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Dubner SE, Morales MC, Marchman VA, Shaw RJ, Travis KE, Scala M. Maternal mental health and engagement in developmental care activities with preterm infants in the NICU. J Perinatol 2023; 43:871-876. [PMID: 37046070 PMCID: PMC10096104 DOI: 10.1038/s41372-023-01661-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/16/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE To examine associations between maternal mental health and involvement in developmental care in the NICU. STUDY DESIGN Mothers of infants born <32 weeks gestation (n = 135) were approached to complete mental health screening questionnaires at two weeks after admission. Mothers who completed screening (n = 55) were further classified as with (n = 19) and without (n = 36) elevated scores. Mothers' frequency, rate, and duration of developmental care activities were documented in the electronic health record. RESULTS 35% of screened mothers scored above the cutoff for clinical concern on ≥1 measure. No significant differences between the 3 groups were identified for rates, frequency, or amount of all developmental care, kangaroo care, and swaddled holding. CONCLUSION Elevated scores on maternal mental health questionnaires did not relate to developmental care. Maternal developmental care engagement may not indicate mental health status. Universal screening for psychological distress is required to accurately detect symptoms in mothers of hospitalized preterm infants.
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Affiliation(s)
- Sarah E Dubner
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Maya Chan Morales
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Virginia A Marchman
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Richard J Shaw
- Division of Child Psychiatry, Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA
| | - Katherine E Travis
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Melissa Scala
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
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Machry H, Joseph A, White R, Allison D. Designing for Family Engagement in Neonatal ICUs: How Is the Interior Design of Single-Family Rooms Supporting Family Behaviors, From Passive to Active? HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:238-260. [PMID: 37157783 DOI: 10.1177/19375867231168651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
PURPOSE Understand how the interior design of single-family rooms (SFRs) in neonatal intensive care units (NICUs) can support family engagement behaviors. BACKGROUND Family members are integral contributors to infant care in NICUs, impacting infant development. While at the NICU, parents are encouraged to participate in a process called family engagement, where they are expected to move from passive to active caregivers, in preparation for their role after discharge. While family engagement is affected by the built environment, no studies have investigated this relationship in any depth. NICU settings morphed to involve families through the SFR design model, but the interior environment of SFRs have not been sufficiently explored as a resource to support specific family engagement behaviors. METHODS We interviewed family and staff and observed family engagement behaviors in SFRs at two NICUs. Behaviors were observed and described in terms of their location, number of people, and design elements involved. Built environment characteristics were collected through physical assessments, and interviews elicited participants' perceptions about design factors impacting family behaviors inside SFRs. Data analysis followed grounded theory segments and pattern matching. RESULTS Three behavioral patterns and five themes were identified showing how SFRs' private bathrooms, family storage, family zone partitions, positive distractions, and information boards can support families' home-like, educational, collaborative, and infant care behaviors. CONCLUSIONS The interior design of SFRs can be a resource to family engagement in the NICU. Future research should operationalize SFR features found in our study to measure and validate their impact on family engagement outcomes.
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Affiliation(s)
- Herminia Machry
- School of Architecture and Design, University of Kansas, Lawrence, KS, USA
| | - Anjali Joseph
- Center for Health Facilities Design and Testing, School of Architecture, Clemson University, SC, USA
| | - Robert White
- Regional Newborn Program, Beacon Children's Hospital, South Bend, IN, USA
| | - David Allison
- Graduate Program in Architecture and Health, School of Architecture, Clemson University, SC, USA
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Buil A, Sankey C, Caeymaex L, Gratier M, Apter G, Vitte L, Devouche E. Skin-to-skin SDF positioning: The key to intersubjective intimacy between mother and very preterm newborn-A pilot matched-pair case-control study. Front Psychol 2022; 13:790313. [PMID: 36304846 PMCID: PMC9593100 DOI: 10.3389/fpsyg.2022.790313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits, for both the baby and the parent. However, very few studies have investigated SSC' benefits for communication, in particular in the very-preterm newborn immediately after birth. Aims To investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother-very-preterm newborn communication and to examine the coordination of the timing of communicative behaviors, just a few days after birth. Subjects and study design Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA, mean age at birth: 30 weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control positioning (n = 17) or the SDF Intervention positioning (n = 17). Mother and newborn were filmed during the first 5 min of their first SSC. Outcome measures Infants' states of consciousness according to the Assessment of Preterm Infants' Behavior scale (APIB). Onset and duration of newborns' and mothers' vocalizations and their temporal proximity within a 1-s time-window. Results In comparison with the Vertical group, very preterm newborns in the SDF Intervention Group spent less time in a drowsy state and more in deep sleep. At 3.5 days of life, newborns' vocal production in SSC did not differ significantly between the two groups. Mothers offered a denser vocal envelope in the SDF group than in the Vertical group and their vocalizations were on average significantly longer. Moreover, in a one-second time-frame, temporal proximity of mother-very preterm newborn behaviors was greater in the SDF Intervention Group. Conclusion Although conducted on a limited number of dyads, our study shows that SDF positioning fosters mother-very preterm newborn intimate encounter during the very first skin to skin contact after delivery. Our pioneer data sheds light on the way a mother and her very preterm vocally meet, and constitutes a pilot step in the exploration of innate intersubjectivity in the context of very preterm birth.
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Affiliation(s)
- Aude Buil
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France
- NICU Service de réanimation néonatale, Hospital Center Intercommunal De Créteil, Créteil, France
| | - Carol Sankey
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France
| | - Laurence Caeymaex
- NICU Service de réanimation néonatale, Hospital Center Intercommunal De Créteil, Créteil, France
- Université Paris Nanterre, Nanterre, France
| | - Maya Gratier
- Faculté de santé - Université Paris Est Créteil, Créteil, France
| | - Gisèle Apter
- Service de pédopsychiatrie universitaire, Hospital Group Du Havre, Le Havre, France
| | - Lisa Vitte
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France
- Service de pédopsychiatrie universitaire, Hospital Group Du Havre, Le Havre, France
| | - Emmanuel Devouche
- Laboratoire de Psychopathologie et Processus de Santé (LPPS UR 4057), Université Paris Cité, Paris, France
- Service de pédopsychiatrie universitaire, Hospital Group Du Havre, Le Havre, France
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Linnér A, Lilliesköld S, Jonas W, Skiöld B. Initiation and duration of skin-to-skin contact for extremely and very preterm infants: A register study. Acta Paediatr 2022; 111:1715-1721. [PMID: 35642385 DOI: 10.1111/apa.16433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
AIM This study sought to describe how skin-to-skin contact between extremely and very preterm infants and their parents is practised in Swedish neonatal units. METHODS Data from the Swedish Neonatal Quality Register from 2020 to 2021 were extracted to analyse initiation time and daily duration of skin-to-skin contact in different gestational ages and regions. RESULTS Of the 1475 infants in the cohort, mean (range) gestational age was 28 weeks (22-31), and mean (range) birthweight was 1205 g (360-2810). For extremely preterm infants (<28 weeks), median (interquartile range) skin-to-skin contact initiation time was at 88 postnatal hours (48-156) and 5% had skin-to-skin contact on the first day. For very preterm infants (<32 weeks), the corresponding numbers were 14 h (4-36) and 34%. Median (interquartile range) daily skin-to-skin contact duration for the entire cohort during the first day, first three and seven days and the remaining hospital stay was 0 (0-0), 0.7 (0-2.7), 1.6 (0.4-3.6) and 4.4 (3.0-6.1) h, respectively. CONCLUSION A minority of extremely and very preterm infants were exposed to skin-to-skin contact on the first postnatal day. Daily duration during the first week of life amounted to less than two hours. Initiation time and daily duration varied among gestational ages.
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Affiliation(s)
- Agnes Linnér
- Department of Women’s and Children’s Health, Karolinska Institutet Stockholm Sweden
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
| | - Siri Lilliesköld
- Department of Women’s and Children’s Health, Karolinska Institutet Stockholm Sweden
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
| | - Wibke Jonas
- Department of Women’s and Children’s Health, Karolinska Institutet Stockholm Sweden
- Faculty of Health University of Applied Sciences Bielefeld Germany
| | - Béatrice Skiöld
- Department of Women’s and Children’s Health, Karolinska Institutet Stockholm Sweden
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
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Linnér A, Lode Kolz K, Klemming S, Bergman N, Lilliesköld S, Markhus Pike H, Westrup B, Rettedal S, Jonas W. Immediate skin-to-skin contact may have beneficial effects on the cardiorespiratory stabilisation in very preterm infants. Acta Paediatr 2022; 111:1507-1514. [PMID: 35466432 DOI: 10.1111/apa.16371] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 12/13/2022]
Abstract
AIM Our aim was to investigate what effect immediate skin-to-skin contact with a parent had on the cardiorespiratory stabilisation of very preterm infants. METHODS This randomised clinical trial was conducted during 2018-2021 at two university hospitals with three neonatal intensive care units in Norway and Sweden. Infants born from 28+0 to 32+6 weeks of gestation were randomised to immediate skin-to-skin contact with a parent for the first six postnatal hours or standard incubator care. The outcome was a composite cardiorespiratory stability score, based on serial measures of heart and respiratory rate, respiratory support, fraction of inspired oxygen and oxygen saturation. RESULTS We recruited 91 newborn infants with a mean gestational age of 31+1 (range 28+4-32+6) weeks and mean birth weight of 1534 (range 555-2440) g: 46 received immediate skin-to-skin contact and 45 received incubator care. The group who received skin-to-skin contact had an adjusted mean score of 0.52 higher (95% confidence interval 0.38-0.67, p < 0.001) on a scale from zero to six when compared to the control group. CONCLUSION Immediate skin-to-skin contact for the first six postnatal hours had beneficial effects on the cardiorespiratory stabilisation of very preterm infants.
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Affiliation(s)
- Agnes Linnér
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
| | - Karoline Lode Kolz
- Department of Paediatrics Stavanger University Hospital Stavanger Norway
- Faculty of Health Sciences Stavanger University Stavanger Norway
- Department of Clinical Neurophysiology Stavanger University Hospital Stavanger Norway
| | - Stina Klemming
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
| | - Nils Bergman
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Siri Lilliesköld
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Neonatal Unit Karolinska University Hospital Stockholm Sweden
| | - Hanne Markhus Pike
- Department of Paediatrics Stavanger University Hospital Stavanger Norway
| | - Björn Westrup
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Siren Rettedal
- Department of Paediatrics Stavanger University Hospital Stavanger Norway
- Faculty of Health Sciences Stavanger University Stavanger Norway
| | - Wibke Jonas
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Faculty of Health University of Applied Sciences Bielefeld Germany
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Thernström Blomqvist Y, Ågren J, Karlsson V. The Swedish approach to nurturing extremely preterm infants and their families: A nursing perspective. Semin Perinatol 2022; 46:151542. [PMID: 34911652 DOI: 10.1016/j.semperi.2021.151542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Nurturing extremely premature infants is a complicated task that not only necessitates a systematic approach to the immature physiology and its medical management, but also to the needs of the family. Infants born at 22-24 weeks require many weeks of intensive care including a long duration of mechanical ventilation, numerous stressful medical interventions, and for the parents to spend a lot of time in the Neonatal Intensive Care unit (NICU). This paper aims to outline the Swedish nursing approach to nurturing these infants and their families. The nursing care is structured so the parents are the primary caregivers supported by the staff and is based on: timely expression and provision of mother's own breast milk, early and prolonged skin-to-skin contact and close collaboration with the family. While this presentation is based on a single-center's experience, it well represents the general features of nursing provided to extremely preterm infants in Swedish NICUs.
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Affiliation(s)
- Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden; Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | - Johan Ågren
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden; Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | - Victoria Karlsson
- Neonatal Intensive Care Unit, University Children's Hospital, Uppsala, Sweden; Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden.
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Gere S, Berhane Y, Worku A. Comparison of Chest-to-Back Skin-to-Skin Contact and Chest-to-Chest Skin-to-Skin Contact on the Risk of Oxygen Desaturation and Change in Heart Rate in Low Birth Weight and/or Premature Babies: A Randomized Controlled Clinical Trial. Int J Pediatr 2021; 2021:7196749. [PMID: 34925513 PMCID: PMC8674035 DOI: 10.1155/2021/7196749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
Chest-to-chest (CC) skin-to-skin contact (SSC) is a widely used method of SSC to prevent low birth weight (LBW) and/or premature babies with the risk of hypothermia. However, very recently, a study has also shown that the chest-to-back (CB) SSC is also useful for such a purpose. It is also evident that CC SSC enhances the cardiorespiratory performance of LBW and/or premature babies from the risk of cold stress. However, whether babies kept in CB SSC have the risk of clinically relevant decreases of oxygen saturation or critical changes of the baby heart rate comparing the two SSC methods has been studied hardly. Thus, we assessed the risk of oxygen desaturation and changes in babies' heart rate among LBW and/or premature babies kept in CB SSC compared to the standard. In this study, we enrolled 46 LBW and/or premature babies born between 32 and 37 completed weeks of gestation. We used a parallel-group randomized controlled clinical trial. Peripheral arterial blood oxygen saturation (SpO2) and heart rate (HR) were measured using an OxiMaxN-600X Pulse Oximeter. We transformed these measurements into stability of the cardiorespiratory system in premature infant (SCRIP) scores. We applied a generalized estimating equation model to analyze the data. No statistically significant difference was observed between babies kept in CB SSC compared to babies kept in CC SSC in either blood oxygen saturation or heart rate (P > 0.05). Thus, the CB SSC can be used as one possible way to care for LBW and preterm babies in the kangaroo mother care. We suggest more studies before scaling up the approach in routine care.
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Affiliation(s)
- Sisay Gere
- Department of Nursing, College of Health Sciences, Arsi University, Asella, Ethiopia
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
- Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Alemayehu Worku
- Department of Biostatistics, Faculty of Health, Addis Ababa University, Addis Ababa, Ethiopia
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Lilliesköld S, Zwedberg S, Linnér A, Jonas W. Parents' Experiences of Immediate Skin-to-Skin Contact After the Birth of Their Very Preterm Neonates. J Obstet Gynecol Neonatal Nurs 2021; 51:53-64. [PMID: 34767779 DOI: 10.1016/j.jogn.2021.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore parents' experiences of immediate skin-to-skin contact after the birth of their very preterm neonates and their perceptions regarding care and support from staff. DESIGN A descriptive qualitative study. SETTING Birth and neonatal units within a university hospital in Sweden. PARTICIPANTS Six parent couples who co-cared for their very preterm neonates with skin-to-skin contact throughout the first 6 hours after birth. METHODS We analyzed individual interviews using reflexive thematic analysis as described by Braun and Clarke. RESULTS The parents' experiences of immediate skin-to-skin contact with their very preterm neonates were represented by the following three themes: A Pathway to Connectedness, Just Being in a Vulnerable State, and Creating a Safe Haven in an Unknown Terrain. Skin-to-skin contact helped the parents attain their roles as essential caregivers and provided a calming physical sensation that promoted parents' feelings of connectedness with their newborns. When parents provide skin-to-skin contact at birth, staff members need to recognize and address their vulnerability. A good relationship with nursing staff, which was mediated through staff behaviors and availability, facilitated skin-to-skin contact. CONCLUSION Skin-to-skin contact initiated at birth with very preterm neonates was a valuable and empowering experience for parents and enhanced early bonding between parents and their newborns. Staff members should recognize that skin-to-skin contact between parents and neonates is an interactive process that has challenges. Future research is warranted to understand the needs of nursing staff who provide initial care in the postpartum period. Furthermore, we recommend the implementation of maternal-neonatal couplet care.
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Physiological Stability in Very Preterm Infants During Skin-to-Skin Contact as Assessed by Near-Infrared Spectroscopy. Adv Neonatal Care 2020; 20:495-498. [PMID: 32384330 DOI: 10.1097/anc.0000000000000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Skin-to-skin contact (SSC) has been demonstrated to allow adequate thermal stability in high-technology settings with extremely preterm infants, while other aspects on how SSC influences basic physiological parameters have been less extensively investigated. PURPOSE To evaluate physiological stability during SSC and incubator care in a group of preterm infants born at a gestational age (GA) of 32 weeks or less and receiving respiratory support. METHODS Descriptive, observational study including 10 preterm infants (GA 22-32 weeks, postnatal age 2-48 days) were evaluated during SSC compared with flanking time periods in the incubator. Cerebral and systemic regional oxygen saturation (rSaO2), pulse oximetry (SpO2), heart rate (HR), and body temperature were recorded, and the fractional tissue oxygen extraction (fTOE) was calculated. RESULTS A total of 16 periods of SSC (mean duration 3 hours 30 minutes) were evaluated, 9 during nasal continuous positive airway pressure and 7 during mechanical ventilation. Cerebral rSaO2 was 68% ± 4% (SE) and 69% ± 4% during incubator care and SSC, respectively (P = .56). Somatic rSao2 was 64% ± 4% during incubator care and 66% ± 4% during SSC (P = .54). Also, fTOE, HR, and SpO2 was similar during the 2 modes of care. Body temperature increased during SSC (P < .01). IMPLICATIONS FOR PRACTICE The present study reveals no differences in cerebral and somatic tissue oxygenation between periods of SSC and care in the incubator. The findings indicate that SSC supports physiological stability also during management of very preterm infants receiving respiratory support. IMPLICATIONS FOR RESEARCH Further studies directed to further optimize SSC performance should enable its safe implementation at gradually lower gestational and postnatal ages.
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van Veenendaal NR, van Kempen AA, Franck LS, O'Brien K, Limpens J, van der Lee JH, van Goudoever JB, van der Schoor SR. Hospitalising preterm infants in single family rooms versus open bay units: A systematic review and meta-analysis of impact on parents. EClinicalMedicine 2020; 23:100388. [PMID: 32548575 PMCID: PMC7284081 DOI: 10.1016/j.eclinm.2020.100388] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Many parents develop stress-related symptoms and depression when their preterm infant is hospitalised in the neonatal intensive care unit (NICU) after birth. We reviewed the evidence of parent well-being with preterm infants hospitalised in single family rooms (SFRs) or in open bay neonatal units (OBUs). METHODS For this systematic review and meta-analysis, we searched MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, Clinicaltrials.gov, and International Clinical Trials Registry Platform (ICTRP) databases from inception through 22 November 2019 using controlled terms and text words related to prematurity and NICU-design. We included randomised and non-randomised studies comparing outcomes in parents with preterm infants admitted to SFRs or OBUs. Methodological quality was assessed using Cochrane Collaboration's Risk of Bias Tool for randomised controlled trials and the Risk of Bias Tool for Non-Randomised Studies of Interventions (ROBINS-I). Outcomes included: parental stress, satisfaction, participation (presence/involvement/skin-to-skin care), self-efficacy, parent-infant-bonding, depression, anxiety, post-traumatic stress, empowerment, and degree of family-centred care. Summary estimates were calculated using random effects models with standardised mean differences (SMDs). PROSPERO registration: CRD42016050643. FINDINGS We identified 614 unique publications. Eleven study populations (1, 850 preterm infants, 1, 549 mothers and 379 fathers) were included. All but one study were at serious to critical risk of bias. SFRs were associated with higher levels of parental presence, involvement, and skin-to-skin care. Upon discharge, SFRs were associated with lower stress levels (n = 828 parents, SMD-0·30,95%CI -0·50;-0·09, p<0·004, I2=46%), specifically NICU-related stress (n = 573, SMD-0·42,95%CI -0·61;-0·23, p<0·0001, I2=0%). In majority of studies higher levels of empowerment, family-centred care, and satisfaction was present with SFRs. No differences were found for anxiety, parent-infant bonding, or self-efficacy. Depression was high (up to 29%) but not different between settings. No studies described post-traumatic stress. INTERPRETATION Single family rooms seem to facilitate parental presence, involvement, skin-to-skin care, and reduce NICU-related parental stress.
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Key Words
- AA, at admission
- BA, before-after study
- BDI, Beck Depression Inventory
- CI, confidence interval
- EPDS, Edinburgh Postnatal Depression Scale
- FCC, Family-Centred Care
- FCCS, Family-Centred Care Survey
- MPAS, Maternal Postnatal Attachment Scale
- Mo, months
- NA, not applicable
- NICU, Neonatal Intensive Care Unit
- NR, not reported
- NRPI, non-randomised prospective intervention study
- NRRI, non-randomised retrospective intervention study
- OBU, Open Bay Unit
- PES, Parent Expectations Scale
- PG, Press Ganey NICU Survey
- PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-analysis
- PROSPERO, International Prospective Register of Systematic Reviews
- PSI, Parental Stress Index
- PSS-NICU, Parental Stressor Scale – NICU
- RCT, Randomised Controlled Trial
- ROBINS-I, Risk of Bias in Non-randomised Studies of Interventions
- RoB, Risk of Bias
- SD, standard deviation
- SFR, Single Family Room
- SMD, standardised mean difference
- SPSQ, Swedish Parental Stress Index
- STAI, State-Trait Anxiety Inventory
- Wks, weeks
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Affiliation(s)
- Nicole R. van Veenendaal
- Department of Pediatrics/Neonatology, OLVG, Amsterdam, Netherlands
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, Netherlands
| | | | - Linda S. Franck
- School of Nursing, University of California San Francisco, San Francisco, CA, United States
| | - Karel O'Brien
- Department of Pediatrics, Mount Sinai Hospital, Toronto, Canada
| | - Jacqueline Limpens
- Medical Library Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Johanna H. van der Lee
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, Netherlands
- Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands
| | - Johannes B. van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Amsterdam, Netherlands
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Angelhoff C, Blomqvist YT, Sahlén Helmer C, Olsson E, Shorey S, Frostell A, Mörelius E. Effect of skin-to-skin contact on parents' sleep quality, mood, parent-infant interaction and cortisol concentrations in neonatal care units: study protocol of a randomised controlled trial. BMJ Open 2018; 8:e021606. [PMID: 30068615 PMCID: PMC6074633 DOI: 10.1136/bmjopen-2018-021606] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Separation after preterm birth is a major stressor for infants and parents. Skin-to-skin contact (SSC) is a method of care suitable to use in the neonatal intensive care unit (NICU) to minimise separation between parents and infants. Less separation leads to increased possibilities for parent-infant interaction, provided that the parents' sleep quality is satisfactory. We aimed to evaluate the effect of continuous SSC on sleep quality and mood in parents of preterm infants born <33 weeks of gestation as well as the quality of parent-infant interaction and salivary cortisol concentrations at the time of discharge. METHODS AND ANALYSIS A randomised intervention study with two arms-intervention versus standard care. Data will be collected from 50 families. Eligible families will be randomly allocated to intervention or standard care when transferred from the intensive care room to the family-room in the NICU. The intervention consists of continuous SSC for four consecutive days and nights in the family-room. Data will be collected every day during the intervention and again at the time of discharge from the hospital. Outcome measures comprise activity tracker (Actigraph); validated self-rated questionnaires concerning sleep, mood and bonding; observed scorings of parental sensitivity and emotional availability and salivary cortisol. Data will be analysed with pairwise, repeated measures, Mann Whitney U-test will be used to compare groups and analysis of variance will be used to adjust for different hospitals and parents' gender. ETHICS AND DISSEMINATION The study is approved by the Regional Research Ethics Board at an appropriate university (2016/89-31). The results will be published in scientific journals. We will also use conferences and social media to disseminate our findings. TRIAL REGISTRATION NUMBER NCT03004677.
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Affiliation(s)
- Charlotte Angelhoff
- Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden
- Department of Clinical and Experimental Medicine and Department of Paediatrics, Linköping University, Linköping, Sweden
| | | | - Charlotte Sahlén Helmer
- Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden
- Department of Clinical and Experimental Medicine and Department of Paediatrics, Linköping University, Linköping, Sweden
| | - Emma Olsson
- Department of Pediatrics and Centre for Health Care Sciences, Örebro University, Örebro, Sweden
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Anneli Frostell
- Division of Psychology, Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
| | - Evalotte Mörelius
- Department of Social and Welfare Studies, Division of Nursing Science, Linköping University, Norrköping, Sweden
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Parent-Infant Closeness, Parents' Participation, and Nursing Support in Single-Family Room and Open Bay NICUs. J Perinat Neonatal Nurs 2018; 32:E22-E32. [PMID: 30358674 DOI: 10.1097/jpn.0000000000000359] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This was a prospective survey study, comparing parent-infant closeness, parents' perceptions of nursing support, and participation in medical rounds in single-family room (SFR) and an open bay (OB) neonatal intensive care units. Nurses' assessments of provided support were also measured. In total, 115 parents of 64 preterm infants less than 35 weeks' gestational age and 129 nurses participated. Parents recorded the presence and skin-to-skin care. Parents were sent 9 text message questions in random order. Nurses answered corresponding Internet-based questions. SFR mothers were more present, 20 hours daily (median) versus 7 hours (P < .001), initiated skin-to-skin contact (SSC) at 4 versus 12 hours (P = .03), and preformed SSC 180 min/24 h versus 120 min/24 h for mothers in the OB unit (P = .02). SFR fathers were also more present, 8 versus 4 hours (P < .001), initiated SSC at 3 versus 40 hours (P = .004), and performed SSC 67 min/24 h versus 31 min/24 h (P = .05). SFR parents rated participation in medical rounds and emotional support higher than OB parents. Parental trust was rated higher by nurses in the OB unit (P = .02). SFR facilitated parent-infant closeness, parents' participation in medical rounds, and increased support from nurses.
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Blomqvist YT, Nyqvist KH, Rubertsson C, Funkquist E. Parents need support to find ways to optimise their own sleep without seeing their preterm infant's sleeping patterns as a problem. Acta Paediatr 2017; 106:223-228. [PMID: 27925691 DOI: 10.1111/apa.13660] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/09/2016] [Accepted: 11/02/2016] [Indexed: 11/27/2022]
Abstract
AIM This study described how parents perceived their own sleep, and their infants', during neonatal intensive care unit (NICU) admission and after discharge. It also explored the infants' sleeping location at home. METHODS The study was conducted in the NICUs of two Swedish university hospitals. The parents of 86 infants - 86 mothers and 84 fathers - answered questionnaires during their infants' hospital stay, at discharge and at the infants' corrected ages of two, six and 12 months. The parents' own sleep was explored with the Insomnia Severity Index. RESULTS Mothers reported more severe insomnia than fathers during their infants' hospitalisation, and these higher insomnia severity scores were associated with more severe infant sleep problems at discharge (p = 0.027) and at two months (p = 0.006) and 12 months (p = 0.002) of corrected age. During the study period, 4%-10% of the parents reported severe or very severe infant sleeping problems. The bed-sharing rate was 75% after discharge and about 60% at the corrected age of 12 months. CONCLUSION Maternal insomnia during an infant's hospital stay was associated with later perceptions of sleep problems in their children. Parents need support to find solutions for optimal sleep without seeing their child's sleeping patterns as a problem.
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Affiliation(s)
- Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit 95 F Uppsala University Children's Hospital Uppsala Sweden
- Department of Women's and Children's Health University Hospital Uppsala Sweden
| | | | | | - Eva‐Lotta Funkquist
- Department of Women's and Children's Health University Hospital Uppsala Sweden
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14
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Larsson C, Wågström U, Normann E, Thernström Blomqvist Y. Parents experiences of discharge readiness from a Swedish neonatal intensive care unit. Nurs Open 2016; 4:90-95. [PMID: 28286665 PMCID: PMC5340163 DOI: 10.1002/nop2.71] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Accepted: 09/12/2016] [Indexed: 11/05/2022] Open
Abstract
Aim The aim of this study was to describe how parents experienced the support at, and preparation for discharge from, the NICU and how they experienced the first time at home. Design A qualitative design with quantitative elements was applied. Methods A questionnaire study. Data were analysed using qualitative content analysis with quantitative elements. Results The majority of included parents felt adequately prepared for going home and sufficiently supported during the first period home. Negative experiences were related to lack of time for preparation, lack of support and information, especially about the infant's food intake, breastfeeding, and tube feeding, and lack of follow‐up counselling post discharge. This study supports that parents who are closely involved in their infant's care at the NICU, and who stay with the infant at the NICU around the clock, are well prepared for the transition to home.
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Affiliation(s)
| | - Ulrika Wågström
- Neonatal Intensive Care Unit University Hospital Uppsala Sweden
| | - Erik Normann
- Neonatal Intensive Care Unit University Hospital Uppsala Sweden; Department of Women's and Children's Health Uppsala University Uppsala Sweden
| | - Ylva Thernström Blomqvist
- Neonatal Intensive Care Unit University Hospital Uppsala Sweden; Department of Women's and Children's Health Uppsala University Uppsala Sweden
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15
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Oras P, Thernström Blomqvist Y, Hedberg Nyqvist K, Gradin M, Rubertsson C, Hellström-Westas L, Funkquist EL. Skin-to-skin contact is associated with earlier breastfeeding attainment in preterm infants. Acta Paediatr 2016; 105:783-9. [PMID: 27100380 DOI: 10.1111/apa.13431] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 02/07/2016] [Accepted: 04/07/2016] [Indexed: 11/28/2022]
Abstract
AIM This study investigated the effects of skin-to-skin contact on breastfeeding attainment, duration and infant growth in preterm infants, as this has not been sufficiently explored. METHODS A prospective longitudinal study on Kangaroo mother care was carried out, comprising 104 infants with a gestational age of 28 + 0 to 33 + 6 and followed up to one year of corrected age. Parents and staff recorded the duration of skin-to skin contact during the stay in the neonatal intensive care unit (NICU). Medical data were collected through patient records, and follow-up questionnaires were filled in by parents. RESULTS The 53 infants who attained full breastfeeding in the NICU did so at a median (range) of 35 + 0 (32 + 1 to 37 + 5) weeks of postmenstrual age, and skin-to-skin contact was the only factor that influenced earlier attainment in the regression analysis (R(2) 0.215 p < 0.001). The daily duration of skin-to-skin contact during the stay in the NICU did not affect the duration of breastfeeding or infant growth after discharge. Furthermore, infant growth was not affected by the feeding strategy of exclusive, partial breastfeeding or no breastfeeding. CONCLUSION A longer daily duration of skin-to-skin contact in the NICU was associated with earlier attainment of exclusive breastfeeding.
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Affiliation(s)
- Paola Oras
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | | | | | - Maria Gradin
- Department of Paediatrics; Faculty of Medicine and Health; Örebro University; Örebro Sweden
| | | | | | - Eva-Lotta Funkquist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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16
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Catherine ZG, Béatrice P, Fabrice L, Claire H, Alain D. Skin-to-skin contact with an umbilical venous catheter: prospective evaluation in a level 3 unit. Eur J Pediatr 2016; 175:551-5. [PMID: 26582650 DOI: 10.1007/s00431-015-2665-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/03/2015] [Accepted: 11/06/2015] [Indexed: 10/22/2022]
Abstract
UNLABELLED The aim was to assess the incidence of complications related to skin-to-skin contact (SSC) in newborns with an umbilical venous catheter (UVC). We carried out a prospective follow-up study of all UVCs in a level 3 unit where SSC is systematic. A total of 333 babies were included (mean gestational age of 31.3 weeks (24-41), mean birth weight of 1618 g (454-4900). Two hundred sixty-three babies (78.9 %) had SSC, at a mean postnatal age of 24 h (3-144 h). Two babies presented with a significant umbilical bleeding, all in the first 3 h, before SSC. In 17 cases of UVC leaking, this necessitated an unwanted withdrawal of the UVC; of these, 14 UVCs (82 %) were in sub-hepatic position. In five cases of UVC displacement, babies had no SSC. The overall incidence (3 % [95 % CI = 1.4-5.4]) and incidence density (6.2/1000 UVC-day [95 % CI = 3-11.4]) of catheter-associated infections are similar to those identified by the French multicenter network NEOCAT in 2012 (5 % [95 % CI = 4.1-5.9] and 11.3/1000 UVC-day [95 % CI = 9.3-13.2]). CONCLUSION In this prospective, non-randomized study in a level unit, routine practice of SSC with a UVC does not seem to influence the incidence of mechanical and infectious complications. What is known? • SSC is beneficial for pretem infants. • Fear of mechanical problems and/or infections with a UVC is an obstacle to early use of SSC. What is New: • In this study, SSC for preterm infants with a UVC is associated with low risks of mechanical complications, and does not seem to be associated with any higher risk of catheter-related infections.
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Affiliation(s)
| | - Pindi Béatrice
- Service de Néonatologie, Centre Hospitalier, 59300, Valenciennes, France
| | - Lapeyre Fabrice
- Service de Néonatologie, Centre Hospitalier, 59300, Valenciennes, France
| | - Huart Claire
- Unité de Lutte contre Les Infections nosocomiales, Centre Hospitalier, 59300, Valenciennes, France
| | - Duhamel Alain
- Department of biostatistics EA 2694, University of Lille, CHRU Lille, Lille, France
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17
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Oras P, Blomqvist YT, Nyqvist KH, Gradin M, Rubertsson C, Hellström-Westas L, Funkquist EL. Breastfeeding Patterns in Preterm Infants Born at 28-33 Gestational Weeks. J Hum Lact 2015; 31:377-85. [PMID: 25956792 DOI: 10.1177/0890334415586406] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 04/20/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Studies of breastfeeding patterns during preterm infants' first year of life are scarce but are important for providing breastfeeding mothers of preterm infants with optimal support. OBJECTIVE This study aimed to describe breastfeeding patterns in preterm infants up to 1 year of corrected age. METHODS As part of a larger study on kangaroo mother care in Sweden, a 24-hour breastfeeding diary was sent home after discharge from hospital, and at 2, 6, and 12 months of the infant's corrected age. Eighty-three mothers responded to the follow-up questionnaires, and the number of respondents to the breastfeeding diary was 48 at discharge, 43 at 2 months, 22 at 6 months, and 8 at 12 months. Infants were born at a median (range) gestational age of 32 (28-33) weeks. Breastfeeding patterns were analyzed according to durations, frequencies per 24 hours, and intervals between sessions. RESULTS In exclusively breastfed infants, the median (range) breastfeeding session frequency was 14 (8-26) times per 24 hours including 4 (1-9) times per night after discharge (n = 24) and 10 (6-25) times per 24 hours including 2 (0-5) times per night at 2 months (n = 23). In partially breastfed infants, the median (range) frequency was 5 (1-14) times per 24 hours including 2 (0-4) times per night at 6 months (n = 20) and 5.5 (1-12) times per 24 hours including 2 (0-3) times per night at 12 months (n = 8). CONCLUSION Mothers reported large variations in breastfeeding patterns, with higher median breastfeeding session frequencies than previously described in term infants in affluent settings.
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Affiliation(s)
- Paola Oras
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | | | - Maria Gradin
- Department of Paediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Christine Rubertsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Eva-Lotta Funkquist
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Baylis R, Ewald U, Gradin M, Hedberg Nyqvist K, Rubertsson C, Thernström Blomqvist Y. First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units. Acta Paediatr 2014; 103:1045-52. [PMID: 24923236 DOI: 10.1111/apa.12719] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 04/23/2014] [Accepted: 06/09/2014] [Indexed: 11/29/2022]
Abstract
AIM Early parental bonding with preterm babies is particularly important, and the aim of our study was to explore when parents experienced what they regarded as important events for the first time while their infant was in the neonatal intensive care unit (NICU). METHODS The study was part of a longitudinal project on Kangaroo Mother Care at two Swedish university hospitals. The parents of 81 infants completed questionnaires during their infants' hospital stay. RESULTS Most parents saw and touched their infants immediately after birth, but only a few could hold them skin to skin or swaddle them. Other important events identified by parents included the first time they performed care giving activities and did so independently, interaction and closeness with the infant, signs of the infant's recovery and integration into the family. The timing of the events depended on the physical design of the NICU, whether parents' could stay with their infant round-the-clock and when they were allowed to provide care under supervision and on their own. CONCLUSION The design and routines of the NICU dictated when parents first interacted with their infants. Clinical guidelines that facilitate early contact with preterm babies can help parents to make the transition to their parental role.
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Affiliation(s)
- Rebecca Baylis
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | - Uwe Ewald
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
| | | | | | | | - Ylva Thernström Blomqvist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
- Neonatal Intensive Care Unit; University Hospital; Uppsala Sweden
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Maastrup R, Hansen BM, Kronborg H, Bojesen SN, Hallum K, Frandsen A, Kyhnaeb A, Svarer I, Hallström I. Breastfeeding progression in preterm infants is influenced by factors in infants, mothers and clinical practice: the results of a national cohort study with high breastfeeding initiation rates. PLoS One 2014; 9:e108208. [PMID: 25251690 PMCID: PMC4177123 DOI: 10.1371/journal.pone.0108208] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/20/2014] [Indexed: 11/19/2022] Open
Abstract
Background and Aim Many preterm infants are not capable of exclusive breastfeeding from birth. To guide mothers in breastfeeding, it is important to know when preterm infants can initiate breastfeeding and progress. The aim was to analyse postmenstrual age (PMA) at breastfeeding milestones in different preterm gestational age (GA) groups, to describe rates of breastfeeding duration at pre-defined times, as well as analyse factors associated with PMA at the establishment of exclusive breastfeeding. Methods The study was part of a prospective survey of a national Danish cohort of preterm infants based on questionnaires and structured telephone interviews, including 1,221 mothers and their 1,488 preterm infants with GA of 24–36 weeks. Results Of the preterm infants, 99% initiated breastfeeding and 68% were discharged exclusively breastfed. Breastfeeding milestones were generally reached at different PMAs for different GA groups, but preterm infants were able to initiate breastfeeding at early times, with some delay in infants less than GA 32 weeks. Very preterm infants had lowest mean PMA (35.5 weeks) at first complete breastfeed, and moderate preterm infants had lowest mean PMA at the establishment of exclusive breastfeeding (36.4 weeks). Admitting mothers to the NICU together with the infant and minimising the use of a pacifier during breastfeeding transition were associated with 1.6 (95% CI 0.4–2.8) and 1.2 days (95% CI 0.1–2.3) earlier establishment of exclusive breastfeeding respectively. Infants that were small for gestational age were associated with 5.6 days (95% CI 4.1–7.0) later establishment of exclusive breastfeeding. Conclusion Breastfeeding competence is not developed at a fixed PMA, but is influenced by multiple factors in infants, mothers and clinical practice. Admitting mothers together with their infants to the NICU and minimising the use of pacifiers may contribute to earlier establishment of exclusive breastfeeding.
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Affiliation(s)
- Ragnhild Maastrup
- Knowledge Centre for Breastfeeding Infants with Special Needs at Department of Neonatology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- * E-mail:
| | - Bo Moelholm Hansen
- Department of Neonatology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Hanne Kronborg
- Department of Public Health, Section of Nursing, University of Aarhus, Aarhus, Denmark
| | - Susanne Norby Bojesen
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- Department of Neonatology, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - Karin Hallum
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- Department of Neonatology, Viborg Regional Hospital, Viborg, Denmark
| | - Annemi Frandsen
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- Paediatric Department, Holbaek University Hospital, Holbaek, Denmark
| | - Anne Kyhnaeb
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- Department of Neonatology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Inge Svarer
- Danish National Panel of Experts on Breastfeeding Infants with Special Needs, Copenhagen, Denmark
- Department of Neonatology, Odense University Hospital, Odense, Denmark
| | - Inger Hallström
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Strand H, Blomqvist YT, Gradin M, Nyqvist KH. Kangaroo mother care in the neonatal intensive care unit: staff attitudes and beliefs and opportunities for parents. Acta Paediatr 2014; 103:373-8. [PMID: 24286253 DOI: 10.1111/apa.12527] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 10/09/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022]
Abstract
AIM To compare attitudes towards Kangaroo mother care (KMC) among staff in two high-tech neonatal intensive care units, which provided parents with different opportunities to get involved in their infants' care. METHOD Questionnaires were completed by healthcare staff in Unit A, which provided parents with unrestricted access so that they could provide continuous KMC, and Unit B, where parents could only practice KMC intermittently. RESULTS Unit A staff were more positive about the benefits and use of KMC, including its use in unstable infants, and rated their knowledge and practical skills more highly than staff in the other unit. Unit B staff also appreciated the method, but expressed more hesitation in using it with unstable infants. In particular, they stressed the need to adapt the physical environment of the NICU to enable parents to stay with their infants and practice the method. CONCLUSION Staff working in the NICU that gave parents unrestricted access were more positive about KMC than staff in the NICU that offered limited opportunities for parents to stay with their children. This finding suggests that it is important to eliminate unjustifiable obstacles to the presence of parents in the NICU, so that they can provide KMC.
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Affiliation(s)
- H Strand
- School Health Nurse; Katedralskolan; Uppsala Sweden
| | - YT Blomqvist
- Neonatal Intensive Care Unit; University Hospital; Uppsala Sweden
| | - M Gradin
- Neonatal Intensive Care Unit; University Hospital; Örebro Sweden
| | - KH Nyqvist
- Department of Women's and Children's Health; Uppsala University; Uppsala Sweden
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