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Lisanti AJ, Vittner DJ, Peterson J, Van Bergen AH, Miller TA, Gordon EE, Negrin KA, Desai H, Willette S, Jones MB, Caprarola SD, Jones AJ, Helman SM, Smith J, Anton CM, Bear LM, Malik L, Russell SK, Mieczkowski DJ, Hamilton BO, McCoy M, Feldman Y, Steltzer M, Savoca ML, Spatz DL, Butler SC. Developmental care pathway for hospitalised infants with CHD: on behalf of the Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative. Cardiol Young 2023; 33:2521-2538. [PMID: 36994672 PMCID: PMC10544686 DOI: 10.1017/s1047951123000525] [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] [Indexed: 03/31/2023]
Abstract
Infants and children born with CHD are at significant risk for neurodevelopmental delays and abnormalities. Individualised developmental care is widely recognised as best practice to support early neurodevelopment for medically fragile infants born premature or requiring surgical intervention after birth. However, wide variability in clinical practice is consistently demonstrated in units caring for infants with CHD. The Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative, formed a working group of experts to create an evidence-based developmental care pathway to guide clinical practice in hospital settings caring for infants with CHD. The clinical pathway, "Developmental Care Pathway for Hospitalized Infants with Congenital Heart Disease," includes recommendations for standardised developmental assessment, parent mental health screening, and the implementation of a daily developmental care bundle, which incorporates individualised assessments and interventions tailored to meet the needs of this unique infant population and their families. Hospitals caring for infants with CHD are encouraged to adopt this developmental care pathway and track metrics and outcomes using a quality improvement framework.
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Affiliation(s)
- Amy J. Lisanti
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA, Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Dorothy J. Vittner
- Egan School of Nursing and Health Studies, Fairfield University Fairfield, CT, USA, Connecticut Children’s, Hartford, CT, USA
| | | | - Andrew H. Van Bergen
- Advocate Children’s Heart Institute, Advocate Children’s Hospital, Oak Lawn, IL, USA
| | - Thomas A. Miller
- Department of Pediatrics, Maine Medical Center, Portland, ME, USA
| | - Erin E. Gordon
- DO, Inpatient Cardiac Neurodevelopment Program, Division of Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Karli A Negrin
- Department of Therapeutic and Rehabilitative Services, Nemours Children Hospital, Wilmington, Delaware, USA
| | - Hema Desai
- Rehabilitation Services, CHOC Children’s Hospital, Orange, CA, USA
| | - Suzie Willette
- Department of Speech-Language Pathology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA
| | - Melissa B Jones
- Cardiac Critical Care, Children’s National Hospital, Washington DC USA
| | - Sherrill D. Caprarola
- Heart Institute, Children’s Hospital Colorado, University of Colorado, Aurora, CO, USA
| | - Anna J. Jones
- Office of Advanced Practice Providers, UT Southwestern Medical Center, Dallas, TX, USA, Heart Center, Children’s Health, Dallas, TX, USA
| | - Stephanie M. Helman
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA
| | - Jodi Smith
- Parent Representative, The Mended Hearts, Inc., Program Director, Richmond, VA, USA
| | - Corinne M. Anton
- Department of Psychology and Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA, Department of Cardiology, Children’s Health, Dallas, Texas, USA
| | - Laurel M. Bear
- Department of Pediatrics, Medical College of Wisconsin, Children’s Wisconsin, Milwaukee, WI, USA
| | - Lauren Malik
- Department of Acute Care Therapy Services, Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Sarah K. Russell
- Department of Therapeutic and Rehabilitative Services, Nemours Children Hospital, Wilmington, DE, USA
| | - Dana J. Mieczkowski
- Department of Therapeutic and Rehabilitative Services, Nemours Children Hospital, Wilmington, DE, USA
| | - Bridy O. Hamilton
- Department of Therapeutic and Rehabilitative Services, Nemours Children Hospital, Wilmington, Delaware, USA
| | - Meghan McCoy
- Pediatric and Congenital Heart Center, Duke University Hospital, Durham, NC, USA
| | - Yvette Feldman
- Nursing & Patient Care Center of Excellence, St. Luke’s Health System, Boise, ID, USA
| | - Michelle Steltzer
- Single Ventricle Center of Excellence, Ann & Robert H. Lurie Children’s Hospital, Chicago, IL, USA
| | - Melanie L Savoca
- Department of Clinical Nutrition, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Diane L. Spatz
- Department of Family & Community Health, University of Pennsylvania School of Nursing, The Center for Pediatric Nursing Research and Evidence Based Practice, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Samantha C. Butler
- Department of Psychiatry (Psychology), Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
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Gupta P, Nagesh K, Garg P, Thomas J, Suryawanshi P, Sethuraman G, Hazarika RD, Verma RJ, Kumar CS, Kumari S, Taneja S, Chavhan V, Thakor P, Pandita A. Evidence-Based Consensus Recommendations for Skin Care in Healthy, Full-Term Neonates in India. Pediatric Health Med Ther 2023; 14:249-265. [PMID: 37654800 PMCID: PMC10465361 DOI: 10.2147/phmt.s414091] [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: 04/26/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023] Open
Abstract
Purpose Neonatal skin care practices guided by personal experience and preferences might be substantially different across different hospital settings. The aim of this consensus recommendation is to provide clinical practice guidance to healthcare practitioners on evidence-based neonatal skin care practices from delivery-to-discharge, in hospital settings. Patients and Methods A Scientific Advisory Board meeting on "Evidence-based Neonatal Skin Care Practices and Protocols" was held in December 2020 with an expert panel comprising neonatologists, pediatricians, obstetricians and gynecologists and pediatric dermatologist. Comprehensive literature search was performed up to 23 March 2021 using PubMed and Google Scholar to retrieve relevant evidence. Results Recommendations were developed on critical aspects of skin care in healthy full-term neonates including cleansing at birth, skin-to-skin care, cord care, diaper area care, initial and routine bathing, cleansers and emollients use, and criteria to choose appropriate skin care products. Recommendations include inclusion of skin assessment in routine neonatal care, first bath timing after cardio-respiratory and thermal stabilization, 6-24 hours after birth; bathing with water alone or adding a mild liquid cleanser could be considered appropriate as it does not impact the developing skin barrier; use of emollients is recommended for neonates with higher risk of development of eczema to maintain and enhance skin barrier function and integrity; and inclusion of skin care advice in neonatal discharge checklist. Importance of rigorous quality control, high-quality clinical trials for assessment of baby products, usage of products that are formulated appropriately for newborns, and full label transparency for baby products were highlighted. The panel identified gaps in literature and discussed the scope for future research. Conclusion These recommendations may help to standardize evidence-based skin care for healthy full-term neonates in Indian hospital settings to improve the quality of care that neonates receive in hospital and facilitate improvement in overall neonatal health outcomes.
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Affiliation(s)
- Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, New Delhi, India
| | - Karthik Nagesh
- Department of Neonatology, Manipal Hospitals Group (MHEPL), Bangalore, Karnataka, India
| | - Pankaj Garg
- Department of Neonatology, Sir Ganga Ram Hospital, New Delhi, India
| | - Jayakar Thomas
- Department of Dermatology, The Tamil Nadu Dr. M.G.R. Medical University, Chennai, Tamil Nadu, India
| | | | - Giridhar Sethuraman
- Department of Neonatology, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
| | - Rashna Dass Hazarika
- Department of Pediatrics & Neonatology, Nemcare Superspecialty Hospital, Guwahati, Assam, India
| | - Rahul J Verma
- Department of Neonatology & General Pediatrics, Sir H.N Reliance Hospital, Mumbai, Maharashtra, India
| | - C Suresh Kumar
- Department of Pediatrics, Apollo Cradle, Jubilee Hills, Hyderabad, Telangana, India
| | - Shantha Kumari
- Department of Obstetrics and Gynecology, Yashoda Hospitals, Hyderabad, Telangana, India
| | - Sunil Taneja
- Sushrut Medical Centre Pvt Ltd, Kanpur, Uttar Pradesh, India
| | - Vaishali Chavhan
- Department of Obstetrics and Gynecology, Sahyadri Superspecialty Hospitals, Pune, Maharashtra, India
| | - Priti Thakor
- Department of Medical Affairs, JNTL Consumer Health (India) Pvt. Ltd., Mumbai, Maharashtra, India
| | - Ankita Pandita
- Department of Medical Affairs, JNTL Consumer Health (India) Pvt. Ltd., Mumbai, Maharashtra, India
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Arimitsu T, Fukutomi R, Kumagai M, Shibuma H, Yamanishi Y, Takahashi KI, Gima H, Seto Y, Adachi H, Arai H, Higuchi M, Ohgi S, Ohta H. Designing artificial circadian environments with multisensory cares for supporting preterm infants' growth in NICUs. Front Neurosci 2023; 17:1152959. [PMID: 37694118 PMCID: PMC10491019 DOI: 10.3389/fnins.2023.1152959] [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: 01/28/2023] [Accepted: 07/26/2023] [Indexed: 09/12/2023] Open
Abstract
Previous studies suggest the importance of stable circadian environments for fetuses to achieve sound physiology and intrauterine development. This idea is also supported by epidemiological and animal studies, in which pregnant females exposed to repeated shifting of light-dark cycles had increased rates of reproductive abnormalities and adverse pregnancy outcomes. In response to such findings, artificial circadian environments with light-dark (LD) cycles have been introduced to NICUs to promote better physical development of preterm infants. Such LD cycles, however, may not be fully effective for preterm infants who are less than 30 weeks gestational age (WGA) since they are too premature to be adequately responsive to light. Instead, circadian rhythmicity of incubated preterm infants less than 30 WGA may be able to be developed through stimulation of the non-visual senses such as touch and sound.
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Affiliation(s)
- Takeshi Arimitsu
- Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan
- The Japan Developmental Care Study Group, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
| | - Rika Fukutomi
- Section of Pediatric Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Mayuko Kumagai
- Department of Nursing, Akita University Graduate School of Medicine, Akita, Japan
| | - Hayato Shibuma
- Department of Rehabilitation, Yamagata Saisei Hospital, Yamagata, Japan
| | - Yoko Yamanishi
- Department of Occupational Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Kei-ichi Takahashi
- Department of Occupational Therapy, Akita University Graduate School of Medicine, Akita, Japan
| | - Hirotaka Gima
- The Japan Developmental Care Study Group, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Yoshitaka Seto
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Hiroyuki Adachi
- Department of Pediatrics, Akita University Graduate School of Medicine, Akita, Japan
| | - Hirokazu Arai
- Department of Neonatology, Akita Red Cross Hospital, Akita, Japan
| | - Masakatsu Higuchi
- The Japan Developmental Care Study Group, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
- Department of Occupational Therapy, Faculty of Health and Medical Science, Teikyo Heisei University, Tokyo, Japan
| | - Shohei Ohgi
- The Japan Developmental Care Study Group, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
| | - Hidenobu Ohta
- The Japan Developmental Care Study Group, School of Rehabilitation Sciences, Seirei Christopher University, Hamamatsu, Japan
- Department of Occupational Therapy, Akita University Graduate School of Medicine, Akita, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Asai Hospital, Chiba, Japan
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Lin L, Yu L, Zhang S, Liu J, Xiong Y. The positive effect of mother-performed infant massage on infantile eczema and maternal mental state: A randomized controlled trial. Front Public Health 2023; 10:1068043. [PMID: 36711419 PMCID: PMC9875301 DOI: 10.3389/fpubh.2022.1068043] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/01/2022] [Indexed: 01/12/2023] Open
Abstract
Objective To observe the influence of MPIM on infantile eczema, quality of life, growth and maternal mental state. Methods This trial was a randomized controlled study. Sixty-six full-term infants with eczema were randomly divided into eczema control group (EC group, n = 33) and eczema with MPIM group (EM group, n = 33), along with healthy full-term infants in the healthy control group (HC group, n = 31). The mothers in the EC group received the instruction of routine care, while the mothers in the EM group applied massage on the infants plus receiving the same instruction of the routine care. HC group received none of any specific intervention. Data were collected in the three groups at the baseline and at the end of 2- and 5-month intervention. Before and at the end of 2-month intervention, the following indexes were investigated in infants including the growth indexes, eczema area severity index (EASI), infantile dermatitis quality of life index (IDQOL). And the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were investigated in mothers at the same timepoints. At the end of 5-month intervention, the infants' growth and relapse condition of eczema were observed. Results Overall, 31 cases in HC group, 31 in EC group and 32 in EM group were included for data analysis. There were no significant differences in the indexes of infantile growth among the three groups (all P >0.05). The scores of EASI and IDQOL significantly lowered (both P < 0.001) in EC group following the instruction of routine care, along with reduced maternal scores of SAS and SDS (both P < 0.05). Compared with the EC group, the EM group showed significantly lower scores of EASI and IDQOL (both P < 0.001) and lower relapse rate (P < 0.01) in infants with eczema, along with significantly lower scores of SAS and SDS in mothers (both P < 0.01). Moreover, none of obvious adverse reaction was reported following MPIM, to which most of the mothers could adhere. Conclusion MPIM could effectively promote the remission of infantile eczema and reduce its relapse, along with relieving maternal anxiety and depression mood. Clinical trial registration Identifier: ChiCTR2200066246.
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Affiliation(s)
- Lin Lin
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Lin Yu
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Shuying Zhang
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jing Liu
- Pediatric Massage Department, Jiangsu Provincial Hospital of Chinese and Western Medicine, Nanjing, Jiangsu, China
| | - Ying Xiong
- Acupuncture and Massage College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China,*Correspondence: Ying Xiong ✉
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Priyadarshi M, Kumar V, Balachander B, Gupta S, Sankar MJ. Effect of whole-body massage on growth and neurodevelopment in term healthy newborns: A systematic review. J Glob Health 2022; 12:12005. [PMID: 36254378 PMCID: PMC9577283 DOI: 10.7189/jogh.12.12005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Infant massage is commonly practiced in many parts of the world. However, the effectiveness of this intervention has not been reviewed for term, healthy newborns. Methods This systematic review of randomized and quasi-randomized controlled trials assessed the effect of whole-body massage with or without oil, compared to no massage in term healthy newborns. Key outcomes were neonatal mortality, systemic infections, growth, behaviour (crying or fussing time, sleep duration), and neurodevelopment. We searched MEDLINE via PubMed, Cochrane CENTRAL, EMBASE, and CINAHL (updated till November 2021), and clinical trials databases and reference lists of retrieved articles. Two authors separately evaluated the risk of bias, extracted data, and synthesized effect estimates using mean difference (MD) and standardized mean difference (SMD). The GRADE approach was used to assess the certainty of evidence. Results We included 31 randomized and quasi-randomized trials involving 3860 participants. Infant massage was performed by different care providers starting in the neonatal period and continuing for 1-2 months in most studies. Thirteen studies reported the use of oil with body massage. No study reported neonatal mortality or systemic infections. Meta-analyses suggested that whole-body massage may increase infant length at the end of the intervention period (median assessment age 6 weeks; mean difference (MD) = 1.6 cm, 95% confidence interval (CI) = 1.4 to 1.7 cm; low certainty evidence), but the effect on weight (MD = 340 g, 95% CI = 240 to 441 g), head circumference (MD = 0.8 cm, 95% CI = 0.6 to 1.1 cm), sleep duration (MD = 0.62 hours/d, 95% CI = 0.12 to 1.12 hours/d) and bilirubin levels (MD = -31.8 mmol/L or -1.8 mg/dL, 95% CI = -23.5 to -40.0 mmol/L) was uncertain. The effect on crying/fussing time at median 3 months of age, sleep duration at 6 months of age, weight, length, and head circumference at 6-12 months follow-up, and neurodevelopment outcomes, both at the end of the intervention period and follow-up was uncertain. Conclusions Whole-body massage may improve the infant length at the end of the intervention period (median age 6 weeks, range 1-6 months) but the effect on other short- or long-term outcomes is uncertain. There is a need for further well-designed trials in future. Registration Priyadarshi M, Balachander B, Rao S, Gupta S, Sankar MJ. Effect of body massage on growth and neurodevelopment in term healthy newborns: a systematic review. PROSPERO 2020 CRD42020177442.
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Affiliation(s)
- Mayank Priyadarshi
- Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vivek Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Bharathi Balachander
- Department of Neonatology, St. Johns Medical College Hospital, Bangalore, Karnataka, India
| | | | - Mari Jeeva Sankar
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Using complexity science to understand the role of co-sleeping (bedsharing) in mother-infant co-regulatory processes. Infant Behav Dev 2022; 67:101723. [PMID: 35594598 DOI: 10.1016/j.infbeh.2022.101723] [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: 05/02/2021] [Revised: 04/27/2022] [Accepted: 05/04/2022] [Indexed: 11/22/2022]
Abstract
Human infants spend most of their time sleeping, but over the first few years of life their sleep becomes regulated to coincide more closely with adult sleep (Galland et al., 2012; Paavonen et al., 2020). Evidence shows that co-sleeping played a role in the evolution of infant sleep regulation, as it is part of an ancient behavioral complex representing the biopsychosocial microenvironment in which human infants co-evolved with their mothers through millions of years of human history (Ball, 2003; McKenna 1986, 1990). This paper is a conceptual, interdisciplinary, integration of the literature on mother-infant co-sleeping and other mother-infant co-regulatory processes from an evolutionary (biological) perspective, using complexity science. Viewing the mother-infant dyad as a "complex adaptive system" (CAS) shows how the CAS fits assumptions of regulatory processes and reveals the role of the CAS in the ontogeny of mother-infant co-regulation of physiological (thermoregulation, breathing, circadian rhythm coordination, nighttime synchrony, and heart rate variability) and socioemotional (attachment and cortisol activity) development.
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Multi-level hypothalamic neuromodulation of self-regulation and cognition in preterm infants: Towards a control systems model. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 9:100109. [PMID: 35755927 PMCID: PMC9216652 DOI: 10.1016/j.cpnec.2021.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/21/2022] Open
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Goldstein Ferber S, Weller A, Ben-Shachar M, Klinger G, Geva R. Development of the Ontogenetic Self-Regulation Clock. Int J Mol Sci 2022; 23:993. [PMID: 35055184 PMCID: PMC8778416 DOI: 10.3390/ijms23020993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/15/2022] [Indexed: 01/27/2023] Open
Abstract
To date, there is no overarching proposition for the ontogenetic-neurobiological basis of self-regulation. This paper suggests that the balanced self-regulatory reaction of the fetus, newborn and infant is based on a complex mechanism starting from early brainstem development and continuing to progressive control of the cortex over the brainstem. It is suggested that this balance occurs through the synchronous reactivity between the sympathetic and parasympathetic systems, both which originate from the brainstem. The paper presents an evidence-based approach in which molecular excitation-inhibition balance, interchanges between excitatory and inhibitory roles of neurotransmitters as well as cardiovascular and white matter development across gestational ages, are shown to create sympathetic-parasympathetic synchrony, including the postnatal development of electroencephalogram waves and vagal tone. These occur in developmental milestones detectable in the same time windows (sensitive periods of development) within a convergent systematic progress. This ontogenetic stepwise process is termed "the self-regulation clock" and suggest that this clock is located in the largest connection between the brainstem and the cortex, the corticospinal tract. This novel evidence-based new theory paves the way towards more accurate hypotheses and complex studies of self-regulation and its biological basis, as well as pointing to time windows for interventions in preterm infants. The paper also describes the developing indirect signaling between the suprachiasmatic nucleus and the corticospinal tract. Finally, the paper proposes novel hypotheses for molecular, structural and functional investigation of the "clock" circuitry, including its associations with other biological clocks. This complex circuitry is suggested to be responsible for the developing self-regulatory functions and their neurobehavioral correlates.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Aron Weller
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Michal Ben-Shachar
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
| | - Gil Klinger
- Department of Neonatology, Schneider Children’s Medical Center, Sackler Medical School, Tel Aviv University, Petach Tikvah 4920235, Israel;
| | - Ronny Geva
- Department of Psychology, Bar Ilan University, Ramat Gan 5290002, Israel; (A.W.); (R.G.)
- The Leslie and Susan Gonda (Goldschmied) Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan 5290002, Israel;
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Field T. Pediatric Massage Therapy Research: A Narrative Review. CHILDREN-BASEL 2019; 6:children6060078. [PMID: 31174382 PMCID: PMC6617372 DOI: 10.3390/children6060078] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/22/2019] [Accepted: 06/03/2019] [Indexed: 11/16/2022]
Abstract
This narrative review on pediatric massage literature from the last decade suggests that massage therapy has positive effects on several pediatric conditions. These include preterm infant growth, psychological problems including aggression, gastrointestinal problems including constipation and diarrhea, painful conditions including burns and sickle cell, muscle tone disorders including cerebral palsy and Down syndrome, and chronic illnesses including diabetes, asthma cancer, and HIV. Potential underlying mechanisms for the massage therapy effects include increased vagal activity and decreased stress hormones. Limitations of the literature include the need for more randomized controlled trials, longitudinal studies, and underlying mechanism studies.
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Affiliation(s)
- Tiffany Field
- University of Miami/Miller School of Medicine, Fielding Graduate University, 2889 McFarlane Rd, Miami, FL 33133, USA.
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Mindell JA, Williamson AA. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev 2018; 40:93-108. [PMID: 29195725 PMCID: PMC6587181 DOI: 10.1016/j.smrv.2017.10.007] [Citation(s) in RCA: 147] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 09/03/2017] [Accepted: 10/30/2017] [Indexed: 12/11/2022]
Abstract
This paper presents a conceptual model and reviews the empirical evidence to support a nightly bedtime routine as a key factor in the promotion of not only healthy sleep, but also of broad development and wellbeing in early childhood. A bedtime routine embodies the characteristics of nurturing care and early child stimulation, which are deemed to be essential for positive outcomes, especially for at-risk children. Furthermore, common, adaptive components of a bedtime routine can contribute to an array of positive developmental outcomes beyond improved sleep, inclusive of language development, literacy, child emotional and behavioral regulation, parent-child attachment, and family functioning, among other outcomes. These bedtime routine components include activities in the broad domains of nutrition (e.g., feeding, healthy snack), hygiene (e.g., bathing, oral care), communication (e.g., reading, singing/lullabies) and physical contact (e.g., massage, cuddling/rocking). A bedtime routine can provide multiple benefits to child and family functioning at a time of day that many parents are present with their children. Although additional research on hypothesized routine-related child outcomes and mechanisms of action are needed, promoting a bedtime routine may be a feasible and cost-effective method to promote positive early childhood development worldwide, particularly for socioeconomically disadvantaged and other at-risk young children.
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Affiliation(s)
- Jodi A Mindell
- Department of Psychology, Saint Joseph's University, Philadelphia, PA, USA; Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Ariel A Williamson
- Sleep Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Empirical research evaluating the effects of non-traditional approaches to enhancing sleep in typical and clinical children and young people. Sleep Med Rev 2018; 39:69-81. [DOI: 10.1016/j.smrv.2017.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 07/12/2017] [Accepted: 07/18/2017] [Indexed: 12/20/2022]
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Cleveland L, Hill CM, Pulse WS, DiCioccio HC, Field T, White-Traut R. Systematic Review of Skin-to-Skin Care for Full-Term, Healthy Newborns. J Obstet Gynecol Neonatal Nurs 2017; 46:857-869. [PMID: 28950108 DOI: 10.1016/j.jogn.2017.08.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To determine the effect of skin-to-skin mother-infant holding, touch, and/or massage on full-term, healthy newborns and their primary caregivers. DATA SOURCES A seven-member scientific advisory panel searched the databases PubMed, CINAHL, and Scopus using the search terms massage, skin-to-skin contact, kangaroo care, touch, therapeutic touch, and full-term newborns for research with human participants published in English with no date parameters. STUDY SELECTION The initial search yielded 416 articles. After reviewing titles and retaining only articles that met the review criteria, 280 articles remained. The panel co-chairs reviewed and discussed the abstracts of these articles and retained 90 for review. DATA EXTRACTION Each article was assigned to one panel member and one co-chair for review. Members of the panel met via teleconference to present articles and to determine whether they had scientific merit and addressed the research question. Articles that did not meet these standards were eliminated. Forty articles included relevant evidence: 33 articles on skin-to-skin holding and 7 on infant massage. DATA SYNTHESIS We created a table that included the purpose, design, and findings of each study. This information was synthesized into a feasibility report by the co-chairs. CONCLUSION Evidence supports recommendations for skin-to-skin care for all full-term, healthy newborns. Although there is inadequate evidence to recommend massage as standard care for all newborns, massage has been shown to help consolidate sleep patterns and reduce jaundice.
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Infant sleep problems and interventions: A review. Infant Behav Dev 2017; 47:40-53. [DOI: 10.1016/j.infbeh.2017.02.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/18/2017] [Accepted: 02/21/2017] [Indexed: 01/04/2023]
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Abstract
PURPOSE To review and analyze studies evaluating the effects of massage on term and preterm infants. DESIGN A systematic review of literature. RESULTS Benefits of massage for term infants are: improved weight gain, growth, and sleep and decreased hyperbilirubinemia. Benefits for preterm infants are: improved weight gain, decreased response to pain, and increased interactions with parents. However, the few studies use different interventions related to timing and number of massages, and the outcomes vary among studies. There is not enough evidence to support the use of massage for term and preterm infants, but massage may be considered on a case-by-case basis.
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Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5. Nurs Womens Health 2016; 20:614-616. [PMID: 27938802 DOI: 10.1016/s1751-4851(16)30331-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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16
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Immediate and Sustained Skin-to-Skin Contact for the Healthy Term Newborn After Birth: AWHONN Practice Brief Number 5. J Obstet Gynecol Neonatal Nurs 2016; 45:842-844. [DOI: 10.1016/j.jogn.2016.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Neu M, Schmiege SJ, Pan Z, Fehringer K, Workman R, Marcheggianni-Howard C, Furuta GT. Interactions during feeding with mothers and their infants with symptoms of gastroesophageal reflux. J Altern Complement Med 2014; 20:493-9. [PMID: 24742255 DOI: 10.1089/acm.2013.0223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine whether maternal-child interaction during feedings was suboptimal in dyads in which the infant had gastroesophageal reflux disease (GERD) and to compare massage therapy to a nonmassage therapy sham treatment in improving the mother-child interaction in these dyads. DESIGN In this randomized, controlled pilot study, infants received massage therapy (n=18) or a nonmassage touch/holding sham treatment (n=18). Mothers, data collectors, and the investigator who scored the feeding observations were blinded to group assignment. SETTINGS/LOCATION Dyads were recruited from pediatric care providers in the Denver metropolitan area and online advertisements at the University of Colorado. Treatments were given in the home of the dyad. PARTICIPANTS Healthy infants, born at 38-42 weeks gestational age, were 5-10 weeks of age at enrollment; had a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised; and were diagnosed with GERD by their pediatric provider. Mothers were English speaking and at least 18 years of age. INTERVENTIONS Treatments were given for 30 minutes twice weekly for 6 weeks. A certified infant massage therapist administered massage, and a registered nurse or physical therapist experienced with infants administered the control treatment. OUTCOME MEASURES Maternal and infant scores on the Nursing Child Assessment of Feeding Scale (NCAFS). RESULTS NCAFS scores were significantly lower than national norms. Small to moderately sized effects showing improvement in the massage group relative to the nonmassage group were seen for Sensitivity to Cues, Social-Emotional Growth Fostering, Cognitive Growth Fostering, and Clarity of Cues (Cohen d) and ranged from 0.24 to 0.56. CONCLUSIONS Mothers and infants with GERD experience significantly worse interactions than those without GERD. Massage given twice weekly by a professional trended toward improved interaction during feeding. Daily maternal administration of massage may have a positive effect on the relationship.
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Affiliation(s)
- Madalynn Neu
- 1 University of Colorado College of Nursing , Aurora, CO
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Neu M, Pan Z, Workman R, Marcheggiani-Howard C, Furuta G, Laudenslager ML. Benefits of massage therapy for infants with symptoms of gastroesophageal reflux disease. Biol Res Nurs 2013; 16:387-97. [PMID: 24379449 DOI: 10.1177/1099800413516187] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This randomized controlled pilot trial was conducted to evaluate the clinical efficacy of massage therapy (MT) for relief of symptoms of gastroesophageal reflux disease (GERD). The hypothesis was that, when compared to infants who received nonmassage therapy, infants who received MT would display fewer GERD symptoms, greater weight gain, greater amount of sleep, lower cortisol levels before and after treatment, and lower daily (area under the curve [AUC]) cortisol secretion. METHODS Participants were 36 infants born at term, 4-10 weeks of age at enrollment, healthy except for a diagnosis of GERD by their pediatrician, and with a score of at least 16 on the Infant Gastroesophageal Reflux Questionnaire-Revised (I-GERQ-R). Infants were randomized to receive either MT or a nonmassage sham treatment in their homes for 30 min twice a week for 6 weeks. Data collectors and parents were blind to study condition. RESULTS GERD symptoms decreased in both groups and weight increased. Pretreatment salivary cortisol levels decreased significantly over time in the massage group while increasing in the nonmassage group. Daily cortisol level also decreased in the massage group and increased in the nonmassage group, but the difference was not significant. CONCLUSIONS MT administered by a professional therapist did not affect symptoms of GERD differently than a sham treatment but did decrease infant stress as measured by cortisol. Research focusing on stress reduction in infants with GERD and multimodal treatments addressing GERD symptoms may yield the most effective treatment.
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Affiliation(s)
- Madalynn Neu
- University of Colorado Anschutz Medical Campus, College of Nursing, Denver, CO, USA
| | - Zhaoxing Pan
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA
| | | | | | - Glenn Furuta
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA Gastrointestinal Eosinophilic Diseases Program, Children's Hospital Colorado, Aurora Colorado
| | - Mark L Laudenslager
- Department of Pediatrics, University of Colorado, School of Medicine, Anschutz Medical Campus, Denver, CO, USA
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Silva L, Schalock M. Treatment of tactile impairment in young children with autism: results with qigong massage. Int J Ther Massage Bodywork 2013; 6:12-20. [PMID: 24298297 PMCID: PMC3838308 DOI: 10.3822/ijtmb.v6i4.227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Following the inclusion of sensory abnormalities in the diagnostic criteria for autism, evidence has emerged showing that tactile abnormalities in young children with autism are severe, universally present, and directly related to delay of early self-regulation milestones required for social development. Parent touch is the most effective means of stimulating early self-regulation, yet parents of children with autism avoid touch because their children respond abnormally to it. This suggests that tactile abnormalities pose a barrier to parent touch in autism, and that treatment of tactile abnormalities may improve developmental outcomes. We have developed a qigong massage treatment for tactile abnormalities in young children with autism. Here we evaluate whether tactile abnormalities decrease following treatment, and whether treatment results in improved self-regulatory outcomes. Methods We retrospectively analyzed our qigong massage database for treatment effect on tactile abnormalities, self-regulatory delay, and parenting stress. Five-month interval data were available for 129 children with autism aged 3–6 years. Of these 129, 97 received treatment and 32 were in the wait-list control condition. There were no differences between treatment and control groups by age, gender, or severity of tactile impairment. Results Treatment resulted in significant decreases of tactile impairment, self-regulatory delay, and parenting stress (p < .001 on all paired t-tests); mean decreases were 25.5%, 24.5%, and 35.8%, respectively. Results were significant compared to controls [F(3,122) = 11.27, p < .001]. In the pretreatment data, tactile impairment was directly related to self-regulatory delay; post-treatment, both variables decreased proportionally. Conclusion Results demonstrate that tactile impairment in young children with autism is treatable with a qigong massage protocol. The direct relationship between tactile impairment and self-regulatory delay pretreatment, and the proportional decrease of both following treatment, suggest that tactile impairment is a cause of self-regulatory delay, and that qigong massage is a promising avenue to improve developmental outcomes in autism.
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Affiliation(s)
- Louisa Silva
- Teaching Research Institute, Western Oregon University, Monmouth, OR, USA
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Underdown A, Norwood R, Barlow J. A REALIST EVALUATION OF THE PROCESSES AND OUTCOMES OF INFANT MASSAGE PROGRAMS. Infant Ment Health J 2013. [DOI: 10.1002/imhj.21408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Bennett C, Underdown A, Barlow J. Massage for promoting mental and physical health in typically developing infants under the age of six months. Cochrane Database Syst Rev 2013; 2013:CD005038. [PMID: 23633323 PMCID: PMC8078453 DOI: 10.1002/14651858.cd005038.pub3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Infant massage is increasingly being used in the community with babies and their primary caregivers. Anecdotal reports suggest benefits for sleep, respiration and elimination, the reduction of colic and wind, and improved growth. Infant massage is also thought to reduce infant stress and promote positive parent-infant interaction. OBJECTIVES The aim of this review was to assess whether infant massage is effective in promoting infant physical and mental health in low-risk, population samples. SEARCH METHODS Relevant studies were identified by searching the following electronic databases up to June 2011: CENTRAL; MEDLINE; EMBASE; CINAHL; PsycINFO; Maternity and Infant Care; LILACS; WorldCat (dissertations); ClinicalTrials.gov; China Masters' Theses; China Academic Journals; China Doctoral Dissertations; China Proceedings of Conference. We also searched the reference lists of relevant studies and reviews. SELECTION CRITERIA We included studies that randomised healthy parent-infant dyads (where the infant was under the age of six months) to an infant massage group or a 'no-treatment' control group. Studies had to have used a standardised outcome measure of infant mental or physical development. DATA COLLECTION AND ANALYSIS Mean differences (MD) and standardised mean differences (SMD) and 95% confidence intervals (CIs) are presented. Where appropriate, the results have been combined in a meta-analysis using a random-effects model. MAIN RESULTS We included 34 studies, which includes one that was a follow-up study and 20 that were rated as being at high risk of bias.We conducted 14 meta-analyses assessing physical outcomes post-intervention. Nine meta-analyses showed significant findings favouring the intervention group for weight (MD -965.25 g; 95% CI -1360.52 to -569.98), length (MD -1.30 cm; 95% CI -1.60 to -1.00), head circumference (MD -0.81 cm; 95% CI -1.18 to -0.45), arm circumference (MD -0.47 cm; 95% CI -0.80 to -0.13), leg circumference (MD -0.31 cm; 95% CI -0.49 to -0.13), 24-hour sleep duration (MD -0.91 hr; 95% CI -1.51 to -0.30), time spent crying/fussing (MD -0.36; 95% CI -0.52 to -0.19), deceased levels of blood bilirubin (MD -38.11 mmol/L; 95% CI -50.61 to -25.61), and there were fewer cases of diarrhoea, RR 0.39; 95% CI 0.20 to 0.76). Non-significant results were obtained for cortisol levels, mean increase in duration of night sleep, mean increase in 24-hour sleep and for number of cases of upper respiratory tract disease and anaemia.Sensitivity analyses were conducted for weight, length and head circumference, and only the finding for length remained significant following removal of studies judged to be at high risk of bias. These three outcomes were the only ones that could also be meta-analysed at follow-up; although both weight and head circumference continued to be significant at 6-month follow-up, these findings were obtained from studies conducted in Eastern countries only. No sensitivity analyses were possible.We conducted 18 meta-analyses measuring aspects of mental health and development. A significant effect favouring the intervention group was found for gross motor skills (SMD -0.44; 95% CI -0.70 to -0.18), fine motor skills (SMD -0.61; 95% CI -0.87 to -0.35), personal and social behaviour (SMD -0.90; 95% CI -1.61 to -0.18) and psychomotor development (SMD -0.35; 95% CI -0.54 to -0.15); although the first three findings were obtained from only two studies, one of which was rated as being at high risk of bias, and the finding for psychomotor development was not maintained following following removal of studies judged to be at high risk of bias in a sensitivity analysis. No significant differences were found for a range of aspects of infant temperament, parent-infant interaction and mental development. Only parent-infant interaction could be meta-analysed at follow-up, and the result was again not significant. AUTHORS' CONCLUSIONS These findings do not currently support the use of infant massage with low-risk groups of parents and infants. Available evidence is of poor quality, and many studies do not address the biological plausibility of the outcomes being measured, or the mechanisms by which change might be achieved. Future research should focus on the impact of infant massage in higher-risk groups (for example, demographically and socially deprived parent-infant dyads), where there may be more potential for change.
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Affiliation(s)
- Cathy Bennett
- Plymouth University Peninsula Schools of Medicine and DentistryThe John Bull Building, Tamar Science Park, Research WayPlymouthUKPL6 8BU
| | - Angela Underdown
- Warwick Medical SchoolDivision of Mental Health and WellbeingUniversity of WarwickGibbett Hill RoadCoventryUKCV4 7AL
| | - Jane Barlow
- Warwick Medical SchoolDivision of Mental Health and WellbeingUniversity of WarwickGibbett Hill RoadCoventryUKCV4 7AL
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Meltzer LJ, Montgomery-Downs HE, Insana SP, Walsh CM. Use of actigraphy for assessment in pediatric sleep research. Sleep Med Rev 2012; 16:463-75. [PMID: 22424706 PMCID: PMC3445439 DOI: 10.1016/j.smrv.2011.10.002] [Citation(s) in RCA: 424] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 10/03/2011] [Accepted: 10/14/2011] [Indexed: 02/02/2023]
Abstract
The use of actigraphs, or ambulatory devices that estimate sleep-wake patterns from activity levels, has become common in pediatric research. Actigraphy provides a more objective measure than parent-report, and has gained popularity due to its ability to measure sleep-wake patterns for extended periods of time in the child's natural environment. The purpose of this review is: 1) to provide comprehensive information on the historic and current uses of actigraphy in pediatric sleep research; 2) to review how actigraphy has been validated among pediatric populations; and 3) offer recommendations for methodological areas that should be included in all studies that utilize actigraphy, including the definition and scoring of variables commonly reported. The poor specificity to detect wake after sleep onset was consistently noted across devices and age groups, thus raising concerns about what is an "acceptable" level of specificity for actigraphy. Other notable findings from this review include the lack of standard scoring rules or variable definitions. Suggestions for the use and reporting of actigraphy in pediatric research are provided.
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Affiliation(s)
- Lisa J. Meltzer
- National Jewish Health, 1400 Jackson Street, G311, Denver, CO
80206, 303-398-1837 (P), 303-270-2141 (F)
| | | | - Salvatore P. Insana
- University of Pittsburgh Medical Center, 3811 O’Hara
Street, E-1107, Pittsburgh, PA 15213, 412-246-6943 (P)
| | - Colleen M. Walsh
- Drexel University, 3141 Chestnut Street, Philadelphia, PA 19104,
215-662-3189 (P)
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23
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Badr LK. Pain Interventions in Premature Infants: What Is Conclusive Evidence and What Is Not. ACTA ACUST UNITED AC 2012. [DOI: 10.1053/j.nainr.2012.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Góis-Eanes M, Gonçalves ÓF, Caldeira-da-Silva P, Sampaio A. Biological and physiological markers of tactile sensorial processing in healthy newborns. Infant Ment Health J 2012; 33:535-542. [DOI: 10.1002/imhj.21328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Ferber SG, Als H, McAnulty G, Peretz H, Zisapel N. Melatonin and mental capacities in newborn infants. J Pediatr 2011; 159:99-103.e1. [PMID: 21315375 DOI: 10.1016/j.jpeds.2010.12.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 11/15/2010] [Accepted: 12/22/2010] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To investigate the role of melatonin in the emergence of mental capacities in the newborn infant. STUDY DESIGN Assessment of Preterm Infant Behavior examination was performed at 2 weeks post-term age for 39 (21 preterm and 18 term) infants. 6-Suphatoxymelatonin from nocturnal urine samples was analyzed by enzyme-linked immunosorbent assays, and the Mental Developmental Index, assessed by Bayley scales, was correlated at 4, 6, and 9 months' corrected age. RESULTS Multivariate analysis of variance with repeated measures showed that improved autonomic function at 2 weeks of age was associated with higher Mental Developmental Index scores at 9 months when related to the amount of melatonin at 4, 6, and 9 months of age. CONCLUSIONS Early compromised autonomic system function in preterm infants is associated with lower mental capacities and is related to lower melatonin levels at later ages.
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Glickman G. Circadian rhythms and sleep in children with autism. Neurosci Biobehav Rev 2010; 34:755-68. [PMID: 19963005 DOI: 10.1016/j.neubiorev.2009.11.017] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2009] [Revised: 11/17/2009] [Accepted: 11/18/2009] [Indexed: 01/08/2023]
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Teaching Chilean mothers to massage their full-term infants: effects on maternal breast-feeding and infant weight gain at age 2 and 4 months. J Perinat Neonatal Nurs 2010; 24:172-81. [PMID: 20442614 DOI: 10.1097/jpn.0b013e3181db5377] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to evaluate the effects of massage on infant weight gain and exclusive maternal breast-feeding of an intervention that involved teaching mothers to massage their full-term infants. The sample included 100 healthy newborn infants who were receiving primary healthcare at 3 health centers in a low-income neighborhood of Santiago, Chile. The control group included 65 infants and the massage group included 35 infants. During their second well-child clinic visit, clinic nurses provided instruction to massage-group mothers about how to massage their infants, based on the methods of the Baby's First Massage program (http://www.babysfirstmassage.com/Scripts/default.asp). Mothers were encouraged to massage their infants for 10 to 15 minutes at least once a day, starting when their infants were 15 days old. There was no difference in the mean weights of the infants between the massage and control groups at baseline, but at age 2 months, massage group infants weighed significantly more than control-group infants. There were no weight differences between the 2 groups at age 4 months. There were no differences between the 2 groups on the incidence of exclusive maternal breast-feeding at age 2 or 4 months. The findings suggest that teaching mothers to massage their newborn infants may have a beneficial effect on the infant's early weight gain. There is a need for additional studies to evaluate the effect of maternal massage on other health and welfare outcomes for both mothers and infants.
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Underdown A, Barlow J, Stewart‐Brown S. Tactile stimulation in physically healthy infants: results of a systematic review. J Reprod Infant Psychol 2009. [DOI: 10.1080/02646830903247209] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Geva R, Feldman R. A neurobiological model for the effects of early brainstem functioning on the development of behavior and emotion regulation in infants: implications for prenatal and perinatal risk. J Child Psychol Psychiatry 2008; 49:1031-41. [PMID: 18771507 DOI: 10.1111/j.1469-7610.2008.01918.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neurobiological models propose an evolutionary, vertical-integrative perspective on emotion and behavior regulation, which postulates that regulatory functions are processed along three core brain systems: the brainstem, limbic, and cortical systems. To date, few developmental studies applied these models to research on prenatal and perinatal risk. We propose a conceptual model that incorporates three integrated levels of observations for the study of early risk: (a) brainstem-related physiological regulation of cyclic processes and sensory integration, e.g., vagal regulation, circadian rhythms; (b) emotion and attention regulation capacities that draw on the integration of brainstem and limbic systems; and (c) higher-level outcomes that draw on the intactness of brainstem and limbic networks, including socio-emotional self-regulation, inhibitory control, and cognitive processing. We discuss implications of the model for the development of regulatory capacities during the prenatal and early postnatal stages in infants born with specific perinatal risk. We underscore the importance of assessing sub-cortical and brainstem systems and the longitudinal effects of transitory brainstem dysfunction on physiological homeostasis, motivation, arousal-modulated attention, stress reactivity, and mother-infant co-regulation. The assessment of brainstem dysfunction can be conducted during hospitalization and may help detect infants at risk for the development of self-regulatory deficits at the first weeks of life.
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Affiliation(s)
- Ronny Geva
- The Gonda Goldschmied Brain Research Center, Bar Ilan University, Ramat Gan, Israel.
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Nakamura T, Sano Y. Two cases of infants who needed cardiopulmonary resuscitation during early skin-to-skin contact with mother. J Obstet Gynaecol Res 2008; 34:603-4. [DOI: 10.1111/j.1447-0756.2008.00892.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ferber SG, Makhoul IR. Neurobehavioural assessment of skin-to-skin effects on reaction to pain in preterm infants: a randomized, controlled within-subject trial. Acta Paediatr 2008; 97:171-6. [PMID: 18177441 DOI: 10.1111/j.1651-2227.2007.00607.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the immediate and sustained effects of Kangaroo Care on reaction to pain of premature infants. PATIENTS AND METHODS A controlled, within-subject randomized study, performed in a large neonatal intensive care unit. Thirty premature infants were observed with blood test stick (BT) or without the blood test stick (W) procedure, either during Kangaroo care (K) or during standard within-crib care (C). Each of the four conditions (BTK, WK, BTC, WC) was observed in four separate sessions: baseline session - 10 min; intervention (BT or W) - 2 min; posttest - 10 min and follow-up - 20 min, in crib (starting 1 h after treatment). For neurobehavioural assessment, the naturalistic observation method was adopted from the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). RESULTS During the BTK session (blood test stick with K-care), we observed a decrease in motor disorganization and extension movements and an increase in attention signs, both negative and positive. Significant neurobehavioural changes were sustained in the follow-up period after K-care in comparison to the within-crib-care intervention sessions. CONCLUSIONS K-care, as compared to within-crib condition, led to a decrease in stressful neurobehavioural signs after BT procedures in premature infants. Painful procedures such as the BT procedure in premature infants should be performed while the infants are being held in K-care position.
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Affiliation(s)
- Sari Goldstein Ferber
- Wolfson Medical Center, Department of Neonatology, Sackler School of Medicine, Tel Aviv University, Israel.
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Thomas KA, Burr RL. Circadian research in mothers and infants: how many days of actigraphy data are needed to fit cosinor parameters? J Nurs Meas 2008; 16:201-6. [PMID: 19886472 DOI: 10.1891/1061-3749.16.3.201] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Actigraphy is an easily applied approach for assessing activity and circadian patterns in mother-infant dyads. However, timing and duration of actigraphic measurements can affect assessment accuracy. The purpose of this study was to determine the number of days of actigraphy data required to portray circadian rhythm in mothers and their young infants. Continuous actigraphy monitoring was performed in 20 mother-infant pairs over a 4-day period. Cycle mesor, amplitude, acrophase, and R2 were calculated and compared using from 1 to 4 days of data. Parameters based on 4 days of data were correlated with parameters derived from 1 to 3 days of data. There were no differences among mother or infant cosinor parameters except infant acrophase, which stabilized after > or = 2 days of data. Acceptable reliability (r > .80) was achieved with > or = 2 days of data. It was concluded that a recording period of 2 days adequately depicted circadian rhythm of actigraphy in mothers and infants.
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Ejindu A. The effects of foot and facial massage on sleep induction, blood pressure, pulse and respiratory rate: Crossover pilot study. Complement Ther Clin Pract 2007; 13:266-75. [DOI: 10.1016/j.ctcp.2007.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2006] [Accepted: 03/09/2007] [Indexed: 11/17/2022]
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Kohen DP, Zajac R. Self-hypnosis training for headaches in children and adolescents. J Pediatr 2007; 150:635-9. [PMID: 17517250 DOI: 10.1016/j.jpeds.2007.02.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2006] [Revised: 01/09/2007] [Accepted: 02/02/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To describe the effect of treatment with self-hypnosis for youth with recurrent headaches. STUDY DESIGN A retrospective review was conducted of outpatient clinical records of 178 consecutive youths referred to the Behavioral Pediatrics Program (University of Minnesota) from 1988 to 2001 for recurrent headaches. All patients were taught self-hypnosis for self-regulation. Intensity, frequency, and duration of headaches before, during, and after treatment were measured. Outcomes included number and frequency of visits, types of medication, and nature of self-hypnosis practice. RESULTS Data were available for 144 patients in this patient self-selected and uncontrolled observation. Compared with self-reports before learning self-hypnosis, children and youths who learned self-hypnosis for recurrent headaches reported reduction in frequency of headache from an average of 4.5 per week to 1.4 per week (P < .01), reduction in intensity (on a self-rating scale of 0 to 12) from an average of 10.3 to 4.7, P < .01, and reduction in average duration from 23.6 hours to 3.0 hours, (P < .01). There were no adverse side effects of self-hypnosis. CONCLUSIONS Training in self-hypnosis is associated with significant improvement of chronic recurrent headaches in children and adolescents.
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Affiliation(s)
- Daniel P Kohen
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA.
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Gribble KD. A Model for Caregiving of Adopted Children After Institutionalization. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2007; 20:14-26. [PMID: 17284235 DOI: 10.1111/j.1744-6171.2007.00076.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
TOPIC Optimizing caregiving for newly adopted postinstitutionalized children. PURPOSE To consider a template of care for postinstitutionalized children based on experiences that physiological measures suggest are expected by infants postbirth. SOURCES Published literature and clinical experience. CONCLUSION Based on an understanding of physiologically expected care postbirth, special care for postinstitutionalized adopted children might include: close physical contact via use of a sling and cosleeping; breastfeeding or nurturing through food; and responsive caregiving. In replicating earlier missed experiences, parents may assist emotional development in their child and promote attachment development.
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Underdown A, Barlow J, Chung V, Stewart-Brown S. Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Syst Rev 2006:CD005038. [PMID: 17054233 DOI: 10.1002/14651858.cd005038.pub2] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Infant massage is increasingly being used in the community for low-risk babies and their primary care givers. Anecdotal claims suggest benefits for sleep, respiration, elimination and the reduction of colic and wind. Infant massage is also thought to reduce infant stress and promote positive parent-infant interaction. OBJECTIVES The aim of this review was to assess the effectiveness of infant massage in promoting infant physical and mental health in population samples. SEARCH STRATEGY Searches were undertaken of CENTRAL 2005 (Issue 3), MEDLINE (1970 to 2005), PsycINFO (1970 to 2005), CINAHL (1982 to 2005), EMBASE (1980 to 2005), and a number of other Western and Chinese databases. SELECTION CRITERIA Studies in which babies under the age of six months were randomised to an infant massage or a no-treatment control group, and utilising a standardised outcome measuring infant mental or physical development. DATA COLLECTION AND ANALYSIS Weighted and standardised mean differences and 95% confidence intervals are presented. Where appropriate the results have been combined in a meta-analysis using a random effects model. MAIN RESULTS Twenty-three studies were included in the review. One was a follow-up study and thirteen were included in a separate analysis due to concerns about the uniformly significant results and the lack of dropout. The results of nine studies providing primary data suggest that infant massage has no effect on growth, but provides some evidence suggestive of improved mother-infant interaction, sleep and relaxation, reduced crying and a beneficial impact on a number of hormones controlling stress. Results showing a significant impact on number of illnesses and clinic visits were limited to a study of Korean orphanage infants. There was no evidence of effects on cognitive and behavioural outcomes, infant attachment or temperament. The data from the 13 studies regarded to be at high risk of bias show uniformly significant benefits on growth, sleep, crying and bilirubin levels. AUTHORS' CONCLUSIONS The only evidence of a significant impact of massage on growth was obtained from a group of studies regarded to be at high risk of bias. There was, however, some evidence of benefits on mother-infant interaction, sleeping and crying, and on hormones influencing stress levels. In the absence of evidence of harm, these findings may be sufficient to support the use of infant massage in the community, particularly in contexts where infant stimulation is poor. Further research is needed, however, before it will be possible to recommend universal provision.
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Affiliation(s)
- A Underdown
- Warwick Medical School, Institute of Education, University of Warwick, Coventry, UK.
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Kelmanson IA, Adulas EI. Massage therapy and sleep behaviour in infants born with low birth weight. Complement Ther Clin Pract 2006; 12:200-5. [PMID: 16835031 DOI: 10.1016/j.ctcp.2005.11.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2005] [Revised: 11/27/2005] [Accepted: 11/29/2005] [Indexed: 11/20/2022]
Abstract
This study attempts to evaluate the impact of massage therapy on sleep behaviour in infants born with low birth weight (LBW) in St. Petersburg, Russia. Fifty infants (22 boys, 28 girls) who were born in St. Petersburg between 2000 and 2002 and defined as LBW babies (<2500g at birth) were enrolled onto the study at the age of 2 months. Of these, 41 (19 boys, 22 girls) were light and pre-term infants (gestational age < or =36 weeks), and 9 (3 boys, 6 girls) born light at term. The control group consisted of 50 healthy infants born with LBW who were cross-matched with an experimental group of babies and controlled for gender, gestational age, weight and date of birth. The groups were also matched for proximal geographical distribution in the city. Babies in the experimental group were assigned massage intervention therapy that include gentle rubbing, stroking, passive movements of the limbs and other means of kinaesthetic stimulation performed by professionals until the infant is 8 months old. The findings suggest that 8-month-old LBW infants who received massage intervention were less likely to snore during sleep, required less feeding on waking-up at night, and appeared more alert during the day. These apparent correlations remained significant after adjustment was made for major potential confounders. No statistically significant difference was found in sleep behaviour between LBW infants exposed to massage therapy who were either born pre-term or at term. It is suggested that massage may be a valuable approach to improve quality of sleep and reduce sleep-disordered breathing in infants born with LBW. It is acknowledged that whilst this study does not represent a large sample, it is felt that the findings suggest further investigation and offer an insight into an area previously relatively unexplored.
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Affiliation(s)
- Igor A Kelmanson
- St. Petersburg State Paediatric Medical Academy, Litovskaya 2, St. Petersburg, 194 100, Russia.
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Arditi H, Feldman R, Eidelman AI. Effects of human contact and vagal regulation on pain reactivity and visual attention in newborns. Dev Psychobiol 2006; 48:561-73. [PMID: 17016840 DOI: 10.1002/dev.20150] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In two experiments we examined the effects of human contact and vagal regulation on newborns' pain reactivity and visual attention. Baseline cardiac vagal tone was measured during quiet sleep and during the experiment, and vagal withdrawal was indexed as change in vagal tone from baseline to pain (study 1) or attention (study 2). In study 1, 62 healthy newborns were videotaped during a heel-prick procedure and pain reactivity was assessed from micro-level coding of facial expressions, cry behavior, and body movements. Infants were randomly assigned to a contact condition, held by a female assistant, or a no contact condition, on an infant-seat in a similar angle. In study 2, 62 additional healthy newborns, randomly assigned to contact and noncontact conditions, were presented with 2 visual stimuli for a 60 s familiarization period, which were then paired with a novel stimulus. Visual interest, alertness, and novelty preference were coded. Human contact had no effect on the newborns' pain response. Visual attention increased with human contact and newborns in the contact condition looked at the stimuli more frequently, with higher alertness, for longer durations, and had a higher novelty preference. Autonomic reactivity-as indexed by vagal withdrawal-differentiated newborns with intense and mild pain response. Discussion focused on proximity to conspecifics as a contributor to emerging regulatory and adaptive functioning in the human infant.
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Affiliation(s)
- Hadar Arditi
- Gonda Brain Sciences Center and Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
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Abstract
This review summarizes the current knowledge about the ontogenetic development of the circadian system in mammals. The developmental changes of overt rhythms are discussed, although the main focus of the review is the underlying neuronal and molecular mechanisms. In addition, the review describes ontogenetic development, not only as a process of morpho-functional maturation. The need of repeated adaptations and readaptations due to changing developmental stage and environmental conditions is also considered. The review analyzes mainly rodent data, obtained from the literature and from the author's own studies. Results from other species, including humans, are presented to demonstrate common features and species-dependent differences. The review first describes the development of the suprachiasmatic nuclei as the central pacemaker system and shows that intrinsic circadian rhythms are already generated in the mammalian fetus. As in adult organisms, the period length is different from 24 h and needs continuous correction by environmental periodicities, or zeitgebers. The investigation of the ontogenetic development of the mechanisms of entrainment reveals that, at prenatal and early postnatal stages, non-photic cues deriving from the mother are effective. Light-dark entrainment develops later. At a certain age, both photic and non-photic zeitgebers may act in parallel, even though the respective time information is 12 h out of phase. That leads to a temporary internal desynchronization. Because rhythmic information needs to be transferred to effector organs, the corresponding neural and humoral signalling pathways are also briefly described. Finally, to be able to transform a rhythmic signal into an overt rhythm, the corresponding effector organs must be functionally mature. As many of these organs are able to generate their own intrinsic rhythms, another aspect of the review is dedicated to the development of peripheral oscillators and mechanisms of their entrainment. The latter includes control by the central pacemaker as well as by distinct environmental signals. Ecological aspects of the described developmental changes in the circadian system and some practical consequences are also briefly discussed.
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Affiliation(s)
- Dietmar Weinert
- Institute of Zoology, Martin-Luther- University Halle- Wittenberg, Halle, Germany.
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Ferber SG, Feldman R, Kohelet D, Kuint J, Dollberg S, Arbel E, Weller A. Massage therapy facilitates mother–infant interaction in premature infants. Infant Behav Dev 2005. [DOI: 10.1016/j.infbeh.2004.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
BACKGROUND Maternal touch (MT) is an essential part of the initial contact between the mother and her newborn and has developmental effects on the child. MT is known to be reduced in postpartum depression (PPD). The nature of MT in mothers experiencing maternity blues and the effect of parity are still unknown. STUDY DESIGN Seventy-five mothers were recruited from the ongoing series of deliveries. SUBJECTS The participating mothers were observed during interaction with their newborns on the second-day postpartum. Touching behavior was scored on-line according to the Touch Scoring Instrument, which includes nine types of MT. Mothers were categorized as exhibiting maternal blues according to Stein's depression scale. OUTCOME MEASURE Touch Scoring Instrument. RESULTS Primiparous mothers with blues avoided all types of touch whereas multiparous mothers with blues provided firm touch and holding. All mothers with blues avoided proprioceptive touch. Multiparous mothers without maternal blues provided various types of touch including affectionate holding and matter-of-fact touch whereas primiparous mothers without blues mostly provided holding. CONCLUSIONS Mothers with maternity blues on day 2 exhibited a pattern of MT similar to that known to characterize postpartum depression. Mothers without blues are able to provide developmental touch in a manner known to facilitate CNS stability and newborn adjustment to the extra-uterine world. Parity modulates the effect of maternity blues on MT and buffers the withdrawal effect of depression. Maternal touch could be used as a diagnostic tool for detection of mothers at risk in a timely manner. Touch interventions, which were previously demonstrated in PPD mothers, may be utilized in an earlier stage postpartum.
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Ferber SG, Makhoul IR. The effect of skin-to-skin contact (kangaroo care) shortly after birth on the neurobehavioral responses of the term newborn: a randomized, controlled trial. Pediatrics 2004; 113:858-65. [PMID: 15060238 DOI: 10.1542/peds.113.4.858] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The method of skin-to-skin contact (kangaroo care [KC]) has shown physiologic, cognitive, and emotional gains for preterm infants; however, KC has not been studied adequately in term newborns. AIMS To evaluate the effect of KC, used shortly after delivery, on the neurobehavioral responses of the healthy newborn. STUDY DESIGN A randomized, controlled trial using a table of random numbers. After consent, the mothers were assigned to 1 of 2 groups: KC shortly after delivery or a no-treatment standard care (control group). SUBJECTS Included were 47 healthy mother-infant pairs. KC began at 15 to 20 minutes after delivery and lasted for 1 hour. Control infants and KC infants were brought to the nursery 15 to 20 and 75 to 80 minutes after birth, respectively. RESULTS During a 1-hour-long observation, starting at 4 hours postnatally, the KC infants slept longer, were mostly in a quiet sleep state, exhibited more flexor movements and postures, and showed less extensor movements. CONCLUSIONS KC seems to influence state organization and motor system modulation of the newborn infant shortly after delivery. The significance of our findings for supportive transition from the womb to the extrauterine environment is discussed. Medical and nursing staff may be well advised to provide this kind of care shortly after birth.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Nursing, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
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Abstract
Behavioral-pharmacological research in infant rats supports the role of cholecystokinin (CCK) and opioid peptides in mediating early learning of new associations with aspects of the nest and dam, such as maternal odor, milk, and contact. The current paper reviews research that examines the hypothesis that these neuropeptide systems are further involved in mediating emotion regulation in infants, thus playing a role in the emergence of stress-reactivity and other motivational systems. The beneficial effects of maternal proximity, handling, and touch on the development of emotion regulation have been demonstrated in both human and animal models. Interventions that promote tactile stimulation of the infant ("touch therapy") and infant-mother contact ("skin-to-skin contact" or "kangaroo care") have been shown to improve the infant's ability to self-regulate, and to moderate the effects of some risk factors. Theoretical perspectives and empirical findings regarding emotion regulation in infants are first discussed. This is followed by a review of work providing evidence in animal models (and suggestive evidence in humans) for the importance of CCK and opioid neuropeptides in affecting infant emotion regulation and the impact of touch-based interventions, in particular in the context of infant-mother attraction, contact, separation, and attachment.
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Affiliation(s)
- Aron Weller
- Department of Psychology, Bar-Ilan University, 52900 Ramat-Gan, Israel.
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