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Dos Anjos FR, Nakato AM, Hembecker PK, Nohama P, Sarquis ALF. Effects of hydrotherapy and tactile-kinesthetic stimulation on weight gain of preterm infants admitted in the Neonatal Intensive Care Unit. J Pediatr (Rio J) 2022; 98:155-160. [PMID: 34181888 PMCID: PMC9432265 DOI: 10.1016/j.jped.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 10/28/2022] Open
Abstract
OBJECTIVE The present study aimed to evaluate the effects of hydrotherapy and tactile-kinesthetic stimulation on the birth weight of preterm infants admitted in the Neonatal Intensive Care Unit. METHOD It was a randomized controlled trial, without blinding, in which 44 preterm infants of both sexes with gestational age between 32 and 34 weeks were included into two groups: hydrotherapy group (n = = 22) and tactile-kinesthetic stimulation group (n = 22). Weight gain was the parameter assessed daily. RESULTS In the tactile-kinesthetic stimulation group there was a variation in weight gain, but without significant difference (p = 0,43). However, in the hydrotherapy group, it was observed that increased weight gain started from the 2nd day (p < 0,001). CONCLUSIONS Hydrotherapy group presented significantly increased weight after the interventions, indicating that this technique can interfere with weight gain in preterm infants.
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Affiliation(s)
- Franciane R Dos Anjos
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas (HC), Departamento de Pediatria, Curitiba, PR, Brazil; Hospital do Rocio, Serviços Neonatais, Campo Largo, PR, Brazil.
| | - Adriane M Nakato
- Universidade Tecnológica Federal do Paraná, Programa de Pós-Graduação em Engenharia Biomédica, Curitiba, PR, Brazil
| | - Paula Karina Hembecker
- Universidade Tecnológica Federal do Paraná, Programa de Pós-Graduação em Engenharia Biomédica, Curitiba, PR, Brazil
| | - Percy Nohama
- Universidade Tecnológica Federal do Paraná, Programa de Pós-Graduação em Engenharia Biomédica, Curitiba, PR, Brazil
| | - Ana Lúcia F Sarquis
- Universidade Federal do Paraná (UFPR), Hospital de Clínicas (HC), Departamento de Pediatria, Curitiba, PR, Brazil
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Effectiveness of Sucrose Used Routinely for Pain Relief and Neonatal Clinical Risk in Preterm Infants: A Nonrandomized Study. Clin J Pain 2019; 34:713-722. [PMID: 29300197 DOI: 10.1097/ajp.0000000000000584] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preterm infants (PI) requiring the neonatal intensive care unit are exposed to early repetitive pain/distress. Little is known about how pain relief strategies interact with infants' clinical health status, such as severity of illness with pain responses. This study aimed to examine main and interactive effects of routine sucrose intervention and neonatal clinical risk (NCR) on biobehavioral pain reactivity-recovery in PI during painful blood collection procedures. METHODS Very low birth weight PI (<1500 g; n=104) were assigned to low and high clinical risk groups, according to the Clinical Risk Index for Babies. Sucrose group (n=52) received sucrose solution (25%; 0.5 mL/kg) 2 minutes before the procedures and control group received standard care. Biobehavioral pain reactivity-recovery was assessed according to the Neonatal Facial Coding System, sleep-wake state scale, crying time, and heart rate at 5 phases (baseline, antisepsis, puncture (P), recovery-dressing, and recovery-resting [R]). Repeated measure ANOVA with mixed-design was performed considering pain assessment phases, intervention group, and NCR. RESULTS Independent of NCR, sucrose presented main effect in decreasing neonates' facial activity pain responses and crying time, during P and R. Independent of NCR level or routine sucrose intervention, all neonates displayed activated state in P and decreased biobehavioral responses in R phase. Although no sucrose or NCR effects were observed on physiological reactivity, all neonates exhibited physiological recovery 10 minutes after P, reaching the same heart rate patterns as the baseline. CONCLUSIONS Independent of NCR level, sucrose intervention for pain relief during acute painful procedures was effective to reduce pain intensity and increase biobehavioral regulation.
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Bergman NJ, Ludwig RJ, Westrup B, Welch MG. Nurturescience versus neuroscience: A case for rethinking perinatal mother–infant behaviors and relationship. Birth Defects Res 2019; 111:1110-1127. [DOI: 10.1002/bdr2.1529] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Nils J. Bergman
- Department of Women's and Children's HealthKarolinska Institute Stockholm Sweden
| | - Robert J. Ludwig
- Department of PediatricsColumbia University Irving Medical Center New York New York
| | - Björn Westrup
- Department of Women's and Children's HealthKarolinska Institute Stockholm Sweden
| | - Martha G. Welch
- Department of PediatricsColumbia University Irving Medical Center New York New York
- Department of Pathology and Cell BiologyColumbia University Irving Medical Center New York New York
- Department of PsychiatryColumbia University Irving Medical Center New York New York
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Robertson AM, Detmer MR. The Effects of Contingent Lullaby Music on Parent-Infant Interaction and Amount of Infant Crying in the First Six Weeks of Life. J Pediatr Nurs 2019; 46:33-38. [PMID: 30826725 DOI: 10.1016/j.pedn.2019.02.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/11/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE The purpose of this study was to examine the effect of a live music intervention provided by the mother on full term infants' amount of crying and parent-infant interaction in the first six weeks of life. DESIGN AND METHODS A randomized posttest-only experimental/no-contact control group design was used for this study. A sample of 66 mothers with healthy, newborn infants were recruited. The researcher wrote an original lullaby with each mother in the experimental group and gave instructions as to how to use the lullaby as reinforcement for infant quiet, non-crying behavior. Mother-infant dyads were assessed over a six-week period for infant crying amounts and parent-infant interaction behaviors. Demographic variables, postpartum depression, and value of music were assessed as well to detect associations between variables and groups. RESULTS Results indicated that there were significant differences between groups for mean crying time per week and mother-infant interaction behaviors. Analysis by demographic variables such as mother parity, socioeconomic status, and marital status showed no significant group differences on infant crying or interaction scores. Mothers who used the contingent music intervention were more motivated to sing and valued the use of music with their infants more than mothers in the control group. CONCLUSIONS The outcomes of this study demonstrate importance of parental singing for mother-infant bonding. PRACTICE IMPLICATIONS Implementing early intervention services, such as music therapy in the postpartum unit, can provide new mothers useful music applications that can enhance mother-infant interaction, especially mothers living in high stress or negative environments.
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Affiliation(s)
- Amy M Robertson
- Florida State University, College of Music, Tallahassee, FL, United States of America.
| | - Michael R Detmer
- Norton Women's and Children's Hospital, University of Louisville, Louisville, KY, United States of America.
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Shattnawi KK, Al-Ali N. The Effect of Short Duration Skin to Skin Contact on Premature Infants' Physiological and Behavioral Outcomes: A Quasi-Experimental Study. J Pediatr Nurs 2019; 46:e24-e28. [PMID: 30782417 DOI: 10.1016/j.pedn.2019.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 02/02/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This study aimed at assessing the effect of short duration Skin to skin contact (SSC) (5 days) on premature infants' short-term physiological and behavioral outcomes. DESIGN AND METHODS A quasi-experimental control group design was utilized. 89 stable premature infants were allocated to either an interventional or control group. RESULTS Results showed that in comparison to the control group, newborns in the SSC group demonstrated higher weight gain (g/day) from day 3-5 of practicing SSC (53.7 g Vs. 32.6 g; P < .05), experienced significantly fewer numbers of apneas (48% Vs. 33.3%; P = .001), and were less likely to use formula feeding (60% Vs. 90%) and more likely to use mixed feeding (formula and breastfeeding) at discharge (33.3% Vs. 10%). Significant differences were also found in the crying, and sleeping patterns of the infants; infants of mothers who practiced SSC were less likely to cry in a continuous pattern and more likely to experience good sleep than infants in the control group. CONCLUSIONS The study highlights the importance of the early and short duration of SSC for premature infants. PRACTICE IMPLICATIONS The initiation of SSC in the first few days of life may have a significant influence on the newborn's short-term outcomes.
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Affiliation(s)
| | - Nahla Al-Ali
- Jordan University of Science and Technology, Irbid, Jordan.
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Geerling I, Roberts RM, Sved Williams A. Impact of infant crying on mothers with a diagnosis of borderline personality disorder: A qualitative study. Infant Ment Health J 2019; 40:405-421. [PMID: 30964954 DOI: 10.1002/imhj.21776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Mothers with borderline personality disorder (BPD) and their infants often have compromised relationships. To further understand the complexities, this study explored (a) the experiences of mothers with BPD in response to infant crying and (b) how these parenting responses impact on mothers' interpersonal functioning with significant others. Six mothers with clinical BPD were recruited from a mother-baby psychiatric unit and interviewed using an interpretative phenomenological analysis (IPA) approach. Transcripts of the semistructured interviews were coded for themes and subthemes. Dominant themes revealed that mothers with BPD entered motherhood in a psychologically fragile state, hypersensitive to experiencing intense physiological-emotional pain and cognitive chaos in response to infant crying. Automatic maladaptive flight-fright responses including suicide attempts were common. A novel theme revealed some mothers' split identity, and only the "mother" part could attend to infant crying. Finally, the data provided an understanding of the detrimental domino effect on close family. Mothers also highlighted gaps in accessibility of current mental health services and parenting programs, and their desire to prevent the intergenerational transmission of attachment problems and BPD symptoms to offspring. Clinical implications include antenatal BPD screening, psychoeducation about infant crying, and greater access for programs supporting the whole family to improve outcomes.
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Affiliation(s)
- Ingrid Geerling
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Rachel M Roberts
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Anne Sved Williams
- Women's & Children's Health Network, Adelaide, Australia.,Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
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Resignation/Dissoziation des Säuglings statt gelungener Selbstregulation. Monatsschr Kinderheilkd 2018. [DOI: 10.1007/s00112-018-0570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kommers D, Broeren M, Oei G, Feijs L, Andriessen P, Bambang Oetomo S. Oxytocin levels in the saliva of preterm infant twins during Kangaroo care. Biol Psychol 2018; 137:18-23. [DOI: 10.1016/j.biopsycho.2018.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/22/2018] [Accepted: 06/29/2018] [Indexed: 12/20/2022]
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De Clifford-Faugère G, Lavallée A, Aita M. Olfactive stimulation interventions for managing procedural pain in preterm and full-term neonates: a systematic review protocol. Syst Rev 2017; 6:203. [PMID: 29041964 PMCID: PMC5646110 DOI: 10.1186/s13643-017-0589-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While hospitalized in the NICU, preterm neonates undergo many painful procedures. This may be the same for full-term neonates when longer hospitalization is required. Untreated and repeated pain has short-term as well as long-term consequences for these neonates. Pharmacological pain management methods have many limitations in their applications for both preterm and full-term neonates. A combination of different non-pharmacological methods is recommended for pain management. The effect of olfactive stimulation as a non-pharmacological pain management method was investigated by a few studies in the past years with premature and term neonates, but no systematic review has been conducted. The objective of this systematic review is to evaluate the effect of olfactive stimulation intervention on the pain response of preterm and full-term neonates during painful procedures. METHODS An electronic search will be conducted in various databases such as PubMed (1946 to date), MEDLINE (1946 to date), CINAHL (1981 to date), Embase (1947 to date), PsycINFO (1806 to date), Web of Science (1945 to date), CENTRAL and Scopus (1960 to date), and Proquest, without restriction for the year of publication. Only studies published in English or French will be included. The search will be conducted using the following three concepts: pain, odors, and neonates. Selection of articles, data extraction, and assessment of risk of bias will be conducted by two independent researchers. A third researcher will intervene in case of disagreement. According to the availability of studies and data homogeneity, the results will be combined to perform a meta-analysis, or they will be described by a narrative synthesis. DISCUSSION This systematic review will provide light on the current state of knowledge on the effectiveness of olfactive stimulation interventions for managing pain in preterm and full-term neonates. This review will guide clinical practice as well as research to improve preterm and full-term neonates' pain management and prevent short-term and long-term complications caused by pain. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017058021.
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Affiliation(s)
- Gwenaëlle De Clifford-Faugère
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, H3C 3J7, Canada. .,CHU Sainte-Justine Research Center, Montreal, Canada.
| | - Andréane Lavallée
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, H3C 3J7, Canada.,CHU Sainte-Justine Research Center, Montreal, Canada
| | - Marilyn Aita
- Faculty of Nursing, Université de Montréal, C.P. 6128 Succ. Centre-ville, Montreal, H3C 3J7, Canada.,CHU Sainte-Justine Research Center, Montreal, Canada.,Quebec Network of Nursing Intervention Research (RRISIQ), Montreal, Canada
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Kommers DR, Truijens SEM, Oei SG, Bambang Oetomo S, Pop VJM. Antenatal mother–infant bonding scores are related to maternal reports of infant crying behaviour. J Reprod Infant Psychol 2017. [DOI: 10.1080/02646838.2017.1354360] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Deedee R. Kommers
- Department of Neonatology, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, The Netherlands
| | - Sophie E. M. Truijens
- Department of Obstetrics and Gynaecology, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands
| | - S. Guid Oei
- Department of Obstetrics and Gynaecology, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sidarto Bambang Oetomo
- Department of Neonatology, Máxima Medical Centre Veldhoven, Veldhoven, The Netherlands
- Department of Industrial Design, Eindhoven University of Technology, The Netherlands
| | - Victor J. M. Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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Koutseff A, Reby D, Martin O, Levrero F, Patural H, Mathevon N. The acoustic space of pain: cries as indicators of distress recovering dynamics in pre-verbal infants. BIOACOUSTICS 2017. [DOI: 10.1080/09524622.2017.1344931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Alexis Koutseff
- Equipe Neuro-Ethologie Sensorielle, ENES/Neuro-PSI CNRS UMR9197, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - David Reby
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Florence Levrero
- Equipe Neuro-Ethologie Sensorielle, ENES/Neuro-PSI CNRS UMR9197, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - Hugues Patural
- SNA-EPIS EA4607, University of Lyon/Saint-Etienne, Saint-Etienne, France
| | - Nicolas Mathevon
- Equipe Neuro-Ethologie Sensorielle, ENES/Neuro-PSI CNRS UMR9197, University of Lyon/Saint-Etienne, Saint-Etienne, France
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Kommers DR, Broeren MAC, Andriessen P, Oei SG, Feijs L, Bambang Oetomo S. Pilot study demonstrates that salivary oxytocin can be measured unobtrusively in preterm infants. Acta Paediatr 2017; 106:34-42. [PMID: 27666329 PMCID: PMC5215538 DOI: 10.1111/apa.13606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 06/08/2016] [Accepted: 09/21/2016] [Indexed: 12/16/2022]
Abstract
Aim This study assessed the feasibility and obtrusiveness of measuring salivary oxytocin in preterm infants receiving Kangaroo care, because this is a period of maximal bonding or co‐regulation. We also analysed possible influential determinants, including maternal oxytocin. Methods The saliva of preterm infants and their mothers was collected prior to, and during, Kangaroo care using cotton swabs and pooled into vials until sufficient volumes were obtained to measure oxytocin levels using a radioimmunoassay. The obtrusiveness of the infants’ collections was measured with a Likert scale. Results Saliva was collected unobtrusively prior to, and during, 30 Kangaroo care sessions in 21 preterm infants. This resulted in three vials with sufficient volumes of before‐Kangaroo care saliva and three with during‐Kangaroo care saliva. Oxytocin was detectable in all six vials. The Kangaroo care duration and the intensity of the mother–infant interaction before and during Kangaroo care seemed to be the most important determinants, and these should preferably be standardised in any future trials. Conclusion Oxytocin was measured unobtrusively in the pooled saliva of preterm infants both before and during Kangaroo care and could therefore be investigated as a biomarker in future studies.
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Affiliation(s)
- DR Kommers
- Department of Neonatology; Máxima Medical Centre; Veldhoven The Netherlands
- Department of Industrial Design; Eindhoven University of Technology; Eindhoven The Netherlands
| | - MAC Broeren
- Clinical Chemistry Laboratory; Máxima Medical Centre; Veldhoven The Netherlands
| | - P Andriessen
- Department of Neonatology; Máxima Medical Centre; Veldhoven The Netherlands
- Department of Pediatrics; School for Mental Health and Neuroscience; Faculty of Health, Medicine and Life Sciences; Maastricht University Medical Center; Maastricht The Netherlands
| | - SG Oei
- Department of Electrical Engineering; Eindhoven University of Technology; Eindhoven The Netherlands
- Department of Gynaecology; Máxima Medical Centre; Veldhoven The Netherlands
| | - L Feijs
- Department of Industrial Design; Eindhoven University of Technology; Eindhoven The Netherlands
| | - S Bambang Oetomo
- Department of Neonatology; Máxima Medical Centre; Veldhoven The Netherlands
- Department of Industrial Design; Eindhoven University of Technology; Eindhoven The Netherlands
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Winsper C, Wolke D. Infant and toddler crying, sleeping and feeding problems and trajectories of dysregulated behavior across childhood. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2015; 42:831-43. [PMID: 24122374 DOI: 10.1007/s10802-013-9813-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Infant and toddler regulatory problems (RPs) including crying, sleeping and feeding, are a frequent concern for parents and have been associated with negative behavioral outcomes in early and middle childhood. Uncertain is whether infant and toddler RPs predict stable, trait-like dysregulated behavior across childhood. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). RPs at 6, 15-18, & 24-30 months and childhood dysregulated behavior at 4, 7, 8, & 9.5 years were assessed using mother report. Latent Class Growth Analysis (LCGA) indicated that trajectories of childhood dysregulated behavior were stable over time. All single RPs (i.e., crying, sleeping & feeding problems) were significantly associated with childhood dysregulated behavior. For example, crying problems at 6 months after controlling for confounders (Odds Ratios; 95% Confidence Intervals): Moderate dysregulated behavior: OR = 1.50, 95% CI [1.09 to 2.06], high dysregulated behavior: OR = 2.13, 95% CI [1.49 to 3.05] and very high dysregulated behavior: OR = 2.85, 95% CI [1.64 to 4.94]. Multiple RPs were especially strongly associated with dysregulated behavior. For example, the RP composite at 15-18 months: 1 RP, very high dysregulated behavior: OR = 2.79, 95% CI [2.17 to 3.57], 2 RPs, very high dysregulated behavior: OR = 3.46, 95% CI [2.38 to 5.01], 3 RPs, very high dysregulated behavior: OR = 12.57, 95% CI [6.38 to 24.74]. These findings suggest that RPs in infants and toddlers predict stable dysregulated behavior trajectories across childhood. Interventions for early RPs could help prevent the development of chronic, highly dysregulated behavior.
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Affiliation(s)
- Catherine Winsper
- Department of Psychology and Division of Mental Health and Wellbeing (Warwick Medical School), University of Warwick, Coventry, CV4 7AL, UK,
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Eksioglu AS, Tasci Yildiz Y, Senel S. Normal sizes of internal jugular veins in children/adolescents aged birth to 18 years at rest and during the Valsalva maneuver. Eur J Radiol 2014; 83:673-9. [PMID: 24461996 DOI: 10.1016/j.ejrad.2013.12.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 12/20/2013] [Accepted: 12/24/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVES We aimed to establish normal ultrasonographic (US) values of internal jugular vein (IJV) sizes in children/adolescents aged birth to 18 years and to determine the correlation of US measurements with age, height, weight and body surface area (BSA) of children in different age groups. METHODS Two hundred and thirty-six healthy children (0-18 years) were divided into four groups according to their age (0-2, 3-6, 7-12, and 13-18 years). US measurements (transverse, anteroposterior diameter, and cross-sectional area at rest and during the Valsalva maneuver) of bilateral IJVs were taken at the level of cricoid cartilage. RESULTS Our study gives information about the reference values in children between birth to 18 years of age. There were significant differences between measurements taken at rest and during the Valsalva maneuver in all age groups. Moderate to strong correlations (clinically significant) between age, height and BSA of the subjects and IJV measurements were detected only in the 0-2 years age group. The strength of the correlations decreased with increasing age. Pearson's correlation revealed that height had the strongest and weight had the weakest correlation with US measurements. 'Height' was an independent variable on the right, and 'age' on the left side, except for rest CSA, when a regression analysis was performed for clinically significant correlations. CONCLUSIONS Determination of normal reference values for US measurements of the IJV and knowledge of correlation with age, height, weight and BSA might be valuable during interventional procedures and for the diagnosis of phlebectasia in children/adolescents.
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Affiliation(s)
- Ayse Secil Eksioglu
- Dr. Sami Ulus Women and Children's Hospital, Radiology Department, Babür Caddesi No:4, 06080 Altındağ, Ankara, Turkey.
| | - Yasemin Tasci Yildiz
- Dr. Sami Ulus Women and Children's Hospital, Radiology Department, Babür Caddesi No:4, 06080 Altındağ, Ankara, Turkey.
| | - Saliha Senel
- Dr. Sami Ulus Women and Children's Hospital, Department of Pediatrics, Babür Caddesi No:4, 06080 Altındağ, Ankara, Turkey.
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Abstract
Pain assessment and measurement are the cornerstones of pain management. Pain assessment connotes a comprehensive multidimensional description. Conversely, pain measurement provides a numeric quantitative description of each factor illustrating pain qualities. Pain scales provide a composite score used to guide practice and research. The type of infant pain instrument chosen is a significant factor in guiding pain management practice. The purpose of this review was to summarize current infant pain measures by introducing a conceptual framework for pain measurement. Although more than 40 infant pain instruments exist, many were devised solely for research purposes; several of the newly developed instruments largely overlap with existing instruments. Integration of pain management into daily practice remains problematic. Understanding how each instrument measures infant pain allows clinicians to make better decisions about what instrument to use with which infant and in what circumstances. In addition, novel new measurement techniques need further testing.
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Zores C, Dufour A, Langlet C, Escande B, Astruc D, Kuhn P. Spontaneous cries can alter the physiological well-being and cerebral oxygenation of very preterm infants. Early Hum Dev 2013; 89:125-9. [PMID: 23022718 DOI: 10.1016/j.earlhumdev.2012.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Revised: 09/02/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Infant crying is a major expression of distress and can occur without any exogenous stimulation. Little is known, however, about the effects of crying on physiological homeostasis in very preterm infants (VPIs). METHODS Environmental, behavioral (video and audio recording) and physiologic (heart rate [HR], respiratory rate [RR], and systemic [SaO(2)] and regional cerebral oxygenation [rSO(2)]) parameters were prospectively evaluated over 10h in 18 VPIs (median gestational age, 28 [27-31] weeks). Only episodes of "spontaneous" and isolated cries were analyzed. Changes in parameters were compared over 5-second periods between baselines and 40s following the onset of crying. Two periods were distinguished: 0-20s (a) and 20-40s (b). Minimal and/or maximal values in these periods were also compared to the baseline. RESULTS Of the 18 VPIs initially studied, 13 (72%) presented crying episodes (CE). They experienced 210 "spontaneous" and isolated CE, with a median of 9 [range, 1-63] CEs per child. Physiological values varied significantly from the baseline with mainly a mean decrease in HR of -4.8±5.3 beats/min (b) after an initial mean increase of +2.6±2.0 beats/min (a); a mean decrease in RR of -3.8±4.8 cycles/min (a), followed by a mean increase of +5.6±7.3 cycles/min (b) and mean unidirectional decreases in SaO(2) and rSO(2) (minimal values) of -1.8±2.3% and -2.5±3.0%, respectively. CONCLUSION Spontaneous cries can alter the homeostasis of VPIs. Their possible adverse consequences and high occurrence emphasize the need for better prevention and response to them.
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Affiliation(s)
- Claire Zores
- Laboratoire d'Imagerie & Neurosciences Cognitives, UMR 7237 Université de Strasbourg, Centre National de la Recherche Scientifique, Strasbourg, France
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Cruise S, Tam-Chan D, Harrison D, Johnston L. Prospective clinical audit of chloral hydrate administration practices in a neonatal unit. J Paediatr Child Health 2012; 48:1010-5. [PMID: 23039031 DOI: 10.1111/j.1440-1754.2012.02586.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM Chloral hydrate is generally considered a safe and effective single dosing procedural sedative for neonates in the clinical setting. However, its safety profile as a repetitive dosing maintenance sedative is largely unknown. This study aimed to document current administration practices of chloral hydrate in the Neonatal Unit, Royal Children's Hospital, Melbourne, Australia, over a 6-month period. METHODS Patients who had been prescribed chloral hydrate during the specified audit period were recruited into the study and prospectively followed for a period of 28 days, or until they were discharged from the unit. Demographic data were collected on recruitment, and daily documentation of chloral hydrate administration was recorded. RESULTS A total of 238 doses of chloral hydrate were administered to a cohort of 32 patients during the study period. The majority of the audited doses (84%) were ordered as repeating doses. Doses were more likely to be given at night than during the day, and the median dosage for repetitive dosing was found to be above the study site's recommended dosing range. Pre-dose and/or post-dose assessment of distress/agitation accompanied dosage approximately half of the time. The audit did not reveal any recognisable pattern of sedation maintenance or weaning process for patients who received multiple doses. CONCLUSIONS Health-care professionals caring for hospitalised infants should be made aware of the potential risks of chloral hydrate as a repetitive dosing sedative, and of the importance of systematically evaluating the appropriateness and effectiveness of utilising such pharmacological intervention for managing and treating distress.
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Affiliation(s)
- Sharon Cruise
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Island, UK
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Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012; 5:CD003519. [PMID: 22592691 PMCID: PMC3979156 DOI: 10.1002/14651858.cd003519.pub3] [Citation(s) in RCA: 230] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Mother-infant separation postbirth is common in Western culture. Early skin-to-skin contact (SSC) begins ideally at birth and involves placing the naked baby, head covered with a dry cap and a warm blanket across the back, prone on the mother's bare chest. According to mammalian neuroscience, the intimate contact inherent in this place (habitat) evokes neurobehaviors ensuring fulfillment of basic biological needs. This time may represent a psychophysiologically 'sensitive period' for programming future physiology and behavior. OBJECTIVES To assess the effects of early SSC on breastfeeding, physiological adaptation, and behavior in healthy mother-newborn dyads. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 November 2011), made personal contact with trialists, and consulted the bibliography on kangaroo mother care (KMC) maintained by Dr. Susan Ludington. SELECTION CRITERIA Randomized controlled trials comparing early SSC with usual hospital care. DATA COLLECTION AND ANALYSIS We independently assessed trial quality and extracted data. Study authors were contacted for additional information. MAIN RESULTS Thirty-four randomized controlled trials were included involving 2177 participants (mother-infant dyads). Data from more than two trials were available for only eight outcome measures. For primary outcomes, we found a statistically significant positive effect of early SSC on breastfeeding at one to four months postbirth (13 trials; 702 participants) (risk ratio (RR) 1.27, 95% confidence interval (CI) 1.06 to 1.53, and SSC increased breastfeeding duration (seven trials; 324 participants) (mean difference (MD) 42.55 days, 95% CI -1.69 to 86.79) but the results did not quite reach statistical significance (P = 0.06). Late preterm infants had better cardio-respiratory stability with early SSC (one trial; 31 participants) (MD 2.88, 95% CI 0.53 to 5.23). Blood glucose 75 to 90 minutes following the birth was significantly higher in SSC infants (two trials, 94 infants) (MD 10.56 mg/dL, 95% CI 8.40 to 12.72).The overall methodological quality of trials was mixed, and there was high heterogeneity for some outcomes. AUTHORS' CONCLUSIONS Limitations included methodological quality, variations in intervention implementation, and outcomes. The intervention appears to benefit breastfeeding outcomes, and cardio-respiratory stability and decrease infant crying, and has no apparent short- or long-term negative effects. Further investigation is recommended. To facilitate meta-analysis, future research should be done using outcome measures consistent with those in the studies included here. Published reports should clearly indicate if the intervention was SSC with time of initiation and duration and include means, standard deviations and exact probability values.
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Poskey GA, Hersch G. Listening to Their Voices: Parents' Perspectives on Infant Crying. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2012. [DOI: 10.1080/19411243.2012.701559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Sadathosseini AS, Negarandeh R, Movahedi Z. The effect of a familiar scent on the behavioral and physiological pain responses in neonates. Pain Manag Nurs 2012; 14:e196-e203. [PMID: 24315273 DOI: 10.1016/j.pmn.2011.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 10/06/2011] [Accepted: 10/17/2011] [Indexed: 11/25/2022]
Abstract
There are adverse physiologic effects of pain in neonates, and effective pain management must be an essential aspect of neonatal care. In this study we assessed the effect of a nonmaternal familiar scent on the neonatal pain responses. This study included 135 neonates randomly assigned to one of three groups. During arterial puncture, one group was exposed to a vanillin scent on a gauze pad held next to their nose. They were familiarized with it the night before blood sampling by a scented gauze pad placed in the incubator next to their head for an average duration of 8.65 hours. The second group was not familiarized with the scent but was exposed to it during the procedure. The third group was neither familiarized nor exposed to the scent. The duration of crying in the familiar scent group was significantly lower than in the two other groups. Comparison of the physiologic parameters showed less variation in oxygen saturation level during arterial puncture in the familiar scent group. In this study, a familiar scent could reduce crying and oxygen consumption during arterial puncture.
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Affiliation(s)
| | - Reza Negarandeh
- School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Movahedi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
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Cong X, Ludington-Hoe SM, Walsh S. Randomized crossover trial of kangaroo care to reduce biobehavioral pain responses in preterm infants: a pilot study. Biol Res Nurs 2010; 13:204-16. [PMID: 21196428 DOI: 10.1177/1099800410385839] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Kangaroo care (KC), skin-to-skin contact between mother and infant, is a promising method for blunting pain responses. This crossover pilot tested KC effects on biobehavioral responses to heel stick in preterm infants (30-32 weeks' gestational age, 2-9 days old) measured by Premature Infant Pain Profile (PIPP) and salivary and serum cortisol. Mother-infant dyads were randomly assigned to KC heel stick (KCH) first or incubator heel stick (IH) first. Study 1 (80-min study, N = 18) tested the effect of 80 min of KC before and throughout the heel stick procedure versus incubator care. Study 2 (30-min study, N = 10) tested 30 min of KC before and throughout the heel stick versus incubator care. KCH and IH began during a premeasurement phase and continued through four data collection phases: baseline, heel warming, heel stick, and recovery. PIPP responses were measured every 30 s during data collection; salivary cortisol was measured at the end of baseline and recovery; and serum cortisol was measured during heel stick. Study 1 showed no differences between KCH and IH. Study 2 showed lower PIPP scores at four time points during recovery (p < .05 to p < .001), lower salivary cortisol at the end of recovery (p < .05), and lower serum cortisol during heel stick for the KCH condition (p < .05) as well as clinically lower PIPP scores in the KCH condition during heel stick. Thirty minutes of KC before and throughout the heel stick reduced biobehavioral responses to pain in preterm infants.
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Affiliation(s)
- Xiaomei Cong
- University of Connecticut School of Nursing, Storrs, CT, USA.
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23
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The beginning breastfeeding survey: Measuring mothers' perceptions of breastfeeding effectiveness during the postpartum hospitalization. Res Nurs Health 2010; 33:329-44. [DOI: 10.1002/nur.20384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Vivancos RBZ, Leite AM, Scochi CGS, Santos CBD. O contato pele a pele ao nascimento e o choro de recém-nascidos durante vacinação contra Hepatite B. ACTA PAUL ENFERM 2010. [DOI: 10.1590/s0103-21002010000400003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Testar a efetividade do contato pele a pele entre mãe e filho após o nascimento na redução do comportamento de estresse/dor manifestado pelo choro do recém-nascido (RN), decorrente do procedimento de vacinação contra a Hepatite B. MÉTODOS: Estudo comparativo quase-experimental abrangendo 40 RN a termo, divididos em dois grupos, com ou sem contato pele a pele com suas mães após o nascimento, e que foram comparados quanto ao tempo de choro durante a vacinação contra Hepatite B. RESULTADOS: Variações no tempo de choro foram observadas nos dois grupos durante as fases desse procedimento. CONCLUSÃO: O efeito do contato na diminuição do tempo de choro dos RN, não foi demonstrado estatisticamente. Clinicamente, a Síndrome do Chamado pelo Estresse foi observada, bem como a efetividade do período de contato, na modulação do comportamento de choro dos neonatos, enquanto estes estiveram sob o momento terapêutico.
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Uyan ZS, Bi˙lgen H, Topuzoğlu A, Akman İ, Özek E. Comparison of three neonatal pain scales during minor painful procedures. J Matern Fetal Neonatal Med 2009; 21:305-8. [DOI: 10.1080/14767050802034107] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Gaspardo CM, Chimello JT, Cugler TS, Martinez FE, Linhares MBM. Pain and tactile stimuli during arterial puncture in preterm neonates. Pain 2008; 140:58-64. [DOI: 10.1016/j.pain.2008.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Revised: 06/11/2008] [Accepted: 07/07/2008] [Indexed: 12/31/2022]
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Arditi-Babchuk H, Feldman R, Eidelman AI. Rapid eye movement (REM) in premature neonates and developmental outcome at 6 months. Infant Behav Dev 2008; 32:27-32. [PMID: 18996599 DOI: 10.1016/j.infbeh.2008.09.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2008] [Revised: 06/17/2008] [Accepted: 09/19/2008] [Indexed: 11/25/2022]
Abstract
Different aspects of early sleep organization have been associated with subsequent development in premature infants. The aim of the present study was to assess the relations between rapid eye movement (REM) activity in premature neonates and infants' developmental outcomes at 6 months. Participants were 81 premature infants (47 males). Sleep-wake states and REM were observed across 4 consecutive evening hours (7-11 PM) in 10-s frames when infants were between 32 and 36 weeks post-menstrual age. Developmental outcome was assessed at 6 months with the mental development index (MDI) of the Bayley II. Infants with low-REM activity spent more time in less growth-promoting states, including crying and unfocused alert states in the neonatal period and had lower MDI scores at 6 months corrected age compared to infants with high-REM. Differences between the high- and low-REM groups were independent of neonatal medical risk. Low-REM activity may serve as an indicator of developmental risk among premature neonates.
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Affiliation(s)
- Hadar Arditi-Babchuk
- Department of Psychology and the Gonda Brain Research Center, Bar-Ilan University, Ramat-Gan, Israel
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29
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Does Hyaluronic Acid Distribution in the Larynx Relate to the Newbornʼs Capacity for Crying? Laryngoscope 2008; 118:1692-9. [DOI: 10.1097/mlg.0b013e3181782754] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kostandy RR, Ludington-Hoe SM, Cong X, Abouelfettoh A, Bronson C, Stankus A, Jarrell JR. Kangaroo Care (skin contact) reduces crying response to pain in preterm neonates: pilot results. Pain Manag Nurs 2008; 9:55-65. [PMID: 18513662 DOI: 10.1016/j.pmn.2007.11.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2007] [Revised: 11/20/2007] [Accepted: 11/27/2007] [Indexed: 12/17/2022]
Abstract
Crying commonly occurs in response to heel stick and adversely affects the infant's physiologic stability. Minimal crying in response to pain is desired. "Kangaroo Care," skin contact between mother and infant, reduces pain and may reduce crying in response to pain. The purpose of this pilot study was to test Kangaroo Care's effect on the preterm infant's audible and inaudible crying response to heel stick. Inaudible crying has not been previously studied. A prospective randomized cross-over study with 10 preterm infants 2-9 days old (30-32 weeks' postmenstrual age) was conducted. Infants were randomly assigned to two sequences (sequence A: day 1 heel stick in Kangaroo Care [after 30 min of prone skin contact upright between maternal breasts] and day 2 heel stick in incubator [inclined, nested and prone]; or sequence B: opposite of sequence A) was conducted. Videotapes of baseline, heel warming, heel stick, and recovery phases were scored for audible and inaudible crying times. Audible and inaudible crying times for each subject in each phase were summed and analyzed by repeated-measures analysis of variance. Subject characteristics did not differ between those in the two sequences. Crying time differed between the study phases on both days (p <or= .001). When in Kangaroo Care compared with the incubator, crying time was less during the heel stick (p = .001) and recovery (p = .01) phases, regardless of sequence. Because Kangaroo Care reduced crying in response to heel stick in medically stable preterm infants, a definitive study is merited before making recommendations.
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Affiliation(s)
- Raouth R Kostandy
- College of Nursing, University of Akron, Akron, Ohio 44325-3701, USA.
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31
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Cruvinel FG, Macedo ECD. Interação mãe-bebê pré-termo e mudança no estado de humor: comparação do Método Mãe-Canguru com visita na Unidade de Terapia Intensiva Neonatal. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2007. [DOI: 10.1590/s1519-38292007000400012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: avaliar mudanças nos estados de humor de mães de bebês pré-termo em função do tipo de contato com o seu filho: Método Mãe-Canguru (MMC) e visita ao filho na incubadora da Unidade de Terapia Intensiva Neonatal. MÉTODOS: foi aplicada a Escala Analógica de Humor em 60 mães divididas em 2 grupos: mães que participam do Método Mãe-Canguru (GC) e mães que acompanharam o bebê na incubadora (GI). Os grupos foram pareados em função da idade das mães, número de gestações e tipo de parto. As mães foram avaliadas antes e depois de uma das visitas ao filho na incubadora ou sessão de MMC. RESULTADOS: as mães do GC melhoraram o humor, relatando: sentirem-se mais calmas, fortes, com idéias claras, ágeis, dinâmicas, satisfeitas, tranqüilas, perspicazes, relaxadas, atentas, competentes, alegres e amistosas. As mães do GI não apresentaram melhora no estado de humor em nenhum item, mas pioraram no item "sentindo-se desajeitada". CONCLUSÕES: o Método Mãe-Canguru mostrou-se eficaz na melhora nos estados de humor de mães de bebês pré-termo, contribuindo assim para a minimização dos efeitos negativos da internação neonatal.
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Karazincir S, Akoğlu E, Balci A, Sangün O, Okuyucu S, Ozbakiş C, Karazincir O. Dimensions of internal jugular veins in Turkish children aged between 0 and 6 years in resting state and during Valsalva maneuver. Int J Pediatr Otorhinolaryngol 2007; 71:1247-50. [PMID: 17540460 DOI: 10.1016/j.ijporl.2007.04.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2007] [Revised: 04/20/2007] [Accepted: 04/24/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We aimed to establish the values of the internal jugular vein (IJV) sizes in Turkish children aged between 0 and 6 years. METHODS Ninety-four normal children included in this study. All of the children were imaged by ultrasonography (USG) at the level of the cricoid cartilage. The maximal antero-posterior (AP) and transverse (T) diameters of the IJV were measured during regular breathing and Valsalva maneuver. RESULTS The mean transverse diameter of the right and left IJV were 8.11+/-3.01 and 7.64+/-2.68 mm in resting state. These values changed to 12.57+/-4.34 and 10.82+/-3.80 mm in Valsalva state, respectively. The AP diameters were found to be 5.43+/-2.07 for the right and 5.86+/-4.53 mm for the left IJV at rest. During VM, these values changed to 8.70+/-2.40 and 8.30+/-2.90 mm for the right and left IJV, respectively. There was no significant difference on the evaluation of the relationship between the right and left diameters of the IJV. While there were significant differences in sizes between the resting and Valsalva states. Also, the T diameter of the right IJV during Valsalva state was greater than those of the left. There were significant correlations between the diameters of the IJV and the age, weight and height of the children. CONCLUSION The results we obtained in this study may be important in an attempt of intravascular intervention to IJV. These values may also be important for the comparison with the IJV sizes of the patients who have phlebectasia.
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Affiliation(s)
- Sinem Karazincir
- Mustafa Kemal University, Faculty of Medicine, Department of Radiology, Turkey
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Abstract
This review examines an age-old approach to parenting recently rediscovered in Western industrialized societies and known by names such as natural parenting, attachment parenting, and instinctive parenting. Its leading principle is utmost sensitivity to the child's innate emotional and physical needs, resulting in extended breastfeeding on demand, extensive infant carrying on the caregiver's body, and cosleeping of infant and parents. The described practices prevailed during the evolutionary history of the human species and reflect the natural, innate rearing style of the human species to which the human infant has biologically adapted over the course of evolution. An overview of research from diverse areas regarding psychological as well as physiological aspects of early care provides evidence for the beneficial effects of natural parenting. Cross-cultural and historical data is cited to reveal the widespread use of the investigated parenting style. It is concluded that the described approach to parenting provides the human infant with an ideal environment for optimal growth both psychologically and physiologically. It is yet to be determined how much departure from this prototype of optimal human parenting is possible without compromising infant and parental wellbeing. The review also invites a critical reevaluation of current Western childrearing practices.
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Affiliation(s)
- Regine A. Schön
- Department of Psychology, University of Helsinki, Helsinki, Finland
| | - Maarit Silvén
- Department of Psychology, University of Tampere, Tampere, Finland
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Mercer RT, Walker LO. A review of nursing interventions to foster becoming a mother. J Obstet Gynecol Neonatal Nurs 2006; 35:568-82. [PMID: 16958712 DOI: 10.1111/j.1552-6909.2006.00080.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To determine the current state of knowledge of nursing interventions that foster the process of becoming a mother. DATA SOURCES A literature search was conducted using CINAHL and PubMed electronic databases and other key references. STUDY SELECTION Reports on nursing intervention research published in English that focused on a facet of maternal behavior in the process of becoming a mother during pregnancy or during the first 4 months following birth, or both, were included. Twenty eight reports were found. DATA EXTRACTION Studies were reviewed, categorized, and analyzed and interventions synthesized to determine the current knowledge base for fostering becoming a mother. Categories included instructions for infant caregiving, building awareness of and responsiveness to infant interactive capabilities, promoting maternal-infant attachment, maternal/social role preparation, and interactive therapeutic nurse-client relationships. DATA SYNTHESIS Interactive therapeutic nurse-client relationships and maternal/social role preparation had greater impact on variables indicating progress in becoming a mother than formal teaching. Instructions without nurse input were ineffective. CONCLUSIONS Interactive reciprocal nursing interventions are the most effective in enhancing mother-infant interactions and maternal knowledge about infant care. Evidence is limited on how to foster the mother's feelings about herself in becoming a mother and attachment to her infant.
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Affiliation(s)
- Ramona T Mercer
- Department of Family Health Nursing in the University of California, San Francisco, Burlingame, USA.
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Abstract
Estudo de natureza qualitativa, cujo objetivo é o de identificar o conhecimento que vem sendo produzido e veiculado a respeito do Método Mãe-Canguru (MMC). Foi realizada uma incursão pela literatura, a partir das bases de dados Medline e Lilacs, assim como busca direta aos principais periódicos de enfermagem, durante o período de 1995 a 2004. Foram selecionados 85 artigos, posteriormente catalogados e submetidos à categorização. Após análise dos artigos, foram extraídas quatro categorias sobre a temática. Os resultados levaram à conclusão de que apesar do MMC estar configurando-se como uma mudança paradigmática no cuidado ao recém-nascido, não há total correspondência com a produção teórica, levando a que a prática seja desenvolvida, muitas vezes, sem a devida sustentação teórica. Esta lacuna de conhecimentos dificulta, inclusive, uma adequada avaliação desta prática com relação ao recémnascido e sua família, mas principalmente no que diz respeito à aplicação do MMC junto à equipe neonatal.
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Ludington-Hoe SM, Hosseini R, Torowicz DL. Skin-to-Skin Contact (Kangaroo Care) Analgesia for Preterm Infant Heel Stick. ACTA ACUST UNITED AC 2005; 16:373-87. [PMID: 16082239 PMCID: PMC1890009 DOI: 10.1097/00044067-200507000-00010] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of the study was to compare a heel stick conducted during Kangaroo Care (skin-to-skin contact) with the mother to a heel stick in a warmer in reducing premature infant physiologic and behavioral pain responses. Twenty-four premature infants in a university-based neonatal intensive care unit were recruited and randomized to 2 sequences: sequence A group received 3 hours of Kangaroo Care (with a heel stick in Kangaroo Care) followed by 3 hours in a warmer (with a heel stick in the warmer). Sequence B group had warmer care and a heel stick (in the warmer) before Kangaroo Care and a heel stick (in Kangaroo Care). Heart rate, respiratory rate, oxygen saturation, crying time, and behavioral state were measured before, during, and after heel stick. Repeated measures ANOVA and Mann Whitney U statistics were performed. Heart rate and length of crying in response to pain were significantly reduced during Kangaroo Care and the Kangaroo Care heel stick as compared to when infants were in the warmer and had a heel stick in the warmer. Three infants did not cry at all during the Kangaroo Care heel stick; infants slept more during Kangaroo Care than in the warmer. Kangaroo Care positioning before and during heel stick is a simple and inexpensive analgesic intervention to ameliorate pain in stable premature infants.
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Affiliation(s)
- Susan M Ludington-Hoe
- FP Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio 44106-4904, and the Pediatric Critical Care Center, Children's Hospital of New Jersey, Newark, USA.
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Charpak N, Ruiz JG, Zupan J, Cattaneo A, Figueroa Z, Tessier R, Cristo M, Anderson G, Ludington S, Mendoza S, Mokhachane M, Worku B. Kangaroo Mother Care: 25 years after. Acta Paediatr 2005; 94:514-22. [PMID: 16188735 DOI: 10.1111/j.1651-2227.2005.tb01930.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
UNLABELLED The components of the Kangaroo Mother Care (KMC) intervention, their rational bases, and their current uses in low-, middle-, and high-income countries are described. KMC was started in 1978 in Bogotá (Colombia) in response to overcrowding and insufficient resources in neonatal intensive care units associated with high morbidity and mortality among low-birthweight infants. The intervention consists of continuous skin-to-skin contact between the mother and the infant, exclusive breastfeeding, and early home discharge in the kangaroo position. In studies of the physiological effects of KMC, the results for most variables were within clinically acceptable ranges or the same as those for premature infants under other forms of care. Body temperature and weight gain are significantly increased, and a meta-analysis showed that the kangaroo position increases the uptake and duration of breastfeeding. Investigations of the behavioral effects of KMC show rapid quiescence. The psychosocial effects of KMC include reduced stress, enhancement of mother-infant bonding, and positive effects on the family environment and the infant's cognitive development. CONCLUSION Past and current research has clarified some of the rational bases of KMC and has provided evidence for its effectiveness and safety, although more research is needed to clearly define the effectiveness of the various components of the intervention in different settings and for different therapeutic goals.
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Abstract
Neonatal mortality is intolerably high in developing countries and in situations of crisis or disaster as a result of inequity, poverty, and lack of health care services. A series of effective, low-cost interventions, based on appropriate technologies can be used to address the main causes of neonatal deaths. Among these interventions, promotion of exclusive breastfeeding and thermal control of the newborn infant are very effective ones. Although the effectiveness of interventions such as kangaroo mother care, newborn resuscitation, and infant massage is not widely recognized, they may have important complementary roles in providing heath care to newborn infants in adverse conditions.
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Affiliation(s)
- Riccardo Davanzo
- Neonatology Department, Istituto per l'Infanzia, Trieste, Italy.
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Walden M, Carrier CT. Sleeping beauties: the impact of sedation on neonatal development. J Obstet Gynecol Neonatal Nurs 2003; 32:393-401. [PMID: 12774882 DOI: 10.1177/0884217503253454] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Sedatives are frequently administered in neonatal intensive care to induce sleep for diagnostic and radiology procedures, calm irritable infants, manage pain-related agitation, and enhance ventilation. The pharmacology and side effects of sedatives commonly used with neonates will be reviewed and placed within the context of their potential effect on neonatal development. Alternative caregiving strategies to minimize or eliminate the need for sedation will be discussed.
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Affiliation(s)
- Marlene Walden
- Center for Clinical Research, Texas Children's Hospital, Houston, USA.
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