1
|
Xu M, Ding M, Kong W, Jia N, Yan S, Zhang X, Zhang Q, Oxford ML, Guan H. Psychometric soundness and predictive factors of the NCAST Parent-Child Interaction Teaching Scale in urban Chinese population. Child Care Health Dev 2024; 50:e13195. [PMID: 37936522 DOI: 10.1111/cch.13195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/27/2023] [Accepted: 10/16/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Quality of parent-child interaction in early childhood functions as a critical indicator of nurturing care and is strongly associated with short-term and long-term development (health, cognition, language, social emotion, well-being, etc.). NCAST PCI Teaching Scale (PCI-TS), a video-based assessment regarded as a gold standard to measure PCI, has been widely used worldwide. However, its psychometric soundness among the urban Chinese population is unclear. This study assesses the PCI-TS's reliability and validity and explores predictive factors among urban Chinese parent-child dyads. METHODS PCI-TS was adopted to code mother-child interaction among urban Chinese dyads recruited during the children's regular health checks in local maternal and child health centres. Reliability was evaluated by internal consistency (Cronbach'α coefficient) and test-retest reliability (Pearson correlation) with an average interval of 18 days. Score distribution of each subscale and total scale were compared with NCAST Database and Canadian community sample by single sample t-test. Criteria-related validity was conducted by Infant-Toddler Home Observation Measurement of the Environment (Pearson correlation). Predictive factors was performed by multiple linear regression. RESULTS Four hundred and twenty-nine eligible mother-child dyads were included for data analysis among the 466 recruited samples. Four qualified local paediatricians accomplished video coding with an average agreement of 86%. The PCI-TS has strong reliability among the Chinese population with the Cronbach'α coefficients of the Caregiver-Infant total score, Caregiver total and Infant total scores of 0.81, 0.81 and 0.74, respectively; an acceptable test-retest reliability (r = 0.73, p < 0.01); and moderate correlation with IT-HOME, ranging from 0.53 to 0.62. Child age, birth weight, maternal education, full-time housewife, living with grandparent(s) and living space were predictive factors on PCI-TS in the Chinese population. CONCLUSION PCI-TS showed good psychometric properties for measuring mother-child interactions among urban Chinese dyads, offering clinicians and researchers a practical tool to evaluate PCI objectively. Child age, maternal education and living space were beneficial factors, while full-time mothers and living with grandparent(s) were risk factors.
Collapse
Affiliation(s)
- Mengxue Xu
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Meiqi Ding
- Department of Pediatrics, HaiDian Maternal & Child Health Hospital, Beijing, People's Republic of China
| | - Wenrui Kong
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Ni Jia
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| | - Shuangqin Yan
- Department of Pediatrics, Maanshan Maternal and Child Health Care Hospital, Maanshan, People's Republic of China
| | - Xuejiao Zhang
- Department of Child Care Guidance, Shenyang Maternal and Child Health Hospital, Shenyang, People's Republic of China
| | - Qinglan Zhang
- Department of Pediatrics, Lanzhou Maternal and Child Health Care Hospital, Lanzhou, People's Republic of China
| | - Monica Lynn Oxford
- Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Hongyan Guan
- Nurturing Care Research and Guidance Center, Capital Institute of Pediatrics, Beijing, People's Republic of China
| |
Collapse
|
2
|
Oluoch D, Hinton L, English M, Irimu G, Onyango T, Jones COH. Mothers' involvement in providing care for their hospitalised sick newborns in Kenya: a focused ethnographic account. BMC Pregnancy Childbirth 2023; 23:389. [PMID: 37237328 DOI: 10.1186/s12884-023-05686-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/07/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION There is growing evidence that parental participation in the care of small and sick newborns benefits both babies and parents. While studies have investigated the roles that mothers play in newborn units in high income contexts (HIC), there is little exploration of how contextual factors interplay to influence the ways in which mothers participate in the care of their small and sick newborn babies in very resource constrained settings such as those found in many countries in sub-Saharan Africa. METHODS Ethnographic methods (observations, informal conversations and formal interviews) were used to collect data during 627 h of fieldwork between March 2017 and August 2018 in the neonatal units of one government and one faith-based hospital in Kenya. Data were analysed using a modified grounded theory approach. RESULTS There were marked differences between the hospitals in the participation by mothers in the care of their sick newborn babies. The timing and types of caring task that the mothers undertook were shaped by the structural, economic and social context of the hospitals. In the resource constrained government funded hospital, the immediate informal and unplanned delegation of care to mothers was routine. In the faith-based hospital mothers were initially separated from their babies and introduced to bathing and diaper change tasks slowly under the close supervision of nurses. In both hospitals appropriate breast-feeding support was lacking, and the needs of the mothers were largely ignored. CONCLUSION In highly resource constrained hospitals with low nurse to baby ratios, mothers are required to provide primary and some specialised care to their sick newborns with little information or support on how undertake the necessary tasks. In better resourced hospital settings, most caring tasks are initially performed by nurses leaving mothers feeling powerless and worried about their capacity to care for their babies after discharge. Interventions need to focus on how to better equip hospitals and nurses to support mothers in caring for their sick newborns, promoting family centred care.
Collapse
Affiliation(s)
- Dorothy Oluoch
- Centre for Geographic Medicine (Coast), KEMRI-Wellcome Trust research programme, Nairobi, Kenya.
| | - Lisa Hinton
- THIS Institute, University of Cambridge, Cambridge, UK
| | - Mike English
- Centre for Geographic Medicine (Coast), KEMRI-Wellcome Trust research programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, NUFFIELD department of medicine, University of Oxford, Oxford, UK
| | - Grace Irimu
- Centre for Geographic Medicine (Coast), KEMRI-Wellcome Trust research programme, Nairobi, Kenya
- Department of Paediatrics and Child Health, University of Nairobi, Nairobi, Kenya
| | - Truphena Onyango
- Centre for Geographic Medicine (Coast), KEMRI-Wellcome Trust research programme, Nairobi, Kenya
| | - Caroline O H Jones
- Centre for Geographic Medicine (Coast), KEMRI-Wellcome Trust research programme, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, NUFFIELD department of medicine, University of Oxford, Oxford, UK
| |
Collapse
|
3
|
D’Angeli G, Mesce M, Cerniglia L, Cimino S. Observational Tools Using Video Recordings of Parent-Child Feeding Interactions: A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121924. [PMID: 36553367 PMCID: PMC9776560 DOI: 10.3390/children9121924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Current research has confirmed that the quality of the caregiver-child relationship influences the child's emotional and behavioral development. Play and feeding contexts, for example, are the best contexts to observe mother-child or father-child interaction. The observation of feeding interaction establishes involvement on the part of both parties and identifies relationship characteristics. The purpose of this study is to select and describe the most frequently used observational methods during feeding interactions in the first three years of a child's life. Instruments that employ video recordings of mealtimes will be detailed to highlight the relevance that specific tools have nowadays. Finally, the SVIA (Scala di Valutazione delle Interazioni Alimentari), a technique for analyzing food interactions by observation that has also been utilized remotely, will be offered. This is intended to provide practitioners and researchers with an overview of tools while also taking into consideration the present scenario in which digital tools are increasingly being employed in health and clinical settings. Furthermore, the purpose of this paper is to review the various observational methods of the parent-child relationship to assist future practitioners and researchers in the field in making an accurate assessment of caregiver-child interaction and selecting a valid tool for the early recognition of problematic relationships and identifying the most appropriate treatment modalities.
Collapse
Affiliation(s)
- Gessica D’Angeli
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
| | - Martina Mesce
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
| | - Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, 00186 Rome, Italy
- Correspondence: ; Tel.: +39-06697621
| | - Silvia Cimino
- Department of Dynamic, Clinical and Health Psychology, Sapienza University of Rome, 00186 Rome, Italy
| |
Collapse
|
4
|
Rheinheimer N, Beijers R, Cooijmans KHM, Brett BE, de Weerth C. Effects of skin-to-skin contact on full-term infants' stress reactivity and quality of mother-infant interactions. Dev Psychobiol 2022; 64:e22308. [PMID: 36282755 PMCID: PMC9539895 DOI: 10.1002/dev.22308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/29/2022] [Accepted: 06/09/2022] [Indexed: 01/27/2023]
Abstract
Skin-to-skin contact (SSC) between mothers and their infants has beneficial effects in both preterm and full-term infants. Underlying mechanisms are largely unknown. This randomized controlled trial assessed whether daily SSC in full-term mother-infant dyads: (1) decreases infants' cortisol and behavioral reactivity to a mild naturalistic stressor, and (2) facilitates interaction quality between infants and mothers (i.e., improved maternal caregiving behavior and mother-infant adrenocortical synchrony). Pregnant Dutch women (N = 116) were recruited and randomly allocated to an SSC or care-as-usual condition. The SSC condition performed 1 h of SSC daily, from birth until postnatal week 5. In week 5, mothers bathed the infant (known mild stressor). Infant and maternal cortisol was sampled at baseline, 25 and 40 min after bathing, and infant and maternal behavior was rated. Results did not indicate effects of SSC on infant behavioral and cortisol reactivity to the bathing session. Similarly, no effect of SSC was found on maternal caregiving behavior and mother-infant adrenocortical synchrony. In conclusion, the findings provide no evidence that daily mother-infant SSC is associated with full-term infants' behavioral and adrenocortical stress reactivity or mother-infant interaction quality. Future studies should replicate these findings and unveil other potential mechanisms underlying beneficial effects of SSC.
Collapse
Affiliation(s)
- Nicole Rheinheimer
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Roseriet Beijers
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Kelly H M Cooijmans
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - Bonnie E Brett
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carolina de Weerth
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
5
|
Windarti SW, Suryawan A. Effectiveness of The Newborn Behavioral Observation (NBO) System in Improving Mother and Infant Interaction. FOLIA MEDICA INDONESIANA 2021. [DOI: 10.20473/fmi.v57i2.21558] [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
The interaction of mother and infant is a fundamental basis for the development of the infant. It can also determine the success of the baby in the future. About 4 out of 10 infants experience problems interacting with their parents. The NBO system was created to sensitize parents on their infant’s competencies to help them understand their infant’s behavior, and promote positive interactions between parents and their new infant. This study aimed to evaluate the effectiveness of the NBO system to improve mother-infant interactions and find out the mothers’ knowledge about their infant’s behavior when participating in this observation. This study was a cross-sectional study consisting of all the newborns and their mothers admitted to the Dr. Soetomo General Academic Hospital Surabaya from May 2019 to January 2020 who met the inclusion criteria. Mothers and infants participated in the NBO within 1-3 days after delivering their infants and one month postpartum for the second NBO. The NBO was carried out with 35 mothers and infants. The mothers’ age was on average 28.5±5.98 years old, multiparous mothers accounted for 71.4%, most infants were male (65.7%), the median gestational age was 38 weeks with the median birth weight 2900 grams. The median score of mothers’ knowledge about their infants before the NBO session was 2 (1-6). After the session, these median scores increased to 7 (5–10) significantly (p<0.001). The NBO system was significant to strengthen mother-infant interaction and increased the mothers’ knowledge about their infants’ behavior.
Collapse
|
6
|
Lemoigne S, Bouvard M, Sutter-Dallay AL. [Early mother-infant care, definition and effectiveness: A review of the literature]. Encephale 2021; 47:470-483. [PMID: 33994160 DOI: 10.1016/j.encep.2021.02.003] [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: 11/11/2019] [Revised: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Professionals agree on the need for early joint mother-baby care, but its effectiveness remains poorly studied. The aim of our work is to propose a review of the literature on this subject. METHODS We included randomized or non-randomized controlled clinical trials of interventions targeting the mother-baby dyad which can begin during pregnancy or during the first three years of life. RESULTS Forty-one studies met the inclusion criteria and focused on mother-baby psychotherapy, educational or guidance programs, care for premature infants, infant massage, and home visits. The results show an improvement of the quality of the interactions whatever the type of approach, but according to different indications or modalities. The heterogeneity of intervention methods and indications make the comparison of results almost impossible. CONCLUSION This work highlights the lack of consensus on mother-child care methods, both for their indications and their effectiveness. The isolated evaluation of interactions is an insufficient criterion for judging the effectiveness of care. Finally, whatever the theoretical models, the interventions must take into account the environment of the child.
Collapse
Affiliation(s)
- S Lemoigne
- Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, centre hospitalier Charles-Perrens, Bordeaux, France.
| | - M Bouvard
- Pôle universitaire de psychiatrie de l'enfant et de l'adolescent, centre hospitalier Charles-Perrens, Bordeaux, France
| | - A-L Sutter-Dallay
- Inserm 1219, Réseau de psychiatrie perinatale, pole universitaire de psychiatrie de l'enfant et de l'adolescent, centre hospitalier Charles-Perrens, Bordeaux et Bordeaux Population Health Research Center, Bordeaux University, Bordeaux, France
| |
Collapse
|
7
|
Dean B, Ginnell L, Boardman JP, Fletcher-Watson S. Social cognition following preterm birth: A systematic review. Neurosci Biobehav Rev 2021; 124:151-167. [PMID: 33524414 DOI: 10.1016/j.neubiorev.2021.01.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 01/15/2023]
Abstract
Social cognitive abilities are affected by preterm birth, but pathways to, and risk factors for this outcome are not well mapped. We examined direct assessment tasks including objective coding of parent-child play to chart social development in infancy and pre-school years. A systematic search and data-extraction procedure yielded seventy-nine studies (4930 preterm and 2109 term children, aged birth - five years), for inclusion. We detected a pattern of reduced social attention in the first 12 months of life with evidence of reduced performance in social cognitive tasks later in the preschool years. However, we did not identify a consistent, distinctive preterm social phenotype in early life. Instead, the interactive behaviour of preterm infants reflects factors from outside the social cognitive domain, such as attention, language, and socioeconomic status. By combining data across samples and measures we revealed the role of domain-general skills, which may in future prove fruitful intervention targets.
Collapse
Affiliation(s)
- Bethan Dean
- MRC Centre for Reproductive Health, University of Edinburgh, UK
| | - Lorna Ginnell
- MRC Centre for Reproductive Health, University of Edinburgh, UK
| | | | | |
Collapse
|
8
|
Aita M, Héon M, Lavallée A, De Clifford Faugère G, Altit G, Le May S, Dorval V, Lippé S, Larone Juneau A, Remmer E, Rennick JE. Nurturing and quiet intervention (NeuroN-QI) on preterm infants' neurodevelopment and maternal stress and anxiety: A pilot randomized clinical trial protocol. J Adv Nurs 2021; 77:3192-3203. [PMID: 33719093 DOI: 10.1111/jan.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Primary objective of this pilot study is to evaluate the feasibility and acceptability of the NeuroN-QI and the study procedures. Secondary objectives are to assess the feasibility and acceptability of the NeuroN-QI by the nurses, assess the nurses' training needs about the components of the NeuroN-QI, and estimate the preliminary effects of the NeuroN-QI on infants' neurodevelopment as well as maternal stress and anxiety at infants' 36 weeks of gestational age. DESIGN A two-group pilot parallel randomized clinical trial stratified by center. METHODS The pilot study will be conducted in two neonatal intensive care units (NICUs). A sample of 24 mother-infant dyads born between 26 and 316/7 gestational age will be randomized into an experimental or control group. Fifty nurses will be recruited. The NeuroN-QI consists of four 2-hour skin-to-skin contact sessions/week with a 15-minute auditory stimulation by mothers with controlled ambient levels of light and noise. A 1-hour quiet period will follow where infants will rest in their incubator/crib with their mother's milk for olfactory stimulation and where the light and noise control will be continued. In the control group, mother-infant dyads will do four skin-to-skin contacts per week and receive standard care. Acceptability and feasibility of the NeuroN-QI in addition to maternal stress and anxiety will be measured through questionnaires, while infants' neurodevelopment will be assessed with Assessment of Preterm Infant Behaviour and General Movement Assessment. CONCLUSIONS This pilot trial will address knowledge gaps and generate evidence in neonatal care by evaluating the feasibility and acceptability of a multi-component developmental care intervention. IMPACT This project is an innovative step towards optimizing the neurodevelopmental trajectory of infants in NICUs and consequently promoting their long-term health outcomes. TRIAL REGISTRATION NCT04593095.
Collapse
Affiliation(s)
- Marilyn Aita
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Marjolaine Héon
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Gabriel Altit
- Department of Pediatrics, Division of Neonatology, Montreal Children's Hospital - McGill University Health Center (MUHC), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
| | - Sylvie Le May
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada
| | | | - Sarah Lippé
- CHU Sainte-Justine Research Centre, Montréal, Canada.,Faculty of Arts and Science, Department of Psychology, Université de Montréal, Montréal, Canada
| | | | - Elissa Remmer
- NICU, Montreal Children's Hospital (MCH, MUHC), Montréal, Canada
| | - Janet E Rennick
- Quebec Network on Nursing Intervention Research (RRISIQ), Montréal, Canada.,Research Institute MUHC, Montréal, Canada.,Department of Pediatrics, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada.,Department of Nursing, MCH, MUHC, Montréal, Canada
| |
Collapse
|
9
|
Bigelow AE, Power M. Mother-Infant Skin-to-Skin Contact: Short- and Long-Term Effects for Mothers and Their Children Born Full-Term. Front Psychol 2020; 11:1921. [PMID: 32982827 PMCID: PMC7485314 DOI: 10.3389/fpsyg.2020.01921] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 07/13/2020] [Indexed: 12/02/2022] Open
Abstract
This brief report reviews findings from a longitudinal study of skin-to-skin contact (SSC) with mothers and full-term infants and a follow-up study of these dyads when the children were 9 years. Findings infer the positive influence of SSC on mother-child interactions in infancy and into children's middle childhood. Mothers and infants in SSC and control groups were seen when infants were 1 week, 1 month, 2 months, and 3 months. SSC group mothers reported fewer depressive symptoms in infants' early weeks and had a greater reduction in salivary cortisol, a physiological stress indicator, in infants' first month (Bigelow et al., 2012). SSC group mothers who initially chose to breastfeed continued to breastfeed their infants throughout the 3 months, whereas breastfeeding mothers in the control group declined over the visits (Bigelow et al., 2014). When engaged in the Still Face Task with their mothers, SSC group infants showed the still face effect with their affect at 1 month, a month before the control group infants did so (Bigelow and Power, 2012). At 3 months, SSC group infants were social bidding to their mothers during the still face phase. When the children were 9 years, the mother-child dyads engaged in conversations about the children's remembered emotional events (Bigelow et al., 2018). Mother-child dyads who had been in the SSC group showed more engagement and reciprocity in the conversations than mother-child dyads who had been in the control group. Oxytocin, which is induced by SSC, is hypothesized to be an underlying factor that helped the mother-infant relationship have a positive trajectory with long-term benefits.
Collapse
Affiliation(s)
- Ann E. Bigelow
- Department of Psychology, St. Francis Xavier University, Antigonish, NS, Canada
| | | |
Collapse
|
10
|
Della Longa L, Carnevali L, Patron E, Dragovic D, Farroni T. Psychophysiological and Visual Behavioral Responses to Faces Associated with Affective and Non-affective Touch in Four-month-old Infants. Neuroscience 2020; 464:67-78. [PMID: 32771501 DOI: 10.1016/j.neuroscience.2020.07.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 01/17/2023]
Abstract
Affective touch (gentle, caress-like touch) carries a rewarding meaning, which may represent a neurophysiological foundation for the development of social interactions from the earliest stages of life. Developmental studies have shown evidence of infants' sensitivity to affective touch as reflected by a decrease in heart rate and activation of the insular cortex. Moreover, affective touch has been shown to regulate infants' emotional state, reinforce eye contact and facilitate learning of facial information, suggesting that affective touch may promote social functioning from the earliest stages of development. The present study aims to investigate the role of affective touch in enhancing engagement with social stimuli, exploring sustained attention and cardiac responses to faces as signatures of the underlying psychophysiological mechanism. Four-months-old infants (N = 40) were repeatedly presented with a female face paired with touch (hand stroking vs tapping with a brush in two different blocks) alternating with a face presented without tactile stimulation (familiarization phase), followed by a visual preference test between the two faces. Our results revealed an attenuated cardiac response in the affective compared to the non-affective condition during the familiarization phase. During the test phase infants looked longer at both the faces presented in the affective touch condition, compared to the faces in the non-affective condition. These findings suggest that affective touch might promote engagement in social interactions by facilitating physiological state regulation during processing of multisensory social information.
Collapse
Affiliation(s)
- Letizia Della Longa
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Laura Carnevali
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Elisabetta Patron
- Department of General Psychology, University of Padova, Padova, Italy
| | - Danica Dragovic
- Paediatric Unit, Hospital of Monfalcone, Monfalcone (GO), Italy
| | - Teresa Farroni
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy.
| |
Collapse
|
11
|
Zhang B, Duan Z, Zhao Y, Williams S, Wall S, Huang L, Zhang X, Wu W, Yue J, Zhang L, Liu J, Zhao G. Intermittent kangaroo mother care and the practice of breastfeeding late preterm infants: results from four hospitals in different provinces of China. Int Breastfeed J 2020; 15:64. [PMID: 32680538 PMCID: PMC7367356 DOI: 10.1186/s13006-020-00309-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND China has an extremely low exclusive breastfeeding rate. Kangaroo mother care (KMC) has been shown to increase the exclusive breastfeeding rate among infants born extremely or very preterm. However, there is limited evidence surrounding intermittent KMC and exclusive breastfeeding in late preterm infants. In our study we investigated the association between the provision of intermittent KMC and breastfeeding practice for late preterm infants in four hospitals in different provinces of China. METHODS Intermittent KMC was recommended to the mothers of all preterm infants admitted to the postnatal wards of participating hospitals between March 2018 and March 2019. Those who agreed to practice KMC were enrolled in the "KMC group", those who did not were enrolled in the "No KMC group". Basic maternal socio-demographic information was collected, feeding practice; outcome and method, were recorded daily whilst in hospital. A follow-up survey of feeding practice was conducted 42 days after discharge. Calculations for feeding practice were performed separately for both groups. Logistics regression was used to analyze the association between KMC and feeding outcome and method, adjusting for socio-demographic covariates. RESULTS Among the 844 mothers participating in the study, 627 (74.3%) chose to perform KMC. More of the mothers who provided KMC were exclusively breast milk feeding their infants in the 24 h before hospital discharge (54.6%) and at follow-up (57.3%), compared to mothers who did not provide KMC (34.6% at discharge and 33.2% at follow-up,). Mothers in the KMC group were more likely to be breastfeeding (method) than mothers in the No KMC group (65.3% vs. 52.1% at discharge, and 83.1% vs. 67.3% at follow up). Logistic regression indicated that compared with the No KMC group, mothers who provided KMC were twice as likely to be exclusively breast milk feeding their infants at discharge (OR = 2.15 (95% CI 1.53, 3.02)), use breastfeeding method at discharge as opposed to other means such as bottle or cup feeding (OR = 1.61 (95% CI 1.15, 2.25)), be exclusive breast milk feeding at follow-up (OR = 2.55 (95% CI 1.81, 3.61)), and use breastfeeding method at follow-up (OR = 2.09 (95% CI 1.44, 3.02)). CONCLUSIONS Intermittent KMC was associated with a nearly doubled increase in exclusive breast milk feeding (outcome) and breastfeeding (method) at both discharge and 42 days after discharge for late preterm infants. This is especially important in China where exclusive breastfeeding rates are low, intermittent KMC provides a feasible means to increase the likelihood of these vulnerable infants receiving the benefits of exclusive breastmilk.
Collapse
Affiliation(s)
- Bo Zhang
- Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China
| | - Zhiying Duan
- Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China
| | - Yingxi Zhao
- University of Oxford Nuffield Department of Medicine, Oxford, UK
| | | | - Stephen Wall
- Save the Children Saving Newborn Lives, Washington, DC, USA
| | - Limin Huang
- Hunan Provincial Maternal and Child Health Hospital, Changsha, Hunan, China
| | - Xiaoqin Zhang
- Northwest Women & Children Hospital Department of Obstetrics, Xi'an, Shaanxi, China
| | - Wenli Wu
- Linyi Maternity and Child Health Hospital, Linyi, Shandong, China
| | - Jieya Yue
- Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China
| | | | - Jun Liu
- Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China.
| | - Gengli Zhao
- Peking University First Hospital, 1 Xi'anmen St, Xicheng, Beijing, China.
| |
Collapse
|
12
|
A Randomized Trial of Continuous Versus Intermittent Skin-to-Skin Contact After Premature Birth and the Effects on Mother-Infant Interaction. Adv Neonatal Care 2020; 20:E48-E56. [PMID: 31764209 DOI: 10.1097/anc.0000000000000675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Premature birth affects opportunities for interaction between infants and mothers. Skin-to-skin contact (SSC) is standard care in neonatal care but has not been sufficiently studied regarding the effects on interaction between preterm infant and mothers. PURPOSE The purpose of this study was to compare interaction between preterm infants and their mothers after continuous versus intermittent SSC from birth to discharge. A secondary aim was to study a potential dose-response effect between time in SSC and quality of interaction. METHODS Families were randomly assigned to either continuous (n = 17) or intermittent (n = 14) SSC before delivery. Interaction was measured from videotapes of a Still-Face Paradigm collected at 4 months' corrected age. Face-to-face interaction was coded according to Ainsworth's Maternal Sensitivity Scales and the Maternal Sensitivity and Responsivity Scales-R. Dose-response correlations were calculated between mean time spent in SSC and each of the interaction scales. RESULTS There were no statistically significant differences between groups in maternal interactive behavior toward their infants regarding sensitivity, interference, availability, acceptance, withdrawal, or intrusivity. There was no correlation between mean time in SSC and quality of interaction. IMPLICATIONS FOR PRACTICE Continuous SSC from birth to discharge was not superior to intermittent SSC concerning mother-infant interaction between preterm infants and their mothers at 4 months' corrected age. However, compared with other studies, mean time in SSC was also high in the intermittent group. IMPLICATIONS FOR RESEARCH Further studies are needed to find out how interaction between parents and preterm infants can be improved, supported, and facilitated in the neonatal intensive care unit (NICU) and whether there is an optimal dose for SSC.
Collapse
|
13
|
Lavallée A, Aita M, Côté J, Bell L, Luu TM. A guided participation nursing intervention to theraupeutic positioning and care (GP_Posit) for mothers of preterm infants: protocol of a pilot randomized controlled trial. Pilot Feasibility Stud 2020; 6:77. [PMID: 32509322 PMCID: PMC7251724 DOI: 10.1186/s40814-020-00601-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the NICU, interventions intended to enhance maternal sensitivity are indicated in order to optimize preterm infant development and long-term mother-infant attachment. A novel nursing intervention was developed following a theory-oriented methodology and is based upon the guided participation theory for mothers to participate in their preterm infant's therapeutic POSITioning and care (GP_Posit). The primary objective of this study is to evaluate the feasibility and acceptability of (i) the study design; and (ii) the experimental GP_Posit nursing intervention during NICU hospitalization. The secondary objective is to estimate the preliminary effects of GP_Posit on maternal and preterm infant outcomes. Methods A pilot parallel-group randomized clinical trial (RCT) was designed where mother-preterm infant dyads are being recruited and randomized to a control group (usual care) or experimental group (GP_Posit intervention). Data collection includes feasibility and acceptability data as well as preliminary effects on maternal sensitivity and infant neurodevelopment. Ethical approval from the University Hospital ethical board was obtained in January 2018 (2017-1540). Discussion Data collection for this pilot study is expected to end in 2020. Results of this pilot study will inform about the feasibility and acceptability of the study design and GP_Posit intervention, a nursing intervention having the potential to favor maternal sensitivity and infant neurodevelopment in the NICU and guide the elaboration of a large-scale RCT. Trial registration clinicaltrial.gov, NCT03677752. Registered 19 September 2018.
Collapse
Affiliation(s)
- Andréane Lavallée
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Marilyn Aita
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Quebec, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, Montréal, Canada.,Quebec Network on Nursing Intervention Research (RRISIQ), Quebec, Canada.,Montreal University Health Center (CHUM) Research Center, Montréal, Canada
| | - Linda Bell
- Quebec Network on Nursing Intervention Research (RRISIQ), Quebec, Canada.,School of Nursing, Faculty of Medicine and Health Sciences, Univertisé de Sherbrooke, Sherbrooke, Canada
| | - Thuy Mai Luu
- CHU Sainte-Justine Research Centre, Montréal, Canada.,Department of Pediatrics, CHU Sainte-Justine, Montréal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| |
Collapse
|
14
|
An intervention to decrease time to parents' first hold of infants in the Neonatal Intensive Care Unit requiring respiratory support. J Perinatol 2020; 40:812-819. [PMID: 31911648 PMCID: PMC7223435 DOI: 10.1038/s41372-019-0569-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 11/27/2019] [Accepted: 12/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are many barriers to parental skin-to-skin contact for critically ill neonates. Our aims were to decrease median time to first parental hold of neonates requiring respiratory support from 6.4 to 3 days, and to increase the percentage of neonates held within the first 24 h after birth from 6 to 75%. METHODS Lean Six Sigma methodology was used to identify barriers to holding and opportunities for improvement. INTERVENTION A multifactorial improvement bundle was implemented to reduce the time to first parental hold of critically ill neonates. RESULTS Median time to first parental hold was reduced from 6.4 to 1.2 days (p < 0.01). Infants held within the first 24 h after birth increased from 6 to 35%. There was no increase in adverse events associated with parental holding. CONCLUSIONS Implementation of an improvement bundle resulted in a significant reduction in time to first parental hold of infants requiring respiratory support.
Collapse
|
15
|
Beiranvand S, Faraji Goodarzi M, Firouzi M. The Effects of Caressing and Hugging Infants to Manage the Pain during Venipuncture. Compr Child Adolesc Nurs 2019; 43:142-150. [PMID: 31192699 DOI: 10.1080/24694193.2019.1609129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study is to investigate the effects of caressing in infants for pain management during venipuncture. This is a randomized control trial, carried out on 120 infants between 2 and 6 months of age, that included 30 males and 30 females in the hugging and control group, respectively. Parameters such as percentage blood saturation of blood, crying, and the duration of pain felt was evaluated. The venipuncture between the control and experimental groups showed that, less pain is felt by females when caressed by their mother. However, this difference does have statistical significance. Overall, caressing in infants had positive effect on pain-relief after venipuncture.
Collapse
Affiliation(s)
- Siavash Beiranvand
- Department of Anesthesiology, Faculty of Medicine, Lorestan University of Medical Sciences , Khorramabad, Iran
| | - Mojgan Faraji Goodarzi
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences , Khorramabad, Iran
| | - Majid Firouzi
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences , Khorramabad, Iran
| |
Collapse
|
16
|
Jafari M, Farajzadeh F, Asgharlu Z, Derakhshani N, Asl YP. Effect of Kangaroo Mother Care on hospital management indicators: A systematic review and meta-analysis of randomized controlled trials. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2019; 8:96. [PMID: 31143813 PMCID: PMC6532364 DOI: 10.4103/jehp.jehp_310_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/12/2019] [Indexed: 06/09/2023]
Abstract
Results of previous studies about the effect of Kangaroo Mother Care (KMC) on hospital management indicators (HMIs) (length of stay [LOS], readmission to hospital, parent satisfaction, and parent's preference for same postdelivery care) had high confusions. The aim of this study was to conduct a systematic review and meta-analysis of randomized controlled trials on the effect of KMC on HMI in comparison with the conventional neonatal care (CNC). In this systematic review and meta-analysis study, required data were collected by searching the following keywords: "length of stay," "readmission to hospital," satisfaction," same post-delivery," "hospital management," indicators, "skin-to-skin," "Kangaroo Mother Care," randomized trial. The following databases were searched: Google Scholar, PubMed, EMBASE, Scopus, and Cochrane. To estimate the hospital management indicators, computer software Comprehensive Meta-Analysis 2 was used. Finally, 18 articles were included to analysis. The overall LOS standard different between groups (KMC vs. CNC) was - 0.91 days (95% confidence interval [CI], -2.14-0.32, Q = 25.6, df = 10, P = 0.004, I 2 = 60.98). The overall readmission to hospital standard different between groups was - 1.78% (95% CI, -1.21%-0.86%, Q = 0.024, df = 1, P = 0.87, I 2 = 0.00). The overall parent satisfaction standard different between groups was 5.3% (95% CI, -32.4%-43%, Q = 0.052, df = 2, P = 0.97, I 2 = 0.00). The overall standard different between groups was 16.2% (95% CI, -24.7%-57.1%, Q = 0.040, df = 1, P = 0.84, I 2 = 0.00). KMC improves HMI but not significantly. According to the current study result and other studies that report positive effect of KMC on health status of the newborns and parents, implemented of KMC in low- and middle-income countries recommended.
Collapse
Affiliation(s)
- Mahdi Jafari
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Farajzadeh
- Department of Health Services Management, School of Health Management and Information Sciences, International Campus (IUMS-IC), Iran University of Medical Sciences, Tehran, Iran
| | - Zoleikha Asgharlu
- Department of Midwifery, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Naser Derakhshani
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Yousof Pashaei Asl
- Department of Health Services Management, Iranian Center of Excellence in Health Management, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
17
|
Tran HT, Nippita T, Nguyen PTK, Nguyen PTT, Huynh TTD, Hua OTL, Roberts CL. Knowledge, experience and attitudes towards skin-to-skin contact following Caesarean sections among health professionals in Vietnam. Acta Paediatr 2018; 107:1917-1923. [PMID: 30054942 DOI: 10.1111/apa.14519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/19/2018] [Accepted: 07/25/2018] [Indexed: 11/28/2022]
Abstract
AIM This study explored knowledge, experience and attitudes of health professionals towards early essential newborn care and skin-to-skin contact following Caesarean sections in a tertiary hospital in Central Vietnam. METHOD We conducted a cross-sectional descriptive study using an anonymous questionnaire in March 2016. Health professionals from obstetrics, anaesthesiology and neonatology departments were surveyed. RESULTS All of the 204 surveys were returned, accounting for 82% of total staff involved in the care for women and newborns with Caesarean sections. Correct knowledge of early essential newborn care was lowest among anaesthesiology staff. Health professionals reported that ≥90% of Caesarean section births they attended in the preceding week had skin-to-skin contact. Approximately 16% obstetricians, 71% midwives, 49% anaesthesiology and 76% neonatology staff considered the current frequency of skin-to-skin contact to be about right. The remainder considered the current rate too high. All professional groups identified the main difficulties of conducting skin-to-skin contact as the temperature in the operating theatre and the need for additional staff. Other concerns included increasing the risk of the baby of falling off, prolonging the operation and difficulty to monitor mothers. CONCLUSION The study identifies issues where improvements can be made in the implementation of skin-to-skin contact following Caesarean sections.
Collapse
Affiliation(s)
- Hoang Thi Tran
- Da Nang Hospital for Women and Children; Da Nang Vietnam
- Faculty of Medicine and Pharmacy; The University of Da Nang; Da Nang Vietnam
| | - Tanya Nippita
- Sydney Medical School-Northern; the University of Sydney; Sydney NSW Australia
| | - Phuong Thi Kim Nguyen
- Da Nang Hospital for Women and Children; Da Nang Vietnam
- Sydney Medical School-Northern; the University of Sydney; Sydney NSW Australia
| | | | | | | | | |
Collapse
|
18
|
Does Kangaroo care affect the weight of preterm/low birth-weight infants in the neonatal setting of a hospital environment? ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2017.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
19
|
Namprom N, Picheansathian W, Jintrawet U, Chotibang J. The effect of maternal participation in preterm's care and improved short-term growth and neurodevelopment outcomes. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.jnn.2018.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
|
20
|
Ward E, Gillies J, Armstrong D, Grant L, Elder A, Burton J, Ryan C, Quinn C. Cultivating Compassionate Care: Why Does it Matter and What Can We Do to Promote It? J R Coll Physicians Edinb 2018; 48:71-77. [DOI: 10.4997/jrcpe.2018.117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - J Gillies
- Co-Director University of Edinburgh Compassion initiative
| | | | - L Grant
- Global Health Academy Co-Director Global Compassion Initiative
| | - A Elder
- Consultant Physician, NHS Lothian
| | - J Burton
- Geriatric Medicine, University of Edinburgh
| | - C Ryan
- Speciality Registrar Geriatric and General Medicine West of Scotland
| | - C Quinn
- Speciality Registrar Medicine of the Elderly, NHS Lothian
| |
Collapse
|
21
|
Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2016; 11:CD003519. [PMID: 27885658 PMCID: PMC6464366 DOI: 10.1002/14651858.cd003519.pub4] [Citation(s) in RCA: 324] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Mother-infant separation post birth is common. In standard hospital care, newborn infants are held wrapped or dressed in their mother's arms, placed in open cribs or under radiant warmers. Skin-to-skin contact (SSC) begins ideally at birth and should last continually until the end of the first breastfeeding. SSC involves placing the dried, naked baby prone on the mother's bare chest, often covered with a warm blanket. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neuro-behaviors ensuring fulfillment of basic biological needs. This time frame immediately post birth may represent a 'sensitive period' for programming future physiology and behavior. OBJECTIVES To assess the effects of immediate or early SSC for healthy newborn infants compared to standard contact on establishment and maintenance of breastfeeding and infant physiology. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (17 December 2015), made personal contact with trialists, consulted the bibliography on kangaroo mother care (KMC) maintained by Dr Susan Ludington, and reviewed reference lists of retrieved studies. SELECTION CRITERIA Randomized controlled trials that compared immediate or early SSC with usual hospital care. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Quality of the evidence was assessed using the GRADE approach. MAIN RESULTS We included 46 trials with 3850 women and their infants; 38 trials with 3472 women and infants contributed data to our analyses. Trials took place in 21 countries, and most recruited small samples (just 12 trials randomized more than 100 women). Eight trials included women who had SSC after cesarean birth. All infants recruited to trials were healthy, and the majority were full term. Six trials studied late preterm infants (greater than 35 weeks' gestation). No included trial met all criteria for good quality with respect to methodology and reporting; no trial was successfully blinded, and all analyses were imprecise due to small sample size. Many analyses had statistical heterogeneity due to considerable differences between SSC and standard care control groups. Results for womenSSC women were more likely than women with standard contact to be breastfeeding at one to four months post birth, though there was some uncertainty in this estimate due to risks of bias in included trials (average risk ratio (RR) 1.24, 95% confidence interval (CI) 1.07 to 1.43; participants = 887; studies = 14; I² = 41%; GRADE: moderate quality). SSC women also breast fed their infants longer, though data were limited (mean difference (MD) 64 days, 95% CI 37.96 to 89.50; participants = 264; studies = six; GRADE:low quality); this result was from a sensitivity analysis excluding one trial contributing all of the heterogeneity in the primary analysis. SSC women were probably more likely to exclusively breast feed from hospital discharge to one month post birth and from six weeks to six months post birth, though both analyses had substantial heterogeneity (from discharge average RR 1.30, 95% CI 1.12 to 1.49; participants = 711; studies = six; I² = 44%; GRADE: moderate quality; from six weeks average RR 1.50, 95% CI 1.18 to 1.90; participants = 640; studies = seven; I² = 62%; GRADE: moderate quality).Women in the SCC group had higher mean scores for breastfeeding effectiveness, with moderate heterogeneity (IBFAT (Infant Breastfeeding Assessment Tool) score MD 2.28, 95% CI 1.41 to 3.15; participants = 384; studies = four; I² = 41%). SSC infants were more likely to breast feed successfully during their first feed, with high heterogeneity (average RR 1.32, 95% CI 1.04 to 1.67; participants = 575; studies = five; I² = 85%). Results for infantsSSC infants had higher SCRIP (stability of the cardio-respiratory system) scores overall, suggesting better stabilization on three physiological parameters. However, there were few infants, and the clinical significance of the test was unclear because trialists reported averages of multiple time points (standardized mean difference (SMD) 1.24, 95% CI 0.76 to 1.72; participants = 81; studies = two; GRADE low quality). SSC infants had higher blood glucose levels (MD 10.49, 95% CI 8.39 to 12.59; participants = 144; studies = three; GRADE: low quality), but similar temperature to infants in standard care (MD 0.30 degree Celcius (°C) 95% CI 0.13 °C to 0.47 °C; participants = 558; studies = six; I² = 88%; GRADE: low quality). Women and infants after cesarean birthWomen practicing SSC after cesarean birth were probably more likely to breast feed one to four months post birth and to breast feed successfully (IBFAT score), but analyses were based on just two trials and few women. Evidence was insufficient to determine whether SSC could improve breastfeeding at other times after cesarean. Single trials contributed to infant respiratory rate, maternal pain and maternal state anxiety with no power to detect group differences. SubgroupsWe found no differences for any outcome when we compared times of initiation (immediate less than 10 minutes post birth versus early 10 minutes or more post birth) or lengths of contact time (60 minutes or less contact versus more than 60 minutes contact). AUTHORS' CONCLUSIONS Evidence supports the use of SSC to promote breastfeeding. Studies with larger sample sizes are necessary to confirm physiological benefit for infants during transition to extra-uterine life and to establish possible dose-response effects and optimal initiation time. Methodological quality of trials remains problematic, and small trials reporting different outcomes with different scales and limited data limit our confidence in the benefits of SSC for infants. Our review included only healthy infants, which limits the range of physiological parameters observed and makes their interpretation difficult.
Collapse
Affiliation(s)
- Elizabeth R Moore
- Vanderbilt UniversitySchool of Nursing314 Godchaux Hall21st Avenue SouthNashvilleTennesseeUSA37240‐0008
| | - Nils Bergman
- University of Cape TownSchool of Child and Adolescent Health, and Department of Human BiologyCape TownSouth Africa
| | - Gene C Anderson
- Professor Emerita, University of FloridaCase Western Reserve UniversityOak Hammock at the University of Florida5000 SW 25th Boulevard #2108GainesvilleFLUSA32608‐8901
| | - Nancy Medley
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
| | | |
Collapse
|
22
|
Conde‐Agudelo A, Díaz‐Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2016; 2016:CD002771. [PMID: 27552521 PMCID: PMC6464509 DOI: 10.1002/14651858.cd002771.pub4] [Citation(s) in RCA: 219] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants. OBJECTIVES To determine whether evidence is available to support the use of KMC in LBW infants as an alternative to conventional neonatal care before or after the initial period of stabilization with conventional care, and to assess beneficial and adverse effects. SEARCH METHODS We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches in CENTRAL (Cochrane Central Register of Controlled Trials; 2016, Issue 6), MEDLINE, Embase, CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILACS (Latin American and Caribbean Health Science Information database), and POPLINE (Population Information Online) databases (all from inception to June 30, 2016), as well as the WHO (World Health Organization) Trial Registration Data Set (up to June 30, 2016). In addition, we searched the web page of the Kangaroo Foundation, conference and symposia proceedings on KMC, and Google Scholar. SELECTION CRITERIA Randomized controlled trials comparing KMC versus conventional neonatal care, or early-onset KMC versus late-onset KMC, in LBW infants. DATA COLLECTION AND ANALYSIS Data collection and analysis were performed according to the methods of the Cochrane Neonatal Review Group. MAIN RESULTS Twenty-one studies, including 3042 infants, fulfilled inclusion criteria. Nineteen studies evaluated KMC in LBW infants after stabilization, one evaluated KMC in LBW infants before stabilization, and one compared early-onset KMC with late-onset KMC in relatively stable LBW infants. Sixteen studies evaluated intermittent KMC, and five evaluated continuous KMC. KMC versus conventional neonatal care: At discharge or 40 to 41 weeks' postmenstrual age, KMC was associated with a statistically significant reduction in the risk of mortality (risk ratio [RR] 0.60, 95% confidence interval [CI] 0.39 to 0.92; eight trials, 1736 infants), nosocomial infection/sepsis (RR 0.35, 95% CI 0.22 to 0.54; five trials, 1239 infants), and hypothermia (RR 0.28, 95% CI 0.16 to 0.49; nine trials, 989 infants; moderate-quality evidence). At latest follow-up, KMC was associated with a significantly decreased risk of mortality (RR 0.67, 95% CI 0.48 to 0.95; 12 trials, 2293 infants; moderate-quality evidence) and severe infection/sepsis (RR 0.50, 95% CI 0.36 to 0.69; eight trials, 1463 infants; moderate-quality evidence). Moreover, KMC was found to increase weight gain (mean difference [MD] 4.1 g/d, 95% CI 2.3 to 5.9; 11 trials, 1198 infants; moderate-quality evidence), length gain (MD 0.21 cm/week, 95% CI 0.03 to 0.38; three trials, 377 infants) and head circumference gain (MD 0.14 cm/week, 95% CI 0.06 to 0.22; four trials, 495 infants) at latest follow-up, exclusive breastfeeding at discharge or 40 to 41 weeks' postmenstrual age (RR 1.16, 95% CI 1.07 to 1.25; six studies, 1453 mothers) and at one to three months' follow-up (RR 1.20, 95% CI 1.01 to 1.43; five studies, 600 mothers), any (exclusive or partial) breastfeeding at discharge or at 40 to 41 weeks' postmenstrual age (RR 1.20, 95% CI 1.07 to 1.34; 10 studies, 1696 mothers; moderate-quality evidence) and at one to three months' follow-up (RR 1.17, 95% CI 1.05 to 1.31; nine studies, 1394 mothers; low-quality evidence), and some measures of mother-infant attachment and home environment. No statistically significant differences were found between KMC infants and controls in Griffith quotients for psychomotor development at 12 months' corrected age (low-quality evidence). Sensitivity analysis suggested that inclusion of studies with high risk of bias did not affect the general direction of findings nor the size of the treatment effect for main outcomes. Early-onset KMC versus late-onset KMC in relatively stable infants: One trial compared early-onset continuous KMC (within 24 hours post birth) versus late-onset continuous KMC (after 24 hours post birth) in 73 relatively stable LBW infants. Investigators reported no significant differences between the two study groups in mortality, morbidity, severe infection, hypothermia, breastfeeding, and nutritional indicators. Early-onset KMC was associated with a statistically significant reduction in length of hospital stay (MD 0.9 days, 95% CI 0.6 to 1.2). AUTHORS' CONCLUSIONS Evidence from this updated review supports the use of KMC in LBW infants as an alternative to conventional neonatal care, mainly in resource-limited settings. Further information is required concerning the effectiveness and safety of early-onset continuous KMC in unstabilized or relatively stabilized LBW infants, as well as long-term neurodevelopmental outcomes and costs of care.
Collapse
Affiliation(s)
- Agustin Conde‐Agudelo
- Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Bethesda, MD and Detroit, MI, and Department of Obstetrics and Gynecology, Wayne State UniversityPerinatology Research BranchDetroitMichiganUSA
| | - José L Díaz‐Rossello
- Departamento de Neonatologia del Hospital de ClínicasUniversidad de la RepublicaMontevideoUruguay
| | | |
Collapse
|
23
|
Montirosso R, Casini E, Del Prete A, Zanini R, Bellù R, Borgatti R. Neonatal developmental care in infant pain management and internalizing behaviours at 18 months in prematurely born children. Eur J Pain 2016; 20:1010-21. [DOI: 10.1002/ejp.826] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2015] [Indexed: 12/12/2022]
Affiliation(s)
- R. Montirosso
- 0-3 Centre for the Study of Social Emotional Development of the At-Risk Infant; Scientific Institute; IRCCS Eugenio Medea; Lecco Italy
| | - E. Casini
- 0-3 Centre for the Study of Social Emotional Development of the At-Risk Infant; Scientific Institute; IRCCS Eugenio Medea; Lecco Italy
| | - A. Del Prete
- Department of Neonatal Care and Neonatal Intensive Care Unit; Manzoni Hospital; Lecco Italy
| | - R. Zanini
- Department of Neonatal Care and Neonatal Intensive Care Unit; Manzoni Hospital; Lecco Italy
| | - R. Bellù
- Department of Neonatal Care and Neonatal Intensive Care Unit; Manzoni Hospital; Lecco Italy
| | - R. Borgatti
- Neuropsychiatry and Neurorehabilitation Unit; Scientific Institute; IRCCS Eugenio Medea; Lecco Italy
| | | |
Collapse
|
24
|
Athanasopoulou E, Fox JRE. Effects of kangaroo mother care on maternal mood and interaction patterns between parents and their preterm, low birth weight infants: a systematic review. Infant Ment Health J 2015; 35:245-62. [PMID: 25798479 DOI: 10.1002/imhj.21444] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The birth of a premature infant can have adverse effects on the mood of mothers and on the interaction patterns between parents and their preterm babies. The aim of the present systematic review was to examine whether the Kangaroo Mother Care (KMC) intervention can attenuate these adverse psychological effects of a premature birth by ameliorating negative maternal mood and/or promoting more positive interactions between preterm infants and their parents. The results showed that although findings of studies were inconclusive, there is some evidence to suggest that KMC can make a positive difference on these areas. Specifically, it was found that KMC can improve negative maternal mood (e.g., anxiety or depression) and promote more positive parent-child interactions. Limitations and directions for future research are discussed.
Collapse
|
25
|
Campbell-Yeo ML, Disher TC, Benoit BL, Johnston CC. Understanding kangaroo care and its benefits to preterm infants. Pediatric Health Med Ther 2015; 6:15-32. [PMID: 29388613 PMCID: PMC5683265 DOI: 10.2147/phmt.s51869] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The holding of an infant with ventral skin-to-skin contact typically in an upright position with the swaddled infant on the chest of the parent, is commonly referred to as kangaroo care (KC), due to its simulation of marsupial care. It is recommended that KC, as a feasible, natural, and cost-effective intervention, should be standard of care in the delivery of quality health care for all infants, regardless of geographic location or economic status. Numerous benefits of its use have been reported related to mortality, physiological (thermoregulation, cardiorespiratory stability), behavioral (sleep, breastfeeding duration, and degree of exclusivity) domains, as an effective therapy to relieve procedural pain, and improved neurodevelopment. Yet despite these recommendations and a lack of negative research findings, adoption of KC as a routine clinical practice remains variable and underutilized. Furthermore, uncertainty remains as to whether continuous KC should be recommended in all settings or if there is a critical period of initiation, dose, or duration that is optimal. This review synthesizes current knowledge about the benefits of KC for infants born preterm, highlighting differences and similarities across low and higher resource countries and in a non-pain and pain context. Additionally, implementation considerations and unanswered questions for future research are addressed.
Collapse
Affiliation(s)
- Marsha L Campbell-Yeo
- School of Nursing, Dalhousie University
- Department of Pediatrics, IWK Health Centre
- Department of Psychology and Neuroscience, Dalhousie University
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS
| | | | | | - C Celeste Johnston
- Department of Pediatrics, IWK Health Centre
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
| |
Collapse
|
26
|
Green SL, Phipps WD. Interactional pattern analysis of mother–baby pairs: Kangaroo mother care versus incubator care. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2015. [DOI: 10.1177/0081246314565961] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Within the field of neonatal care, two approaches have gained prominence – incubator care and kangaroo mother care. Each contributes to a baby’s physiological well-being. The aim of this study was to conduct an investigation into the effects of incubator care and kangaroo mother care from a psychological perspective – specifically an interactional approach – by undertaking interactional pattern analyses of mother–baby pairs receiving incubator care and kangaroo mother care, respectively. Person-centred interviews were conducted and audio recorded with 17 mothers whose babies were receiving either incubator care or kangaroo mother care at the Dr George Mukhari Academic Hospital in Ga-Rankuwa, South Africa. Each interview was studied by an independent clinical psychologist trained in observation and, in particular, the interactional pattern analysis and who then completed an adapted interactional pattern analysis questionnaire. The procedure yielded standardised interactional pattern analyses for the mother–baby pairs. Mann–Whitney U tests revealed that, in relation to their babies, the mothers in the kangaroo mother care group yielded significantly more effective interactional patterns than those in the incubator care group, highlighting that, in terms of the interactional approach, kangaroo mother care may be the preferred method of neonatal care.
Collapse
Affiliation(s)
- Sian L Green
- Department of Clinical Psychology, University of Limpopo, Medunsa Campus, South Africa
| | | |
Collapse
|
27
|
Posttraumatic stress symptoms in mothers of preterm infants. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2015. [DOI: 10.1016/j.ijans.2015.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
28
|
The Effects of Skin-to-Skin Contact on Temperature and Breastfeeding Successfulness in Full-Term Newborns after Cesarean Delivery. Int J Pediatr 2014; 2014:846486. [PMID: 25610472 PMCID: PMC4291124 DOI: 10.1155/2014/846486] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 11/29/2014] [Accepted: 11/29/2014] [Indexed: 11/17/2022] Open
Abstract
Background. The skin-to-skin contact (SSC) of mother and newborn is uncommon full-term newborns after delivering via cesarean section due to the possibility of hypothermia in the infants. The aim of this study was to compare mothers' and infant's temperatures after delivering via cesarean section. Material and Methods. In this randomized clinical trial, 90 infant/mothers dyads delivered via cesarean section were randomized to SSC (n = 46) and routine care (n = 44). In experimental group, skin-to-skin contact was performed for one hour and in the routine group the infant was dressed and put in the cot according to hospital routine care. The newborns' mothers' temperatures in both groups were taken at half-hour intervals. The data was analyzed using descriptive statistics, t-tests, and chi-square tests. Results. The means of the newborns' temperatures immediately after SSC (P = 0.86), half an hour (P = 0.31), and one hour (P = 0.52) after the intervention did not show statistically significant differences between the two groups. The mean scores of the infants' breastfeeding assessment in SSC (8.76±3.63) and routine care (7.25±3.5) groups did not show significant differences (P = 0.048). Conclusion. Mother and infant's skin-to-skin contact is possible after delivering via cesarean section and does not increase the risk of hypothermia.
Collapse
|
29
|
Badiee Z, Faramarzi S, MiriZadeh T. The effect of kangaroo mother care on mental health of mothers with low birth weight infants. Adv Biomed Res 2014; 3:214. [PMID: 25371871 PMCID: PMC4219210 DOI: 10.4103/2277-9175.143262] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 07/10/2013] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The mothers of premature infants are at risk of psychological stress because of separation from their infants. One of the methods influencing the maternal mental health in the postpartum period is kangaroo mother care (KMC). This study was conducted to evaluate the effect of KMC of low birth weight infants on their maternal mental health. MATERIALS AND METHODS The study was conducted in the Department of Pediatrics of Isfahan University of Medical Sciences, Isfahan, Iran. Premature infants were randomly allocated into two groups. The control group received standard caring in the incubator. In the experimental group, caring with three sessions of 60 min KMC daily for 1 week was practiced. Mental health scores of the mothers were evaluated by using the 28-item General Health Questionnaire. Statistical analysis was performed by the analysis of covariance using SPSS. RESULTS The scores of 50 infant-mother pairs were analyzed totally (25 in KMC group and 25 in standard care group). Results of covariance analysis showed the positive effects of KMC on the rate of maternal mental health scores. There were statistically significant differences between the mean scores of the experimental group and control subjects in the posttest period (P < 0.001). CONCLUSION KMC for low birth weight infants is a safe way to improve maternal mental health. Therefore, it is suggested as a useful method that can be recommended for improving the mental health of mothers.
Collapse
Affiliation(s)
- Zohreh Badiee
- Department of Pediatrics, School of Medicine and Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Salar Faramarzi
- Department of Psychology and Education of Children with Special Needs, University of Isfahan, Isfahan, Iran
| | - Tahereh MiriZadeh
- Department of Psychology and Education of Children with Special Needs, University of Isfahan, Isfahan, Iran
| |
Collapse
|
30
|
Holditch-Davis D, White-Traut RC, Levy JA, O'Shea TM, Geraldo V, David RJ. Maternally administered interventions for preterm infants in the NICU: effects on maternal psychological distress and mother-infant relationship. Infant Behav Dev 2014; 37:695-710. [PMID: 25247740 DOI: 10.1016/j.infbeh.2014.08.005] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 08/21/2014] [Accepted: 08/26/2014] [Indexed: 11/26/2022]
Abstract
Although studies have examined the effects of interventions focused on preterm infants, few studies have examined the effects on maternal distress (anxiety, depressive symptoms, post-traumatic stress symptoms, parenting stress) or parenting. This study examined the effects of the auditory-tactile-visual-vestibular (ATVV) intervention and kangaroo care (KC) on maternal distress and the mother-infant relationship compared to an attention control group. 240 mothers from four hospitals were randomly assigned to the three groups. Maternal characteristics in the three groups were similar: 64.1% of ATVV mothers, 64.2% of KC mothers, and 76.5% of control mothers were African American; maternal age averaged 26.3 years for ATVV mothers, 28.1 for KC mothers, and 26.6 for control mothers; and years of education averaged 13.6 for ATVV and KC mothers, and 13.1 for control mothers. Mothers only differed on parity: 68.4% of ATVV and 54.7% of KC mothers were first-time mothers as compared to 43.6% of control mothers. Their infants had a similar mean gestational ages (27.0 weeks for ATVV, 27.2 for KC, and 27.4 for control) and mean birthweights (993 g for ATVV, 1022 for KC, and 1023 for control). Mothers completed questionnaires during hospitalization, and at 2, 6 and 12 months corrected age on demographic characteristics, depressive symptoms, state anxiety, post-traumatic stress symptoms, parenting stress, worry about child health, and child vulnerability (only at 12 months). At 2 and 6 months, 45-min videotapes of mother-infant interactions were made, and the HOME Inventory was scored. Behaviors coded from the videotapes and a HOME subscale were combined into five interactive dimensions: maternal positive involvement and developmental stimulation and child social behaviors, developmental maturity, and irritability. Intervention effects were examined using general linear mixed models controlling for parity and recruitment site. The groups did not differ on any maternal distress variable. Kangaroo care mothers showed a more rapid decline in worry than the other mothers. The only interactive dimensions that differed between the groups were child social behaviors and developmental maturity, which were both higher for kangaroo care infants. Change over time in several individual infant behaviors was affected by the interventions. When mothers reported on the interventions they performed, regardless of group assignment, massage (any form including ATVV) was associated with a more rapid decline in depressive symptoms and higher HOME scores. Performing either intervention was associated with lower parenting stress. These findings suggest that as short-term interventions, KC and ATVV have important effects on mothers and their preterm infants, especially in the first half of the first year.
Collapse
Affiliation(s)
| | - Rosemary C White-Traut
- Children's Hospital of Wisconsin and the College of Nursing, University of Illinois at Chicago, Chicago, IL 60607, United States
| | - Janet A Levy
- School of Nursing, Duke University, Durham, NC 27710, United States
| | - T Michael O'Shea
- Wake Forest School of Medicine, Winston Salem, NC 27157, United States
| | - Victoria Geraldo
- Mount Sinai Children's Hospital, Chicago, IL 60608, United States
| | - Richard J David
- College of Medicine, University of Illinois at Chicago, Chicago, IL 60607, United States; Stroger Hospital, Chicago, IL 60612, United States
| |
Collapse
|
31
|
Samra NM, Taweel AE, Cadwell K. Effect of intermittent kangaroo mother care on weight gain of low birth weight neonates with delayed weight gain. J Perinat Educ 2014; 22:194-200. [PMID: 24868132 DOI: 10.1891/1058-1243.22.4.194] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To evaluate intermittent Kangaroo Mother Care (KMC) with additional opportunities to breastfeed on weight gain of low birth weight (LBW) neonates with delayed weight gain. METHODS 40 LBW neonates were followed to see whether KMC with additional opportunities to breastfeed improved weight gain. RESULTS In the KMC group, the mean age of regaining birth weight was significantly less (15.68 vs. 24.56 days) and the average daily weight gain was significantly higher (22.09 vs. 10.39 g, p < .001) than controls. CONCLUSION KMC with additional opportunities to breastfeed was found to be an effective intervention for LBWs with delayed weight gain and should be considered to be an effective strategy.
Collapse
|
32
|
Conde-Agudelo A, Díaz-Rossello JL. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2014:CD002771. [PMID: 24752403 DOI: 10.1002/14651858.cd002771.pub3] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants. OBJECTIVES To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional neonatal care. SEARCH METHODS The standard search strategy of the Cochrane Neonatal Group was used. This included searches in MEDLINE, EMBASE, LILACS, POPLINE, CINAHL databases (all from inception to March 31, 2014) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2014) In addition, we searched the web page of the Kangaroo Foundation, conference and symposia proceedings on KMC, and Google scholar. SELECTION CRITERIA Randomized controlled trials comparing KMC versus conventional neonatal care, or early onset KMC (starting within 24 hours after birth) versus late onset KMC (starting after 24 hours after birth) in LBW infants. DATA COLLECTION AND ANALYSIS Data collection and analysis were performed according to the methods of the Cochrane Neonatal Review Group. MAIN RESULTS Eighteen studies, including 2751 infants, fulfilled inclusion criteria. Sixteen studies evaluated KMC in LBW infants after stabilization, one evaluated KMC in LBW infants before stabilization, and one compared early onset KMC with late onset KMC in relatively stable LBW infants. Thirteen studies evaluated intermittent KMC and five evaluated continuous KMC. At discharge or 40-41 weeks' postmenstrual age, KMC was associated with a reduction in the risk of mortality (typical risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.92; eight trials, 1736 infants), nosocomial infection/sepsis (typical RR 0.45, 95% CI 0.27 to 0.76), hypothermia (typical RR 0.34, 95% CI 0.17 to 0.67), and length of hospital stay (typical mean difference 2.2 days, 95% CI 0.6 to 3.7). At latest follow up, KMC was associated with a decreased risk of mortality (typical RR 0.67, 95% CI 0.48 to 0.95; 11 trials, 2167 infants) and severe infection/sepsis (typical RR 0.56, 95% CI 0.40 to 0.78). Moreover, KMC was found to increase some measures of infant growth, breastfeeding, and mother-infant attachment. There were no significant differences between KMC infants and controls in neurodevelopmental and neurosensory impairment at one year of corrected age. Sensitivity analysis suggested that the inclusion of studies with high risk of bias did not affect the general direction of findings or the size of the treatment effect for the main outcomes. AUTHORS' CONCLUSIONS The evidence from this updated review supports the use of KMC in LBW infants as an alternative to conventional neonatal care mainly in resource-limited settings. Further information is required concerning effectiveness and safety of early onset continuous KMC in unstabilized or relatively stabilized LBW infants, long term neurodevelopmental outcomes, and costs of care.
Collapse
Affiliation(s)
- Agustin Conde-Agudelo
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Detroit, Michigan, USA
| | | |
Collapse
|
33
|
Chiavetta NM, Martins AR, Henriques IC, Fregni F. Differences in methodological quality between positive and negative published clinical trials. J Adv Nurs 2014; 70:2389-403. [DOI: 10.1111/jan.12380] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2014] [Indexed: 12/24/2022]
Affiliation(s)
- Noelle M. Chiavetta
- Spaulding Neuromodulation Center; Spaulding Rehabilitation Hospital and Massachusetts General Hospital; Boston Massachusetts USA
| | - Ana R.S. Martins
- Spaulding Neuromodulation Center; Spaulding Rehabilitation Hospital and Massachusetts General Hospital; Boston Massachusetts USA
| | | | - Felipe Fregni
- Harvard Medical School Director; Spaulding Neuromodulation Center; Spaulding Rehabilitation Hospital and Massachusetts General Hospital Director; Principles and Practice of Clinical Research; Harvard Medical School; Boston Massachusetts USA
| |
Collapse
|
34
|
Bigelow AE, Power M, Gillis DE, Maclellan-Peters J, Alex M, McDonald C. Breastfeeding, skin-to-skin contact, and mother-infant interactions over infants' first three months. Infant Ment Health J 2013; 35:51-62. [PMID: 25424406 DOI: 10.1002/imhj.21424] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The effects of skin-to-skin contact (SSC) on the maintenance of mothers' decision to breastfeed, the effects of breastfeeding and SSC on mother-infant interactions, and whether maternal depressive symptoms mediate these effects were investigated over infants' first 3 months. When infants were 1 week, 1 month, 2 months, and 3 months of age, mothers in the SSC and control groups reported the type of infant feeding provided and completed the Edinburgh Postnatal Depression Scale (EPDS; J.L. Cox, J.M. Holden, & R. Sagovsky, 1987); mother-infant interactions were coded on the Nursing Child Assessment Feeding Scale (NCAFS; G. Summer & A. Spietz, 1994). Percentage of breastfeeding dyads in the SSC group was stable over the 3 months; yet, fewer dyads in the control group were breastfeeding at the 2- and 3-month visits than at the 1-week visit. Breastfeeding dyads had higher NCAFS Caregiver subscale scores, indicating more positive maternal interactions, at 1 week, 2 months, and 3 months. NCAFS scores did not differ for the SSC and control groups. EPDS scores did not mediate the effect of SSC on breastfeeding or breastfeeding on NCAFS Caregiver subscale scores.
Collapse
|
35
|
Holditch-Davis D, White-Traut R, Levy J, Williams KL, Ryan D, Vonderheid S. Maternal satisfaction with administering infant interventions in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs 2013; 42:641-54. [PMID: 25803213 PMCID: PMC4531372 DOI: 10.1111/1552-6909.12255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To examine mothers' satisfaction with administering interventions for their preterm infants and with the helpfulness of the study nurse by comparing massage with auditory, tactile, visual, and vestibular stimulation (ATVV intervention), kangaroo care, and education about equipment needed at home and to explore whether mother and infant characteristics affected maternal satisfaction ratings. DESIGN Three-group experimental design. SETTING Four neonatal intensive care units (NICUs) (two in North Carolina, two in Illinois). PARTICIPANTS Two hundred and eight (208) preterm infants and their mothers. METHODS When the infant was no longer critically ill, mother/infant dyads were randomly assigned to ATVV, kangaroo care, or the education group all taught by study nurses. At discharge and 2 months corrected age, mothers completed questionnaires. RESULTS All groups were satisfied with the intervention and with nurse helpfulness, and the degree of satisfaction did not differ among them. Intervention satisfaction, but not nurse helpfulness, was related to recruitment site. Older, married, and minority mothers were less satisfied with the intervention but only at 2 months. Higher anxiety was related to lower intervention satisfaction at discharge and lower ratings of nurse helpfulness at discharge and 2 months. More depressive symptoms were related to lower nurse helpfulness ratings at 2 months. CONCLUSIONS Mothers were satisfied with interventions for their infants regardless of the intervention performed. Maternal satisfaction with the intervention was related to recruitment site, maternal demographic characteristics, and maternal psychological distress, especially at 2 months. Thus, nursing interventions that provide mothers with a role to play in the infant's care during hospitalization are particularly likely to be appreciated by mothers.
Collapse
|
36
|
Firoozi M, Besharat MA, Rahimian Boogar E. Emotional regulation and adjustment to childhood cancer: role of the biological, psychological and social regulators on pediatric oncology adjustment. IRANIAN JOURNAL OF CANCER PREVENTION 2013; 6:65-72. [PMID: 25250113 PMCID: PMC4142920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 01/15/2013] [Indexed: 12/03/2022]
Abstract
BACKGROUND Children with cancer should deal with difficult situations such asundergoing multimodal treatment. Emotion Regulation Mechanisms (ERM) could be more effective for childhood cancer adaptation. The main purpose of this study was examination a number of the biological, psychological and social emotion regulators on adjustment to pediatric oncology. METHOD In this study, 98 children (39 girls and 59 boys) have participated that diagnosed as Acute Lymphoblastic Leukemia (ALL) cases along with their mothers. The participants were between 8 to 12 years old. Salivary cortisol, cognitive emotion regulation, children's level of inhibition, maternal positivity and Beck Depression Inventory have been applied for evaluation of Emotion Regulation (ER) while Cancer-Specific Stress and Coping, Connor-Davidson Resilience Scale, anxiety-depression scales and vitality test have all used for assessing the Emotional Adjustment (EA). RESULTS Using the canonical correlation has been showing significant relation between predictors of ER and EA. Cortisol level and mother's depression have played the most important role in above correlation. CONCLUSION Variation of cortisol level has identified by its various effects on the mother's behavioral system depression, cognitive strategies and emotional inhibition; would determine the rate of coping with cancer, resiliency and vitality.
Collapse
Affiliation(s)
- Manijeh Firoozi
- Cancer Research Center,Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dept. of Psychology, University of Tehran, Tehran, Iran
| | | | | |
Collapse
|
37
|
Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012; 5:CD003519. [PMID: 22592691 PMCID: PMC3979156 DOI: 10.1002/14651858.cd003519.pub3] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, head covered with a dry cap and a warm blanket across the back, prone on the mother's bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically 'sensitive period' for programming future physiology and behavior. OBJECTIVES To assess the effects of early SSC on breastfeeding, physiological adaptation, and behavior in healthy mother-newborn dyads. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2011), made personal contact with trialists, and consulted the bibliography on kangaroo mother care (KMC) maintained by Dr. Susan Ludington. SELECTION CRITERIA Randomized controlled trials comparing early SSC with usual hospital care. DATA COLLECTION AND ANALYSIS We independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS Thirty-four randomized controlled trials were included involving 2177 participants (mother-infant dyads). Data from more than two trials were available for only eight outcome measures. For primary outcomes, we found a statistically significant positive effect of early SSC on breastfeeding at one to four months postbirth (13 trials; 702 participants) (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.06 to 1.53, and SSC increased breastfeeding duration (seven trials; 324 participants) (mean difference (MD) 42.55 days, 95% CI -1.69 to 86.79) but the results did not quite reach statistical significance (P = 0.06). Late preterm infants had better cardio-respiratory stability with early SSC (one trial; 31 participants) (MD 2.88, 95% CI 0.53 to 5.23). Blood glucose 75 to 90 minutes following the birth was significantly higher in SSC infants (two trials, 94 infants) (MD 10.56 mg/dL, 95% CI 8.40 to 12.72).The overall methodological quality of trials was mixed, and there was high heterogeneity for some outcomes. AUTHORS' CONCLUSIONS Limitations included methodological quality, variations in intervention implementation, and outcomes. The intervention appears to benefit breastfeeding outcomes, and cardio-respiratory stability and decrease infant crying, and has no apparent short- or long-term negative effects. Further investigation is recommended. To facilitate meta-analysis, future research should be done using outcome measures consistent with those in the studies included here. Published reports should clearly indicate if the intervention was SSC with time of initiation and duration and include means, standard deviations and exact probability values.
Collapse
|
38
|
Gürol A, Polat S. The Effects of Baby Massage on Attachment between Mother and their Infants. Asian Nurs Res (Korean Soc Nurs Sci) 2012; 6:35-41. [PMID: 25030689 DOI: 10.1016/j.anr.2012.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 02/22/2012] [Accepted: 02/22/2012] [Indexed: 10/28/2022] Open
Abstract
PURPOSE This study was conducted to examine the effect of baby massage on attachment between mothers and their newborns. METHODS This study was carried out from June 2008 to February 2010 in a quasi-experimental design (57 in the experimental group, 60 in the control group). Between the dates of the study, all healthy primipara mothers and their healthy babies were included. Data were collected regarding their demographic characteristics and by using the Maternal Attachment Inventory (MAI). All mothers were assessed on the first and the last days of the 38-day study period. In the experimental group, the babies received a 15-minute massage therapy session everyday during the 38 days. RESULTS There was no significant difference found in the pretest mean value baseline of the MAI score in both groups. The posttest mean values of the MAI of the experimental group mothers (90.87 ± 10.76) were significantly higher than those of control group (85.10 ± 15.50). There was a significant difference between groups (p < .05). CONCLUSION The results of the study have shown that baby massage is effective in increasing the mother-infant attachment.
Collapse
Affiliation(s)
- Ayşe Gürol
- Assistant Professor, Atatürk University, Health Services Vocational School, Erzurum, Turkey
| | - Sevinç Polat
- Associate Professor, Bozok University, School of Health, Department of Pediatric Nursing, Yozgat, Turkey
| |
Collapse
|
39
|
Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Cochrane Review: Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. ACTA ACUST UNITED AC 2012. [DOI: 10.1002/ebch.1837] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
40
|
Lee J, Bang KS. The Effects of Kangaroo Care on Maternal Self-esteem and Premature Infants' Physiological Stability. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2011; 17:454-462. [PMID: 37697531 DOI: 10.4069/kjwhn.2011.17.5.454] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023] Open
Abstract
PURPOSE This paper identified the effects of kangaroo care (KC) on maternal self-esteem and the growth and physiological stability of premature infants hospitalized in the neonatal intensive care unit. METHODS The experiment was conducted with an experimental group of 17 infants, and a control group of 17 infants selected by convenience sampling. KC was given to the infants one time a day for 30 minutes after feeding for two weeks. Their weight was measured every morning, and their physiological stability was measured in terms of their body temperature, respiratory rate, heart rate, oxygen saturation, and stability of the cardio-respiratory system in premature infants (SCRIP) score, as physiological responses at every 10 minutes during the intervention. Maternal self-esteem was assessed by a maternal self-report inventory. RESULTS The experimental group showed significant increase in the self-esteem of mothers. Also, KC was effective on physiological stabilization of preterm infants. CONCLUSION This study suggests that KC can be provided in clinical settings more widely in Korea as one of the nursing interventions aimed at promoting maternal self-esteem as well as infants' physiological stabilization.
Collapse
Affiliation(s)
- Jihye Lee
- College of Nursing, Seoul National University, Korea
| | | |
Collapse
|
41
|
Nagai S, Yonemoto N, Rabesandratana N, Andrianarimanana D, Nakayama T, Mori R. Long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for low-birth-weight (LBW) infants in Madagascar. Acta Paediatr 2011; 100:e241-7. [PMID: 21635363 DOI: 10.1111/j.1651-2227.2011.02372.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIM To examine the long-term effects of earlier initiated continuous Kangaroo Mother Care (KMC) for relatively stable low-birth-weight (LBW) infants in a resource-limited country. METHODS A randomized controlled trial with long-term follow-up was performed in LBW infants in Madagascar. Earlier continuous KMC (intervention group) was initiated as soon as possible within 24 h postbirth, and later continuous KMC (control group: conventional care) was initiated after complete stabilization. Outcome measures were mortality or readmission, nutritional indicators at 6-12 months postbirth and feeding condition at 6 months postbirth (ClinicalTrials.gov, NCT00531492). RESULTS A total of 72 infants were followed for mortality or readmission at 6-12 months postbirth. There was no difference between the two groups (7/36 vs. 7/36, Risk ratio (RR), 1.00; 95% CIs, 0.39-2.56; p = 1.00). The proportion of exclusive breast feeding (EBF) at 6 months postbirth was significantly higher with earlier KMC than later KMC (12/29 vs. 4/26; RR 2.69; 95% CIs, 1.00-7.31; p = 0.04). There were no differences in nutritional indicators between the two groups at 6-12 months postbirth. CONCLUSION Earlier initiated continuous KMC results in a significantly higher proportion of EBF at 6 months postbirth. Further larger-scale long-term evaluations of earlier initiated continuous KMC for LBW infants are needed.
Collapse
Affiliation(s)
- Shuko Nagai
- Department of Health Informatics, Kyoto University, School of Public Health, Kyoto, Japan
| | | | | | | | | | | |
Collapse
|
42
|
Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev 2011:CD002771. [PMID: 21412879 DOI: 10.1002/14651858.cd002771.pub2] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Kangaroo mother care (KMC), originally defined as skin-to-skin contact between a mother and her newborn, frequent and exclusive or nearly exclusive breastfeeding, and early discharge from hospital, has been proposed as an alternative to conventional neonatal care for low birthweight (LBW) infants. OBJECTIVES To determine whether there is evidence to support the use of KMC in LBW infants as an alternative to conventional neonatal care. SEARCH STRATEGY The standard search strategy of the Cochrane Neonatal Group was used. This included searches of MEDLINE, EMBASE, LILACS, POPLINE, CINAHL databases (from inception to January 31, 2011), and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2011). In addition, we searched the web page of the Kangaroo Foundation, conference and symposia proceedings on KMC, and Google scholar. SELECTION CRITERIA Randomized controlled trials comparing KMC versus conventional neonatal care, or early onset KMC (starting within 24 hours after birth) versus late onset KMC (starting after 24 hours after birth) in LBW infants. DATA COLLECTION AND ANALYSIS Data collection and analysis were performed according to the methods of the Cochrane Neonatal Review Group. MAIN RESULTS Sixteen studies, including 2518 infants, fulfilled inclusion criteria. Fourteen studies evaluated KMC in LBW infants after stabilization, one evaluated KMC in LBW infants before stabilization, and one compared early onset KMC with late onset KMC in relatively stable LBW infants. Eleven studies evaluated intermittent KMC and five evaluated continuous KMC. At discharge or 40 - 41 weeks' postmenstrual age, KMC was associated with a reduction in the risk of mortality (typical risk ratio (RR) 0.60, 95% confidence interval (CI) 0.39 to 0.93; seven trials, 1614 infants), nosocomial infection/sepsis (typical RR 0.42, 95% CI 0.24 to 0.73), hypothermia (typical RR 0.23, 95% CI 0.10 to 0.55), and length of hospital stay (typical mean difference 2.4 days, 95% CI 0.7 to 4.1). At latest follow up, KMC was associated with a decreased risk of mortality (typical RR 0.68, 95% CI 0.48 to 0.96; nine trials, 1952 infants) and severe infection/sepsis (typical RR 0.57, 95% CI 0.40 to 0.80). Moreover, KMC was found to increase some measures of infant growth, breastfeeding, and mother-infant attachment. AUTHORS' CONCLUSIONS The evidence from this updated review supports the use of KMC in LBW infants as an alternative to conventional neonatal care mainly in resource-limited settings. Further information is required concerning effectiveness and safety of early onset continuous KMC in unstabilized LBW infants, long term neurodevelopmental outcomes, and costs of care.
Collapse
Affiliation(s)
- Agustin Conde-Agudelo
- Perinatology Research Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health/Department of Health and Human Services, Detroit, Michigan, USA
| | | | | |
Collapse
|
43
|
Neu M, Robinson J. Maternal holding of preterm infants during the early weeks after birth and dyad interaction at six months. J Obstet Gynecol Neonatal Nurs 2010; 39:401-14. [PMID: 20629927 PMCID: PMC2935695 DOI: 10.1111/j.1552-6909.2010.01152.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine whether a supportive nursing intervention that promoted kangaroo holding of healthy preterm infants by their mothers during the early weeks of the infant's life facilitated coregulation between mother and infant at 6 months of age. DESIGN Randomized controlled trial. PARTICIPANTS Sixty-five mother/infant dyads with mean gestational age at birth of 33 weeks. Fifty percent of infants were male, and 50% were non-White. INTERVENTIONS An 8-week home intervention encouraged daily 1-hour, uninterrupted holding with either blanket (baby wrapped in blanket and held in mother's arms) or the kangaroo (baby in skin-to-skin contact on mother's chest) method. In both conditions, weekly home visits by an experienced RN included encouragement to hold the infant, emotional support, and information about infant behavior and development. A control group received brief social visits, had no holding constraints, and participated in all assessments. MAIN OUTCOME MEASURES When infants were 6 months of age, the Still-Face Paradigm was used to assess mother/infant interaction. Outcome measures were coregulation of the dyad's responses during the play episodes of the Still-Face Paradigm and vitality in infant efforts to reengage the mother during the neutral face portion of the Still-Face Procedure. RESULTS Significant differences among groups were found in mother/infant coregulation. Post hoc analysis showed that dyads who were supported in kangaroo holding displayed more coregulation behavior during play than dyads in the blanket-holding group. No differences were found between groups in infant vitality during the neutral face portion of the Still-Face Procedure. CONCLUSION Dyads supported in practicing kangaroo holding in the early weeks of life may develop more coregulated interactional strategies than other dyads.
Collapse
Affiliation(s)
- Madalynn Neu
- College of Nursing, University of Colorado-Denver, Denver, CO, USA.
| | | |
Collapse
|