them. And so we have duration, we have average, we have the average of the baby, we have the average of the, of the, of the coaches. The team leader can see all the sessions of the babies that, you know, that are in their team.

 

They can participate in contests. So the team leader can either join or create a contest. And all the people in the team participates. Privacy was really important for us. So everybody works in screen names. And it's just duration that goes back and forth. You know, the parents, if you see, like parents only see the.

 

Yamile (46:38.686)

the screen name of a baby, which if you want to call it, you know, the name of the baby, or just say baby warrior or whatever, they see the location of the baby, just city, state, and country, and the duration, and the screen name. And the team leader can see a little bit more information, like who is the father, the parent, and who is, what is the name of the baby with that screen name.

 

And then when you're in kangaroo-athons, you see the average of kangaroo care. And the average for us is all the baby, the duration of all the babies in the team, divided by the number of babies and divided by the number of days. And so you, you see that average from every team. And again, the team can be

 

Daphna Barbeau (47:26.519)

That's great.

 

Yamile (47:35.182)

called whatever the team leader wants to call it. If they want to call it the name of the hospital and the NICU, or they can call it the baby warriors. But that name of the team plus the average plus the number of babies, number of coaches and location is gonna be shared. But everything, like you cannot talk to...

 

babies of another team or coaches in another team. That is not there.

 

Daphna Barbeau (48:03.595)

Mm-hmm.

 

Daphna Barbeau (48:07.167)

So how do people get the app if they want to try it out on this May 15th for Kangaroo Peer Day?

 

Yamile (48:13.67)

Yes. So, and then, but, you know, one thing that I didn't mention was that what we, all the data is real time and you can use the data of Kangaroo Care year long. So it's not just for the two weeks of Kangaroo Care one day. Yeah. The app, you can go to kangaroo.care and press on Kangarooathon and we have a register.

 

Daphna Barbeau (48:23.604)

Mm.

 

Daphna Barbeau (48:28.003)

Mm-hmm. That's great. The one day, right.

 

Yamile (48:42.866)

And then we'll give you information on how to use it. We can also go to the Zaki.app. And that's, that's the actual app and you can start registering your team. That this Zaki.app tells you like the links to for the parents, where is the app, the mobile app for the parents. And then the coaches register in the, in the mobile app, in the web app.

 

Daphna Barbeau (49:07.507)

I love that. And I have one last question for you as we're wrapping up our conversation today. The 2024 theme for Kangaroo Care, International Kangaroo Care Awareness Day this year is Embrace the Magic. What does that mean to you?

 

Yamile (49:27.842)

Um, to me, kangaroo care is just magic. Uh, you don't, you cannot explain all the things that happen to your body, to your mental health, to, you know, things that it's very difficult to put a scientific reasoning of what is happening. Um,

 

I think that we know that kangaroo care is important, but we haven't embraced it yet. And I hope that with the app, where we know where we are, then we can get better. But if we don't start counting what counts, it's going to be harder to do better. And that's, you know...

 

Daphna Barbeau (50:14.815)

Mm-hmm.

 

Yamile (50:27.63)

coming from an engineering mind that you have to measure everything that counts and by counting it, it gives the importance that it needs, I think, especially in the US.

 

Daphna Barbeau (50:38.183)

I love that. And I think that will really resonate with the medical community, right? Who likes to dot their I's and cross their T's and be documenting readily. So I think that's so exciting. I thank you so much for sharing your journey with us and a little bit more about Zach with us. And we look forward to everybody posting really big numbers, right, for Kangaroo Care Awareness Day.

 

Yamile (51:06.426)

Yes, yes. And the first year might be, you know, not that big. But the idea is that we get better every year, right? Every day we want to get better. And don't wait until you're holding eight hours a day.

 

because there are many roadblocks for that too. I mean, there is no maternity leave in the US. There is no, it's important. So if you want to help a family during kangaroo care day or between now and kangaroo care day, I recommend that you reach out to the NICU and ask what they need for moms to do kangaroo care. Sometimes it's something as simple as pay for parking for these moms or pay for...

 

babysitter so somebody else can take care of the babies while the mom comes and does kangaroo care. Realize that not only moms and dads can kangaroo care, you know, grandmothers and anybody with permission by the parents can do kangaroo care. And we have the evidence of that. There is a study that shows that surrogate kangaroo care is very important and it has a very, you know, if not probably the same very good

 

very good results.

 

Daphna Barbeau (52:24.179)

thank you for providing even more solutions, right? To the barriers and the obstacles we have to providing really well-rounded kangaroo care.

 

Yamile (52:26.61)

laughs

 

Yamile (52:34.062)

Yeah, we just need to remove barriers. That's what we're doing.

 

Daphna Barbeau (52:39.12)

That's right. Well, thank you for joining us.

 

Yamile (52:42.146)

Thank you so much for staying and listening to my story.

 

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