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Dereddy N, Moats RA, Ruth D, Pokelsek A, Pepe J, Wadhawan R, Oh W. Maternal recorded voice played to preterm infants in incubators reduces her own depression, anxiety and stress: a pilot randomized control trial. J Matern Fetal Neonatal Med 2024; 37:2362933. [PMID: 38910112 DOI: 10.1080/14767058.2024.2362933] [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: 03/22/2024] [Accepted: 05/29/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE To study the effects of playing mother's recorded voice to preterm infants in the NICU on their mothers' mental health as measured by the Depression, Anxiety and Stress Scale -21 (DASS-21) questionnaire. DESIGN/METHODS This was a pilot single center prospective randomized controlled trial done at a level IV NICU. The trial was registered at clinicaltrials.gov (NCT04559620). Inclusion criteria were mothers of preterm infants with gestational ages between 26wks and 30 weeks. DASS-21 questionnaire was administered to all the enrolled mothers in the first week after birth followed by recording of their voice by the music therapists. In the interventional group, recorded maternal voice was played into the infant incubator between 15 and 21 days of life. A second DASS-21 was administered between 21 and 23 days of life. The Wilcoxon rank-sum test was used to compare DASS-21 scores between the two groups and Wilcoxon signed-rank test was used to compare the pre- and post-intervention DASS-21 scores. RESULTS Forty eligible mothers were randomized: 20 to the intervention group and 20 to the control group. The baseline maternal and neonatal characteristics were similar between the two groups. There was no significant difference in the DASS-21 scores between the two groups at baseline or after the study intervention. There was no difference in the pre- and post-interventional DASS-21 scores or its individual components in the experimental group. There was a significant decrease in the total DASS-21 score and the anxiety component of DASS-21 between weeks 1 and 4 in the control group. CONCLUSION In this pilot randomized control study, recorded maternal voice played into preterm infant's incubator did not have any effect on maternal mental health as measured by the DASS-21 questionnaire. Data obtained in this pilot study are useful in future RCTs (Randomized Controlled Trial) to address this important issue.
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Affiliation(s)
- Narendra Dereddy
- AdventHealth for Children, Orlando, FL, USA
- University of Central Florida College of Medicine, Orlando, FL, USA
| | | | - Deborah Ruth
- AdventHealth Research Institute, Orlando, FL, USA
| | - Ann Pokelsek
- AdventHealth Research Institute, Orlando, FL, USA
| | - Julie Pepe
- AdventHealth Research Institute, Orlando, FL, USA
| | | | - William Oh
- AdventHealth for Children, Orlando, FL, USA
- AdventHealth Research Institute, Orlando, FL, USA
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Di Fiore JM, Liu G, Loparo KA, Bearer CF. The effect of early postnatal auditory stimulation on outcomes in preterm infants. Pediatr Res 2024:10.1038/s41390-024-03329-7. [PMID: 38909158 DOI: 10.1038/s41390-024-03329-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 04/18/2024] [Indexed: 06/24/2024]
Abstract
Preterm infants are deprived of in utero sensory stimulation during the third trimester, an important period of central nervous system development. As a result, maturational trajectories are often reduced in infants born preterm. One such system affected is the brain including the auditory and respiratory control pathways. During normal pregnancy the intrauterine environment attenuates external auditory stimuli while exposing the fetus to filtered maternal voice, intra-abdominal sounds, and external stimuli. In contrast, during the third trimester of development, preterm infants are exposed to a vastly different soundscape including non-attenuated auditory sounds and a lack of womb related stimuli, both of which may affect postnatal brain maturation. Therefore, fostering a nurturing postnatal auditory environment during hospitalization may have a significant impact on related outcomes of preterm infants. Studies using a range of postnatal auditory stimulations have suggested that exposure to sounds or lack thereof can have a significant impact on outcomes. However, studies are inconsistent with sound levels, duration of exposure to auditory stimuli, and the gestational age at which infants are exposed. IMPACT: Auditory stimulation can provide a low cost and low risk intervention to stabilize respiration, improve neuronal maturation and reduce long-term sequelae in preterm infants. The potential benefits of auditory stimulation are dependent on the type of sound, the duration of exposure and age at time of exposure. Future studies should focus on the optimal type and duration of sound exposure and postnatal developmental window to improve outcomes.
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Affiliation(s)
- Juliann M Di Fiore
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA
| | - Gloria Liu
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA
| | - Kenneth A Loparo
- ISSACS: Institute for Smart, Secure and Connected Systems, Case Western Reserve University, Cleveland, OH, USA
| | - Cynthia F Bearer
- Dept of Pediatrics, Case Western Reserve University, Cleveland, OH, 44016, USA.
- Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, OH, 44016, USA.
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Aija A, Leppänen J, Aarnos L, Hyvönen M, Ståhlberg-Forsén E, Ahlqvist-Björkroth S, Stolt S, Toome L, Lehtonen L. Exposure to the parents' speech is positively associated with preterm infant's face preference. Pediatr Res 2024:10.1038/s41390-024-03239-8. [PMID: 38783114 DOI: 10.1038/s41390-024-03239-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND The parents' presence and involvement in neonatal care is a promising approach to improve preterm infants' neurodevelopmental outcomes. We examined whether exposure to the parents' speech is associated with the preterm infant's social-cognitive development. METHODS The study included infants born before 32 gestational weeks in two neonatal units. Each infant's language environment was assessed from 16-hour recordings using Language Environment Analysis (LENA®). Parental presence was assessed with Closeness Diary for 14 days during the hospital stay. Attention to faces and non-face patterns was measured at the corrected age of seven months using an eye-tracking disengagement test. RESULTS A total of 63 preterm infants were included. Infants were less likely to disengage their attention from faces (M = 0.55, SD = 0.26) than non-face patterns (M = 0.24, SD = 0.22), p < 0.001, d = 0.84. Exposure to the parents' speech during the neonatal period was positively correlated with the preference for faces over non-face patterns (rs = 0.34, p = 0.009) and with the preference for parents over unfamiliar faces (rs = 0.28, p = 0.034). CONCLUSION The exposure to the parents' speech during neonatal hospital care is a potential early marker for later social development in preterm infants. IMPACT The exposure to the parents' speech during neonatal intensive care is a potential early marker for optimal social-cognitive development in preterm infants. This is the first study to show an association between parental vocal contact during neonatal intensive care and early social development (i.e., face preference), measured at seven months of corrected age. Our findings suggest that we should pay attention to the parents' vocal contact with their child in the neonatal intensive care unit and identify need for tailored support for face-to-face and vocal contact.
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Affiliation(s)
- Anette Aija
- University of Turku, Turku, Finland.
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia.
| | - Jukka Leppänen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | | | | | - Eva Ståhlberg-Forsén
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | | | - Suvi Stolt
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia
| | - Liisa Lehtonen
- University of Turku, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
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Düken ME, Yayan EH. The effects of massage therapy and white noise application on premature infants' sleep. Explore (NY) 2024; 20:319-327. [PMID: 37806925 DOI: 10.1016/j.explore.2023.09.002] [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: 02/03/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
AIM Sleep is vital to premature infants' physical, social and emotional development. The significance of sleep duration, efficiency, and function in premature infants regarding growth development, behavior and neurological development has been increasing. MATERIALS AND METHODS This study was conducted in a randomized controlled experimental design with three groups. Premature infants at 28-37 weeks of gestation who were admitted to the Neonatal Intensive Care Unit of Şanlıurfa Mehmet Akif İnan Training and Research Hospital Haliliye Annex Building were the research population. The sample of the present study consisted of 120 premature infants in the massage therapy group (40), white noise group (40), and control group (40). RESULTS The sleep duration and sleep efficiency of the premature infants in the massage group increased compared to before the application, whereas the number of awakenings and WASO values decreased. The sleep duration of premature infants in the massaged group increased by some five hours. In the white noise group, the sleep duration increased by about two hours than the pre-treatment, and there was an increase in sleep efficiency. White noise application provided a significant decrease in the number of awakenings and WASO values in premature infants. CONCLUSION In this experimental study, which was designed with three groups, it was revealed that massage and white noise application in premature infants were significant non-pharmacological methods to increase sleep duration and sleep efficiency. It was concluded that massage therapy and white noise application is one of the considerable interventions regarding sleep duration, efficiency and functions in premature infants who left the intrauterine period early.
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Affiliation(s)
- Mehmet Emin Düken
- Health Sciences of Faculty, Department of Child Health and Diseases Nursing, Harran University, Şanlıurfa 63000, Turkey.
| | - Emriye Hilal Yayan
- Faculty of Nursing, Department of Child Health and Diseases Nursing, Inönü University, Malatya 44280, Turkey.
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Chen Y, Zhou L, Tan Y. The effect of maternal voice and non-nutritional sucking on repeated procedural pain of heel prick in neonates: a quasi-experimental study. BMC Pediatr 2024; 24:256. [PMID: 38627645 PMCID: PMC11020345 DOI: 10.1186/s12887-024-04738-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/02/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Neonates in the neonatal intensive care unit undergo frequent painful procedures. It is essential to reduce pain using safe and feasible methods. PURPOSE To evaluate the effects of non-nutritional sucking, mother's voice, or non-nutritional sucking combined with mother's voice on repeated procedural pain in hospitalized neonates. METHODS A quasi-experimental study was conducted in which 141 neonates were selected in a hospital in Changsha, China. Newborns were divided into four groups: non-nutritional sucking (NNS) (n = 35), maternal voice (MV) (n = 35), NNS + MV (n = 34), and control (n = 37) groups. The Preterm Infant Pain Profile-Revised Scale (PIPP-R) was used to assess pain. RESULTS During the heel prick, the heart rate value and blood oxygen saturation were significantly different between the groups (P < 0.05). Both non-nutritional sucking and maternal voice significantly reduced PIPP-R pain scores of hospitalized newborns (P < 0.05). The pain-relief effect was more robust in the combined group than in other groups. CONCLUSIONS This study showed that both non-nutritional sucking and the mother's voice alleviated repeated procedural pain in neonates. Therefore, these interventions can be used as alternatives to reduce repeated procedural pain.
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Affiliation(s)
- Yushuang Chen
- Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Leshan Zhou
- Xiangya Nursing School, Yuelu District, Central South University, No 172, Tongzipo Road, Changsha City, 410013, China.
| | - Yanjuan Tan
- Xiangya Thrid Hospital, Central South University, Changsha, China
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McGowan EC, Caskey M, Tucker R, Vohr BR. A Randomized Controlled Trial of a Neonatal Intensive Care Unit Language Intervention for Parents of Preterm Infants and 2-Year Language Outcomes. J Pediatr 2024; 264:113740. [PMID: 37717908 DOI: 10.1016/j.jpeds.2023.113740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 08/17/2023] [Accepted: 09/13/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE To test whether a neonatal intensive care unit-based language curriculum for families with preterm infants enhances the language environment and postdischarge Bayley Scales of Infant and Toddler Development (BSID)-III language and cognitive scores. METHODS A randomized controlled trial was conducted with infants born at ≤32 weeks assigned to a parent-driven language intervention or health-safety lessons (controls). Recordings of adult word counts (AWC), conversational turns, and child vocalizations were captured at 32, 34, and 36 weeks. Primary outcomes included 2-year BSID-III language and cognitive scores. RESULTS We randomized 95 infants; 45 of the 48 intervention patients (94%) and 43 of the 47 controls (91%) with ≥2 recordings were analyzed. The intervention group had higher AWCs (rate ratio, 1.52; 95% CI, 1.05-2.19; P = .03) at 36 weeks, increased their AWCs between all recordings, and had lower rates of 2-year receptive language scores <7 (10% vs 38%; P < .02). The intervention was associated with 80% decreased odds of a language composite score of <85 (aOR, 0.20; 95% CI, 0.05-0.78; P = .02), and 90% decreased odds of a receptive score of <7 (0.10; 95% CI, 0.02-0.46; P = .003); there was no association found with cognitive scores. Increases in AWC and conversational turns between 32 and 36 weeks were independently associated with improved 2-year BSID-III language scores for both study groups. CONCLUSIONS Short-term parent-driven language enrichment in the neonatal intensive care unit contributes to increased AWCs at 36 weeks and improved 2-year language scores. In adjusted analyses, increases in conversational turns and AWCs at 36 weeks were independently associated with improved language scores. This low-cost, easily implemented intervention can potentially help to mitigate speech delays among preterm infants. TRIAL REGISTRATION Registered with www. CLINICALTRIALS gov, NCT02528227.
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Affiliation(s)
| | | | - Richard Tucker
- Department of Pediatrics, Women and Infant's Hospital, Providence, RI
| | - Betty R Vohr
- Department of Pediatrics, Women and Infant's Hospital, Providence, RI
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Haslbeck FB, Mueller K, Karen T, Loewy J, Meerpohl JJ, Bassler D. Musical and vocal interventions to improve neurodevelopmental outcomes for preterm infants. Cochrane Database Syst Rev 2023; 9:CD013472. [PMID: 37675934 PMCID: PMC10483930 DOI: 10.1002/14651858.cd013472.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
BACKGROUND Preterm birth interferes with brain maturation, and subsequent clinical events and interventions may have additional deleterious effects. Music as therapy is offered increasingly in neonatal intensive care units aiming to improve health outcomes and quality of life for both preterm infants and the well-being of their parents. Systematic reviews of mixed methodological quality have demonstrated ambiguous results for the efficacy of various types of auditory stimulation of preterm infants. A more comprehensive and rigorous systematic review is needed to address controversies arising from apparently conflicting studies and reviews. OBJECTIVES We assessed the overall efficacy of music and vocal interventions for physiological and neurodevelopmental outcomes in preterm infants (< 37 weeks' gestation) compared to standard care. In addition, we aimed to determine specific effects of various interventions for physiological, anthropometric, social-emotional, neurodevelopmental short- and long-term outcomes in the infants, parental well-being, and bonding. SEARCH METHODS We searched Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, RILM Abstracts, and ERIC in November 2021; and Proquest Dissertations in February 2019. We searched the reference lists of related systematic reviews, and of studies selected for inclusion and clinical trial registries. SELECTION CRITERIA We included parallel, and cluster-randomised controlled trials with preterm infants < 37 weeks` gestation during hospitalisation, and parents when they were involved in the intervention. Interventions were any music or vocal stimulation provided live or via a recording by a music therapist, a parent, or a healthcare professional compared to standard care. The intervention duration was greater than five minutes and needed to occur more than three times. DATA COLLECTION AND ANALYSIS Three review authors independently extracted data. We analysed the treatment effects of the individual trials using RevMan Web using a fixed-effects model to combine the data. Where possible, we presented results in meta-analyses using mean differences with 95% CI. We performed heterogeneity tests. When the I2 statistic was higher than 50%, we assessed the source of the heterogeneity by sensitivity and subgroup analyses. We used GRADE to assess the certainty of the evidence. MAIN RESULTS We included 25 trials recruiting 1532 infants and 691 parents (21 parallel-group RCTs, four cross-over RCTs). The infants gestational age at birth varied from 23 to 36 weeks, taking place in NICUs (level 1 to 3) around the world. Within the trials, the intervention varied widely in type, delivery, frequency, and duration. Music and voice were mainly characterised by calm, soft, musical parameters in lullaby style, often integrating the sung mother's voice live or recorded, defined as music therapy or music medicine. The general risk of bias in the included studies varied from low to high risk of bias. Music and vocal interventions compared to standard care Music/vocal interventions do not increase oxygen saturation in the infants during the intervention (mean difference (MD) 0.13, 95% CI -0.33 to 0.59; P = 0.59; 958 infants, 10 studies; high-certainty evidence). Music and voice probably do not increase oxygen saturation post-intervention either (MD 0.63, 95% CI -0.01 to 1.26; P = 0.05; 800 infants, 7 studies; moderate-certainty evidence). The intervention may not increase infant development (Bayley Scales of Infant and Toddler Development (BSID)) with the cognitive composition score (MD 0.35, 95% CI -4.85 to 5.55; P = 0.90; 69 infants, 2 studies; low-certainty evidence); the motor composition score (MD -0.17, 95% CI -5.45 to 5.11; P = 0.95; 69 infants, 2 studies; low-certainty evidence); and the language composition score (MD 0.38, 95% CI -5.45 to 6.21; P = 0.90; 69 infants, 2 studies; low-certainty evidence). Music therapy may not reduce parental state-trait anxiety (MD -1.12, 95% CI -3.20 to 0.96; P = 0.29; 97 parents, 4 studies; low-certainty evidence). The intervention probably does not reduce respiratory rate during the intervention (MD 0.42, 95% CI -1.05 to 1.90; P = 0.57; 750 infants; 7 studies; moderate-certainty evidence) and post-intervention (MD 0.51, 95% CI -1.57 to 2.58; P = 0.63; 636 infants, 5 studies; moderate-certainty evidence). However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention (MD -1.38, 95% CI -2.63 to -0.12; P = 0.03; 1014 infants; 11 studies; moderate-certainty evidence). This beneficial effect was even stronger after the intervention. Music/vocal interventions reduce heart rate post-intervention (MD -3.80, 95% CI -5.05 to -2.55; P < 0.00001; 903 infants, 9 studies; high-certainty evidence) with wide CIs ranging from medium to large beneficial effects. Music therapy may not reduce postnatal depression (MD 0.50, 95% CI -1.80 to 2.81; P = 0.67; 67 participants; 2 studies; low-certainty evidence). The evidence is very uncertain about the effect of music therapy on parental state anxiety (MD -0.15, 95% CI -2.72 to 2.41; P = 0.91; 87 parents, 3 studies; very low-certainty evidence). We are uncertain about any further effects regarding all other secondary short- and long-term outcomes on the infants, parental well-being, and bonding/attachment. Two studies evaluated adverse effects as an explicit outcome of interest and reported no adverse effects from music and voice. AUTHORS' CONCLUSIONS Music/vocal interventions do not increase oxygen saturation during and probably not after the intervention compared to standard care. The evidence suggests that music and voice do not increase infant development (BSID) or reduce parental state-trait anxiety. The intervention probably does not reduce respiratory rate in preterm infants. However, music/vocal interventions probably reduce heart rates in preterm infants during the intervention, and this beneficial effect is even stronger after the intervention, demonstrating that music/vocal interventions reduce heart rates in preterm infants post-intervention. We found no reports of adverse effects from music and voice. Due to low-certainty evidence for all other outcomes, we could not draw any further conclusions regarding overall efficacy nor the possible impact of different intervention types, frequencies, or durations. Further research with more power, fewer risks of bias, and more sensitive and clinically relevant outcomes are needed.
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Affiliation(s)
| | - Katharina Mueller
- Zentrum für Kinder und Jugendmedizin, University Freiburg, Freiburg, Germany
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
| | - Joanne Loewy
- Mount Sinai Health System, The Louis Armstrong Center for Music & Medicine, New York City, USA
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, Zurich, Switzerland
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Sharman KM, Meissel K, Tait JE, Rudd G, Henderson AME. The effects of live parental infant-directed singing on infants, parents, and the parent-infant dyad: A systematic review of the literature. Infant Behav Dev 2023; 72:101859. [PMID: 37343492 DOI: 10.1016/j.infbeh.2023.101859] [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: 05/13/2022] [Revised: 05/29/2023] [Accepted: 06/14/2023] [Indexed: 06/23/2023]
Abstract
Singing to infants is widely accepted as an enjoyable, positive, and beneficial interaction between the parent and infant across cultures. Whilst the literature suggests that live infant-directed singing impacts the infant, the parent doing the singing and the dyad in powerful ways, no systematic review of the evidence has yet been conducted. To this end, this systematic review identified 21 studies that investigated the effect of live parental infant-directed singing. These impacts were categorized as either being directly related to the infant, the parent, or the parent-infant dyad. Three main themes - one for each of the impact categories considered - were identified using thematic analysis techniques; infant-directed singing impacts on: infants' emotional regulation, provides validation of the parent's role, and promotes affect attunement within the dyad. The findings reinforce the benefits of live parental infant-directed singing for all parties involved, particularly when parents sing to typically developing infants born at full term. In contrast, the findings were inconsistent for pre-term infants. The implications of these findings are discussed.
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Affiliation(s)
- Kirsten M Sharman
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand
| | - Kane Meissel
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand.
| | - Josie E Tait
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Georgia Rudd
- School of Learning, Development and Professional Practice, Faculty of Education and Social Work, The University of Auckland, New Zealand
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Pineda R, Kellner P, Guth R, Gronemeyer A, Smith J. NICU sensory experiences associated with positive outcomes: an integrative review of evidence from 2015-2020. J Perinatol 2023; 43:837-848. [PMID: 37029165 PMCID: PMC10325947 DOI: 10.1038/s41372-023-01655-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 04/09/2023]
Abstract
To inform changes to the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, studies investigating sensory-based interventions in the NICU with preterm infants born ≤32 weeks were identified. Studies published between October 2015 to December 2020, and with outcomes related to infant development or parent well-being, were included in this integrative review. The systematic search used databases including MEDLINE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, and Google Scholar. Fifty-seven articles (15 tactile, 9 auditory, 5 visual, 1 gustatory/olfactory, 5 kinesthetic, and 22 multimodal) were identified. The majority of the sensory interventions that were identified within the articles were reported in a previous integrative review (1995-2015) and already included in the SENSE program. New evidence has led to refinements of the SENSE program, notably the addition of position changes across postmenstrual age (PMA) and visual tracking starting at 34 weeks PMA.
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Affiliation(s)
- Roberta Pineda
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA.
- Keck School of Medicine, Department of Pediatrics, Los Angeles, CA, USA.
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO, USA.
| | - Polly Kellner
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
| | - Rebecca Guth
- Center for Clinical Excellence, BJC HealthCare, St. Louis, MO, USA
| | | | - Joan Smith
- Department of Quality, Safety, and Practice Excellence, St. Louis Children's Hospital, St. Louis, MO, USA
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10
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Schneider P, Groß C, Bernhofs V, Christiner M, Benner J, Turker S, Zeidler BM, Seither‐Preisler A. Short-term plasticity of neuro-auditory processing induced by musical active listening training. Ann N Y Acad Sci 2022; 1517:176-190. [PMID: 36114664 PMCID: PMC9826140 DOI: 10.1111/nyas.14899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Although there is strong evidence for the positive effects of musical training on auditory perception, processing, and training-induced neuroplasticity, there is still little knowledge on the auditory and neurophysiological short-term plasticity through listening training. In a sample of 37 adolescents (20 musicians and 17 nonmusicians) that was compared to a control group matched for age, gender, and musical experience, we conducted a 2-week active listening training (AULOS: Active IndividUalized Listening OptimizationS). Using magnetoencephalography and psychoacoustic tests, the short-term plasticity of auditory evoked fields and auditory skills were examined in a pre-post design, adapted to the individual neuro-auditory profiles. We found bilateral, but more pronounced plastic changes in the right auditory cortex. Moreover, we observed synchronization of the auditory evoked P1, N1, and P2 responses and threefold larger amplitudes of the late P2 response, similar to the reported effects of musical long-term training. Auditory skills and thresholds benefited largely from the AULOS training. Remarkably, after training, the mean thresholds improved by 12 dB for bone conduction and by 3-4 dB for air conduction. Thus, our findings indicate a strong positive influence of active listening training on neural auditory processing and perception in adolescence, when the auditory system is still developing.
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Affiliation(s)
- Peter Schneider
- Division of NeuroradiologyUniversity of Heidelberg Medical SchoolHeidelbergGermany,Department of Neurology, Section of BiomagnetismUniversity of Heidelberg Medical SchoolHeidelbergGermany,Jazeps Vitols Latvian Academy of MusicRigaLatvia,Centre for Systematic MusicologyUniversity of GrazGrazAustria
| | - Christine Groß
- Division of NeuroradiologyUniversity of Heidelberg Medical SchoolHeidelbergGermany,Jazeps Vitols Latvian Academy of MusicRigaLatvia
| | | | - Markus Christiner
- Jazeps Vitols Latvian Academy of MusicRigaLatvia,Centre for Systematic MusicologyUniversity of GrazGrazAustria
| | - Jan Benner
- Division of NeuroradiologyUniversity of Heidelberg Medical SchoolHeidelbergGermany,Department of Neurology, Section of BiomagnetismUniversity of Heidelberg Medical SchoolHeidelbergGermany
| | - Sabrina Turker
- Lise Meitner Research Group “Cognition and Plasticity”Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
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11
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Bernard S, Hebert C, Katz C, Mogilner L, Weintraub A, Bragg J, Guttmann KF. Maternal and staff perceptions of shared reading in the neonatal intensive care unit. J Perinatol 2022; 43:529-531. [PMID: 36261620 DOI: 10.1038/s41372-022-01539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Stephanie Bernard
- Division of Newborn Medicine, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Camille Hebert
- Division of Newborn Medicine, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cynthia Katz
- Division of General Pediatrics, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leora Mogilner
- Division of General Pediatrics, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea Weintraub
- Division of Newborn Medicine, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jennifer Bragg
- Division of Newborn Medicine, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Katherine F Guttmann
- Division of Newborn Medicine, Department of Pediatrics, the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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12
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Maternal Voice Exposure and Its Effect on Premature Infants' Feeding Milestones: A Systematic Review. Adv Neonatal Care 2022; 23:E40-E49. [PMID: 36191331 DOI: 10.1097/anc.0000000000001029] [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 Premature infants experience alterations in maternal stimulation (including auditory sensory alteration such as talking or singing to the infant in the neonatal intensive care unit) due to admission to the neonatal intensive care unit. Because of their physiological and neurobehavioral immaturity, infants are at an increased risk of delays in reaching feeding milestones (a key developmental milestone), which often need to be achieved before discharge. PURPOSE This systematic review evaluated the literature regarding the effect of maternal speech on achievement of feeding milestones in premature infants. DATA SOURCES A systematic search of CINAHL, PubMed, Web of Science, and Google Scholar from 2010 to 2021. STUDY SELECTION Studies were selected if they examined the effect of maternal voice interventions on premature infants' feeding milestones. DATA EXTRACTION Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. RESULTS Six studies were identified. This systematic review of the literature on the effects of maternal voice on feeding milestones in premature infants found equivocal results. IMPLICATIONS FOR PRACTICE Given the inconsistent results, this systematic review does not support a change in clinical practice. However, encouragement of maternal visits is highly recommended as the additional benefits of the mother's presence may extend beyond exposure to maternal voice. IMPLICATIONS FOR RESEARCH More research is needed including use of more homogenous samples, application of recommended decibel levels, and utilization of an adequately powered randomized controlled trial to further examine the effects of maternal voice on feeding milestones.
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13
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Zheng W, Chotipanvithayakul R, Ingviya T, Xia X, Xie L, Gao J. Sensory stimulation program improves developments of preterm infants in Southwest China: A randomized controlled trial. Front Psychol 2022; 13:867529. [PMID: 36046409 PMCID: PMC9421138 DOI: 10.3389/fpsyg.2022.867529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Preterm infants are prone to growth and developmental delay, especially social-emotional development. Sensory stimulation may benefit developmental outcomes for these vulnerable infants. This study aims to determine whether 5-integrated sensory stimulation (5-ISS) improves preterm infant social-emotional development. A randomized, parallel trial was conducted from November 2018 to January 2020 at three tertiary hospitals in Kunming, China. Preterm infants were eligible if gestational ages were from 28 to 36 weeks based on ultrasound results when discharged from neonatal wards. Two hundred preterm infants (male n = 110, female n = 90) were randomly allocated to the 5-ISS intervention group (n = 98) and the standard care group (n = 102). Social-emotional development was assessed with the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). Temperament was assessed with the Infant Behavior Questionnaire-Revised. Anthropometry, which included weight, length, and head circumference, was measured at corrected ages of 1, 3, and 6 months. Demographic and clinical characteristics were similar between the intervention and the standard care groups. At 1- and 3-month corrected age, no significant differences between the two groups were observed in terms of infant development and temperament. At 6 months, significant disparities were found in the social-emotional development scale (mean difference −0.29, 95% CI: −0.58, < -0.001, p = 0.01), infant length (mean difference 0.70, 95% CI: < 0.001, 1.4, p = 0.03), distress to limitation (p = 0.04), and sadness (p = 0.03). A mixed model revealed that the 5-ISS intervention positively affected social-emotional development, length, distress to limitation, and sadness for preterm infants. Integrated sensory stimulation has benefits on social-emotional development, temperament, and length for preterm infants. This program provides a feasible method to promote social-emotional development for preterm infants.
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Affiliation(s)
- Wenjing Zheng
- Department of Pediatrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Rassamee Chotipanvithayakul
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Research Center for Kids and Youth Development, Prince of Songkla University, Hat Yai, Thailand
- *Correspondence: Rassamee Chotipanvithayakul,
| | - Thammasin Ingviya
- Department of Family Medicine and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
- Research Center for Applied Medical Data Analytics, Prince of Songkla University, Hat Yai, Thailand
| | - Xiaoling Xia
- Department of Pediatrics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lu Xie
- Department of Neonatology, Kunming University Affiliated Maternal and Child Health Hospital, Kunming, China
| | - Jin Gao
- Department of Neonatology, Kunming Children Hospital, Kunming, China
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14
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Vohr BR, McGowan EC, Brumbaugh JE, Hintz SR. Overview of Perinatal Practices with Potential Neurodevelopmental Impact for Children Affected by Preterm Birth. J Pediatr 2022; 241:12-21. [PMID: 34673090 DOI: 10.1016/j.jpeds.2021.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Betty R Vohr
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI.
| | - Elisabeth C McGowan
- Department of Pediatrics, Alpert Medical School of Brown University and Women & Infants Hospital, Providence, RI
| | - Jane E Brumbaugh
- Children's Center of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | - Susan R Hintz
- Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA
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15
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Karadag OE, Kerimoglu Yildiz G, Akdogan R, Yildiz S, Hakyemez Toptan H. The effect of simulative heartbeat nest used in preterm new-borns on vital signs, pain, and comfort in Turkey: A randomized controlled study. J Pediatr Nurs 2022; 62:e170-e177. [PMID: 34702595 DOI: 10.1016/j.pedn.2021.10.003] [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: 07/09/2021] [Revised: 09/03/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Creating a womb-like environment for the preterm infant is vital to reduce the stress caused by stimuli and facilitate optimal neurological-behavioral development. PURPOSE This randomized-controlled study aimed to determine the effect of simulative heartbeat nest use on vital signs, pain level, and comfort in preterms. METHODS The study population consisted of 52 (experiment: 25, control: 27) preterms hospitalized in a university hospital's neonatal intensive care unit between May-November 2018. Before the application, preterms in both groups were evaluated with PIPP and Comfort scales. The experiment group was monitored in the nest with a heart beating device for 15 min. The control group was observed in the nest without the device for 15 min. Their heartbeats and oxygen saturation were recorded. After the application, preterms in both groups were re-evaluated with PIPP and Comfort scale. RESULTS There was no statistically significant difference between the groups in terms of gestation week, age, birth weight and height, HB, SaO2, PIPP, and Comfort Scale total scores before and after the application (p > .05). However, the mean SaO2 increased significantly during the application (p < .003) in the experiment group; and that the PIPP total score decreased statistically significantly (p: 0.001) after the application. The comfort scale total score averages of the preterms in both groups decreased statistically significantly after the application (experiment:p < .01; control:p < .05). IMPLICATIONS FOR PRACTICE AND RESEARCH Preterms in both groups had similar indicators. The nests that create heartbeat provide positive outcomes, such as the standard nests'.
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Affiliation(s)
- Ozge Eda Karadag
- Istanbul Kent University, Faculty of Health Sciences, Department of Nursing, Istanbul, Turkey
| | - Gizem Kerimoglu Yildiz
- Hatay Mustafa Kemal University, Faculty of Health Sciences, Department of Nursing, Hatay, Turkey
| | - Ridvan Akdogan
- Van Yüzüncü Yıl University, Faculty of Health Sciences, Department of Nursing, Van, Turkey.
| | - Suzan Yildiz
- Istanbul University-Cerrahpasa, Florence Nightingale Faculty of Nursing, Department of Pediatric Nursing, Istanbul, Turkey
| | - Handan Hakyemez Toptan
- Specialist in Pediatrics and Neonatology, Department of Pediatrics, Division of Neonatology, University of Health Sciences, Zeynep Kamil Maternity and Children's Disease Health Training and Research Center, Istanbul, Turkey
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16
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Döra Ö, Büyük ET. RETRACTED: Effect of White Noise and Lullabies on Pain and Vital Signs in Invasive Interventions Applied to Premature Babies. Pain Manag Nurs 2021; 22:724-729. [PMID: 34210600 DOI: 10.1016/j.pmn.2021.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 04/03/2021] [Accepted: 05/21/2021] [Indexed: 10/21/2022]
Abstract
This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). The editors have decided to retract the article based on the lack of ethical standard care interventions that should have been administered to the control group during planned blood collection. That standard of care includes known, evidence-based interventions such as massage, kangaroo care, listening to music, non-nutritive sucking/pacifier, and wrapping.
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Affiliation(s)
- Özge Döra
- Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey
| | - Esra Tural Büyük
- Department of Child Health Nursing, Ondokuz Mayıs University, Samsun, Turkey.
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17
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Yui Y, October TW. Parental Perspectives on the Postpartum Bonding Experience after Neonatal Intensive Care Unit Transfer to a Referral Hospital. Am J Perinatol 2021; 38:1358-1365. [PMID: 32512609 DOI: 10.1055/s-0040-1712963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The aim of this study is to describe the postpartum bonding experience of parents whose newborns were transferred to a referral hospital while their mothers remained at the delivery hospital. STUDY DESIGN A total of 18 semi-structured interviews conducted with mothers within 2 weeks of birth were completed. Thematic analysis was performed. RESULT In total, 72% of mothers were unable to hold their newborns, and mothers spent a median of 15 minutes with their newborn prior to transfer. Thematic analysis revealed five themes: three barriers to bonding (medical, hospital, and family barriers) and two themes of interventions that helped promote bonding (parent and hospital-initiated interventions). Using technology such as bedside cameras, recording of heart beats, and video chatting on rounds were extremely popular. CONCLUSION Parents identified multiple barriers to maternal-infant bonding and suggested several parent-focused and hospital-focused interventions to enhance bonding. Strategies that address barriers should be used to help parents promote bonding during separation from their newborns. KEY POINTS · Transfer to referral neonatal intensive care units interrupts bonding.. · Interviews reveal multiple barriers to bonding.. · Interventions can be parent or hospital initiated.. · Technology is playing a growing role..
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Affiliation(s)
- Yvonne Yui
- Department of Neonatology, Children's National Hospital, Washington, District of Columbia
| | - Tessie W October
- Department of Critical Care, Children's National Hospital, Washington, District of Columbia.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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18
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Neri E, De Pascalis L, Agostini F, Genova F, Biasini A, Stella M, Trombini E. Parental Book-Reading to Preterm Born Infants in NICU: The Effects on Language Development in the First Two Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111361. [PMID: 34769878 PMCID: PMC8582730 DOI: 10.3390/ijerph182111361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Background: After preterm birth, infants are at high risk for delays in language development. A promising intervention to reduce this risk is represented by the exposure to parental voices through book-reading in Neonatal Intensive Care Units (NICU). This study investigated the possible advantages of book-reading to preterm neonates during their NICU stay on their subsequent language development. Methods: 100 families of preterm infants were recruited. The parents of 55 preterm infants (Reading Group) received a colored picture-book on NICU admission and were supported to read to their neonate as often as possible and to continue after hospital discharge. Forty-five infants (Control Group) were recruited before the beginning of the intervention. Infant language development was assessed with the Hearing and Language quotients of the Griffith Mental Development Scale at the corrected ages of 3, 6, 9, 12, 18 and 24 months. Results: Regardless of group membership, Hearing and Language mean quotients decreased between 9 and 18 months; nevertheless, this decrease was considerably reduced in the Reading group, compared to the Control Group. Conclusions: Reading in NICUs represents a suitable intervention that could positively influence language development and parent-infant relationships in preterm children. The study findings support its implementation as a preventive measure.
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Affiliation(s)
- Erica Neri
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
- Correspondence: (E.N.); (F.A.)
| | - Leonardo De Pascalis
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
| | - Francesca Agostini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
- Correspondence: (E.N.); (F.A.)
| | - Federica Genova
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
| | - Augusto Biasini
- Donor Human Milk Bank Italian Association (AIBLUD), 20126 Milan, Italy;
| | - Marcello Stella
- Pediatric and Neonatal Intensive Care Unit, Maurizio Bufalini Hospital, 47521 Cesena, Italy;
| | - Elena Trombini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
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19
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Kostilainen K, Partanen E, Mikkola K, Wikström V, Pakarinen S, Fellman V, Huotilainen M. Repeated Parental Singing During Kangaroo Care Improved Neural Processing of Speech Sound Changes in Preterm Infants at Term Age. Front Neurosci 2021; 15:686027. [PMID: 34539329 PMCID: PMC8446605 DOI: 10.3389/fnins.2021.686027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
Preterm birth carries a risk for adverse neurodevelopment. Cognitive dysfunctions, such as language disorders may manifest as atypical sound discrimination already in early infancy. As infant-directed singing has been shown to enhance language acquisition in infants, we examined whether parental singing during skin-to-skin care (kangaroo care) improves speech sound discrimination in preterm infants. Forty-five preterm infants born between 26 and 33 gestational weeks (GW) and their parents participated in this cluster-randomized controlled trial (ClinicalTrials ID IRB00003181SK). In both groups, parents conducted kangaroo care during 33-40 GW. In the singing intervention group (n = 24), a certified music therapist guided parents to sing or hum during daily kangaroo care. In the control group (n = 21), parents conducted standard kangaroo care and were not instructed to use their voices. Parents in both groups reported the duration of daily intervention. Auditory event-related potentials were recorded with electroencephalogram at term age using a multi-feature paradigm consisting of phonetic and emotional speech sound changes and a one-deviant oddball paradigm with pure tones. In the multi-feature paradigm, prominent mismatch responses (MMR) were elicited to the emotional sounds and many of the phonetic deviants in the singing intervention group and in the control group to some of the emotional and phonetic deviants. A group difference was found as the MMRs were larger in the singing intervention group, mainly due to larger MMRs being elicited to the emotional sounds, especially in females. The overall duration of the singing intervention (range 15-63 days) was positively associated with the MMR amplitudes for both phonetic and emotional stimuli in both sexes, unlike the daily singing time (range 8-120 min/day). In the oddball paradigm, MMRs for the non-speech sounds were elicited in both groups and no group differences nor connections between the singing time and the response amplitudes were found. These results imply that repeated parental singing during kangaroo care improved auditory discrimination of phonetic and emotional speech sounds in preterm infants at term age. Regular singing routines can be recommended for parents to promote the development of the auditory system and auditory processing of speech sounds in preterm infants.
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Affiliation(s)
- Kaisamari Kostilainen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Eino Partanen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kaija Mikkola
- New Children's Hospital, Pediatric Research Center, Neonatology, Department of Pediatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Valtteri Wikström
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Satu Pakarinen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Vineta Fellman
- Pediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden.,Children's Hospital, University of Helsinki, Helsinki, Finland
| | - Minna Huotilainen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,CICERO Learning Network, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
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20
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Chin Foo CA, Dansereau LM, Hawes K, Oliveira EL, Lester BM. Improving the Assessment of Neonatal Abstinence Syndrome (NAS). CHILDREN (BASEL, SWITZERLAND) 2021; 8:685. [PMID: 34438576 PMCID: PMC8394483 DOI: 10.3390/children8080685] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/20/2022]
Abstract
Neonatal Abstinence Syndrome (NAS) is a public health problem of epidemic proportions. The Finnegan Neonatal Abstinence Scoring System (FNASS) is the tool most widely used to evaluate NAS. However, it is limited by its lack of interrater reliability and standardized approach. Surveys to evaluate the FNASS were distributed to nurses at the Women and Infants Hospital in Providence, RI, USA. Infants (n = 78) treated for NAS and born to methadone-maintained mothers were examined to compare items administered from the FNASS and the NICU Network Neurobehavioral Scale (NNNS). All nurses reported that the FNASS was somewhat to very subjective. More than half reported that it was somewhat to not accurate and a new scoring method is needed to accurately diagnose NAS. Correlations between FNASS items and NNNS items showed 9 of 32 (28.1%) correlations were strong (rs > 0.5), 5 of 32 (15.6%) were moderate (0.3 < rs < 0.5), and 10 of 32 (31.3%) were weak (0.1 < rs < 0.3). Principal component factor analysis (PCA) of the NNNS explained more variance (35.1%) than PCA of NNNS and FNASS items combined (33.1%). The nursing survey supported the need for developing a more objective exam to assess NAS. NNNS exam items may be used to improve the evaluation of NAS.
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Affiliation(s)
- Claire A. Chin Foo
- Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02912, USA; (L.M.D.); (K.H.); (E.L.O.)
| | - Lynne M. Dansereau
- Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02912, USA; (L.M.D.); (K.H.); (E.L.O.)
| | - Katheleen Hawes
- Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02912, USA; (L.M.D.); (K.H.); (E.L.O.)
- Department of Pediatrics, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02908, USA
| | - Erica L. Oliveira
- Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02912, USA; (L.M.D.); (K.H.); (E.L.O.)
| | - Barry M. Lester
- Brown Center for the Study of Children at Risk, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02912, USA; (L.M.D.); (K.H.); (E.L.O.)
- Department of Pediatrics, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI 02908, USA
- Department of Psychiatry and Human Behavior, Brown Alpert Medical School, Providence, RI 02912, USA
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21
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Namjoo R, Mehdipour-Rabori R, Bagherian B, Nematollahi M. Comparing the effectiveness of mother's live lullaby and recorded lullaby on physiological responses and sleep of preterm infants: a clinical trial study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2021; 19:121-129. [PMID: 34022122 DOI: 10.1515/jcim-2020-0507] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/05/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Environmental stimuli in neonatal intensive care units can disrupt the physiological stability and sleep of infants. It is essential to perform nursing interventions to reduce the adverse effects of such stimuli. This study aimed to compare the effect of recorded lullabies and mothers' live lullabies on physiological responses and sleep duration of preterm infants. METHODS This study was a randomized clinical trial. The participants were 90 preterm infants selected using convenience sampling. In the intervention groups, music (recorded lullabies and mother's live lullabies) was played for 14 days, 20 min a day, while the control group did not receive any intervention. The data were collected using physiological criteria and infant sleep checklists before, during, and after the intervention. The data were analyzed using SPSS software (Version 21.0). RESULTS The mean scores of physiological parameters (O2 saturation and heart rate) were not significantly different in the three groups before, during, and after the intervention (p>0.05). However, there was an improvement in O2-saturation and a decrease in the heart rate in two intervention groups. The mean duration of the infants' overnight sleep was not statistically significant between the groups before the intervention (p>0.05). However, there was a statistically significant difference in the intervention groups after the intervention, (p<0.05), and the infants' overnight sleep was longer in the recorded-lullaby group than the other two groups. CONCLUSIONS Although performing interventions, including recorded lullaby and mother's live lullaby did not differ significantly with that of the control group in physiological criteria, it can be clinically important. In addition, recorded-lullaby increased the infants' overnight sleeping. Thus, it is suggested that further studies be conducted to confirm the effect of recorded lullaby and mother's live lullaby interventions on physiological parameters and sleep duration of hospitalized infants.
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Affiliation(s)
- Razyeh Namjoo
- Nursing in Neonatal Intensive Care, Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Behnaz Bagherian
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
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22
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Efendi D, Caswini N, Tane R, Kurniasari MD, Hasanul HM, Farid RI. Comparison of mother’s therapeutic touch and voice stimulus in reduce pain in premature infants undergoing invasive procedures. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 37184330 DOI: 10.4081/pmc.2021.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 11/23/2022] Open
Abstract
Invasive procedures commonly cause recurring pain in preterm infants. Noninvasive pain management is an essential part of nursing intervention in the Neonatal Intensive Care Unit (NICU). The study’s aim is to identify the impact of touch therapy on pain in premature infants undergoing invasive treatments. The method was a quasi- experiment with 63 premature infants. The premature infants were classified into four groups: i) Mother’s touch Therapy (MTT), ii) Mother’s Voice Stimulus (MVS), iii) a combination of MTT and MVS, and iv) routine care. The observed infants’ pain scores were determined through a multiple regression model using the Generalized Estimating Equation (GEE) method. The GEE test showed that the combination of touch and sound therapy significantly reduced pain in premature infants undergoing invasive measures (p<0.05). A combined application of MTT and MVS is the most effective in reducing pain scores in infants undergoing invasive procedures and thus, can used safely as part of nursing intervention in the NICU.
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23
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Vitale FM, Chirico G, Lentini C. Sensory Stimulation in the NICU Environment: Devices, Systems, and Procedures to Protect and Stimulate Premature Babies. CHILDREN-BASEL 2021; 8:children8050334. [PMID: 33923031 PMCID: PMC8146433 DOI: 10.3390/children8050334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/13/2021] [Accepted: 04/22/2021] [Indexed: 01/30/2023]
Abstract
Prematurity deprives infants of the prenatal sensory stimulation essential to their correct development; in addition, the stressful environment of the NICU impacts negatively on their growth. The purpose of this review was to investigate the effects of NICU noise pollution on preterm infants and parents. We focused on the systems and projects used to control and modulate sounds, as well as on those special devices and innovative systems used to deliver maternal sounds and vibrations to this population. The results showed beneficial effects on the preterm infants in different areas such as physiological, autonomic, and neurobehavioral development. Although most of these studies highlight positive reactions, there is also a general acknowledgement of the current limits: small and heterogeneous groups, lack of structured variable measurements, systematic control groups, longitudinal studies, and normative values. The mother's presence is always preferred, but the use of music therapy and the devices analyzed, although not able to replace her presence, aim to soften her absence through familiar and protective stimuli, which is a very powerful aid during the COVID-19 pandemic.
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Affiliation(s)
- Francesco Massimo Vitale
- Psicologia Magistrale (LM-51), Clinical and Rehabilitation Psychology, Università Niccolò Cusano, 00166 Roma, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Gaetano Chirico
- Neonatology and Neonatal Intensive Care Unit, Children Hospital, ASST Spedali Civili, 25123 Brescia, Italy
- Correspondence: (F.M.V.); (G.C.)
| | - Carmen Lentini
- Neonatal Pathology/NICU, Ospedale Civile Padova—AOPD, 35128 Padova, Italy;
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Fernandes JBDP, Peixoto Junior CA. Apego e comunicação: considerando o desenvolvimento infantil sob a ótica da etologia e da psicanálise. PSICOLOGIA USP 2021. [DOI: 10.1590/0103-6564e190144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Este artigo tem como objetivo abordar o vínculo primário da criança com sua mãe, colocando-o como primordial no desenvolvimento humano. Sob a ótica interdisciplinar da etologia e da psicanálise, discutem-se as noções de períodos sensíveis, estampagem e comportamento de apego, estabelecendo um paralelo entre os desenvolvimentos animal e humano. Em seguida, disserta-se sobre os modos de comunicação e suas raízes nas relações de apego que o indivíduo estabelece no início da vida, levando-se em consideração a clínica psicanalítica com o auxílio da teoria etológica.
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Enhancing the NICU language environment with a neonatal Cuddler program. J Perinatol 2021; 41:2063-2071. [PMID: 33772111 PMCID: PMC7995673 DOI: 10.1038/s41372-021-01037-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/11/2020] [Accepted: 03/01/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To compare effects of a language intervention on Cuddler and parent adult word counts (AWC), and to compare Cuddler versus parent and nurse-care times. DESIGN Prospective pilot cohort intervention study. Twelve Cuddler-low-visit (≤2/week) infant pairs and 17 high-visit (≥3/week) parent-infant pairs were enrolled. Each had a 16-hour baseline recording (R1) followed by a language curriculum with linguistic feedback and an outcome recording (R2) 1 week later. Bivariate group analyses and longitudinal negative binomial regressions were run. RESULTS After the intervention, there were non-significant increases in AWC/h for Cuddlers and high-visit parents. Cuddler AWCs were similar to high-visit parents and significantly higher than nurse-care times on both recordings. Within the low-visit group, hourly AWCs were higher when Cuddlers were present versus absent (R1 = 1779 versus 552, R2 = 2530 versus 534, p < 0.0001). CONCLUSIONS NICU language environments are different for low-visit and high-visit infants and Cuddlers can increase infant language exposure in the NICU.
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Kostilainen K, Mikkola K, Erkkilä J, Huotilainen M. Effects of maternal singing during kangaroo care on maternal anxiety, wellbeing, and mother-infant relationship after preterm birth: a mixed methods study. NORDIC JOURNAL OF MUSIC THERAPY 2020. [DOI: 10.1080/08098131.2020.1837210] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Kaisamari Kostilainen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Kaija Mikkola
- Children’s Hospital, Jorvi Hospital, Department of Pediatrics and Neonatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Erkkilä
- Department of Music, Art and Culture Studies, Faculty of Humanities and Social Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Minna Huotilainen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- CICERO Learning Network, Faculty of Educational Sciences, University of Helsinki, Helsinki, Finland
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Lang A, Ott P, del Giudice R, Schabus M. Memory Traces Formed in Utero-Newborns' Autonomic and Neuronal Responses to Prenatal Stimuli and the Maternal Voice. Brain Sci 2020; 10:brainsci10110837. [PMID: 33187287 PMCID: PMC7697227 DOI: 10.3390/brainsci10110837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/03/2020] [Accepted: 11/08/2020] [Indexed: 12/16/2022] Open
Abstract
In our pilot study, we exposed third-trimester fetuses, from week 34 of gestation onwards, twice daily to a maternal spoken nursery rhyme. Two and five weeks after birth, 34 newborns, who were either familiarized with rhyme stimulation in utero or stimulation naïve, were (re-)exposed to the familiar, as well as to a novel and unfamiliar, rhyme, both spoken with the maternal and an unfamiliar female voice. For the stimulation-naïve group, both rhymes were unfamiliar. During stimulus presentation, heart rate activity and high-density electroencephalography were collected and newborns’ responses during familiar and unfamiliar stimulation were analyzed. All newborns demonstrated stronger speech–brain coupling at 1 Hz during the presentation of the maternal voice vs. the unfamiliar female voice. Rhyme familiarity originating from prenatal exposure had no effect on speech–brain coupling in experimentally stimulated newborns. Furthermore, only stimulation-naïve newborns demonstrated an increase in heart rate during the presentation of the unfamiliar female voice. The results indicate prenatal familiarization to auditory speech and point to the specific significance of the maternal voice already in two- to five-week-old newborns.
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Affiliation(s)
- Adelheid Lang
- Centre for Cognitive Neuroscience (CCNS), Department of Psychology, University of Salzburg, 5020 Salzburg, Austria;
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, 5020 Salzburg, Austria; (P.O.); (R.d.G.)
- Correspondence: ; Tel.: +43-662-8044-5113
| | - Peter Ott
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, 5020 Salzburg, Austria; (P.O.); (R.d.G.)
- Information Technology and Systems Management, Salzburg University of Applied Sciences, 5020 Salzburg, Austria
| | - Renata del Giudice
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, 5020 Salzburg, Austria; (P.O.); (R.d.G.)
- Department of Mental Health, University of Milan, 20142 Milan, Italy
- San Paolo University Hospital, ASST Santi Paolo e Carlo, 20142 Milan, Italy
| | - Manuel Schabus
- Centre for Cognitive Neuroscience (CCNS), Department of Psychology, University of Salzburg, 5020 Salzburg, Austria;
- Laboratory for Sleep, Cognition and Consciousness Research, University of Salzburg, 5020 Salzburg, Austria; (P.O.); (R.d.G.)
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Gebuza G, Kaźmierczak M, Leńska K. The effects of kangaroo mother care and music listening on physiological parameters, oxygen saturation, crying, awake state and sleep in infants in NICU. J Matern Fetal Neonatal Med 2020; 35:3659-3669. [PMID: 33081550 DOI: 10.1080/14767058.2020.1836619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Kangaroo mother care and musical stimulation are recommended nursing interventions in the NICU. However, there is little research on the combination of kangaroo care with musical stimulation and their relationship with the health condition of infants. The aim of the study was to compare the parameters of the physiological state and behavior of infants during kangaroo mother care as well as kangaroo mother care and musical stimulation. STUDY DESIGN The study included 100 infants, with corrected gestational ages of 35 weeks, with an average body weight of 2704 g. During kangaroo care the child was supported by their parent, then musical stimulation was added to kangaroo care. Measurements were made in an incubator after the 1st and the 15th minute of each intervention. RESULTS Neonatal parameters differed in the incubator and during each intervention. During kangaroo care and kangaroo care and musical stimulation, heart rate (p < .0001), respiration rate (p < .0001), crying (p < .0001) and awake state (p < .0001) decreased, oxygen saturation levels (p < .0001) and the number of children who fell asleep (p < .0001) increased. During kangaroo care and musical stimulation significantly fewer children were awake (p = .0003) and more fell asleep (p < .0001) than after kangaroo care alone (p < .0001). CONCLUSIONS This study suggests that kangaroo care and kangaroo care and musical stimulation can be used to stabilize the physiological functions of infants. Kangaroo care and musical stimulation can be one of the most effective nursing interventions in the neonatal intensive care unit for the care of infants.
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Affiliation(s)
- Grażyna Gebuza
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Marzena Kaźmierczak
- Faculty of Health Sciences, Nicolaus Copernicus University in Torun, Torun, Poland
| | - Katarzyna Leńska
- Neonatal Intensive Care Unit, University Hospital No 2, Bydgoszcz, Poland
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Sleep, Little Baby: The Calming Effects of Prenatal Speech Exposure on Newborns' Sleep and Heartrate. Brain Sci 2020; 10:brainsci10080511. [PMID: 32748860 PMCID: PMC7464711 DOI: 10.3390/brainsci10080511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 01/08/2023] Open
Abstract
In a pilot study, 34 fetuses were stimulated daily with a maternal spoken nursery rhyme from week 34 of gestation onward and re-exposed two and five weeks after birth to this familiar, as well as to an unfamiliar rhyme, both spoken with the maternal and an unfamiliar female voice. During auditory stimulation, newborns were continuously monitored with polysomnography using video-monitored hdEEG. Afterward, changes in sleep–wake-state proportions during familiar and unfamiliar voice stimulation were analyzed. Our preliminary results demonstrate a general calming effect of auditory stimulation exclusively in infants who were prenatally “familiarized” with a spoken nursery rhyme, as evidenced by less waking states, more time spent in quiet (deep) sleep, and lower heartrates. A stimulation naïve group, on the other hand, demonstrated no such effects. Stimulus-specific effects related to the familiarity of the prenatally replayed voice or rhyme were not evident in newborns. Together, these results suggest “fetal learning” at a basic level and point to a familiarization with auditory stimuli prior to birth, which is evident in the first weeks of life in behavioral states and heartrate physiology of the newborn.
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Saliba S, Gratier M, Filippa M, Devouche E, Esseily R. Fathers’ and Mothers’ Infant Directed Speech Influences Preterm Infant Behavioral State in the NICU. JOURNAL OF NONVERBAL BEHAVIOR 2020. [DOI: 10.1007/s10919-020-00335-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Lemos RA, Veríssimo MDLÓR. Methodological strategies for the elaboration of educational material: focus on the promotion of preterm infants' development. CIENCIA & SAUDE COLETIVA 2020; 25:505-518. [PMID: 32022191 DOI: 10.1590/1413-81232020252.04052018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe and analyze the process of elaborating educational material to promote the development of preterm infants. The procedures included participative exploratory research with the target audience, integrative reviews of the literature on the subject, and systematization of contents through robust theoretical references. Popular Education in Health guided the elaboration of the educational material, and the participatory approach; the Bioecological Theory of Human Development conducted the analysis and systematization of the contents; and Simply Put guided the graphic organization of the material. The theoretical model of the development of preterm infants, and data systematization and organization, allowed the elaboration of an interactive educational material, a technology in a book format for the family. The multiple research strategies and theoretical references have provided methodological rigor, increasing the educational material's action potential, which draws family experience closer to the updated scientific knowledge, thus enhancing child health promotion.
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Affiliation(s)
- Rayla Amaral Lemos
- Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora. R. Eugênio do Nascimento s/n, Bairro Dom Bosco. 36038-330, Juiz de Fora, MG, Brasil.
| | - Maria de La Ó Ramallo Veríssimo
- Departamento de Enfermagem Materno-Infantil e Psiquiátrica, Escola de Enfermagem, Universidade de São Paulo. São Paulo, SP, Brasil
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Degaga GT, Sendo EG, Tesfaye T. Prevalence of Exclusive Breast Milk Feeding at Discharge and Associated Factors Among Preterm Neonates Admitted to a Neonatal Intensive Care Unit in Public Hospitals, Addis Ababa, Ethiopia: A Cross-Sectional Study. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2020; 11:21-28. [PMID: 32021552 PMCID: PMC6980858 DOI: 10.2147/phmt.s215295] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 12/07/2019] [Indexed: 11/23/2022]
Abstract
Background Studies show that rates of breast milk feeding are much lower among preterm infants than term infants, and breast milk feeding at discharge varies widely between countries. However, research examining factors associated with exclusive breast milk feeding at discharge among preterm neonates in Ethiopia is limited. The study aimed to assess the prevalence of exclusive breast milk feeding at discharge and associated factors among preterm neonates at the neonatal intensive care unit (NICU) in public hospitals, Addis Ababa, Ethiopia. Methods This facility-based cross-sectional study was conducted from February to March 2017 among preterm infants discharged from the NICU of public hospitals. Data were collected using pretested structured questionnaires. Purposive sampling technique was used. Factors associated with exclusive breast milk-fed infants at discharge among preterm neonates were determined using bivariate and multivariate logistic regression models. Statistically significant associations were declared at P<0.05. Results The study assessed 263 mother-preterm dyads. The findings from this study revealed that 71.9% of exclusive breast milk-fed infants at discharge at NICU of the selected Public hospitals in Addis Ababa. Factors associated with exclusive breast milk-fed infants at discharge included duration of hospital stay for 7-14 days (AOR 0.19, 95% CI 0.049-0.808) and more than 14 days (AOR 0.20, 95% CI 0.046,0.891), Initiation of breast milk expression later than 48 hrs postpartum (AOR 0.10, 95% CI 0.032-0.365) and receiving hospital support (AOR 39.00, 95% CI 11.676-130.290). Conclusion In this study, nearly ¾ of the NICU premature population exclusively breast milk fed at discharge, which designates to establish exclusive breastfeeding in the majority of preterm infants in this cohort. Thus, support for exclusive breast milk fed should be at the forefront of maternity practice in hospital and mothers of preterm infants to be guided to initiation of early breast milk expression as soon after delivery as possible and frequent expression thereafter.
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Affiliation(s)
| | - Endalew Gemechu Sendo
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tewodros Tesfaye
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Stefana A, Lavelli M, Rossi G, Beebe B. Interactive sequences between fathers and preterm infants in the neonatal intensive care unit. Early Hum Dev 2019; 140:104888. [PMID: 31670161 DOI: 10.1016/j.earlhumdev.2019.104888] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/15/2019] [Accepted: 09/17/2019] [Indexed: 10/25/2022]
Abstract
AIMS The first purpose of the study was to examine fathers' spontaneous communicative behavior with their preterm infants in the neonatal intensive care unit, and how father's and infant's behaviors affected each other. The second purpose was to examine any possible association between the fathers' and/or infants' characteristics and the quality of fathers' behaviors with their infants. STUDY DESIGN/SUBJECTS/OUTCOME MEASURES Father-preterm infant dyads (n=20) were assessed at 34-36 weeks postmenstrual age, during a spontaneous face-to-face communication with the infant placed in a heated cot in the NICU, and coded according to the Parent-Preterm Infant Coding System. RESULTS The presence of the father's Affiliative Behavior increased the occurrences of infant Gazing at the parent's face. In turn, infant gazing increased the occurrence of paternal Affiliative Behavior. The likelihood of infant's Gazing at the father's face was also significantly elicited by infrequent occurrences of paternal Affectionate Talk, co-occurring with Gazing at infant with Positive Facial Affect (but no Touch). With regard to the predictors of quality in father-infant interactions, we found a significant positive correlation between fathers' level of depressive symptomatology and fathers' Affiliative Behavior. CONCLUSION Our results show the of bidirectional sequential patterns of communication between fathers and preterm infants at 35 weeks postmenstrual age, and provide important information about the quality and modalities of paternal communication and their influence on infant behavioral states. From a clinical perspective, these results suggest that father-specific interventions designed to improve and sustain fathers' positive engagement with infants in the NICU should be pursued.
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Affiliation(s)
| | - Manuela Lavelli
- Department of Human Sciences, University of Verona, Lungadige Porta Vittoria 17, 37129 Verona, Italy
| | - Germano Rossi
- Department of Psychology, University of Milan Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milano, Italy
| | - Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, 40 Haven Avenue Unit 78 New York, NY 10032, USA
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Gormley JE, Williams DL. Providing Supportive Hospital Environments to Promote the Language Development of Infants and Children Born Prematurely: Insights From Neuroscience. J Pediatr Health Care 2019; 33:520-528. [PMID: 30871967 DOI: 10.1016/j.pedhc.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/22/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Rapid neural development occurs beginning in utero and extending throughout a child's first years of life, shaped by environmental input, which is essential for language learning. If this development is disrupted by premature birth and/or related repeated hospitalizations, atypical language development may result even in the absence of severe neurologic damage. METHOD This narrative review describes typical neurodevelopment associated with language and the atypical neurodevelopment often experienced by children born prematurely that can adversely affect their language development. RESULTS We describe evidence-based intervention strategies applicable in the hospital setting that can support the language development of young children who are born prematurely. DISCUSSION To promote neurodevelopmental growth that will support language learning, children born prematurely need to engage in supportive interactions with others. Awareness of evidence-based strategies can equip health care staff to provide a supportive hospital environment to promote the language development of children born premature.
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Abstract
BACKGROUND/SIGNIFICANCE Premature infants often experience extended stays in the neonatal intensive care unit (NICU) as opposed to home with parents. This prolonged separation creates a strain for both parents and infants, decreasing attachment and parental caregiving. One strategy to combat this shared stress is increasing parental participation, particularly through the use of their voices whether parents are present or not. PURPOSE This Evidence-Based Practice Brief column explores the connection between mother and child, specifically the effects of maternal voice on infant autonomic stability, weight gain, and behavioral states. METHODS A systematic search of CINAHL, PubMed, and PsycInfo was used to identify studies involving the use of maternal voice intervention with preterm infants in the NICU. RESULTS Fifteen studies were identified. Three intervention categories emerged: (1) live maternal speech, (2) recorded maternal speech (subcategories included whether intervention content was prescribed or not), and (3) recorded maternal speech that was combined with biological maternal sounds (heart rate). Within each category, studies were organized chronologically to reflect how knowledge has changed overtime. IMPLICATIONS FOR PRACTICE Maternal voice has physiological as well as behavioral and emotional effect on preterm infants. Several studies found that maternal voice increased autonomic stability improving (heart rate and respirations) as well as weight gain. No negative effects were identified. Given these findings, incorporating different types of maternal voice into routine care by the bedside nurse can assist the mother in feeling more involved in her infant's care without seemingly being a distraction or obstacle to providers. IMPLICATIONS FOR RESEARCH A major limitation for generalizability was sample size; more research is needed with larger sample sizes replicating interventions types to discern best outcomes.Video Abstract available at https://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?videoId=31&autoPlay=true.
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McGowan EC, Vohr BR. Impact of Nonmedical Factors on Neurobehavior and Language Outcomes of Preterm Infants. Neoreviews 2019; 20:e372-e384. [PMID: 31261104 DOI: 10.1542/neo.20-7-e372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Preterm infants are at increased risk for adverse neurodevelopmental outcomes. The impact of maternal, NICU, and social environmental factors on early neurobehavior and language outcomes of preterm infants is recognized. There is a need for health care professionals to have a clear understanding of the importance of facilitating positive mother-infant relationships, and to address not only the infant's sensory and language environment, but also focus on adverse maternal mental health and social adversities to optimize infant outcomes.
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Affiliation(s)
- Elisabeth C McGowan
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
| | - Betty R Vohr
- Warren Alpert Medical School of Brown University, and Department of Pediatrics, Women & Infants Hospital of Rhode Island, Providence, RI
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Language in Preterm Born Children: Atypical Development and Effects of Early Interventions on Neuroplasticity. Neural Plast 2019; 2019:6873270. [PMID: 30930944 PMCID: PMC6410465 DOI: 10.1155/2019/6873270] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 12/23/2018] [Indexed: 01/28/2023] Open
Abstract
Predicting language performances after preterm birth is challenging. It is described in the literature that early exposure to the extrauterine environment can be either detrimental or advantageous for neurodevelopment. However, the emphasis mostly lies on the fact that preterm birth may have an unfavorable effect on numerous aspects of development such as cognition, language, and behavior. Various studies reported atypical language development in preterm born children in the preschool years but also in school-aged children and adolescents. This review gives an overview of the course of language development and examines how prematurity can lead to atypical linguistic performances. In this paper, we mainly focus on environmental and neurophysiological factors influencing preterm infant neuroplasticity with potential short- and long-term effects on language development. Further research, however, should focus on examining the possible benefits that early exposure might entail.
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Cutuli D, Berretta E, Laricchiuta D, Caporali P, Gelfo F, Petrosini L. Pre-reproductive Parental Enriching Experiences Influence Progeny's Developmental Trajectories. Front Behav Neurosci 2018; 12:254. [PMID: 30483072 PMCID: PMC6240645 DOI: 10.3389/fnbeh.2018.00254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 10/10/2018] [Indexed: 01/09/2023] Open
Abstract
While the positive effects of environmental enrichment (EE) applied after weaning, in adulthood, during aging, or even in the presence of brain damage have been widely described, the transgenerational effects of pre-reproductive EE have been less examined. And yet, this issue is remarkable given that parental environmental experience may imprint offspring’s phenotype over generations through many epigenetic processes. Interactions between individual and environment take place lifelong even before conception. In fact, the environment pre-reproductively experienced by the mother and/or the father exerts a substantial impact on neural development and motor and cognitive performances of the offspring, even if not directly exposed to social, cognitive, physical and/or motor enrichment. Furthermore, pre-reproductive parental enrichment exerts a transgenerational impact on coping response to stress as well as on the social behavior of the offspring. Among the effects of pre-reproductive parental EE, a potentiation of the maternal care and a decrease in global methylation levels in the frontal cortex and hippocampus of the progeny have been described. Finally, pre-reproductive EE modifies different pathways of neuromodulation in the brain of the offspring (involving brain-derived neurotrophic factor, oxytocin and glucocorticoid receptors). The present review highlights the importance of pre-reproductive parental enrichment in altering the performances not only of animals directly experiencing it, but also of their progeny, thus opening the way to new hypotheses on the inheritance mechanisms of behavioral traits.
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Affiliation(s)
- Debora Cutuli
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Fondazione Santa Lucia, Rome, Italy
| | - Erica Berretta
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Fondazione Santa Lucia, Rome, Italy
| | - Daniela Laricchiuta
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Fondazione Santa Lucia, Rome, Italy
| | - Paola Caporali
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Fondazione Santa Lucia, Rome, Italy
| | - Francesca Gelfo
- Fondazione Santa Lucia, Rome, Italy.,Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Laura Petrosini
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.,Fondazione Santa Lucia, Rome, Italy
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Involvement of Parents in the Care of Preterm Infants: A Pilot Study Evaluating a Family-Centered Care Intervention in a Chinese Neonatal ICU. Pediatr Crit Care Med 2018; 19:741-747. [PMID: 29781955 DOI: 10.1097/pcc.0000000000001586] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. DESIGN Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. SETTING Stand-alone tertiary children's hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. PATIENTS Premature infants (n = 61) and their parents (n = 110). INTERVENTIONS Parent education program followed by parents' participation in care as primary caregiver until discharge for a minimum of 4 hours per day. MEASUREMENTS AND MAIN RESULTS Primary outcomes were infants' weight gain at discharge, length of stay, and readmission. Parental outcomes were stress, anxiety, satisfaction, and clinical knowledge. Infants in family-centered care group (n = 31) had higher weight gain (886g vs 542g; p = 0.013), less neonatal ICU length of stay in days (43 vs 46; p = 0.937), and decreased readmission rate at 1 week (41.9 vs 70.0; p = 0.045) and at 1 month (6.5% vs 50%; p < 0.001) compared with the control group (n = 30). Total Mean Parental Stress and Anxiety scores were lower in the family-centered care group (42 vs 59; p ≤ 0.007), mean satisfaction rates in family-centered care group were higher compared with control group (96 vs 90; p < 0.001), and parents in the family-centered care group had better educational outcomes related to neonatal specialized care skills (p < 0.05). CONCLUSIONS Involving parents in the care of their infant improved clinical outcomes of infants. Family-centered care also contributed to a better understanding of parent's clinical education, decrease stress levels, and increased parental satisfaction. Our study suggests that involving parents in the daily care of their infants is feasible and should be promoted by neonatal ICU clinicians.
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Provenzi L, Broso S, Montirosso R. Do mothers sound good? A systematic review of the effects of maternal voice exposure on preterm infants' development. Neurosci Biobehav Rev 2018. [PMID: 29535067 DOI: 10.1016/j.neubiorev.2018.03.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Preterm infants are hospitalized in the Neonatal Intensive Care Unit (NICU) and are precociously separated from their mothers. Although developmental care interventions are meant to facilitate mother-infant bonding, physical contact is not always possible. Maternal voice exposure has been proposed as a way to foster maternal closeness and support postnatal bonding. Here we present a systematic review on maternal voice effects on preterm infants' development. Literature search occurred on 4 databases (PubMed, Scopus, Web of Science and CINAHL). Preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines have been adopted and standardized quality appraisal has been carried on. Wide differences emerged in infants' characteristics and maternal voice exposure methods. Inconsistency emerged for physiological outcomes (e.g., heart rate variability, oxygen saturation, number of critical alarm events), whereas a robust pattern of findings emerged for feeding behaviors, as well as cognitive and neurobehavioral development. Maternal voice appears to be a non-noxious intervention, which is consistent with developmental care and which can be embedded in developmental care strategies.
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Affiliation(s)
- Livio Provenzi
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy.
| | - Sara Broso
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
| | - Rosario Montirosso
- 0-3 Center for the at-Risk Infant, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, LC, Italy
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Chirico G, Cabano R, Villa G, Bigogno A, Ardesi M, Dioni E. Randomised study showed that recorded maternal voices reduced pain in preterm infants undergoing heel lance procedures in a neonatal intensive care unit. Acta Paediatr 2017; 106:1564-1568. [PMID: 28580602 DOI: 10.1111/apa.13944] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/14/2017] [Accepted: 06/01/2017] [Indexed: 11/30/2022]
Abstract
AIM Alleviating pain in neonates should be the goal of all caregivers. We evaluated whether recorded maternal voices were safe and effective in limiting pain in preterm infants undergoing heel lance procedures in the neonatal intensive care unit of an Italian children's hospital. METHODS This prospective, controlled study took place from December 2013 to December 2015. We enrolled 40 preterm infants, born at a 26-34 weeks of gestation, at a corrected gestational age 29-36 weeks and randomised them to listen or not listen to a recording of their mother's voice during a painful, routine heel lance for blood collection. Changes in the infants' Premature Infant Pain Profile, heart rate, oxygen saturation and blood pressure during the procedure were compared by analysis of variance. Possible side effects, of apnoea, bradycardia, seizures and vomiting, were also recorded. RESULTS Both groups showed a marked increase in PIPP scores and decrease in oxygen saturation during the procedure, but infants in the treatment group had significantly lower PIPP scores (p = 0.00002) and lower decreases in oxygen saturation (p = 0.0283). No significant side effects were observed. CONCLUSION Using recorded maternal voices to limit pain in preterm infants undergoing heel lance procedures appeared safe and effective.
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Affiliation(s)
- G Chirico
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
| | - R Cabano
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
| | - G Villa
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
| | - A Bigogno
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
| | - M Ardesi
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
| | - E Dioni
- Neonatology and Neonatal Intensive Care Unit; Children Hospital; ASST Spedali Civili; Brescia Italy
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Filippa M, Panza C, Ferrari F, Frassoldati R, Kuhn P, Balduzzi S, D'Amico R. Systematic review of maternal voice interventions demonstrates increased stability in preterm infants. Acta Paediatr 2017; 106:1220-1229. [PMID: 28378337 DOI: 10.1111/apa.13832] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 01/19/2017] [Accepted: 03/07/2017] [Indexed: 12/16/2022]
Abstract
We systematically reviewed how effectively maternal voice interventions supported the clinical outcomes and development of preterm infants. A total of 512 preterm infants were included in 15 studies with different designs, from January 2000 to July 2015. Live and recorded maternal voice interventions were associated with the physiologic and behavioural stabilisation of preterm infants, with fewer cardiorespiratory events, but the evidence was insufficient to evaluate the long-term effects. Well-defined determinants and clear setting conditions are needed for such interventions. CONCLUSION Further research that investigates the long-term efficacy and effects of live maternal voices on preterm infant development is needed.
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Affiliation(s)
- Manuela Filippa
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | | | - Fabrizio Ferrari
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | - Rossella Frassoldati
- Department of Neonatology and Intensive Neonatal Care University; University of Modena and Reggio Emilia; Modena Italy
| | - Pierre Kuhn
- Médecine et Réanimation du Nouveau-né Hôpital de Hautepierre; CHU Strasbourg France
| | - Sara Balduzzi
- Department of Diagnostics; Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Roberto D'Amico
- Department of Diagnostics; Clinical and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
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Philpott-Robinson K, Lane SJ, Korostenski L, Lane AE. The impact of the Neonatal Intensive Care Unit on sensory and developmental outcomes in infants born preterm: A scoping review. Br J Occup Ther 2017. [DOI: 10.1177/0308022617709761] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Preterm infants admitted to the Neonatal Intensive Care Unit are at higher risk of poor neurodevelopmental and sensory outcomes. There is interest in establishing whether elements of the Neonatal Intensive Care Unit sensory environment may influence the sensory and overall development of these infants. Method The purpose of this scoping review was to provide a comprehensive overview of relevant research regarding the sensory elements of the Neonatal Intensive Care Unit, and their short- and long-term influence on preterm infants. This scoping review is underpinned by the six-stage framework by Arksey and O’Malley. Results There are few studies that have directly examined the influence of the Neonatal Intensive Care Unit environment upon the sensory and developmental outcomes of infants born preterm, in infancy. The findings of the studies included in this review suggest that the Neonatal Intensive Care Unit sensory environment may alter developmental trajectories of preterm infants. However, low-quality evidence exists in this field, with much of the literature being preliminary. Conclusion Further experimental studies are required that combine multiple methods of assessment to more rigorously understand the sensory characteristics of the Neonatal Intensive Care Unit, and their relationship with developmental outcomes across early childhood.
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Affiliation(s)
| | - Shelly J Lane
- Professor, School of Health Sciences, University of Newcastle, NSW, Australia
| | - Larissa Korostenski
- Neonatologist, Neonatal Intensive care, John Hunter Children's Hospital, NSW, Australia
| | - Alison E Lane
- Associate Professor, School of Health Sciences, University of Newcastle, NSW, Australia
- Priority Research Centre, GrowUpWell, University of Newcastle, NSW, Australia
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Pineda R, Guth R, Herring A, Reynolds L, Oberle S, Smith J. Enhancing sensory experiences for very preterm infants in the NICU: an integrative review. J Perinatol 2017; 37:323-332. [PMID: 27763631 PMCID: PMC5389912 DOI: 10.1038/jp.2016.179] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 09/09/2016] [Accepted: 09/13/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Very preterm infants hospitalized in the neonatal intensive care unit (NICU) experience alterations in sensory experiences. Defining types, timing and frequency of sensory-based interventions that optimize outcomes can inform environmental modifications. The objective of this study was to conduct an integrative review on sensory-based interventions used with very preterm infants in the NICU to improve infant and parent outcomes. STUDY DESIGN The data sources include MEDLINE, CINAHL, Cochrane Library and Google Scholar. Studies were identified that used sensory-based interventions in the NICU with preterm infants born ⩽32 weeks gestation, were published in a peer-reviewed journal between 1995 and 2015, and measured outcomes related to infant and parent outcomes. Studies were extracted from electronic databases and hand-searched from identified reference lists. RESULTS Eighty-eight articles were identified (31 tactile, 12 auditory, 3 visual, 2 kinesthetic, 2 gustatory/olfactory and 37 multimodal). There was evidence to support the use of kangaroo care, music and language exposure, and multimodal interventions starting at 25 to 28 weeks postmenstrual age. These interventions were related to better infant development and lower maternal stress, but not all findings were consistent. Limitations included lack of consistent outcome measures, study quality and gaps in the literature. CONCLUSIONS Most research identified interventions that were done for short periods of time. It is unclear what the potential is for improving outcomes if positive sensory exposures occur consistently throughout NICU hospitalization. Until more research defines appropriate sensory-based interventions to use with infants born very preterm in the NICU, information from this review can be combined with expert opinion and parent/family values to determine best practice.
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Affiliation(s)
- R Pineda
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - R Guth
- Center for Clinical Excellence, BJC HealthCare, St Louis, MO, USA
| | - A Herring
- Center for Clinical Excellence, BJC HealthCare, St Louis, MO, USA
| | - L Reynolds
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA
| | - S Oberle
- Program in Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA
| | - J Smith
- St Louis Children's Hospital, St Louis, MO, USA
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Azarmnejad E, Sarhangi F, Javadi M, Rejeh N, Amirsalari S, Tadrisi SD. The effectiveness of familiar auditory stimulus on hospitalized neonates' physiologic responses to procedural pain. Int J Nurs Pract 2017; 23. [DOI: 10.1111/ijn.12527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 10/24/2016] [Accepted: 12/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Elham Azarmnejad
- New Hearing Technologist Research Center; Baqiyatallah University of Medical Sciences; Tehran Iran
| | - Forogh Sarhangi
- Pediatric Nursing, Faculty of Nursing; Baqiyatallah University of Medical Sciences; Tehran Iran
| | - Mahrooz Javadi
- Pediatric Nursing, Faculty of Nursing; Baqiyatallah University of Medical Sciences; Tehran Iran
| | - Nahid Rejeh
- College of Nursing & Midwifery, Shahed University; Tehran Iran
| | - Susan Amirsalari
- New Hearing Technologist Research Center; Baqiyatallah University of Medical Sciences; Tehran Iran
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Sajjadian N, Mohammadzadeh M, Alizadeh Taheri P, Shariat M. Positive effects of low intensity recorded maternal voice on physiologic reactions in premature infants. Infant Behav Dev 2017; 46:59-66. [DOI: 10.1016/j.infbeh.2016.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/03/2016] [Accepted: 11/05/2016] [Indexed: 11/24/2022]
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The Effect of Experience on Recognition of Mother’s Voice in Preterm Infants. Nurs Midwifery Stud 2016. [DOI: 10.5812/nmsjournal.40964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Ahmadi Vastani M, Zahedpasha Y, Jafarian Amiri SR, Khafri S, Farhadi R. The Effect of Experience on Recognition of Mother’s Voice in Preterm Infants. Nurs Midwifery Stud 2016. [DOI: 10.17795/nmsjournal40964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Feeley N, Genest C, Niela-Vilén H, Charbonneau L, Axelin A. Parents and nurses balancing parent-infant closeness and separation: a qualitative study of NICU nurses' perceptions. BMC Pediatr 2016; 16:134. [PMID: 27543122 PMCID: PMC4992200 DOI: 10.1186/s12887-016-0663-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 08/05/2016] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND When a newborn requires neonatal intensive care unit (NICU) hospitalization, parent and infant experience an unusual often prolonged separation. This critical care environment poses challenges to parent-infant closeness. Parents desire physical contact and holding and touching are particularly important. Evidence shows that visitation, holding, talking, and skin to skin contact are associated with better outcomes for infants and parents during hospitalization and beyond. Thus, it would be important to understand closeness in this context. The purpose of this study was to explore from nurses' perspective, what do parents and nurses do to promote parent-infant closeness or provoke separation. METHODS Qualitative methods were utilized to attain an understanding of closeness and separation. Following ethics approval, purposive sampling was used to recruit nurses with varying experience working different shifts in NICUs in two countries. Nurses were loaned a smartphone over one work shift to record their thoughts and perceptions of events that occurred or experiences they had that they considered to be closeness or separation between parents and their hospitalized infant. Sample size was determined by saturation (18 Canada, 19 Finland). Audio recordings were subjected to inductive thematic analysis. Team meetings were held to discuss emerging codes, refine categories, and confirm these reflected data from both sites. One overarching theme was elaborated. RESULTS Balancing closeness and separation was the major theme. Both parents and nurses engaged in actions to optimize closeness. They sought closeness by acting autonomously in infant caregiving, assuming decision-making for their infant, seeking information or skills, and establishing a connection in the face of separation. Parents balanced their desire for closeness with other competing demands, such as their own needs. Nurses balanced infant care needs and ability to handle stimulation with the need for closeness with parents. Nurses undertook varied actions to facilitate closeness. Parent, infant and NICU-related factors influenced closeness. Consequences, both positive and negative, arose for parents, infants, and nurses. CONCLUSION Findings point to actions that nurses undertake to promote closeness and help parents cope with separation including: promoting parent decision-making, organizing care to facilitate closeness, and supporting parent caregiving.
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Affiliation(s)
- Nancy Feeley
- Ingram School of Nursing, McGill University, Montreal, Canada & Senior Researcher, Jewish General Hospital Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Room H 301.1, 5790 Cote des Neiges Rd, Montreal, Quebec H3S 1Y9 , Canada
| | - Christine Genest
- Ingram School of Nursing, McGill University, Montreal, Canada & Senior Researcher, Jewish General Hospital Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Room H 301.1, 5790 Cote des Neiges Rd, Montreal, Quebec H3S 1Y9 , Canada
| | - Hannakaisa Niela-Vilén
- Department of Nursing Science, University of Turku, Lemminkäisenkatu 1, 20014 Turku, Finland
| | - Lyne Charbonneau
- Ingram School of Nursing, McGill University, Montreal, Canada & Senior Researcher, Jewish General Hospital Centre for Nursing Research & Lady Davis Institute, Jewish General Hospital, Room H 301.1, 5790 Cote des Neiges Rd, Montreal, Quebec H3S 1Y9 , Canada
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Lemminkäisenkatu 1, 20014 Turku, Finland
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Ettenberger M, Rojas Cárdenas C, Parker M, Odell-Miller H. Family-centred music therapy with preterm infants and their parents in the Neonatal Intensive Care Unit (NICU) in Colombia – A mixed-methods study. NORDIC JOURNAL OF MUSIC THERAPY 2016. [DOI: 10.1080/08098131.2016.1205650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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