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Ayala A, Erlandsson K, Christensson K, Christensson E, Cavada G, Velandia M. Initiated Breastfeeding and Physiological Patterns in Newborn Infants When Reunited With Mother After Separation Due to Elective Cesarean Birth. Birth 2024. [PMID: 39369425 DOI: 10.1111/birt.12880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 08/27/2024] [Accepted: 08/29/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND The purpose of this study was to compare the effects of two caregiving models on full-term healthy infants' wakefulness, rooting and sucking reflexes, initiation of breastfeeding, and physiological parameters when reunited with their mothers after a mother-infant separation of 130 min after elective cesarean birth. METHODS Ninety-five mother-infant pairs participated in a randomized controlled trial, in which full-term healthy infants were allocated to be either dressed in their mothers' arms (n = 56) or skin-to-skin with their mother (n = 39) when reunited with the mother within 130 min after cesarean birth. Data were collected by the Neonatal Behavioral Assessment Scale (NBAS) to assess the infants' wakefulness and prebreastfeeding behaviors. Physiological parameters were assessed at 15 min intervals, from 130 to 205 min after birth. Time to first breastfeed was measured in minutes from the reunion with the mother. RESULTS The primary finding was that physiologic parameters did not differ but time for initiation of breastfeeding after the reunion with the mother was significantly faster in the skin-to-skin group compared to the infants in the mothers' arms group (p = 0.005). Over the full study period, a more relaxed state and drowsy were found in the skin-to-skin group compared to the infants in the mothers' arms group. CONCLUSION Healthy full-term infants born by elective cesarean, who were cared for by their mothers when reunited within 130 min of separation and cared for by their fathers during the mother-infant separation, initiated breastfeeding successfully and showed stable physiological patterns.
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Affiliation(s)
- Ana Ayala
- Department of Women's and Children's Health, Division Reproductive Health, Karolinska Institutet, Stockholm, Sweden
- Ministry of Health, Santiago de Chile, Chile
| | - Kerstin Erlandsson
- Department of Women's and Children's Health, Division Reproductive Health, Karolinska Institutet, Stockholm, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Kyllike Christensson
- Department of Women's and Children's Health, Division Reproductive Health, Karolinska Institutet, Stockholm, Sweden
| | - Eva Christensson
- Departments of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Gabriel Cavada
- School of Public Health, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Marianne Velandia
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
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Lloyd-Fox S, McCann S, Milosavljevic B, Katus L, Blasi A, Bulgarelli C, Crespo-Llado M, Ghillia G, Fadera T, Mbye E, Mason L, Njai F, Njie O, Perapoch-Amado M, Rozhko M, Sosseh F, Saidykhan M, Touray E, Moore SE, Elwell CE. The Brain Imaging for Global Health (BRIGHT) Project: Longitudinal cohort study protocol. Gates Open Res 2024; 7:126. [PMID: 39372355 PMCID: PMC11452580 DOI: 10.12688/gatesopenres.14795.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2024] [Indexed: 10/08/2024] Open
Abstract
There is a scarcity of prospective longitudinal research targeted at early postnatal life which maps developmental pathways of early-stage processing and brain specialisation in the context of early adversity. Follow up from infancy into the one-five year age range is key, as it constitutes a critical gap between infant and early childhood studies. Availability of portable neuroimaging (functional near infrared spectroscopy (fNIRS) and electroencephalography (EEG)) has enabled access to rural settings increasing the diversity of our sampling and broadening developmental research to include previously underrepresented ethnic-racial and geographical groups in low- and middle- income countries (LMICs). The primary objective of the Brain Imaging for Global Health (BRIGHT) project was to establish brain function - using longitudinal data from mother - for-age reference curves infant dyads living in the UK and rural Gambia and investigate the association between context-associated moderators and developmental trajectories across the first two years of life in The Gambia. In total, 265 participating families were seen during pregnancy, at 7-14 days, 1-, 5-, 8-, 12-, 18- and 24-months post-partum. An additional visit is now underway at 3-5 years to assess pre-school outcomes. The majority of our Gambian cohort live in poverty, but while resource-poor in many factors they commonly experience a rich and beneficial family and caregiving context with multigenerational care and a close-knit supportive community. Understanding the impact of different factors at play in such an environment ( i.e., detrimental undernutrition versus beneficial multigenerational family support) will (i) improve the representativeness of models of general cognitive developmental pathways from birth, (ii) identify causal pathways of altered trajectories associated with early adversity at both individual and group level, and (iii) identify the context-associated moderators ( i.e. social context) that protect development despite the presence of poverty-associated challenges. This will in turn contribute to the development of targeted interventions.
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Affiliation(s)
- Sarah Lloyd-Fox
- Psychology, University of Cambridge, Cambridge, England, UK
- Psychological Sciences, Birkbeck University of London, London, England, UK
| | - Sam McCann
- Women's and Children's Health, Kings College London, London, UK
| | - Bosiljka Milosavljevic
- Psychology, University of Cambridge, Cambridge, England, UK
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, England, UK
| | - Laura Katus
- School of Human Sciences, University of Greenwich, London, England, UK
| | - Anna Blasi
- Medical Physics and Biomedical Engineering, University College London, London, England, UK
| | - Chiara Bulgarelli
- Psychological Sciences, Birkbeck University of London, London, England, UK
- Medical Physics and Biomedical Engineering, University College London, London, England, UK
| | - Maria Crespo-Llado
- Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, England, UK
| | - Giulia Ghillia
- Women's and Children's Health, Kings College London, London, UK
| | - Tijan Fadera
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Ebrima Mbye
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Luke Mason
- Women's and Children's Health, Kings College London, London, UK
| | - Fabakary Njai
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Omar Njie
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | | | - Maria Rozhko
- Psychology, University of Cambridge, Cambridge, England, UK
| | - Fatima Sosseh
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Mariama Saidykhan
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Ebou Touray
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Sophie E. Moore
- Women's and Children's Health, Kings College London, London, UK
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Clare E. Elwell
- Medical Physics and Biomedical Engineering, University College London, London, England, UK
| | - The BRIGHT Project team
- Psychology, University of Cambridge, Cambridge, England, UK
- Psychological Sciences, Birkbeck University of London, London, England, UK
- Women's and Children's Health, Kings College London, London, UK
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, England, UK
- School of Human Sciences, University of Greenwich, London, England, UK
- Medical Physics and Biomedical Engineering, University College London, London, England, UK
- Institute of Lifecourse and Medical Sciences, University of Liverpool, Liverpool, England, UK
- The Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Banjul, The Gambia
- Psychology, University of East London, London, England, UK
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3
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Cordolcini L, Castagna A, Mascheroni E, Montirosso R. Skin-to-Skin Care and Spontaneous Touch by Fathers in Full-Term Infants: A Systematic Review. Behav Sci (Basel) 2024; 14:60. [PMID: 38247712 PMCID: PMC10813587 DOI: 10.3390/bs14010060] [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: 10/27/2023] [Revised: 12/28/2023] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
A series of studies have shown that mothers' early tactile behaviors have positive effects, both on full-term and preterm infants, and on mothers alike. Regarding fathers, research has focused mostly on paternal skin-to-skin care with preterm infants and has overlooked the tactile behavior effects with full-term newborns on infants' outcomes and on fathers themselves. The current systematic review considered the evidence regarding paternal tactile behaviors with full-term infants, including skin-to-skin care (SSC) and spontaneous touch (ST), during parent-infant interactions, and differentiated biophysiological, behavioral and psychological variables both in fathers and in infants. We also compared fathers' and mothers' tactile behaviors for potential differences. The few available studies suggest that paternal touch-SSC and ST-can have positive effects on fathers and infants alike. They also show that, despite some intrinsic differences, paternal touch is as pleasant as maternal touch. However, given the paucity of studies on the topic, we discuss why this field of research should be further explored.
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Affiliation(s)
| | | | | | - Rosario Montirosso
- 0–3 Center for the at-Risk Infant, Scientific Institute IRCCS “Eugenio Medea”, 22040 Bosisio Parini, Italy; (L.C.); (A.C.); (E.M.)
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4
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Lode-Kolz K, Hermansson C, Linnér A, Klemming S, Hetland HB, Bergman N, Lilliesköld S, Pike HM, Westrup B, Jonas W, Rettedal S. Immediate skin-to-skin contact after birth ensures stable thermoregulation in very preterm infants in high-resource settings. Acta Paediatr 2022; 112:934-941. [PMID: 36333892 DOI: 10.1111/apa.16590] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/06/2022]
Abstract
AIM To investigate the impact of immediate skin-to-skin contact with a parent after birth on thermal regulation in very preterm infants. METHODS This clinical trial was conducted in three neonatal intensive care units in Scandinavia from 2018 to 2021. Infants born between 28 + 0 and 32 + 6 weeks and days of gestation were randomised to immediate skin-to-skin contact or conventional care in an incubator during the first 6 postnatal hours. We report on a secondary outcome: serial measurements of axillary temperature. RESULTS Ninety-one infants were randomised to skin-to-skin contact or conventional care. Mean (range) gestational ages were 31 + 2 (28 + 6, 32 + 5) and 31 + 0 (28 + 4, 32 + 6) weeks and days, mean birth weights were 1572 (702, 2352) and 1495 (555, 2440) grams, respectively. Mean (95%CI, p-value) temperatures were within the normal range in both groups, 0.2°C (-0.29, -0.14, p < 0.001) lower in the skin-to-skin contact group. The skin-to-skin contact group had a lower relative risk (95%CI, p-value) of developing events of hyperthermia, RR = 0.70 (0.50, 0.99, p = 0.04). CONCLUSIONS Very preterm infants, irrespective of clinical stability, do not develop hypothermia during immediate skin-to-skin contact after birth. Immediate skin-to-skin contact did protect against events of hyperthermia. Concerns about thermal regulation should not limit implementation of immediate skin-to-skin contact in high-resource settings.
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Affiliation(s)
- Karoline Lode-Kolz
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.,Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Department of Clinical Neurophysiology, Stavanger University Hospital, Stavanger, Norway
| | - Charlotte Hermansson
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Agnes Linnér
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Stockholm, Sweden
| | - Stina Klemming
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Lund-Malmö NIDCAP Training and Research Center, Department of Neonatology, Skåne University Hospital, Lund, Sweden
| | - Hanne Brit Hetland
- Departement of Biostatistics, Stavanger University Hospital, Stavanger, Norway
| | - Nils Bergman
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Siri Lilliesköld
- Department of Neonatology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, 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
| | - Wibke Jonas
- 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, University of Stavanger, Stavanger, Norway
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5
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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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6
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Opiyo N, Bellizzi S, Torloni MR, Souza JP, Betran AP. Association between prelabour caesarean section and perinatal outcomes: analysis of demographic and health surveys from 26 low-income and middle-income countries. BMJ Open 2022; 12:e053049. [PMID: 35039290 PMCID: PMC8765036 DOI: 10.1136/bmjopen-2021-053049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 12/30/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Caesarean section (CS) conducted before labour (prelabour CS (PLCS)), compared with vaginal birth, may pose additional maternal and perinatal risks. No multicountry analysis has examined PLCS in low-income and middle-income countries (LMICs). This study assessed rates, risk factors and associations of PLCS with perinatal outcomes in LMICs. DESIGN Population-based cross-sectional surveys. SETTING Demographic and Health Surveys conducted between 2015 and 2018 in 26 LMICs (13 countries in Africa, 11 in Asia and 2 in the Americas). PARTICIPANTS Women aged 15-49 years with singleton term births. OUTCOME MEASURES Main outcomes were early neonatal mortality, neonatal mortality, early breastfeeding (within 1 hour of birth), skin-to-skin contact and duration of hospital stay. RESULTS 255 227 women were included in the main analysis. Average rates of primary PLCS ranged from 1.3% in Zambia to 19.5% in Maldives. Median PLCS rate was 1.8% in the poorest versus 5.8% in the richest subgroups.Higher maternal age, education, economic status and BMI, lower parity, urban residence, delivery in private hospitals, larger baby size, having health insurance, more antenatal care (ANC) visits, ANC by a doctor and ANC in private hospitals were associated with increased primary PLCS.Across the 26 countries, primary PLCS, compared with vaginal delivery, was associated with increased neonatal mortality (adjusted odds ratio, aOR 1.2, 95% CI 1.0 to 1.5), decreased early breastfeeding (aOR 0.4, 95% CI 0.3 to 0.5) and skin-to-skin contact (aOR 0.4, 95% CI 0.3 to 0.5) and longer hospital stay (aOR 6.6, 95% CI 5.9 to 7.4). No significant association was found for early neonatal mortality (aOR 1.2, 95% CI 0.9 to 1.5). CONCLUSION Primary PLCS, compared with vaginal birth, is associated with adverse perinatal outcomes in singleton term pregnancies in LMICs. Caesarean births should be audited regularly to monitor trends, appropriateness and context-specific drivers of CS.
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Affiliation(s)
- Newton Opiyo
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Maria Regina Torloni
- Evidence-Based Healthcare Post-Graduate Program, Department of Medicine, São Paulo Federal University, Sao Paulo, Brazil
| | - Joao Paulo Souza
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, São Paulo, Brazil
| | - Ana Pilar Betran
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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7
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. Nurs Womens Health 2021; 25:e9-e11. [PMID: 34462236 DOI: 10.1016/j.nwh.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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8
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Immediate and Sustained Skin-to-Skin Contact for Healthy Late Preterm and Term Newborns After Birth: AWHONN Practice Brief Number 14. J Obstet Gynecol Neonatal Nurs 2021; 50:e13-e15. [PMID: 34462182 DOI: 10.1016/j.jogn.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Vogl JL, Dunne EC, Liu C, Bradley A, Rwei A, Lonergan EK, Hopkins BS, Kwak SS, Simon CD, Rand CM, Rogers JA, Weese-Mayer DE, Garfield CF. Kangaroo father care: A pilot feasibility study of physiologic, biologic, and psychosocial measures to capture the effects of father-infant and mother-infant skin-to-skin contact in the Neonatal Intensive Care Unit. Dev Psychobiol 2021; 63:1521-1533. [PMID: 33521969 DOI: 10.1002/dev.22100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 01/01/2023]
Abstract
Robust literature supports the positive effects of kangaroo mother care (KMC) on infant physiologic stability and parent-infant bonding in the Neonatal Intensive Care Unit (NICU). Comparatively little is known about kangaroo father care (KFC) in the NICU, and KFC implementation has been limited. Our pilot feasibility study objective was to examine KFC effects on premature infants and fathers as compared to KMC. Parents of preterm NICU infants independently completed a 90-min Kangaroo Care (KC) session on consecutive days. Infant heart rate variability (HRV) and apnea/periodicity measures were compared (pre-KC to KC; KFC to KMC). Additionally, we assessed the feasibility of administering three psychosocial questionnaires to fathers and mothers in the NICU and after discharge. Ten preterm infants completed 20 KC sessions (334/7 -374/7 weeks post-menstrual age). Results demonstrated similar infant physiologic responses between KMC and KFC, including significant differences in measures of HRV (p < .05) between KC and non-KC periods. Eighty-eight percentage of questionnaires administered were completed, supporting the utilization of these instruments in future research of this population. If confirmed, these preliminary results identify an opportunity to objectively assess KFC effects, supporting the development of empirically based KFC programs benefitting NICU families.
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Affiliation(s)
- Jamie L Vogl
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Emma C Dunne
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Claire Liu
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Allison Bradley
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Alina Rwei
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Erin K Lonergan
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Bradley S Hopkins
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Sung Soo Kwak
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Clarissa D Simon
- Family and Child Health Innovations Program, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - Casey M Rand
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
| | - John A Rogers
- Simpson Querrey Institute, Center for Bio-integrated Electronics, Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
| | - Debra E Weese-Mayer
- Division of Pediatric Autonomic Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Craig F Garfield
- Family and Child Health Innovations Program, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Division of Hospital Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago and Stanley Manne Children's Research Institute, Chicago, IL, USA
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