A case study of infant massage outcomes

Incorporating speech-language pathology within Australian neonatal intensive care units

Working in neonatal intensive care units (NICU) is considered to be advanced practice for speech-language pathologists (SLPs) requiring post-graduate specialised education and ongoing clinical mentoring, not easily accessible within some countries such as Australia. This review investigated whether there was evidence to support SLPs as core NICU team members, rather than fleeting therapists. The review found that the roles and responsibilities of SLPs in NICUs included assessment and intervention of preterm infant communication, feeding and swallowing using a family-centred approach. This approach was respectful of the cultural and linguistic diversity of the parents and the particular expertise of other NICU team members. Whilst there has been a significant and promising increase in research with regard to SLP involvement with preterm infants (especially around feeding and swallowing assessment and specific treatments), the need for high-quality well-designed research is essential.

Touch and massage for medically fragile infants

Research investigating the efficacy of infant massage has largely focused on premature and low birth weight infants. The majority of investigations have neglected highly acute patients in academic neonatal intensive care units (NICUs). The current study was developed with two aims: (Phase 1) to develop, implement and demonstrate the feasibility and safety of a parent-trained compassionate touch/massage program for infants with complex medical conditions and (Phase 2) to conduct a longitudinal randomized control trial (RCT) of hand containment/massage versus standard of care in a level III academic Center for Newborn and Infant Critical Care (CNICC). Certified infant massage instructors (CIMIs) taught parents to massage their hospitalized infants. Massage therapy and instruction were performed for seven consecutive days and health outcomes were collected for up to 1 month following treatment. Caregivers, nurses and certified infant massage therapists indicated moderate to high levels of satisfaction and feasibility with the implementation of hand containment/massage in a level III academic center CNICC. In addition, infant behavioral and physiological measures were within safe limits during the massage sessions. All caregivers participating in the massage group reported high levels of satisfaction 7 days into the intervention and at the 1-month follow-up with regards to their relationship with their infant, the massage program's impact on that relationship and the massage program. Due to unequal and small sample sizes, between group analyses (control versus massage) were not conducted. Descriptive infant characteristics of health outcomes are described. Preliminary data from this study indicates feasibility and safety of infant massage and satisfaction among the caregivers, CIMIs and the nurses in the CNICC. An important contribution from this study was the demonstration of the infants' safety based on physiological stability and no change in agitation/pain scores of the infants receiving massage. Massage in a tertiary urban academic NICU continues to be an area of needed study. Future studies examining infant health outcomes, such as weight gain, decreased length of hospitalization and caregiver-infant bonding, would provide greater insight into the impact of massage for medically fragile infants.

Implications of Kangaroo Care for Growth and Development in Preterm Infants

OBJECTIVE

To review research on kangaroo care with implications for growth and development in preterm infants.

DATA SOURCES

Nursing, medical, and child development research literature was searched through PubMed through 2003 using the search terms kangaroo Care, skin-to-skin, growth/development, and premature infants.

STUDY SELECTION

Randomized controlled trials, pretest-posttest designs, and other comparative studies of kangaroo care were reviewed. Reports exploring parent perspectives were examined for attachment and parent-infant interaction findings. Theory and research regarding growth in preterm infants were explored.

DATA EXTRACTION

Research on topics of kangaroo care, skin-to-skin contact, preterm infant growth, preterm infant weight gain, and failure to thrive was evaluated.

DATA SYNTHESIS

Research on kangaroo care reports physiologic safety for preterm infants and increased attachment for parents. Attachment promotes nurturing behaviors that support growth and development. Weight gain as a benefit of kangaroo care remains in question.

CONCLUSIONS

Kangaroo care is safe for preterm infants and may have important benefits for growth and development. Suggestions are made for future research on effects of KC on preterm infants.

Recognizing the potential effect of stress and trauma on premature infants in the NICU: how are outcomes affected?

Extensive research of the long-term outcomes of premature infants has shown significant risk for emotional, behavioral, and psychological problems. Chronic stress and trauma have not been researched specifically in this population, however, studies of the neurobiological impact of traumatic stress on infants and children in the general population show noteworthy parallels in symptomotology. Careful consideration should be given to practitioner caregiving, parent education, future research, assessment, and interventions while being mindful of the impact that chronic stress and trauma may have on the developing brain of the premature infant.

Infant massage programs may assist in decreasing parental perceived stress levels in new parents

A qualitative study was conducted to determine whether there is a relationship between the perceived stress levels of new parents in interacting with their infant and the parental implementation of infant massage techniques. A sample of four new parents demonstrated decreased perceived stress levels following involvement in a month long infant massage program, indicating an enhanced perception of their individual parenting abilities. The results of the study indicate that infant massage training is an effective tool to be used in assisting parents/caregivers in the acquisition of the parenting role and the development of role related skills.