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Sinisalo H, Bakermans‐Kranenburg MJ, Peltola MJ. Hormonal and behavioral responses to an infant simulator in women with and without children. Dev Psychobiol 2022; 64:e22321. [PMID: 36282748 PMCID: PMC9545496 DOI: 10.1002/dev.22321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/27/2023]
Abstract
We investigated the impact of maternal status on hormonal reactivity and behavioral responses to an infant simulator in 117 women (54 primiparous, 63 nulliparous). The amount of affectionate touch and motherese were analyzed as behavioral measures of caregiving. Saliva was collected before and 10 min after interaction with the infant simulator to analyze oxytocin, testosterone, cortisol, and estradiol levels. Nulliparous women also provided information about their fertility motivation. Linear mixed models indicated that greater use of affectionate touch was associated with lower overall testosterone levels. Cortisol decreased in response to the interaction in both groups. In the primiparous group, the amount of affectionate touch associated inversely with cortisol levels, whereas in the nulliparous group such association was not found. Oxytocin or estradiol reactivity to the simulator did not differ between the groups, nor were these hormones associated with behavior. Higher fertility motivation in nulliparous women was related to more motherese, and lower testosterone levels. Our results indicate that the simulator elicits hormonal reactivity both in mothers and nonmothers, but the patterns of associations between caregiving behavior and hormonal levels may be partially different. These results encourage using the infant simulator to explore hormonal processes related to the transition to parenthood.
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Affiliation(s)
- Hanneli Sinisalo
- Human Information Processing Laboratory, Faculty of Social Sciences, PsychologyTampere UniversityTampereFinland
| | - Marian J. Bakermans‐Kranenburg
- Faculty of Behavioural and Movement Sciences, Educational and Family StudiesVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Mikko J. Peltola
- Human Information Processing Laboratory, Faculty of Social Sciences, PsychologyTampere UniversityTampereFinland
- Tampere Institute for Advanced StudyTampere UniversityTampereFinland
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Rashidi M, Maier E, Dekel S, Sütterlin M, Wolf RC, Ditzen B, Grinevich V, Herpertz SC. Peripartum effects of synthetic oxytocin: The good, the bad, and the unknown. Neurosci Biobehav Rev 2022; 141:104859. [PMID: 36087759 DOI: 10.1016/j.neubiorev.2022.104859] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/23/2022] [Accepted: 09/03/2022] [Indexed: 11/30/2022]
Abstract
The first clinical applications of oxytocin (OT) were in obstetrics as a hormone to start and speed up labor and to control postpartum hemorrhage. Discoveries in the 1960s and 1970s revealed that the effects of OT are not limited to its peripheral actions around birth and milk ejection. Indeed, OT also acts as a neuromodulator in the brain affecting fear memory, social attachment, and other forms of social behaviors. The peripheral and central effects of OT have been separately subject to extensive scrutiny. However, the effects of peripheral OT-particularly in the form of administration of synthetic OT (synOT) around birth-on the central nervous system are surprisingly understudied. Here, we provide a narrative review of the current evidence, suggest putative mechanisms of synOT action, and provide new directions and hypotheses for future studies to bridge the gaps between neuroscience, obstetrics, and psychiatry.
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Affiliation(s)
- Mahmoud Rashidi
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany.
| | - Eduard Maier
- Department of Neuropeptide Research in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sharon Dekel
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Marc Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Robert C Wolf
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, Center for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Valery Grinevich
- Department of Neuropeptide Research in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
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Implementation and Practice Barriers of Family-Centered Care Encountered by Neonatal Nurses. Adv Neonatal Care 2022; 22:432-443. [PMID: 34596093 DOI: 10.1097/anc.0000000000000948] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Approximately 7 out of every 100 births in the United States result in admission to the neonatal intensive care unit (NICU), which contributes to a delay in initial physical contact between the parents and their newborn. While family-centered care (FCC) increases opportunities for parent-infant connection, implementation barriers persist in clinical practice. Research has yet to examine whether organizational and nursing factors of empowerment and compassion fatigue (CF) in the NICU are associated with FCC practice. PURPOSE The aim of this study was to determine the relationship between empowerment, CF, and FCC practices among NICU nurses. METHODS This quantitative portion of a mixed-methods study used a cross-sectional, descriptive correlational design. Bedside NICU nurses with at least 6-month experience were recruited to complete an anonymous online survey using established, valid, and reliable instruments. RESULTS Except for organizations with Magnet status, there were no significant differences in FCC practice within individual and institutional characteristics. Hierarchical linear regression model indicated nurse empowerment was a strong predictor of FCC practice (β= 0.31, R2 = 0.35, P < .001). There was only a weak, inverse association between CF and FCC practices ( r =-0.199, P < .001). IMPLICATION FOR RESEARCH AND PRACTICE Further qualitative research will integrate these findings to understand the process by which neonatal nurses engage in FCC practices in the context of NICU setting. Future studies should examine facilitators and barriers of FCC practice in the NICU. Strategies (eg, policies and trainings) to increase nurse empowerment and support for FCC implementation should be developed and evaluated.
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Lebel V, Campbell-Yeo M, Feeley N, Axelin A. Understanding factors associated with emotional closeness in parents with a preterm infant in the neonatal intensive care unit. Early Hum Dev 2022; 173:105664. [PMID: 36075153 DOI: 10.1016/j.earlhumdev.2022.105664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/30/2022] [Accepted: 08/30/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND There is a dearth of knowledge regarding the specific factors associated with emotional closeness in parents with an infant in the NICU. AIM To determine if parental presence, involvement in infant care, holding, skin-to-skin contact (SSC), perceived family-centered care, depression symptoms, and sociodemographic characteristics are associated with the emotional closeness of parents with an infant hospitalized at the NICU. STUDY DESIGN This longitudinal descriptive study was conducted in two Canadian level-three NICUs. A sociodemographic questionnaire was completed by parents at enrolment. A closeness diary was completed by each parent for 14 days to measure parental presence, involvement in infant care, holding, SSC, and emotional closeness. One question from the DigiFCC tool was sent daily via text message to the parents' cellphones to measure their perception of the quality of family-centered care they experienced. Parent depression symptoms were measured using the Edinburgh Postnatal Depression Scale at discharge. RESULTS A total of 60 families were involved in the study. Increased parental presence (B = 0.21, p < 0.001), increased time involved in infant care (B = 0.14, p < 0.001), increased holding time (B = 0.53, p < 0.001), and greater time in SSC (B = 0.27, p = 0.01) were associated with greater parental emotional closeness. CONCLUSION Several factors may enhance parents' emotional closeness when their infant is in the NICU. Care providers need to be aware and adapt their clinical practices accordingly to promote emotional closeness by encouraging parental presence, involvement in infant care, holding, and skin-to-skin contact.
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Affiliation(s)
- Valérie Lebel
- Nursing department, Université du Québec en Outaouais, 5 St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada.
| | - Marsha Campbell-Yeo
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Avenue PO BOX 15000, Halifax, Nova Scotia B3H 4R2, Canada; Division of Neonatal Perinatal Medicine, Department of Pediatrics, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Izaak Walton Killam Health Centre, 5980 University Ave #5850, Halifax, Nova Scotia B3K 6R8, Canada
| | - Nancy Feeley
- Ingram School of Nursing, McGill University, 680 Sherbrooke St W, Bureau 1800, Montreal, Québec H3A 2M7, Canada; Jewish General Hospital Centre for Nursing Research & Lady Davis Institute, 3755 Côte-Sainte-Catherine Street, Montréal, Québec H3T 1E2, Canada
| | - Anna Axelin
- Department of Nursing Science, University of Turku, 20014, Finland
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Brzozowska A, Longo MR, Mareschal D, Wiesemann F, Gliga T. Oxytocin but not naturally occurring variation in caregiver touch associates with infant social orienting. Dev Psychobiol 2022; 64:e22290. [PMID: 35748632 PMCID: PMC9328151 DOI: 10.1002/dev.22290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/05/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022]
Abstract
Caregiver touch is crucial for infants' healthy development, but its role in shaping infant cognition has been relatively understudied. In particular, despite strong premises to hypothesize its function in directing infant attention to social information, little empirical evidence exists on the topic. In this study, we investigated the associations between naturally occurring variation in caregiver touch and infant social attention in a group of 6- to 13-month-old infants (n = 71). Additionally, we measured infant salivary oxytocin as a possible mediator of the effects of touch on infant social attention. The hypothesized effects were investigated both short term, with respect to touch observed during parent-infant interactions in the lab, and long term, with respect to parent-reported patterns of everyday touching behaviors. We did not find evidence that caregiver touch predicts infant social attention or salivary oxytocin levels, short term or long term. However, we found that salivary oxytocin predicted infant preferential attention to faces relative to nonsocial objects, measured in an eye-tracking task. Our findings confirm the involvement of oxytocin in social orienting in infancy, but raise questions regarding the possible environmental factors influencing the infant oxytocin system.
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Affiliation(s)
- Alicja Brzozowska
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
- Department of Developmental and Educational PsychologyUniversity of ViennaViennaAustria
| | - Matthew R. Longo
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Denis Mareschal
- Department of Psychological SciencesBirkbeck, University of LondonLondonUK
| | - Frank Wiesemann
- Baby CareProcter & Gamble Service GmbHSchwalbach am TaunusGermany
| | - Teodora Gliga
- Department of PsychologyUniversity of East AngliaNorwichUK
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Shou Q, Yamada J, Nishina K, Matsunaga M, Matsuda T, Takagishi H. Association between salivary oxytocin levels and the amygdala and hippocampal volumes. Brain Struct Funct 2022; 227:2503-2511. [PMID: 35943580 DOI: 10.1007/s00429-022-02543-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022]
Abstract
Salivary oxytocin levels have been widely measured and studied in relation to social behavior because of procedural simplicity and noninvasiveness. Although the relationship between oxytocin levels in the blood and the hippocampus and amygdala is now becoming clear with reliable blood oxytocin studies, few studies have examined the relationship between salivary oxytocin and the brain function and structure. This study aimed to investigate whether the salivary oxytocin level is associated with the volume of the amygdala and hippocampus in 178 adults (92 women and 86 men) in their third to seventh decade of life. We performed volumetric analysis of the amygdala and hippocampus using FreeSurfer and measured salivary oxytocin levels using enzyme-linked immunosorbent assay. The results showed contradictory effects of the salivary oxytocin level on the amygdala volume by sex and no significant effect on the hippocampal volume. Specifically, men showed a positive correlation between the salivary oxytocin level and amygdala volume, whereas women showed a negative correlation between the salivary oxytocin level and amygdala volume. The present study's finding of sex differences in the association between salivary oxytocin and brain structure supports previous findings that there are sex differences in the oxytocin system.
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Affiliation(s)
- Qiulu Shou
- Graduate School of Brain Sciences, Tamagawa University, Tokyo, Japan
| | - Junko Yamada
- Brain Science Institute, Tamagawa University, Tokyo, Japan
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Pavlyshyn H, Sarapuk I, Horishna I, Slyva V, Skubenko N. Skin-to-skin contact to support preterm infants and reduce NICU-related stress. Int J Dev Neurosci 2022; 82:639-645. [PMID: 35850037 DOI: 10.1002/jdn.10216] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 07/13/2022] [Accepted: 07/14/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Hospitalization in the neonatal intensive care unit (NICU) with numerous painful medical interventions, being separated from parents, leads to the high risk of chronic stress for preterm infants. Today, many NICUs use more appropriate developmental care and pain management, but the early and long-term outcomes of stress in these vulnerable infants require searching for more stress-reducing interventions in neonatal care. The objective of the study was to investigate how skin-to-skin contact (SSC) can influence the biologic stress levels in preterm infants in the NICU by assessing cortisol and oxytocin levels. PARTICIPANTS AND METHODS The study included 71 preterm infants with gestational age less than 34 + 0/7 weeks who were recruited from level III NICU. The overall design was a baseline-response design. Saliva and urine were collected before (baseline) and after skin-to-skin contact to measure salivary cortisol and urinary oxytocin by enzyme immunoassay method. RESULTS The infants' baseline hormonal status was represented by the following indicators: the level of salivary cortisol was 0.402 [0.227; 1,271] μg/dl, urinary oxytocin 48.88 [32.97; 88.11] pg/ml. There was a decrease in salivary cortisol levels to 0.157 [0.088; 0.351] μg/dl compared to baseline (p ˂ 0.001) with a simultaneous increase of the urinary oxytocin level -73.59 [45.18; 108.8] pg/ml (p = 0.028) in response to SSC. CONCLUSION Preterm infants in the NICU experience significant stress, characterized by hormonal imbalance: an increased level of the stress hormone cortisol and a decreased level of the anti-stress hormone oxytocin. Skin-to-skin contact helps to ameliorate the hormonal stress in preterm infants by activating the oxytocin release with simultaneous reduction of cortisol secretion.
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Affiliation(s)
- Halyna Pavlyshyn
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Iryna Sarapuk
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Ivanna Horishna
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Viktoriia Slyva
- Department of Pediatrics No 2, I. Horbachevsky Ternopil National Medical University, Ternopil, Ukraine
| | - Neonila Skubenko
- Neonatal Intensive Care Unit, CNE "Ternopil Regional Clinical Perinatal Center "Mother and Child", Ternopil, Ukraine
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Lomas T, Bartels M, Van De Weijer M, Pluess M, Hanson J, VanderWeele TJ. The Architecture of Happiness. EMOTION REVIEW 2022. [DOI: 10.1177/17540739221114109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Happiness is an increasingly prominent topic of interest across academia. However, relatively little attention has been paid to how it is created, especially not in a multidimensional sense. By ‘created’ we do not mean its influencing factors, for which there is extensive research, but how it actually forms in the person. The work that has been done in this arena tends to focus on physiological dynamics, which are certainly part of the puzzle. But they are not the whole picture, with psychological, phenomenological, and socio cultural processes also playing their part. As a result, this paper offers a multidimensional overview of scholarship on the ‘architecture’ of happiness, providing a stimulus for further work into this important topic.
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Benefits of Kangaroo Mother Care on the Physiological Stress Parameters of Preterm Infants and Mothers in Neonatal Intensive Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127183. [PMID: 35742429 PMCID: PMC9223087 DOI: 10.3390/ijerph19127183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022]
Abstract
It is well documented that the stress of separation of mother and baby can lead to short-term physiological instability as well as neurological, sociological or psychological consequences that may last a lifetime. Objective: The goal was to estimate the effect of kangaroo mother care (KMC) on physiological and biochemical parameters of preterm infant stress and maternal stress in neonatal intensive care. Methods: The investigation involved 112 preterm infants. Two groups were compared according to the mean duration of KMC during 12 days of study: the KMC group (mean duration more than 90 min daily) and the control group (less than 90 min). Results: Kangaroo mother care for more than 90 min on average per day in preterm infants is associated 12 days after the intervention with lower mean cortisol levels (p = 0.02), greater weight gain and less need for parenteral nutrition in preterm infants, as well as less postpartum depression (p = 0.02) and lower cortisol levels (p = 0.002) in the mothers of preterm infants. Conclusions: This study suggests that KMC can be used to improve the stress of preterm infants and their mothers, and that the greater weight gain observed in these preterm infants could contribute to a shorter average hospital stay and lower healthcare expenditure.
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Possible oxytocin-related biomarkers in anxiety and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry 2022; 116:110531. [PMID: 35150782 DOI: 10.1016/j.pnpbp.2022.110531] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/30/2021] [Accepted: 02/05/2022] [Indexed: 02/08/2023]
Abstract
Anxiety and mood disorders are prevalent, disabling, and frequently difficult to treat. Such disorders are often comorbid and share similar characteristics. For more accurate diagnosis and improved treatment, a deeper understanding of the pathophysiology of anxiety and mood disorders is important. Oxytocin, a neuropeptide synthesized in the hypothalamus, affects human psychology and behaviors such as social and affiliative behaviors, fear and emotion processing, and stress regulation. Thus, oxytocin is believed to exert anxiolytic and antidepressant-like effects. This review article provides an overview of clinical studies on relationships between the oxytocin system and anxiety and mood disorders, focusing on oxytocin-related biomarker findings. Biomarkers used in such studies include central and peripheral oxytocin levels, analysis of oxytocin-related genes, and expression levels of oxytocin and oxytocin receptor genes in postmortem brains. Although a growing number of studies support the presence of oxytocinergic effects on anxiety and mood disorders, study results are heterogeneous and inconclusive. Moderating factors such as the characteristics of study populations, including sex, age, context, early life adversity, and attachment styles in patient cohorts, might affect the heterogeneity of the study results. Limitations in existing research such as small sample sizes, large dependence on peripheral sources of oxytocin, and inconsistent results between immunoassay methods complicate the interpretation of existing findings.
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Aydin Kartal Y, Kaya L, Yazici S, Engin B, Karakus R. Effects of skin-to-skin contact on afterpain and postpartum hemorrhage: A randomized controlled trial. Nurs Health Sci 2022; 24:479-486. [PMID: 35451239 DOI: 10.1111/nhs.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 12/01/2022]
Abstract
This study determined the effects of skin-to-skin contact between the mother and the infant during the third stage of labor on postpartum hemorrhage and pain. This assessor-blinded randomized controlled trial was conducted with primiparous women. Skin-to-skin contact interventions between the infants and their mothers occurred for 30 min after birth (n = 34), whereas the infants in the control group were provided routine care (n = 34). Data were gathered using a Personal Information Form, the Visual Analog Scale-Pain, postpartum bleeding follow-up bags, and records of blood oxytocin and beta endorphin levels. There was no significant difference in beta-endorphin levels in both groups (p = 0.771), whereas it was determined that the 30th min oxytocin level was significantly higher in the intervention group (The Visual Analog Scale-Pain score at the postpartum sixth hour was significantly lower in the intervention group. It was found that skin-to-skin contact made at the third stage of labor reduced the amount of postpartum hemorrhage. The results of this study suggested that skin-to-skin contact intervention may have beneficial effects on postpartum pain and postpartum hemorrhage in the early postpartum period.
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Affiliation(s)
- Yasemin Aydin Kartal
- Department of Midwifery, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Leyla Kaya
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Saadet Yazici
- Department of Midwifery, Hamidiye Faculty of Health Sciences, University of Health Sciences, Istanbul, Turkey
| | - Betül Engin
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
| | - Resul Karakus
- Department of Obstetrics and Gynaecology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Istanbul, Turkey
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A Systematic Review of the Effects of Skin-to-Skin Contact on Biomarkers of Stress in Preterm Infants and Parents. Adv Neonatal Care 2022; 22:223-230. [PMID: 34054011 PMCID: PMC9150851 DOI: 10.1097/anc.0000000000000905] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Premature infants and their parents experience significant stress related to separation and lifesaving procedures. While evidence suggests that skin-to-skin contact (SSC) is a stress-reducing intervention for both neonates and parents, the mechanisms that underlie its efficacy are not well understood. OBJECTIVE Purpose of this systematic review is to summarize the current state of knowledge on changes in biomarkers (ie, oxytocin [OT], cortisol, hypoxanthine, xanthine, uric acid, and allantoin), associated with SSC in premature infants and parents, that may reflect physiologic responses to stress. METHODS A comprehensive literature search was conducted from 1990 to 2020. Studies were selected using prespecified inclusion and exclusion criteria. RESULTS Of the 175 studies identified, only 19 are included in this review. Ten studies evaluated only infants, 2 evaluated only parents, and 7 evaluated for changes in biomarkers in both infants and parents. Cortisol was the most common biomarker evaluated. While changes in infants' cortisol levels were highly variable, in 55% of the parent studies, parent cortisol levels decreased following SSC. In both parents and infants, OT levels decreased following SSC. Only 1 study found that allantoin levels were significantly lower in infants who received SSC. IMPLICATIONS FOR PRACTICE AND RESEARCH While evidence suggests the numerous benefits of SSC, additional research is needed to identify the optimal biomarker to determine the mechanisms that underlie these effects. The use of novel biomarkers (eg, gene expression changes microbiome) may provide new insights into the mechanisms that underlie the efficacy of SSC.Video Abstract available at:https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=48.
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Kokkinaki T, Hatzidaki E. COVID-19 Pandemic-Related Restrictions: Factors That May Affect Perinatal Maternal Mental Health and Implications for Infant Development. Front Pediatr 2022; 10:846627. [PMID: 35633965 PMCID: PMC9133722 DOI: 10.3389/fped.2022.846627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/30/2022] [Indexed: 11/28/2022] Open
Abstract
This review aims to discuss the factors that may affect maternal mental health and infant development in COVID-19 pandemic condition. Toward this direction, the two objectives of this review are the following: (a) to discuss possible factors that may have affected negatively perinatal mental health through the pandemic-related restrictions; and (b) to present the implications of adversely affected maternal emotional wellbeing on infant development. We conclude that the pandemic may has affected maternal mental health with possible detrimental effects for the infants of the COVID-19 generation. We highlight the need for evidence-based interventions to be integrated within the health system for prenatal and postpartum care in an effort to promote maternal mental health and infant development.
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Affiliation(s)
- Theano Kokkinaki
- Child Development and Education Unit, Laboratory of Applied Psychology, Department of Psychology, University of Crete, Rethymno, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology, Neonatal Intensive Care Unit (NICU), School of Medicine, University of Crete, Rethymno, Greece
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Kimkool P, Huang S, Gibbs D, Banerjee J, Deierl A. Cuddling very and extremely preterm babies in the delivery room is a positive and normal experience for mothers after the birth. Acta Paediatr 2022; 111:952-960. [PMID: 34971010 DOI: 10.1111/apa.16241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/20/2021] [Accepted: 12/30/2021] [Indexed: 11/28/2022]
Abstract
AIM Extremely preterm infants are separated from their mothers immediately after birth and not placed skin-to-skin in routine neonatal intensive care unit settings. Visual and physical contact in the delivery room as a first cuddle potentially can facilitate early parent-infant interaction and reduce the trauma of separation. Our aim in this study was to explore mothers' experience of delivery room cuddle by collecting qualitative feedback via emotional mapping. METHODS Six mothers experiencing delivery room cuddle had been recruited (GA of their babies 24 + 5-29 + 0 weeks, birth weight 540-1019 g). Using a descriptive qualitative approach, semi-structured interviews were performed with six mothers following consent via Zoom or phone between September 2020 and March 2021. Interviews were transcribed using AI Otter and then analysed using thematic analysis. RESULTS Analysis of the participants' experiences revealed five themes: fears and hopes around delivery; the moment of delivery-recognising uncertainty; reclaiming normalcy; forming connections; and the journey ahead as an empowered parent. CONCLUSION All mothers reported positive emotions about the cuddle with their baby. They highlighted that this physical contact was often the only positive and 'normal' birth experience they had from the time of delivery.
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Affiliation(s)
- Parisut Kimkool
- Neonatal Unit Imperial College Healthcare NHS Trust London UK
| | - Shirley Huang
- Neonatal Unit Imperial College Healthcare NHS Trust London UK
| | | | - Jayanta Banerjee
- Neonatal Unit Imperial College Healthcare NHS Trust London UK
- Institute of Reproductive and Developmental Biology Imperial College London UK
| | - Aniko Deierl
- Neonatal Unit Imperial College Healthcare NHS Trust London UK
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Olsson Mägi CA, Wik Despriee Å, Småstuen MC, Almqvist C, Bahram F, Bakkeheim E, Bjerg A, Glavin K, Granum B, Haugen G, Hedlin G, Jonassen CM, Lødrup Carlsen KC, Rehbinder EM, Rolfsjord LB, Staff AC, Skjerven HO, Vettukattil R, Nordlund B, Söderhäll C. Maternal Stress, Early Life Factors and Infant Salivary Cortisol Levels. CHILDREN 2022; 9:children9050623. [PMID: 35626800 PMCID: PMC9139396 DOI: 10.3390/children9050623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/09/2022] [Accepted: 04/20/2022] [Indexed: 11/30/2022]
Abstract
Background: Salivary cortisol (SC), a commonly used biomarker for stress, may be disrupted by negative events in pregnancy, at birth and in infancy. We aimed to explore if maternal perceived stress (PSS) in or after pregnancy and SC levels in pregnancy were associated with SC in early infancy, and, secondly, to identify early life factors associated with infants’ SC levels (iSC). Methods: At 3 months of age, SC was analyzed in 1057 infants participating in a Nordic prospective mother-child birth cohort study. Maternal PSS was available from questionnaires at 18- and 34-week gestational age (GA) and 3-month post-partum, and SC was analyzed at 18-week GA. Early life factors included sociodemographic and infant feeding from questionnaires, and birth data from medical charts. Associations to iSC were analyzed by Spearman correlation and multinomial logistic regression analyses. Results: In this exploratory study neither PSS at any time point nor maternal SC (mSC) were associated with iSC. Higher birth weight was associated with higher levels of iSC, while inverse associations were observed in infants to a mother not living with a partner and mixed bottle/breastfeeding. Conclusions: Maternal stress was not associated with iSC levels, while birth weight, single motherhood and infant feeding may influence iSC levels.
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Affiliation(s)
- Caroline-Aleksi Olsson Mägi
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Correspondence:
| | - Åshild Wik Despriee
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | | | - Catarina Almqvist
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden
| | - Fuad Bahram
- Research Centre, Stockholm South General Hospital, SE-118 83 Stockholm, Sweden;
| | - Egil Bakkeheim
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Anders Bjerg
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Martina Children’s Hospital, SE-114 86 Stockholm, Sweden
| | - Kari Glavin
- Faculty of Health, VID Specialized University, NO-0424 Oslo, Norway; (M.C.S.); (K.G.)
| | - Berit Granum
- Department of Chemical Toxicology, Norwegian Institute of Public Health, NO-0213 Oslo, Norway;
| | - Guttorm Haugen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Gunilla Hedlin
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Christine Monceyron Jonassen
- Faculty of Chemistry, Biotechnology and Food Science, Norwegian University of Life Sciences, NO-1430 Ås, Norway;
- Genetic Unit, Centre for Laboratory Medicine, Østfold Hospital Trust, NO-1714 Kalnes, Norway
| | - Karin C. Lødrup Carlsen
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Eva Maria Rehbinder
- Department of Dermatology and Vaenerology, Oslo University Hospital, NO-0424 Oslo, Norway;
| | - Leif-Bjarte Rolfsjord
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
- Department of Paediatric and Adolescent Medicine Elverum, Innlandet Hospital Trust, NO-2381 Brumunddal, Norway
| | - Anne Cathrine Staff
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Obstetrics and Gynaecology, Oslo University Hospital, NO-0424 Oslo, Norway
| | - Håvard Ove Skjerven
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Riyas Vettukattil
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, NO-0424 Oslo, Norway; (Å.W.D.); (G.H.); (K.C.L.C.); (A.C.S.); (H.O.S.); (R.V.)
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, NO-0424 Oslo, Norway; (E.B.); (L.-B.R.)
| | - Björn Nordlund
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
| | - Cilla Söderhäll
- Department of Women’s and Children’s Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (A.B.); (G.H.); (B.N.); (C.S.)
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, SE-171 64 Stockholm, Sweden;
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Mother-Infant Dyadic Synchrony in the NICU Context. Adv Neonatal Care 2022; 22:170-179. [PMID: 35703926 DOI: 10.1097/anc.0000000000000855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dyadic synchrony is a co-constructed social process relating to the back and forth interactions between mothers and infants that are strongly associated with neurodevelopment, self-regulation, and attachment. In the neonatal intensive care unit (NICU), this process may become interrupted because of the physiological state of the infant, the emotional state of the mother, and the physical environment of the NICU. PURPOSE In applying Feldman's Biobehavioral Model of Synchrony, this empirical review deconstructs the process of dyadic synchrony in the NICU context and provides a conceptual approach to guide both research and clinical practice. METHODS First, we examine the theoretical and empirical literature to explicate the primary structural and biophysiological components of synchrony and relate these constructs to the extant research on premature infants. Next, we synthesize the maternal, infant, and contextual factors that facilitate or inhibit the ontogenesis of dyadic synchrony in the NICU. The final section highlights the state of the science in dyadic synchrony in the NICU including gaps and recommendations for future research. FINDINGS An empirical review synthesis presents a visual conceptual framework to illustrate multiple processes that depict maternal, infant, and contextual influences of mother-infant synchrony in the NICU. IMPLICATIONS FOR PRACTICE/RESEARCH Despite the challenges posed to mother-infant relationships in the NICU, high-quality mother-infant interactions are possible, dyadic synchrony can emerge, and premature infants can develop secure attachments. Clinicians and researchers can apply this conceptual framework of mother-infant dyadic synchrony in the NICU to promote evidence-based research and clinical practice.
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67
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Hodsoll J, Pickles A, Bozicevic L, Supraja TA, Hill J, Chandra PS, Sharp H. A Comparison of Non-verbal Maternal Care of Male and Female Infants in India and the United Kingdom: The Parent-Infant Caregiving Touch Scale in Two Cultures. Front Psychol 2022; 13:852618. [PMID: 35401353 PMCID: PMC8984138 DOI: 10.3389/fpsyg.2022.852618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
Differences in infant caregiving behavior between cultures have long been noted, although the quantified comparison of touch-based caregiving using uniform standardized methodology has been much more limited. The Parent-Infant Caregiving Touch scale (PICTS) was developed for this purpose and programming effects of early parental tactile stimulation (stroking) on infant hypothalamic-pituitary adrenal (HPA)-axis functioning (stress-response system), cardiovascular regulation and behavioral outcomes, similar to that reported in animals, have now been demonstrated. In order to inform future studies examining such programming effects in India, we first aimed to describe and examine, using parametric and non-parametric item-response methods, the item-response frequencies and characteristics of responses on the PICTS, and evidence for cross-cultural differential item functioning (DIF) in the United Kingdom (UK) and India. Second, in the context of a cultural favoring of male children in India, we also aimed to test the association between the sex of the infant and infant "stroking" in both cultural settings. The PICTS was administered at 8-12 weeks postpartum to mothers in two-cohort studies: The Wirral Child Health and Development Study, United Kingdom (n = 874) and the Bangalore Child Health and Development Study, India (n = 395). Mokken scale analysis, parametric item-response analysis, and structural equation modeling for categorical items were used. Items for two dimensions, one for stroking behavior and one for holding behavior, could be identified as meeting many of the criteria required for Mokken scales in the United Kingdom, only the stroking scale met these criteria in the sample from India. Thus, while a comparison between the two cultures was possible for the stroking construct, comparisons for the other non-verbal parenting constructs within PICTS were not. Analyses revealed higher rates of early stroking being reported for the United Kingdom than India, but no sex differences in rates in either country and no differential sex difference by culture. We conclude that PICTS items can be used reliably in both countries to conduct further research on the role of early tactile stimulation in shaping important child development outcomes.
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Affiliation(s)
- John Hodsoll
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Andrew Pickles
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Laura Bozicevic
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | | | - Jonathan Hill
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Prabha S. Chandra
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Helen Sharp
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
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Factors That Influence NICU Health Care Professionals' Decision Making to Implement Family-Centered Care. Adv Neonatal Care 2022; 22:87-94. [PMID: 33675305 DOI: 10.1097/anc.0000000000000846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Neonatal intensive care unit (NICU) is a multifaceted, technology-driven high stress environment for professionals, infants and families. PURPOSE Examine healthcare professionals' beliefs and perceptions regarding providing FCC within the context of NICU. METHODS This exploratory descriptive study used an online-survey format. The survey comprised several instruments including the Perceived Stress Scale, symptoms of burnout subscale from the Professional Quality of Life scale, and the Family Nurse Caring Belief Scale (FNCBS). Demographic and open-ended items were also included. RESULTS Sample consisted of 115 multidisciplinary participants working in a level IV neonatal intensive care unit. Participants report strong levels of FCC beliefs. Participants strongly agreed (82%) or agreed (18%) that no matter how sick the infant is, he or she needs to be treated as an individual. A significant correlation (r=-0.343, P < .001) exists between participant's stress composite score and FNCBS composite score. There were significant relationships between participant's years of experience (F = 5.35, P < .002) and education levels (F = 2.60, P < .05) and higher FNCBS composite scores. There were also significant relationships between participant's years of experience (F = 4.77, P < .004) and education (F = 2.89, P < .039) with higher Perceived Stress Scale composite scores. IMPLICATIONS FOR PRACTICE Results suggest that while participants agreed that FCC is important, they also believed that inadequate staffing and inappropriate assignments may lead to rationing of care. IMPLICATIONS FOR RESEARCH Further research is needed to explore factors that lead to rationing of FCC.
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69
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The Effect of Paternal Skin-to-Skin Care: A Systematic Review and Meta-analysis of Randomized Control Trials. Adv Neonatal Care 2022; 22:E22-E32. [PMID: 34054012 DOI: 10.1097/anc.0000000000000890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Research about skin-to-skin care (SSC) experiences in early period after birth has focused on mothers and infants. PURPOSE The purpose of this study was to determine the outcomes of paternal skin-to-skin care (P-SSC) in both fathers and infants. METHODS The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed/MEDLINE, Embase, CINAHL, PsycInfo, Airiti Library, and Google Scholar were searched for randomized controlled trials (RCTs) that reported outcomes of P-SSC in both fathers and infants. We calculated pooled mean differences (MDs) and 95% confidence intervals (CIs) using RevMan 5.3 for the meta-analysis [PROSPERO: CRD42018106790]. RESULTS Seven RCTs including a total of 552 participants were eligible for inclusion. Compared to the maternal skin-to-skin care (M-SSC), fathers in the P-SSC exhibited no significant differences in salivary oxytocin levels (MD: -0.35 pg/mL; 95% CI: -0.75, 0.05), salivary cortisol levels (MD: 0.25 μg/dL; 95% CI: -0.82, 1.33), or anxiety scores (MD: -0.17; 95% CI: -0.57, 0.22) during the period of SSC. Similarly, there were no significant differences in the salivary cortisol levels (MD: -0.11 μg/dL; 95% CI: -0.05, 0.28) among preterm infants between the 2 groups. However, the crying time was less among full-term infants in the P-SSC group compared with infants in the incubator care or cot care groups. IMPLICATIONS FOR PRACTICE AND RESEARCH P-SSC had similar effects as M-SSC on stress-related outcomes during and after SSC among fathers and infants in the early stages after birth. We recommend that P-SSC be implemented in the early stages after birth. Further RCTs with a longitudinal design and large samples are needed to better understand the long-term effects of P-SSC on fathers and infants.
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70
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Agudelo SI, Molina CF, Gamboa OA, Acuña E. Comparison of the Effects of Different Skin-to-Skin Contact Onset Times on Breastfeeding Behavior. Breastfeed Med 2021; 16:971-977. [PMID: 34494889 DOI: 10.1089/bfm.2021.0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objective: Skin-to-skin contact (SSC) between mother and child improves the rates of exclusive breastfeeding (EBF) in the neonatal period. This study evaluated the effects of two SSC onset times on breastfeeding behavior in the neonatal period. Materials and Methods: A multicenter clinical trial was conducted, with random allocation of participants to two different SSC onset times: immediate (at birth) and early (at 60 minutes of life). Low-risk neonates at birth were included. The researchers responsible for analyzing the data were blinded. The outcomes evaluated were early breastfeeding; EBF in the hospital, in the first week of life, and in the first month; and breastfeeding effectiveness in the neonatal period. Bivariate analyses were performed to evaluate the effect of the onset of SSC on breastfeeding indicators. The relative risk (RR) was reported as an effect measure. Results: A total of 297 neonates were included (immediate SSC, n = 148; and early SSC, n = 149). No differences were found in early breastfeeding (93.6% versus 90.6%; RR 1.6, 95% confidence interval 0.07-3.82), breastfeeding effectiveness, or EBF in the neonatal period. There was an earlier initiation of breastfeeding in the immediate SSC group (22 versus 27 minutes, p < 0.001). Conclusions: No differences in breastfeeding indicators in the neonatal period were observed between groups with different onset times of SSC (immediate versus early) in the neonatal sensitive period among low-risk neonates at birth. Clinical Trial Registration Number: NCT02687685.
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Affiliation(s)
- Sergio I Agudelo
- Ciencias de La Salud, Escuela de Graduados, Universidad CES, Medellín, Colombia.,Pediatrics Department, Universidad de La Sabana, Chía, Colombia
| | | | - Oscar A Gamboa
- Departamento de Investigación, Universidad de La Sabana, Chía, Colombia
| | - Eduardo Acuña
- Pediatrics Department, Hospital Regional de Zipaquirá, Hospital Universitario de La Samaritana, Zipaquirá, Colombia
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Filippa M, Saliba S, Esseily R, Gratier M, Grandjean D, Kuhn P. Systematic review shows the benefits of involving the fathers of preterm infants in early interventions in neonatal intensive care units. Acta Paediatr 2021; 110:2509-2520. [PMID: 34053115 PMCID: PMC8453504 DOI: 10.1111/apa.15961] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/17/2021] [Accepted: 05/27/2021] [Indexed: 11/28/2022]
Abstract
Aim This review identifies interventions involving the fathers of preterm infants that have been tested in neonatal intensive care units (NICU). It examines their effects on the fathers and infants and highlights any differences between fathers and mothers who took part in the same interventions. Methods A systematic search was performed in English from 1995 to 1 September 2020, using the CINAHL, Cochrane Central Register of Controlled Trials, Embase, PubMed and PsycINFO databases. We examined 14 peer‐reviewed studies that investigated NICU interventions involving 478 fathers, whose 511 infants were born before 37 weeks of gestation. These included empirical studies with clinical outcomes. Results Studies on fathers' interventions in NICUs were limited and mainly restricted to basic skin‐to‐skin contact or tactile interventions. The interventions had similar general positive effects on mothers and fathers when it came to infant physiological and behavioural reactions. There was also evidence of a positive effect on the fathers, including their mental health. Conclusion Including fathers as active partners in the care of their preterm newborn infants produced good outcomes for both of them. Further research is needed to develop new, multimodal and interactive interventions that provide fathers with positive contact with their preterm infants.
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Affiliation(s)
- Manuela Filippa
- Neuroscience of Emotion and Affective Dynamics Lab Swiss Center for Affective Sciences and Faculty of Psychology and Educational Sciences University of Geneva Geneva Switzerland
- Division of Development and Growth Department of Pediatrics Geneva University Hospitals Geneva Switzerland
| | - Sahar Saliba
- Department of Psychomotor Therapy Faculty of Public Health Lebanese University Beirut Lebanon
| | - Rana Esseily
- Ethology, Cognition and Development Laboratory UPL University of Paris Nanterre Nanterre France
| | - Maya Gratier
- Ethology, Cognition and Development Laboratory UPL University of Paris Nanterre Nanterre France
| | - Didier Grandjean
- Neuroscience of Emotion and Affective Dynamics Lab Swiss Center for Affective Sciences and Faculty of Psychology and Educational Sciences University of Geneva Geneva Switzerland
| | - Pierre Kuhn
- Department of Neonatal Medicine Hautepierre Hospital University Hospital, University of Strasbourg Strasbourg France
- Centre National de la Recherche Scientifique and University of StrasbourgInstitut des Neurosciences Cellulaires et Intégratives Strasbourg France
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72
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Bartick M, Hernández-Aguilar MT, Wight N, Mitchell KB, Simon L, Hanley L, Meltzer-Brody S, Lawrence RM. ABM Clinical Protocol #35: Supporting Breastfeeding During Maternal or Child Hospitalization. Breastfeed Med 2021; 16:664-674. [PMID: 34516777 DOI: 10.1089/bfm.2021.29190.mba] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. The Academy of Breastfeeding Medicine recognizes that not all lactating individuals identify as female. Using gender-inclusive language, however, is not possible in all languages and all countries and for all readers. The position of the Academy of Breastfeeding Medicine (https://doi.org/10.1089/bfm.2021.29188.abm) is to interpret clinical protocols within the framework of inclusivity of all breastfeeding, chestfeeding, and human milk-feeding individuals.
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Affiliation(s)
- Melissa Bartick
- Department of Medicine, Mount Auburn Hospital and Harvard Medical School, Cambridge and Boston, Massachusetts, USA
| | | | - Nancy Wight
- Retired; Neonatology, Sharp Mary Birch Hospital for Women and Newborns, San Diego, California, USA
| | - Katrina B Mitchell
- Breast Surgical Oncology, Ridley Tree Cancer Center at Sansum Clinic, Santa Barbara, California, USA
| | - Liliana Simon
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Lauren Hanley
- Department of Psychiatry, UNC Center for Mood Disorders, University of North Carolina Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Samantha Meltzer-Brody
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert M Lawrence
- Division of Pediatric Infectious Disease, Department of Pediatrics, University of Florida, Gainesville, Florida, USA
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Filippa M, Monaci MG, Spagnuolo C, Serravalle P, Daniele R, Grandjean D. Maternal speech decreases pain scores and increases oxytocin levels in preterm infants during painful procedures. Sci Rep 2021; 11:17301. [PMID: 34453088 PMCID: PMC8397753 DOI: 10.1038/s41598-021-96840-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/11/2021] [Indexed: 12/28/2022] Open
Abstract
Preterm infants undergo early separation from parents and are exposed to frequent painful clinical procedures, with resultant short- and long-term effects on their neurodevelopment. We aimed to establish whether the mother's voice could provide an effective and safe analgesia for preterm infants and whether endogenous oxytocin (OXT) could be linked to pain modulation. Twenty preterm infants were exposed to three conditions-mother's live voice (speaking or singing) and standard care-in random order during a painful procedure. OXT levels (pg/mL) in saliva and plasma cortisol levels were quantified, and the Premature Infant Pain Profile (PIPP) was blindly coded by trained psychologists. During the mother's live voice, PIPP scores significantly decreased, with a concomitant increase in OXT levels over baseline. The effect on pain perception was marginally significant for singing. No effects on cortisol levels were found. The mother's live voice modulated preterm infants' pain indicators. Endogenous OXT released during vocal contact is a promising protective mechanism during early painful interventions in at-risk populations.
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Affiliation(s)
- Manuela Filippa
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
- Department of Social Sciences, University of Valle D'Aosta, Aosta, Italy.
| | | | | | | | - Roberta Daniele
- Department of Clinical Pathology, Parini Hospital, Aosta, Italy
| | - Didier Grandjean
- Swiss Center of Affective Sciences, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Bieleninik Ł, Ettenberger M, Epstein S, Elefant C, Arnon S. Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8557. [PMID: 34444304 PMCID: PMC8394319 DOI: 10.3390/ijerph18168557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant's response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic-pituitary-adrenal axis' role in stabilization of behavioral state, the autonomic nervous system's role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia;
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Gupta N, Deierl A, Hills E, Banerjee J. Systematic review confirmed the benefits of early skin-to-skin contact but highlighted lack of studies on very and extremely preterm infants. Acta Paediatr 2021; 110:2310-2315. [PMID: 33973279 DOI: 10.1111/apa.15913] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 02/16/2021] [Accepted: 05/07/2021] [Indexed: 12/27/2022]
Abstract
AIM We systematically reviewed the literature to identify the benefits of early skin-to-skin contact (SSC) for all gestational ages. METHODS The MEDLINE, Embase and CINAHL databases were searched for papers published in English from 1 January 1975 to 31 March 2020. Early SSC was defined as when the infant was placed directly onto the mother's chest within 180 min of birth. Two authors independently searched the databases, appraised study quality and extracted the study design and outcome data. The primary outcomes were the infants' physiological stability after birth: thermoregulation and stabilisation. The secondary outcomes were exclusive breastfeeding and mother-infant interaction. RESULTS We reviewed 30 studies that assessed the benefits of early SSC: 22 comprised term-born healthy infants and eight focused on preterm or ill infants. These included various gestational ages, birth methods and cultural backgrounds. The studies demonstrated that early SSC stabilised neonatal physiological parameters, promoted exclusive breastfeeding and supported bonding. Most of the data were from term and late preterm births. CONCLUSION This systematic review showed that early SSC could be beneficial. Further studies that focus on providing very and extremely preterm infants with SSC, and parental experiences, are needed to enable SSC to be adopted as routine practice.
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Affiliation(s)
- Nidhi Gupta
- Imperial College Healthcare NHS Trust London UK
| | | | - Emily Hills
- Imperial College Healthcare NHS Trust London UK
| | - Jayanta Banerjee
- Imperial College Healthcare NHS Trust London UK
- Imperial College London London UK
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76
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Cong S, Wang R, Fan X, Song X, Sha L, Zhu Z, Zhou H, Liu Y, Zhang A. Skin-to-skin contact to improve premature mothers' anxiety and stress state: A meta-analysis. MATERNAL AND CHILD NUTRITION 2021; 17:e13245. [PMID: 34258864 PMCID: PMC8476413 DOI: 10.1111/mcn.13245] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/02/2021] [Accepted: 06/27/2021] [Indexed: 01/16/2023]
Abstract
Premature mothers present more anxiety and stress after delivery, which may be caused by mother–infant separation while hospitalised. Skin‐to‐skin contact (SSC), a mitigating factor for mother–infant separation, can benefit infants and mothers in many ways, but few studies focused on its efficacy on maternal anxiety and stress states. Therefore, this review aims to evaluate the effect of SSC on anxiety and stress. Comprehensive research was conducted in nine databases. Meta‐analysis was conducted to investigate the effect of SSC, and subgroup analyses were performed to explain the sources of heterogeneity. Eight randomised controlled trials with 728 participants were included, and SSC significantly reduced the level of anxiety ([standardised mean difference, SMD] −0.72; 95% CI −1.08 to −0.35) and stress state ([SMD] −0.84; 95% CI −1.59 to −0.09). One subgroup analysis revealed that SSC can relieve anxiety if performing SSC no less than 1 h per day ([SMD] −0.94; 95% CI −1.34 to −0.53). Another subgroup analysis suggested that applying SSC repeatedly and lasting less than 1 week ([SMD] −1.49; 95% CI −2.31 to −0.66) or for 1 week to 2 weeks ([SMD] −1.04; 95% CI −1.29 to −0.79) can significantly reduce maternal anxiety level but no significance if lasting over 2 weeks ([SMD] −0.33; 95% CI −0.67 to 0.01). SSC can effectively improve anxiety and stress states among premature mothers after delivery, and not definitive finding presents that only SSC that was performed no less than 60 min could improve postpartum anxiety states, while SSC alone was not as effective when carried out over 2 weeks.
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Affiliation(s)
- Shengnan Cong
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Rui Wang
- School of Nursing, Nanjing Medical University, Jiangsu, China
| | - Xuemei Fan
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Xiaowei Song
- Department of Neurosurgery, Sir Run Run Hospital, Nanjing Medical University, Jiangsu, China
| | | | - Zhu Zhu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Hui Zhou
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Ying Liu
- Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
| | - Aixia Zhang
- School of Nursing, Nanjing Medical University, Jiangsu, China.,Women's Hospital of Nanjing Medical University (Nanjing Maternity and Child Health Care Hospital), Nanjing, China
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77
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Uchoa JL, Barbosa LP, Mendonça LBDA, Lima FET, Almeida PCD, Rocha SSD. Influence of social determinants of health on skin to skin contact between mother and newborn. Rev Bras Enferm 2021; 74:e20200138. [PMID: 34133704 DOI: 10.1590/0034-7167-2020-0138] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 11/24/2020] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVE to analyze the association of skin-to-skin contact and social determinants of health. METHODS this is a cross-sectional study with 187 medical records of newborns from a reference rooming in in northeastern Brazil. An instrument with maternal and neonatal data was used. Analysis was descriptive and inferential statistics. For the associations, a chi-square test was used to measure strength, an Odds Ratio was calculated, with a 95% confidence interval. RESULTS 62% of newborns who made skin-to-skin contact at birth were eutrophic, full-term, Apgar > 7, mothers with prenatal care and without abortion. The determinants associated with non-skin-to-skin contact were preterm (CR=3.2;95%CI: 2.72-18.98); 1st minute Apgar < 7 (CR:2.9;95%CI: 2.38-3.06), cesarean section (CR:8.4;95%CI: 4.29-16.57), and unhealthy NB (CR 12.7;95%CI: 4.9-32.67). We used STROBE guidelines. CONCLUSION skin-to-skin contact was influenced by gestational age, Apgar, delivery, and newborn health.
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Affiliation(s)
- Janaiana Lemos Uchoa
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio. Fortaleza, Ceará, Brazil
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78
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Murdoch J, Hauck Y, Aydon L, Sharp M, Zimmer M. When can I hold my baby? An audit of time to first cuddle for preterm babies (<32 weeks) pre introduction and post introduction of a Family-Integrated Care model. J Clin Nurs 2021; 30:3481-3492. [PMID: 33982368 DOI: 10.1111/jocn.15850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 10/31/2020] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
AIM The audit examined time to first cuddle between preterm babies (born < 32 weeks) and their parent pre- and post-introduction of a family-integrated care model. Secondary outcomes included time to full feeds and length of neonatal intensive care stay. BACKGROUND Parental separation due to neonatal intensive care unit admission is known to negatively affect parental and baby wellbeing. DESIGN A "before-after" design compared outcomes for babies admitted pre- (2015) and post (2018)-implementation of the model in a Western Australian neonatal intensive care unit. METHODS A retrospective medical record audit included babies from two gestational age groups in 2015 and 2018, born ≤27 + 6 weeks and 28-31 + 6 weeks. SQUIRE checklist guided reporting of the audit. RESULTS One hundred fifty-three babies were included in the audit, 79 from 2015 (≤27 + 6 weeks n = 39 and 28-31 + 6 weeks n = 40) and 74 from 2018 (≤27 + 6 weeks n = 35 and 28-31 + 6 weeks n = 39). Babies in both years were born at similar median gestational ages with comparable birthweights. Babies born ≤27 + 6 weeks in 2018 were cuddled earlier (median = 141 h old) compared with those in 2015 (median = 157 h old). Median time to reach full feeds decreased and was significant in the ≤27 + 6-week group: 288 h (12 days) in 2015 to 207.5 h (8.6 days) in 2018. Length of stay was longer for the ≤27 + 6-week gestation 2018 group (median = 64 days) and 28-31 + 6-week gestation 2018 group (median = 22 days). CONCLUSION Family-integrated care models may decrease the time to first cuddle and full feeds. Further research on outcomes such as breastfeeding, infant weight gain and length of stay can extend existing knowledge. RELEVANCE TO CLINICAL PRACTICE Family-integrated care models may offer benefits to families of hospitalised preterm babies and investigating barriers to its implementation and creation of solutions to overcome barriers warrants attention.
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Affiliation(s)
- Jamee Murdoch
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia
| | - Yvonne Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Bentley, Australia.,Department of Nursing and Midwifery Education and Research, King Edward Memorial Hospital, Perth, WA, Australia
| | - Laurene Aydon
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia.,Department Nursing Research, Child and Adolescent Health Service, Nedlands, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Mary Sharp
- Neonatal Directorate, Kind Edward Memorial Hospital, Subiaco & Perth Children's Hospital, CAHS, Nedlands, WA, Australia.,Centre for Research and Neonatal Education, School of Child and Paediatric Health, University of Western Australia, Perth, WA, Australia
| | - Margo Zimmer
- Department Nursing Research, Child and Adolescent Health Service, Nedlands, WA, Australia
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79
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Gill VR, Liley HG, Erdei C, Sen S, Davidge R, Wright AL, Bora S. Improving the uptake of Kangaroo Mother Care in neonatal units: A narrative review and conceptual framework. Acta Paediatr 2021; 110:1407-1416. [PMID: 33289201 DOI: 10.1111/apa.15705] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/06/2020] [Accepted: 11/30/2020] [Indexed: 01/08/2023]
Abstract
Kangaroo Mother Care is a beneficial intervention for high-risk infants; however, global uptake is lacking. Recent systematic reviews have collated the numerous studies that identify diverse barriers and enablers to the use of Kangaroo Mother Care. In this narrative review, we combine the findings of these systematic reviews with more recent studies to propose a conceptual framework, encompassing factors that may affect the initiation and maintenance of Kangaroo Mother Care in neonatal units. CONCLUSION: This conceptual framework includes parental, healthcare professional, and healthcare system factors, and highlights the potential interplay between them. In line with this, we suggest strategies to improve the uptake of Kangaroo Mother Care in neonatal units.
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Affiliation(s)
- Victoria R. Gill
- Mothers, Babies and Women’s Health Program Mater Research Institute Faculty of Medicine The University of Queensland South Brisbane QLD Australia
| | - Helen G. Liley
- Mothers, Babies and Women’s Health Program Mater Research Institute Faculty of Medicine The University of Queensland South Brisbane QLD Australia
| | - Carmina Erdei
- Department of Pediatric Newborn Medicine Brigham and Women’s HospitalHarvard Medical School Boston MA USA
| | - Sarbattama Sen
- Department of Pediatric Newborn Medicine Brigham and Women’s HospitalHarvard Medical School Boston MA USA
| | - Ruth Davidge
- Maternal, Child and Women's Health Department of Health Pietermaritzburg KZN South Africa
| | - Amy L. Wright
- Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto ON Canada
| | - Samudragupta Bora
- Mothers, Babies and Women’s Health Program Mater Research Institute Faculty of Medicine The University of Queensland South Brisbane QLD Australia
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80
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Norholt H. Delivering Clinically on Our Knowledge of Oxytocin and Sensory Stimulation: The Potential of Infant Carrying in Primary Prevention. Front Psychol 2021; 11:590051. [PMID: 33995157 PMCID: PMC8116555 DOI: 10.3389/fpsyg.2020.590051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/16/2020] [Indexed: 11/18/2022] Open
Abstract
Oxytocin (OT) is one of the most intensively researched neuropeptides during the three past decades. In benign social contexts, OT exerts a range of desirable socioemotional, stress-reducing, and immunoregulatory effects in mammals and humans and influences mammalian parenting. Consequentially, research in potential pharmacological applications of OT toward human social deficits/disorders and physical illness has increased substantially. Regrettably, the results from the administration of exogenous OT are still relatively inconclusive. Research in rodent maternal developmental programming has demonstrated the susceptibility of offspring endogenous OT systems to maternal somatosensory stimulation, with consequences for behavioral, epigenetic, cognitive, and neurological outcomes. A translation of this animal research into practically feasible human parenting recommendations has yet to happen, despite the significant prevention potential implied by the maternal developmental programming research. Extended physical contact with full-term healthy infants in the months following birth (infant carrying) might constitute the human equivalent of those specific rodent maternal behaviors, found to positively influence emerging OT systems. Findings from both OT and maternal programming research parallel those found for infants exposed to such extended parental physical contact, whether through skin-to-skin contact or infant carrying. Clinical support of parents to engage in extended physical contact represents a feasible intervention to create optimum conditions for the development of infant OT systems, with potential beneficial long-term health effects.
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Affiliation(s)
- Henrik Norholt
- SomAffect - The Somatosensory & Affective Neuroscience Group, Liverpool, United Kingdom
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81
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Gettler LT, Kuo PX, Sarma MS, Trumble BC, Burke Lefever JE, Braungart-Rieker JM. Fathers' oxytocin responses to first holding their newborns: Interactions with testosterone reactivity to predict later parenting behavior and father-infant bonds. Dev Psychobiol 2021; 63:1384-1398. [PMID: 33860940 DOI: 10.1002/dev.22121] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 11/09/2022]
Abstract
Little is known about human fathers' physiology near infants' births. This may represent a period during which paternal psychobiological axes are sensitive to fathers' new experiences of interacting with their newborns and that can provide insights on how individual differences in fathers' biology relate to post-partum parenting. Drawing on a sample of men in South Bend, IN (U.S.), we report results from a longitudinal study of fathers' oxytocin, cortisol, and testosterone (N = 211) responses to their first holding of their infants on the day of birth and men's reported caregiving and father-infant bonding at 2-4 months post-partum (N = 114). First-time fathers' oxytocin was higher following first holding of their newborns, compared to their pre-holding levels. Contrasting with prior results, fathers' percentage change in oxytocin did not differ based on skin-to-skin or standard holding. Drawing on psychobiological frameworks, we modeled the interactions for oxytocin reactivity with testosterone and cortisol reactivity, respectively, in predicting father-infant outcomes months later. We found significant cross-over interactions for (oxytocin × testosterone) in predicting fathers' later post-partum involvement and bonding. Specifically, we found that fathers whose testosterone declined during holding reported greater post-partum play if their oxytocin increased, compared to fathers who experienced increases in both hormones. We also observed a similar non-significant interaction for (oxytocin × cortisol) in predicting fathers' post-partum play. Fathers whose testosterone declined during holding also reported less involvement in direct caregiving and lower father-infant bonding if their oxytocin decreased but greater direct care and bonding if their testosterone increased and oxytocin decreased. The results inform our understanding of the developmental time course of men's physiological responsiveness to father-infant interaction and its relevance to later fathering behavior and family relationships.
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Affiliation(s)
- Lee T Gettler
- Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA.,Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.,William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA
| | - Patty X Kuo
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Mallika S Sarma
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | | | - Julia M Braungart-Rieker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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82
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Grumi S, Saracino A, Volling BL, Provenzi L. A systematic review of human paternal oxytocin: Insights into the methodology and what we know so far. Dev Psychobiol 2021; 63:1330-1344. [PMID: 33694219 DOI: 10.1002/dev.22116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/04/2021] [Accepted: 02/20/2020] [Indexed: 02/03/2023]
Abstract
With the consolidation of fathers' engagement in caregiving, understanding the neuroendocrine and hormonal mechanisms underlying fatherhood becomes a relevant topic. Oxytocin (OT) has been linked with maternal bonding and caregiving, but less is known about the role of OT in human fatherhood and paternal caregiving. A systematic review of methods and findings of previous OT research in human fathers was carried. The literature search on PubMed and Scopus yielded 133 records. Twenty-four studies were included and analyzed. Significant variability emerged in OT methodology, including laboratory tasks, assessment methods, and outcome measures. Fathers' OT levels appear to increase after childbirth. OT was significantly correlated with less hostility and with the quality of paternal physical stimulation in play interactions, but not with paternal sensitivity. Fathers' and children's OT levels were significantly correlated in a limited subset of studies, intriguingly suggesting that cross-generational OT regulation may occur during the early years of life. This study highlights relevant issues and limitations of peripheral OT assessment in human subjects, especially in fathers. Although the study of paternal neuroendocrinology appears promising, coping with these issues requires dedicated efforts and methodological suggestions are provided to guide future advances in this field.
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Affiliation(s)
- Serena Grumi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Annalisa Saracino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Brenda L Volling
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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83
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Melchior M, Kuhn P, Poisbeau P. The burden of early life stress on the nociceptive system development and pain responses. Eur J Neurosci 2021; 55:2216-2241. [PMID: 33615576 DOI: 10.1111/ejn.15153] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/27/2021] [Accepted: 02/12/2021] [Indexed: 02/07/2023]
Abstract
For a long time, the capacity of the newborn infant to feel pain was denied. Today it is clear that the nociceptive system, even if still immature, is functional enough in the newborn infant to elicit pain responses. Unfortunately, pain is often present in the neonatal period, in particular in the case of premature infants which are subjected to a high number of painful procedures during care. These are accompanied by a variety of environmental stressors, which could impact the maturation of the nociceptive system. Therefore, the question of the long-term consequences of early life stress is a critical question. Early stressful experience, both painful and non-painful, can imprint the nociceptive system and induce long-term alteration in brain function and nociceptive behavior, often leading to an increase sensitivity and higher susceptibility to chronic pain. Different animal models have been developed to understand the mechanisms underlying the long-term effects of different early life stressful procedures, including pain and maternal separation. This review will focus on the clinical and preclinical data about early life stress and its consequence on the nociceptive system.
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Affiliation(s)
- Meggane Melchior
- Centre National de la Recherche Scientifique and University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
| | - Pierre Kuhn
- Centre National de la Recherche Scientifique and University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France.,Service de Médecine et Réanimation du Nouveau-né, Hôpital de Hautepierre, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France
| | - Pierrick Poisbeau
- Centre National de la Recherche Scientifique and University of Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, Strasbourg, France
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84
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Recovering Together: Mothers' Experiences Providing Skin-to-Skin Care for Their Infants With NAS. Adv Neonatal Care 2021; 21:16-22. [PMID: 33350710 DOI: 10.1097/anc.0000000000000819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Over the past 2 decades, the prevalence of neonatal abstinence syndrome (NAS) has increased almost 5-fold. Skin-to-skin care (SSC), a method of parent-infant holding, is a recommended nonpharmacologic intervention for managing NAS symptoms. SSC has the potential to reduce withdrawal symptoms while positively influencing parent-infant attachment. Yet, little is known about the SSC experiences of mothers of infants with NAS. PURPOSE The purpose of this study was to explore the SSC experiences of mothers of infants with NAS, including perceived barriers to SSC in the hospital and following discharge home. METHODS A qualitative descriptive design was used to obtain new knowledge regarding the experience of SSC of mothers of infants with NAS. Purposive sampling was used to recruit participants eligible for the study. We conducted semistructured individual interviews with postpartum mothers of infants with NAS. Data were analyzed using thematic analysis. FINDINGS/RESULTS Thirteen mothers participated in the study. Four themes emerged from the data analysis: "a little nerve racking"; "she needed me, and I needed her"; dealing with the "hard times"; and "a piece of my puzzle is missing." SSC was described as a conduit for healing and bonding; in addition, several barriers to SSC were reported. IMPLICATIONS FOR PRACTICE AND RESEARCH These findings highlight the inherent benefits of SSC for infants with NAS and demonstrate the unique challenges of these mother-infant dyads. Critical changes in hospital practices are needed to create an environment supportive of SSC for this patient population. In addition, research regarding implementation of interventions to increase SSC usage in this population is warranted.
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85
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Vogl JL, Dunne EC, Liu C, Bradley A, Rwei A, Lonergan EK, Hopkins BS, Kwak SS, Simon CD, Rand CM, Rogers JA, Weese-Mayer DE, Garfield CF. Kangaroo father care: A pilot feasibility study of physiologic, biologic, and psychosocial measures to capture the effects of father-infant and mother-infant skin-to-skin contact in the Neonatal Intensive Care Unit. Dev Psychobiol 2021; 63:1521-1533. [PMID: 33521969 DOI: 10.1002/dev.22100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/01/2023]
Abstract
Robust literature supports the positive effects of kangaroo mother care (KMC) on infant physiologic stability and parent-infant bonding in the Neonatal Intensive Care Unit (NICU). Comparatively little is known about kangaroo father care (KFC) in the NICU, and KFC implementation has been limited. Our pilot feasibility study objective was to examine KFC effects on premature infants and fathers as compared to KMC. Parents of preterm NICU infants independently completed a 90-min Kangaroo Care (KC) session on consecutive days. Infant heart rate variability (HRV) and apnea/periodicity measures were compared (pre-KC to KC; KFC to KMC). Additionally, we assessed the feasibility of administering three psychosocial questionnaires to fathers and mothers in the NICU and after discharge. Ten preterm infants completed 20 KC sessions (334/7 -374/7 weeks post-menstrual age). Results demonstrated similar infant physiologic responses between KMC and KFC, including significant differences in measures of HRV (p < .05) between KC and non-KC periods. Eighty-eight percentage of questionnaires administered were completed, supporting the utilization of these instruments in future research of this population. If confirmed, these preliminary results identify an opportunity to objectively assess KFC effects, supporting the development of empirically based KFC programs benefitting NICU families.
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Affiliation(s)
- Jamie L Vogl
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Emma C Dunne
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Claire Liu
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Allison Bradley
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Alina Rwei
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Erin K Lonergan
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Bradley S Hopkins
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Sung Soo Kwak
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Clarissa D Simon
- Family and Child Health Innovations Program, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Casey M Rand
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - John A Rogers
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Debra E Weese-Mayer
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Craig F Garfield
- Family and Child Health Innovations Program, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Hospital Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
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86
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Carozza S, Leong V. The Role of Affectionate Caregiver Touch in Early Neurodevelopment and Parent-Infant Interactional Synchrony. Front Neurosci 2021; 14:613378. [PMID: 33584178 PMCID: PMC7873991 DOI: 10.3389/fnins.2020.613378] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/07/2020] [Indexed: 01/04/2023] Open
Abstract
Though rarely included in studies of parent–infant interactions, affectionate touch plays a unique and vital role in infant development. Previous studies in human and rodent models have established that early and consistent affectionate touch from a caregiver confers wide-ranging and holistic benefits for infant psychosocial and neurophysiological development. We begin with an introduction to the neurophysiological pathways for the positive effects of touch. Then, we provide a brief review of how affectionate touch tunes the development of infant somatosensory, autonomic (stress regulation), and immune systems. Affective touch also plays a foundational role in the establishment of social affiliative bonds and early psychosocial behavior. These touch-related bonding effects are known to be mediated primarily by the oxytocin system, but touch also activates mesocorticolimbic dopamine and endogenous opioid systems which aid the development of social cognitive processes such as social learning and reward processing. We conclude by proposing a unique role for affectionate touch as an essential pathway to establishing and maintaining parent-infant interactional synchrony at behavioral and neural levels. The limitations of the current understanding of affectionate touch in infant development point to fruitful avenues for future research.
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Affiliation(s)
- Sofia Carozza
- Department of Physiology, Development and Neuroscience, Faculty of Biology, University of Cambridge, Cambridge, United Kingdom
| | - Victoria Leong
- Division of Psychology, Nanyang Technological University, Singapore, Singapore.,Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Endo T, Sampei M, Fukuda S. Kangaroo mother care alters chromogranin A and perfusion index in preterm babies. Pediatr Int 2021; 63:53-59. [PMID: 32542824 DOI: 10.1111/ped.14350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/11/2020] [Accepted: 06/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND While providing various benefits, concerns about the potential risks of kangaroo mother care, or skin-to-skin contact (SSC), between mother and her preterm infant hinder its widespread implementation in some resource- rich countries. In neonates, salivary chromogranin A (s-CgA) is elevated upon exposure to stress, whereas the perfusion index (PI) is associated with hemodynamics and peripheral perfusion. Here, we investigated the effects of SSC on s-CgA and the PI in preterm infants. METHODS Twelve infants were enrolled in the study. Factors associated with baseline s-CgA were analyzed. Baseline s-CgA and the level after SSC were compared. Secreted IgA in the saliva was compared as the control. The PI before, throughout, and after SSC were compared. RESULTS Baseline s-CgA was significantly lower in infants who were supplemented with baby formula milk in addition to breast milk before SSC (n = 2) compared with those fed with their mother's breast milk alone (n = 10, P = 0.03). SSC significantly decreased s-CgA in babies who were fed breast milk only before SSC (n = 10, P = 0.01) but not in those supplemented with formula milk before SSC (n = 2). Secreted IgA in saliva was not affected by SSC. The PI was significantly elevated during SSC (P = .01). CONCLUSION Our data indicate that SSC can reduce s-CgA levels when combined with mother's breast milk and increase the PI in preterm infants, thereby providing additional evidence of the benefit of SSC.
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Affiliation(s)
- Tomohiro Endo
- Department of Clinical Nursing, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - Mari Sampei
- Department of Clinical Nursing, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,School of Nursing, Fukushima Medical University, Fukushima, Japan
| | - Seiji Fukuda
- Department of Clinical Nursing, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Department of Pediatrics, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.,Division of Patient Safety, Shimane University Hospital, Izumo, Shimane, Japan
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88
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Chen Y, Li Q, Zhang Q, Kou J, Zhang Y, Cui H, Wernicke J, Montag C, Becker B, Kendrick KM, Yao S. The Effects of Intranasal Oxytocin on Neural and Behavioral Responses to Social Touch in the Form of Massage. Front Neurosci 2020; 14:589878. [PMID: 33343285 PMCID: PMC7746800 DOI: 10.3389/fnins.2020.589878] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 11/16/2020] [Indexed: 12/13/2022] Open
Abstract
Manually-administered massage can potently increase endogenous oxytocin concentrations and neural activity in social cognition and reward regions and intranasal oxytocin can increase the pleasantness of social touch. In the present study, we investigated whether intranasal oxytocin modulates behavioral and neural responses to foot massage applied manually or by machine using a randomized placebo-controlled within-subject pharmaco-fMRI design. 46 male participants underwent blocks of massage of each type where they both received and imagined receiving the massage. Intranasal oxytocin significantly increased subjective pleasantness ratings of the manual but not the machine massage and neural responses in key regions involved in reward (orbitofrontal cortex, dorsal striatum and ventral tegmental area), social cognition (superior temporal sulcus and inferior parietal lobule), emotion and salience (amygdala and anterior cingulate and insula) and default mode networks (medial prefrontal cortex, parahippocampal gyrus, posterior cingulate, and precuneus) as well as a number of sensory and motor processing regions. Both neural and behavioral effects of oxytocin occurred independent of whether subjects thought the massage was applied by a male or female masseur. These findings support the importance of oxytocin for enhancing positive behavioral and neural responses to social touch in the form of manually administered massage and that a combination of intranasal oxytocin and massage may have therapeutic potential in autism. CLINICAL TRIALS REGISTRATION The Effects of Oxytocin on Social Touch; registration ID: NCT03278860; URL: https://clinicaltrials.gov/ct2/show/NCT03278860.
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Affiliation(s)
- Yuanshu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Qianqian Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Kou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yingying Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Han Cui
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jennifer Wernicke
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Christian Montag
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Keith M. Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuxia Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
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89
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Selman SB, Dilworth-Bart J, Selman HS, Cook JG, Duncan LG. Skin-to-skin contact and infant emotional and cognitive development in chronic perinatal distress. Early Hum Dev 2020; 151:105182. [PMID: 32977205 PMCID: PMC8536803 DOI: 10.1016/j.earlhumdev.2020.105182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We examined whether the timing of maternal-neonate skin-to-skin contact (SSC) predicts infant emotional and cognitive development in the context of chronic maternal perinatal stress and depressive symptoms. STUDY DESIGN This secondary analysis included data from a group-based prenatal care clinical trial for 37 pregnant women with low household income. Mothers completed the Perceived Stress Scale (PSS), and the Center for Epidemiologic Studies Depression Scale (CES-D) during the third trimester and postpartum. After birth, they reported timing of SSC, and completed the Infant Behavior Questionnaire-Revised Very Short Form (IBQ-R VSF) (M = 51.7 weeks, SD = 4.2). Increased PSS or CES-D score from the third trimester to post-birth indicates chronic maternal perinatal stress or depressive symptoms compared to a decrease or no change. Using hierarchical regression models, we examined if the timing of SSC makes a unique contribution in predicting infant outcomes in the context of chronic maternal perinatal stress and depressive symptoms. RESULTS Stress-exposed infants had less negative emotionality if SSC is provided immediately after delivery, less than 10 min after birth. The effect of SSC on effortful control in relation to chronic perinatal stress was not statistically significant. The impact of timing of SSC on negative emotionality or effortful control in relation to chronic perinatal depressive symptoms was not statistically significant. CONCLUSION This work implies that very early SSC may play a role in later infant emotion regulation process and could act as a protective factor in chronically stressed pregnant women.
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Affiliation(s)
- Saliha B. Selman
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Janean Dilworth-Bart
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - H. Sule Selman
- Department of Midwifery, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Joseph G. Cook
- Osher Center for Integrative Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Larissa G. Duncan
- Department of Human Development & Family Studies, School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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90
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Lisanti AJ, Demianczyk AC, Costarino A, Vogiatzi MG, Hoffman R, Quinn R, Chittams JL, Medoff-Cooper B. Skin-to-Skin Care is Associated with Reduced Stress, Anxiety, and Salivary Cortisol and Improved Attachment for Mothers of Infants With Critical Congenital Heart Disease. J Obstet Gynecol Neonatal Nurs 2020; 50:40-54. [PMID: 33181093 DOI: 10.1016/j.jogn.2020.09.154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To estimate the effect of skin-to-skin care (SSC) on biobehavioral measures of stress (anxiety and salivary cortisol) and attachment (attachment scores and salivary oxytocin) of mothers before and after their infants' neonatal cardiac surgery. DESIGN A prospective interventional, baseline response-paired pilot study. SETTING Cardiac center of a large, metropolitan, freestanding children's hospital. PARTICIPANTS Thirty women whose infants were hospitalized for neonatal cardiac surgery. METHODS Participants acted as their own controls before, during, and after SSC at two time points: once before and once after surgery. We measured the stress response of mothers, as indicated by self-reported scores of anxiety and maternal salivary cortisol, and maternal-infant attachment, as indicated by self-reported scores and maternal salivary oxytocin. RESULTS Significant reductions in self-reported scores of anxiety and salivary cortisol were found as a result of SSC at each time point, as well as increased self-reported attachment. No significant differences were found in oxytocin. CONCLUSION Our findings provide initial evidence of the benefits of SSC as a nurse-led intervention to support maternal attachment and reduce physiologic and psychological stress responses in mothers of infants with critical congenital heart disease before and after neonatal cardiac surgery.
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91
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Lehtonen L, Lee SK, Kusuda S, Lui K, Norman M, Bassler D, Håkansson S, Vento M, Darlow BA, Adams M, Puglia M, Isayama T, Noguchi A, Morisaki N, Helenius K, Reichman B, Shah PS. Family Rooms in Neonatal Intensive Care Units and Neonatal Outcomes: An International Survey and Linked Cohort Study. J Pediatr 2020; 226:112-117.e4. [PMID: 32525041 DOI: 10.1016/j.jpeds.2020.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/27/2020] [Accepted: 06/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To evaluate the proportion of neonatal intensive care units with facilities supporting parental presence in their infants' rooms throughout the 24-hour day (ie, infant-parent rooms) in high-income countries and to analyze the association of this with outcomes of extremely preterm infants. STUDY DESIGN In this survey and linked cohort study, we analyzed unit design and facilities for parents in 10 neonatal networks of 11 countries. We compared the composite outcome of mortality or major morbidity, length of stay, and individual morbidities between neonates admitted to units with and without infant-parent rooms by linking survey responses to patient data from 2015 for neonates of less than 29 weeks of gestation. RESULTS Of 331 units, 13.3% (44/331) provided infant-parent rooms. Patient-level data were available for 4662 infants admitted to 159 units in 7 networks; 28% of the infants were cared for in units with infant-parent rooms. Neonates from units with infant-parent rooms had lower odds of mortality or major morbidity (aOR, 0.76; 95% CI, 0.64-0.89), including lower odds of sepsis and bronchopulmonary dysplasia, than those from units without infant-parent rooms. The adjusted mean length of stay was 3.4 days shorter (95%, CI -4.7 to -3.1) in the units with infant-parent rooms. CONCLUSIONS The majority of units in high-income countries lack facilities to support parents' presence in their infants' rooms 24 hours per day. The availability vs absence of infant-parent rooms was associated with lower odds of composite outcome of mortality or major morbidity and a shorter length of stay.
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Affiliation(s)
- Liisa Lehtonen
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital; and Department of Clinical Medicine, University of Turku, Turku, Finland.
| | - Shoo K Lee
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Departments of Pediatrics and Obstetrics and Gynecology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Maternal-infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Satoshi Kusuda
- Neonatal Research Network of Japan, Kyorin University, Tokyo Women's Medical University, Tokyo, Japan
| | - Kei Lui
- Royal Hospital for Women, National Perinatal Epidemiology and Statistic Unit, University of New South Wales, Randwick, Australia
| | - Mikael Norman
- Department of Neonatal Medicine, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Stellan Håkansson
- Department of Clinical Science/Pediatrics, Umeå University, Umeå, Sweden
| | - Maximo Vento
- Division of Neonatology and Health Research Institute of La Fe University Hospital, Valencia, Spain
| | - Brian A Darlow
- Department of Pediatrics, University of Otago, Christchurch, Canterbury, New Zealand
| | - Mark Adams
- Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Monia Puglia
- Unit of Epidemiology, Regional Health Agency, Florence, Italy
| | - Tetsuya Isayama
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | | | - Naho Morisaki
- Neonatal Research Network Japan, Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Kjell Helenius
- Department of Pediatrics and Adolescent Medicine, Turku University Hospital; and Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Brian Reichman
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel
| | - Prakesh S Shah
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada; Maternal-infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pediatrics, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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92
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Moberg KU, Handlin L, Petersson M. Neuroendocrine mechanisms involved in the physiological effects caused by skin-to-skin contact – With a particular focus on the oxytocinergic system. Infant Behav Dev 2020; 61:101482. [DOI: 10.1016/j.infbeh.2020.101482] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 07/30/2020] [Accepted: 08/04/2020] [Indexed: 10/23/2022]
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93
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Kahalon R, Preis H, Benyamini Y. Who benefits most from skin-to-skin mother-infant contact after birth? Survey findings on skin-to-skin and birth satisfaction by mode of birth. Midwifery 2020; 92:102862. [PMID: 33126046 DOI: 10.1016/j.midw.2020.102862] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/16/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous research has shown that skin-to-skin contact in the delivery room is associated with an increase satisfaction with childbirth. The purpose of the present study was to examine whether this association differs as a function of mode of birth, such that the positive effect of skin-to-skin contact would be especially pronounced for women who had operative births. DESIGN Survey design using self-administered questionnaires during pregnancy (Time 1) and at two months postpartum (Time 2). SETTING At Time 1, women were recruited at community and hospital medical centres in two large metropolitan areas in the centre of Israel and through home midwives and internet forums. At Time 2, women completed a second questionnaire in which they reported whether they had skin-to-skin contact with their infant immediately after birth and their birth satisfaction. PARTICIPANTS Pregnant women, gestation week ≥24, with singleton pregnancy, who took part in both T1 and T2 (N = 1371, 75% of the 1833 women recruited at T1). MEASUREMENTS Analysis of covariance (ANCOVA) was used to examine whether the association between skin-to-skin contact after birth and birth satisfaction two months post-partum, differs as a function of mode of birth. Maternal or infant complications during birth, parity, and whether the pregnancy was planned, served as covariates. Birth satisfaction was measured using the Childbirth Satisfaction Scale. All measures were self-reported. FINDINGS The frequency of skin-to-skin was high (83%) for women who had vaginal birth, but lower for women who had an instrumental birth (66%) or a caesarean section (31%). At two months postpartum, women who had operative births reported less satisfaction with their birth than women who gave birth via vaginal birth. A significant interaction between skin-to-skin and mode of birth showed that although skin-to-skin was associated with higher birth satisfaction among women across all three modes of birth, i.e., vaginal (Cohen's d = .41), instrumental (Cohen's d = .64) and caesarean (Cohen's d = .87), the effect for the difference in birth satisfaction between women with and without skin-to-skin was especially large for operative births, particularly for caesarean sections. KEY CONCLUSIONS Operative birth is related to lower satisfaction with childbirth and lower rates of skin-to-skin contact immediately after birth. Yet, the association between skin-to-skin and birth satisfaction is especially strong for women who had operative births and specifically a caesarean section, suggesting that the possible contribution of skin-to-skin to birth satisfaction should be emphasised particularly after operative births. IMPLICATIONS FOR PRACTICE It is recommended that maternity care providers, managers, policy makers and medical teams facilitate skin-to-skin contact between the woman and her infant immediately, or as soon as possible, after childbirth, in both operative and non-operative births.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work Tel Aviv University, Israel; The School of Psychological Sciences, Tel-Aviv University, Israel.
| | - Heidi Preis
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Stoney Brook University, U.S
| | - Yael Benyamini
- Bob Shapell School of Social Work Tel Aviv University, Israel
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94
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Bellosta-Batalla M, Del Carmen Blanco-Gandía M, Rodríguez-Arias M, Cebolla A, Pérez-Blasco J, Moya-Albiol L. Brief mindfulness session improves mood and increases salivary oxytocin in psychology students. Stress Health 2020; 36:469-477. [PMID: 32227624 DOI: 10.1002/smi.2942] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 01/09/2023]
Abstract
Mindfulness-based interventions (MBI) have been shown to be effective in increasing empathy in health professionals. Yet, more research is needed to analyse the specific influence of mindfulness exercises on biological variables involved in empathy, such as the biological system of oxytocin activity. In this study, we analyse the effects of a brief mindfulness session on positive and negative affect, state anxiety and salivary oxytocin (sOXT) in psychology students (N = 68). In the experimental group (n = 42), a mindfulness session was performed that included different guided meditation exercises. In the control group (n = 26), an emotion recognition exercise was carried out, along with a series of creative activities. Results showed that the mindfulness session was effective, because there was a significant reduction in negative affect (d = -.56, p < .001) and state anxiety (d = -.54, p = .007) in the experimental group. Likewise, there was an increase in sOXT (d = .99, p < .001) in this group, compared with the control group. Guided mindfulness meditation practice could be useful to reach an emotional and biological state that facilitates empathy. In this regard, the increase in sOXT after the mindfulness session adds further evidence about the biological mechanisms underlying the benefits of MBI on empathy.
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Affiliation(s)
| | | | | | - Ausiàs Cebolla
- Department of Personality, Evaluation and Psychological Treatment. University of Valencia, Valencia, Spain
- Ciber Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - Josefa Pérez-Blasco
- Department of Evolutionary and Educational Psychology, University of Valencia, Valencia, Spain
| | - Luis Moya-Albiol
- Department of Psychobiology, University of Valencia, Valencia, Spain
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95
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Skin-to-Skin Care Is a Safe and Effective Comfort Measure for Infants Before and After Neonatal Cardiac Surgery. Pediatr Crit Care Med 2020; 21:e834-e841. [PMID: 32740179 PMCID: PMC8865053 DOI: 10.1097/pcc.0000000000002493] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine the effect of skin-to-skin care on stress, pain, behavioral organization, and physiologic stability of infants with critical congenital heart disease before and after neonatal cardiac surgery. DESIGN A baseline response-paired design was used, with infants acting as their own controls before, during, and after skin-to-skin care at two distinct time points: once in the preoperative period (T1) and once in the postoperative period (T2). SETTING Cardiac ICU and step-down unit in a large metropolitan freestanding children's hospital. SUBJECTS Convenience sample of 30 infants admitted preoperatively for critical congenital heart disease. INTERVENTIONS Eligible infants were placed into skin-to-skin care for 1 hour with their biological mothers once each at T1 and T2. MEASUREMENTS AND MAIN RESULTS Measurements of stress (salivary cortisol), pain and behavior state (COMFORT scale), and physiologic stability (vital signs) were assessed immediately before skin-to-skin care, 30 minutes into skin-to-skin care, and 30 minutes after skin-to-skin care ended.At both T1 and T2, infant pain scores were significantly decreased (p < 0.0001) and infants moved into a calmer behavior state (p < 0.0001) during skin-to-skin care as compared to baseline. At T1, infants also had significantly reduced heart rate (p = 0.002) and respiratory rate (p < 0.0001) and increased systolic blood pressure (p = 0.033) during skin-to-skin care. At both T1 and T2, infant cortisol remained stable and unchanged from pre-skin-to-skin care to during skin-to-skin care (p = 0.096 and p = 0.356, respectively), and significantly increased from during skin-to-skin care to post-skin-to-skin care (p = 0.001 and p = 0.023, respectively). Exploratory analysis revealed differences in cortisol reactivity for infants with higher baseline cortisol (> 0.3 μg/dL) versus lower (≤ 0.3 μg/dL) prior to skin-to-skin care. Infants with higher baseline cortisol at T2 experienced significantly reduced cortisol during skin-to-skin care (p = 0.025). No significant differences in demographics or baseline variables were found between infants in either group. CONCLUSIONS Skin-to-skin care is a low-cost, low-risk intervention that promotes comfort and supports physiologic stability in infants before and after neonatal cardiac surgery.
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96
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Pados BF, Fuller K. Establishing a Foundation for Optimal Feeding Outcomes in the NICU. Nurs Womens Health 2020; 24:202-209. [PMID: 32387143 DOI: 10.1016/j.nwh.2020.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/13/2020] [Accepted: 03/01/2020] [Indexed: 06/11/2023]
Abstract
Many infants in the NICU experience difficulties with oral feeding, which contribute to prolonged length of stay. Oral feeding is a complex task involving sensorimotor functioning of the face, mouth, and larynx, as well as coordination of sucking, swallowing, and breathing. The care provided in the NICU starting at birth sets the stage for future oral feeding. The purpose of this article is to describe strategies that will establish a positive foundation to support optimal oral feeding. Nurses can use these strategies to protect newborns from noxious stimuli and promote positive auditory, tactile, gustatory, and olfactory experiences to optimize neurodevelopment for the complex task of feeding.
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97
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Zeev-Wolf M, Levy J, Ebstein RP, Feldman R. Cumulative Risk on Oxytocin-Pathway Genes Impairs Default Mode Network Connectivity in Trauma-Exposed Youth. Front Endocrinol (Lausanne) 2020; 11:335. [PMID: 32528417 PMCID: PMC7256187 DOI: 10.3389/fendo.2020.00335] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 04/29/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Although the default mode network (DMN) is a core network essential for brain functioning, little is known about its developmental trajectory, particularly on factors associated with its coherence into a functional network. In light of adult studies indicating DMN's susceptibility to stress-related conditions, we examined links between variability on oxytocin-pathway genes and DMN connectivity in youth exposed to chronic war-related trauma Methods: Following a cohort of war-exposed children from early childhood, we imaged the brains of 74 preadolescents (age 11-13 years; 39 war-exposed) during rest using magnetoencephalography (MEG). A cumulative risk index on oxytocin-pathway genes was constructed by combining single nucleotide polymorphisms on five genes previously linked with social deficits and psychopathology; OXTR rs1042778, OXTR rs2254298, OXTRrs53576, CD38 rs3796863, and AVPR1A RS3. Avoidant response to trauma reminders in early childhood and anxiety disorders in late childhood were assessed as predictors of disruptions to DMN theta connectivity. Results: Higher vulnerability on oxytocin-pathway genes predicted greater disruptions to DMN theta connectivity. Avoidant symptoms in early childhood and generalized anxiety disorder in later childhood were related to impaired DMN connectivity. In combination, stress exposure, oxytocin-pathway genes, and stress-related symptoms explained 24.6% of the variance in DMN connectivity, highlighting the significant effect of stress on the maturing brain. Conclusions: Findings are the first to link the oxytocin system and maturation of the DMN, a core system sustaining autobiographical memories, alteration of intrinsic and extrinsic attention, mentalization, and sense of self. Results suggest that oxytocin may buffer the effects of chronic early stress on the DMN, particularly theta rhythms that typify the developing brain.
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Affiliation(s)
- Maor Zeev-Wolf
- Department of Education, Zlotowski Center for Neuroscience, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Jonathan Levy
- Interdiscilinary Center Herzliya, Baruch Ivcher School of Psychology, Herzliya, Israel
- Department of Neuroscience and Biomedical Engineering, Aalto University, Espoo, Finland
| | - Richard P. Ebstein
- Department of Psychology, National University of Singapore, Singapore, Singapore
| | - Ruth Feldman
- Interdiscilinary Center Herzliya, Baruch Ivcher School of Psychology, Herzliya, Israel
- Child Study Center, Yale University, New Haven, CT, United States
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98
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Brotherton H, Gai A, Tann CJ, Samateh AL, Seale AC, Zaman SMA, Cousens S, Roca A, Lawn JE. Protocol for a randomised trial of early kangaroo mother care compared to standard care on survival of pre-stabilised preterm neonates in The Gambia (eKMC). Trials 2020; 21:247. [PMID: 32143737 PMCID: PMC7059319 DOI: 10.1186/s13063-020-4149-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 02/06/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Complications of preterm birth cause more than 1 million deaths each year, mostly within the first day after birth (47%) and before full post-natal stabilisation. Kangaroo mother care (KMC), provided as continuous skin-to-skin contact for 18 h per day to fully stabilised neonates ≤ 2000 g, reduces mortality by 36-51% at discharge or term-corrected age compared with incubator care. The mortality effect of starting continuous KMC before stabilisation is a priority evidence gap, which we aim to investigate in the eKMC trial, with a secondary aim of understanding mechanisms, particularly for infection prevention. METHODS We will conduct a single-site, non-blinded, individually randomised, controlled trial comparing two parallel groups to either early (within 24 h of admission) continuous KMC or standard care on incubator or radiant heater with KMC when clinically stable at > 24 h of admission. Eligible neonates (n = 392) are hospitalised singletons or twins < 2000 g and 1-24 h old at screening who are mild to moderately unstable as per a trial definition using cardio-respiratory parameters. Randomisation is stratified by weight category (< 1200 g; ≥ 1200 g) and in random permuted blocks of varying sizes with allocation of twins to the same arm. Participants are followed up to 28 ± 5 days of age with regular inpatient assessments plus criteria-led review in the event of clinical deterioration. The primary outcome is all-cause neonatal mortality by age 28 days. Secondary outcomes include the time to death, cardio-respiratory stability, hypothermia, exclusive breastfeeding at discharge, weight gain at age 28 days, clinically suspected infection (age 3 to 28 days), intestinal carriage of extended-spectrum beta-lactamase producing (ESBL) Klebsiella pneumoniae (age 28 days), and duration of the hospital stay. Intention-to-treat analysis will be applied for all outcomes, adjusting for twin gestation. DISCUSSION This is one of the first clinical trials to examine the KMC mortality effect in a pre-stabilised preterm population. Our findings will contribute to the global evidence base in addition to providing insights into the infection prevention mechanisms and safety of using this established intervention for the most vulnerable neonatal population. TRIAL REGISTRATION ClinicalTrials.gov NCT03555981. Submitted 8 May 2018 and registered 14 June 2018. Prospectively registered.
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Affiliation(s)
- Helen Brotherton
- Faculty of Epidemiology and Population Health, and MARCH Centre, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, UK.
- MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia.
- Department of Medical Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK.
| | - Abdou Gai
- MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia
| | - Cally J Tann
- Faculty of Epidemiology and Population Health, and MARCH Centre, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, UK
- MRC/UVRI & LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Entebbe, Uganda
- Neonatal Medicine, University College London Hospitals NHS Trust, 235 Euston Rd, London, UK
| | | | - Anna C Seale
- Faculty of Epidemiology and Population Health, and MARCH Centre, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, UK
| | - Syed M A Zaman
- Education Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Simon Cousens
- Faculty of Epidemiology and Population Health, and MARCH Centre, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, UK
| | - Anna Roca
- MRC Unit The Gambia at LSHTM, Atlantic Road, Fajara, The Gambia
| | - Joy E Lawn
- Faculty of Epidemiology and Population Health, and MARCH Centre, London School of Hygiene & Tropical Medicine (LSHTM), Keppel Street, London, UK
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Tarumi W, Shinohara K. The Effects of Essential Oil on Salivary Oxytocin Concentration in Postmenopausal Women. J Altern Complement Med 2020; 26:226-230. [PMID: 32013535 DOI: 10.1089/acm.2019.0361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objectives: The aim of this study was to find essential oils that have increased the oxytocin concentration in postmenopausal women. Methods: Fifteen postmenopausal women participated in this study and the effects of 10 different essential oils were investigated. The essential oils included rose otto, sweet orange, lavender, neroli, frankincense, jasmine absolute, ylang ylang, roman chamomile, clary sage, and Indian sandalwood. The subjects were exposed to the control first for 20 min, followed by exposure to an essential oil for 20 min. Each subject received exposure to only a single kind of essential oil per day. Saliva was collected four times for each patient: immediately before and immediately after control exposure, and immediately before and immediately after essential oil exposure. The oxytocin concentration in the saliva was measured using a competitive ELISA kit. Results: The results showed that salivary oxytocin concentrations increased significantly more after exposure to lavender, neroli, jasmine absolute, roman chamomile, clary sage, and Indian sandalwood than after exposure to the control odor. Conclusions: The aroma of certain essential oils may elicit increased secretion of oxytocin in postmenopausal women. This study suggests that olfactory stimulation with any of a number of essential oils increases salivary oxytocin concentrations, which may inhibit aging-induced reduction in muscle mass and function in women.
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Affiliation(s)
- Wataru Tarumi
- Division of Advanced Preventive Medical Sciences, Department of Neurobiology and Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuyuki Shinohara
- Division of Advanced Preventive Medical Sciences, Department of Neurobiology and Behavior, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Systematic Review of the Effects of Skin-to-Skin Care on Short-Term Physiologic Stress Outcomes in Preterm Infants in the Neonatal Intensive Care Unit. Adv Neonatal Care 2020; 20:48-58. [PMID: 30893092 DOI: 10.1097/anc.0000000000000596] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Infants in the neonatal intensive care unit (NICU) are exposed to many stressors. There is growing evidence that chronic stress early in life has long-term neurodevelopmental implications. Skin-to-skin care (SSC) is an intervention used to reduce stress in the NICU. CLINICAL QUESTION In premature infants in the NICU, what is the available evidence that SSC improves short-term physiologic stress outcomes compared with incubator care? SEARCH STRATEGY PubMed and CINAHL were searched for terms related to SSC, stress, physiology, and premature infants. Of 1280 unique articles, 19 were identified that reported on research studies comparing SSC with incubator care in the NICU and reported stress-related physiologic outcome measures. RESULTS Although there have been some mixed findings, the research supports that SSC improves short-term cardiorespiratory stress outcomes compared with incubator care. The evidence is clearer for studies reporting stress hormone outcomes, with strong evidence that SSC reduces cortisol and increases oxytocin levels in preterm infants. IMPLICATIONS FOR PRACTICE AND RESEARCH SSC is safe and has stress-reducing benefits. SSC should be considered an essential component to providing optimal care in the NICU. More research is needed to determine the timing of initiation, duration, and frequency of SSC to optimize the stress-reducing benefits. Future research should include the most fragile infants, who are most likely to benefit from SSC, utilize power analyses to ensure adequate sample sizes, and use sophisticated data collection and analysis techniques to more accurately evaluate the effect of SSC on infants in the NICU.
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