Cardiac responding to auditory stimuli in newborn infants: Why pacifiers should not be used when heart rate is the major dependent variable

Depressed mothers' newborns show less discrimination of other newborns' cry sounds

Newborns' crying in response to the cry of another newborn has been called an empathetic response. The purpose of this study was to determine whether newborns of depressed mothers showed the same response. Newborns of depressed and non-depressed mothers were presented with cry sounds of themselves or other infants, and their sucking and heart rate were recorded. The newborns of non-depressed mothers responded to the cry sounds of other infants with reduced sucking and decreased heart rate. In contrast, the newborns of depressed mothers did not show a change in their sucking or heart rate to the cry sounds of other infants. This lesser attentiveness/responsiveness to other infants' cry sounds may predict their later lack of empathy.

Developmental patterns of physiological response to a multisensory intervention in extremely premature and high-risk infants

OBJECTIVE

To compare the developmental patterns of heart rate (HR), respiratory rate (RR), and hemoglobin oxygen saturation (SaO2) of premature infants with and without central nervous system (CNS) injury, and evaluate whether a multisensory intervention altered this development.

SAMPLE

Thirty-seven premature infants born at 23-26 weeks with normal head ultrasounds or at 24-32 weeks and diagnosed with periventricular leukomalacia (PVL) and/or intraventricular hemorrhage (IVH) were studied at 33-35 weeks postconceptional age.

DESIGN

Infants were randomly assigned to control and experimental groups. The experimental group infants received auditory, tactile, visual, and vestibular (ATVV) multisensory intervention twice daily from 33 weeks postconceptional age (PCA) until hospital discharge.

MAIN OUTCOME MEASURES

HR, RR, and SaO2 were continuously monitored during baseline, intervention, and the 30-minute postintervention period.

RESULTS

Between 33 and 35 weeks PCA, control group infants with and without CNS injury and experimental group infants without CNS injury had a significant decrease in resting mean HR, whereas RR and SaO2 remained stable. The infants with PVL who received the intervention showed increases in HR even at rest.

CONCLUSIONS

The absence of a weekly decline in HR for experimental group infants with PVL suggests that PVL may affect maturation of the autonomic nervous system and increase risk of decelerative HR changes and associated clinical compromise. Infants diagnosed with PVL should be closely monitored during procedures or interventions that may be stressful or involve handling. Further research is needed to tailor multisensory interventions for infants with PVL.

Infant stimulation: modification of an intervention based on physiologic and behavioral cues

Research involving developmental intervention with premature infants in the hospital has traditionally taken two paths: application of a sensory stimulation protocol and individualized assessment and treatment. This article describes a new method that combines some of the philosophical strengths of these two approaches. A decision tree is presented to standardize the modifications of a developmental intervention based on physiologic and behavioral cues.

Effects of sound frequency on behavioral and cardiac orienting in newborn and five-month-old infants

Alert newborn and 5-month-old infants' responsivity to variations in spectral composition of a rattle sound was examined. Each child received four stimulus conditions: low-, mid-, and high-frequency bandpass-filtered rattles and an unfiltered broadband rattle. Stimuli were played through a single loudspeaker laterally positioned, and head orientation and cardiac responses to sound were recorded. Compared to other stimuli, the low-frequency sound elicited less head turning in both age groups, with this effect exaggerated in younger infants. Head orientation toward the mid-frequency, high-frequency, and broadband stimuli did not differ with age. For all conditions, latency and duration of newborns' head turning was longer than that of 5-month-olds. Newborns responded with cardiac deceleration only on trials when they failed to turn. When head turns occurred, an acceleratory cardiac response was obtained. Five-month-olds responded with reliable cardiac deceleration irrespective of head turning toward the sound. Heart rate change did not vary as a function of frequency at either age, suggesting that all stimuli were equally effective in eliciting the infant's attention.