Sudden infant death syndrome (SIDS): Microgravity and inadequate sensory stimulation

Appropriate Vestibular Stimulation in Children and Adolescents-A Prerequisite for Normal Cognitive, Motor Development and Bodily Homeostasis-A Review

The structural development of the vestibular part of the inner ear is completed by birth but its central connections continue to develop until adolescence. Their development is dependent on vestibular stimulation-vestibular experience. Studies have shown that vestibular function, modulated by experience and epigenetic factors, is not solely an instrument for body position regulation, navigation, and stabilization of the head and images but also influences cognition, emotion, the autonomous nervous system and hormones. To emphasize the importance of appropriate vestibular stimulation, we present a literature review of its effect on bodily homeostasis, cognition and emotion.

Vibration-induced motor responses of infants with and without myelomeningocele

BACKGROUND

The severity of myelomeningocele (MMC) stems both from a loss of neurons due to neural tube defect and a loss of function in viable neurons due to reduced movement experience during the first year after birth. In young infants with MMC, the challenge is to reinforce excitability and voluntary control of all available neurons. Muscle vibration paired with voluntary movement may increase motoneuron excitability and contribute to improvements in neural organization, responsiveness, and control.

OBJECTIVES

This study examined whether infants with or without MMC respond to vibration by altering their step or stance behavior when supported upright on a treadmill.

DESIGN

This was a cross-sectional study.

METHODS

Twenty-four 2- to 10-month-old infants, 12 with typical development (TD) and 12 with MMC (lumbar and sacral lesions), were tested. Infants were supported upright with their feet in contact with a stationary or moving treadmill during 30-second trials. Rhythmic alternating vibrations were applied to the right and left rectus femoris muscles, the lateral gastrocnemius muscle, or the sole of the foot. Two cameras and behavior coding were used to determine step count, step type, and motor response to vibration onset.

RESULTS

Step count decreased and swing duration increased in infants with TD during vibration of the sole of the foot on a moving treadmill (FT-M trials). Across all groups the percentage of single steps increased during vibration of the lateral gastrocnemius muscle on a moving treadmill. Infants with MMC and younger infants with TD responded to onset of vibration with leg straightening during rectus femoris muscle stimulation and by stepping during FT-M trials more often than older infants with TD.

CONCLUSIONS

Vibration seems a viable option for increasing motor responsiveness in infants with MMC. Follow-up studies are needed to identify optimal methods of administering vibration to maximize step and stance behavior in infants.

Management of isolated and associated colonic atresia

PURPOSE

Colonic atresia is a rare cause of congenital intestinal obstruction in the neonate. A review of the management and outcome of children with colonic atresia was performed.

METHODS

A retrospective analysis of the complete records of children treated for colonic atresia during the 30-year period.

RESULTS

A total of 14 newborns were treated. Seven infants suffered from an isolated colonic atresia (group 1). In the other seven infants (group 2), colonic atresia was either associated with additional intestinal atresias (n = 2), or gastroschisis (n = 5). Gestational age and birth weight were significantly lower in infants from group 2 compared to group 1 (40 ± 0.5 vs. 37 ± 1 weeks (P < 0.05); and 3,478 ± 208 vs. 2,626 ± 242 g (P < 0.01), respectively). The first surgical procedure was performed in all newborns within 24 h after birth. All but one infant from group 1 received primary colostomies at the level of colonic atresia, followed by end-to-side anastomoses. All but one infant from group 2 needed ileocoecal resection due to bowel necrosis. No child died in group 1, whereas three children died in group 2.

CONCLUSIONS

Isolated colonic atresia is amenable with a short hospital stay and an excellent outcome. In contrast, infants with colonic atresia associated with gastroschisis present a serious clinical challenge.

Exploring the Role of Touch in the First Year of Life: Mothers' Perspectives of Tactile Interactions with Their Infants

Introduction:

Touch is a basic instinctual interaction between a parent and his or her infant and has a vital role in the infant's early development. Parents provide a variety of tactile stimulation while addressing their infant's daily care routines. This paper reports on research findings, exploring the nature of this tactile interaction and how it is influenced by personal and contextual factors.

Method:

A qualitative study, employing a phenomenological approach, was conducted to explore the experiential nature of tactile interaction. Data were collected from six mothers of typically developing infants through single semi-structured interviews, and analysed thematically. Credibility and trustworthiness were addressed throughout the research process through peer checking, an audit trail and the completion of a reflexive diary.

Findings:

The mothers described the importance of tactile interaction as a medium through which to bond with their infant and also discussed the influence that the infant's development has on this dyadic relationship. Personal and contextual factors were identified as affecting engagement in tactile interaction.

Conclusion:

Based on these findings, recommendations are made for occupational therapists who work with infants. The consideration of personal and contextual factors that influence mother-infant tactile interaction will contribute to a family-centred approach to therapy and support the achievement of best practice in this area.

Impact of enhanced sensory input on treadmill step frequency: infants born with myelomeningocele

PURPOSE

To determine the effect of enhanced sensory input on the step frequency of infants with myelomeningocele (MMC) when supported on a motorized treadmill.

METHODS

Twenty-seven infants aged 2 to 10 months with MMC lesions at, or caudal to, L1 participated. We supported infants upright on the treadmill for 2 sets of 6 trials, each 30 seconds long. Enhanced sensory inputs within each set were presented in random order and included baseline, visual flow, unloading, weights, Velcro, and friction.

RESULTS

Overall friction and visual flow significantly increased step rate, particularly for the older subjects. Friction and Velcro increased stance-phase duration. Enhanced sensory input had minimal effect on leg activity when infants were not stepping.

CONCLUSIONS

: Increased friction via Dycem and enhancing visual flow via a checkerboard pattern on the treadmill belt appear to be more effective than the traditional smooth black belt surface for eliciting stepping patterns in infants with MMC.

[Physical aspects of morphogenesis]

During human morphogenesis, intrauterine liquid movements, whose amniotic fluid is at the first place, play an essential part with some unexpected consequences on the vestibular apparatus development and function. Underlying the ubiquitous container-content relation, they give a new and effective approach of the morphogenetic process.

Postnatal hypokinesia and the delayed time frame of sudden infant death syndrome

The sudden infant death syndrome peaks in the second and third month of life. This is the period of the "two-month transformation of the central nervous system" in the human infant. Studies of 120 days of imposed hypokinesia in man demonstrated that the maximum period of autonomic dysfunction was delayed until the beginning of the second month through to the fourth month of the experiment. Hypokinesia also impaired sleep mechanisms and induced polymorphic changes in almost all systems of the human body. These studies suggest that prolonged postnatal hypokinesia in infants may induce autonomic dysfunction in the CNS, especially during the "two-month transformation period" of major postnatal neural development.