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Ismail A, Mahdi A, Al-Nuaimi KM. Parents' Perception and Use of Skin-to-Skin Care in Jeddah, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56734. [PMID: 38646219 PMCID: PMC11033043 DOI: 10.7759/cureus.56734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Skin-to-skin care (SSC) between newborns and their parents provides many positive outcomes for both newborns and their parents. However, there is a lack of research assessing the perception of parents, especially fathers, of SSC in Saudi Arabia. PURPOSE The aim of the study is to assess parents' perception of SSC in Saudi Arabia. METHODS This cross-sectional study used an online survey. Data were collected from a convenience sample of 140 parents of hospitalized neonates between January and June 2023. Data were collected from one private hospital (Dr. Soliman Fakeeh Hospital) and one public hospital (King Abdulla Medical Complex) in Jeddah, Saudi Arabia. The parents' perceptions of SSC were assessed using the Parents' Perceptions of SSC tool. An independent t-test was used to compare mothers and fathers in their perceptions of SSC. RESULTS One hundred and forty parents completed the online survey (70 females and 70 males). The majority of the parents did not use SSC with their babies (n=102, 73%), did not read or hear about the use and benefits of skin-to-skin care (n=100, 71%), and did not receive information or training on SSC from healthcare professionals (n=112, 80%). Mothers' perception of SSC was significantly higher than that of fathers (p ≤ 0.05). CONCLUSION Fathers' perception of SSC was lower than that of mothers. Awareness and training programs are needed to inform parents, especially fathers, regarding SSC and its benefits in Saudi Arabia.
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Affiliation(s)
- Ahmad Ismail
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
| | - Amnah Mahdi
- Nursing, Fakeeh College for Medical Sciences, Jeddah, SAU
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Hall M, Valencia CM, Soma-Pillay P, Luyt K, Jacobsson B, Shennan A. Effective and simple interventions to improve outcomes for preterm infants worldwide: The FIGO PremPrep-5 initiative. Int J Gynaecol Obstet 2024. [PMID: 38264849 DOI: 10.1002/ijgo.15269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/07/2023] [Accepted: 11/11/2023] [Indexed: 01/25/2024]
Abstract
Preterm birth remains the leading cause of mortality among under-5's and is a major contributor to the reduction in quality-of-life adjusted years and reduction in human capital. Globally, there are many interventions and care bundles that aim to reduce the impact of preterm birth once preterm labor has ensued and into the neonatal period; not all of these are applicable in all settings. Here, we introduce the FIGO PremPrep-5 initiative, which aims to disseminate key information on the most simple and effective interventions with the aim of increasing implementation globally. Before delivery, we recommend a course of antenatal corticosteroids, and intrapartum magnesium sulfate. At delivery, we recommend delayed cord clamping. Postnatally, we recommend early feeding with breast milk and immediate kangaroo care. While there are many other interventions that may improve outcomes at the time of labor and after preterm birth, these are clinically effective and relatively inexpensive options that can be practiced in most settings and supplemented with more advanced care. We include examples of a training video and infographics that will be used for dissemination.
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Affiliation(s)
- Megan Hall
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
| | - Catalina M Valencia
- Department of Obstetrics and Gynecology, Universidad CES, Medellín, Colombia
- Maternal Fetal Medicine Unit, Clinica del Prado, Medellín, Colombia
| | - Priya Soma-Pillay
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Steve Biko Academic Hospital, Pretoria, South Africa
| | - Karen Luyt
- Bristol Medical School, University of Bristol, Bristol, UK
- Neonatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Andrew Shennan
- Department of Women and Children's Health, St Thomas' Hospital, King's College London, London, UK
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Swieter E, Gross JM, Stephen J, Watterberg K, Maxwell JR. Pilot study shows skin-to-skin care with parents improves heart rate variability in preterm infants in the neonatal intensive care unit. Front Pediatr 2023; 11:1269405. [PMID: 37790693 PMCID: PMC10544889 DOI: 10.3389/fped.2023.1269405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/01/2023] [Indexed: 10/05/2023] Open
Abstract
Background Skin-to-skin care in the newborn intensive care unit typically lasts for short periods of time and enhances breastfeeding, attachment, and parental self-esteem. Heart rate variability (HRV) increases with gestational age and is a measure of maturation of parasympathetic vs. sympathetic autonomic nervous system activity. HRV measurements may be useful in capturing changes in autonomic regulation in response to skin-to-skin care. Objective To analyze the effects of skin-to-skin care on HRV in preterm infants receiving respiratory support. We hypothesized that skin-to-skin care would result in a more mature pattern of parasympathetic activity. Methods In this prospective crossover study, infants <30 weeks' gestation and 1-6 weeks postnatal age had HRV recorded for 30 min before, during, and after skin-to-skin care sessions. HRV characteristics analyzed included the standard deviation of the normal-to-normal interval (SDNN), the root mean squared of successive differences of normal-to-normal intervals (RMSSD), and the standard deviation of decelerations (SDDec). Results 10 infants between 25 5/7-29 6/7 weeks gestational age and 7-41 days postnatal age completed 22 sessions while receiving respiratory support (positive pressure ventilation or nasal cannula oxygen). Two measures of HRV (SDNN and RMSSD) were significantly decreased by the end of the skin-to-skin sessions, compared to pre-session values. SDNN decreased from a median of 10.44 ms before the session to 6.70 ms after being placed back in bed (p < 0.05), with RMSSD decreasing from a median of 6.80 ms before the session to 4.32 ms while being held at the end of 30 min (p < 0.05). Discussion Skin-to-skin care with a parent resulted in a more mature autonomic nervous system pattern in preterm infants receiving respiratory support, suggesting physiologic benefit for the infant. No adverse events were seen during any session.
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Affiliation(s)
- Erin Swieter
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States
| | - Jessica M. Gross
- Clinical and Translational Science Center, University of New Mexico, Albuquerque, NM, United States
| | - Julia Stephen
- The Mind Research Network a Division of Lovelace Biomedical Research Institute, Albuquerque, NM, United States
| | - Kristi Watterberg
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States
| | - Jessie R. Maxwell
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States
- Department of Neurosciences, University of New Mexico, Albuquerque, NM, United States
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Larocque C, Venegas CL, Dunn S, Campbell-Yeo M, Gilmore L, Harrold J, Hu J, McArthur L, Modanloo S, Nicholls SG, O'Flaherty P, Premji SS, Reszel J, Semenic S, Squires JE, Stevens B, Taljaard M, Trepanier MJ, Venter K, Wilding J, Harrison D. Exploring implementation processes of a parent-targeted educational video for improving newborn pain treatment: A sequential exploratory mixed-methods study. J Child Health Care 2023:13674935231176888. [PMID: 37351924 DOI: 10.1177/13674935231176888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Despite known analgesic effects of breastfeeding (BF), skin-to-skin care (SSC), and sweet solutions (sucrose) for newborns, these interventions remain underutilized. Our team produced a five-minute parent-targeted video (BSweet2Babies) demonstrating BF, SSC, and sucrose during newborn blood sampling. We conducted a sequential exploratory mixed-methods study with eight maternal-newborn units across Ontario, Canada to identify barriers and facilitators to implementing the video and the three pain management strategies.Over a 6-month period, data collection included 15 telephone interviews, two email communications, and three community of practice teleconferences with the participating sites (n = 8). We used the Theoretical Domains Framework as the coding matrix. Participants discussed integrating the video in prenatal education and the importance of involving leadership when planning for practice change. Key barriers included lack of comfort with parental presence, perception of high complexity of the strategies, short postpartum stays, competing priorities, and interprofessional challenges. Key facilitators included alignment with the Baby-Friendly Hospital Initiative, modeling by Lactation Consultants, and frequent reminders.
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Affiliation(s)
| | | | - Sandra Dunn
- University of Ottawa, Ottawa, Ontario, Canada
- Better Outcome Registry and Network, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Marsha Campbell-Yeo
- Dalhousie University, Halifax, Nova Scotia, Canada
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Lucy Gilmore
- Headwaters Health Care Centre, Orangeville, Ontario, Canada
| | - JoAnn Harrold
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Jiale Hu
- Virginia Commonwealth University, Richmond, Virginia, United States of America
| | | | | | | | - Pat O'Flaherty
- Champlain Maternal Newborn Regional Program, Ottawa, Ontario, Canada
| | | | - Jessica Reszel
- University of Ottawa, Ottawa, Ontario, Canada
- Arthur Labatt Family School of Nursing, London, Ontario, Canada
| | | | - Janet E Squires
- University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Bonnie Stevens
- The Hospital for Sick Children, Toronto, Ontario, Canada
- The University of Toronto, Toronto, Ontario, Canada
| | - Monica Taljaard
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Kathy Venter
- Baby-Friendly Initiative Ontario, Toronto, Ontario, Canada
| | - Jodi Wilding
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Denise Harrison
- University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
- University of Melbourne, Parkville, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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Ulmer-Yaniv A, Yirmiya K, Peleg I, Zagoory-Sharon O, Feldman R. Developmental Cascades Link Maternal-Newborn Skin-to-Skin Contact with Young Adults' Psychological Symptoms, Oxytocin, and Immunity; Charting Mechanisms of Developmental Continuity from Birth to Adulthood. Biology (Basel) 2023; 12:847. [PMID: 37372132 DOI: 10.3390/biology12060847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/04/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
Premature birth disrupts the continuity of maternal-newborn bodily contact, which underpins the development of physiological and behavioral support systems. Utilizing a unique cohort of mother-preterm dyads who received skin-to-skin contact (Kangaroo Care, KC) versus controls, and following them to adulthood, we examined how a touch-based neonatal intervention impacts three adult outcomes; anxiety/depressive symptoms, oxytocin, and secretory immunoglobulin A (s-IgA), a biomarker of the immune system. Consistent with dynamic systems' theory, we found that links from KC to adult outcomes were indirect, mediated by its effects on maternal mood, child attention and executive functions, and mother-child synchrony across development. These improvements shaped adult outcomes via three mechanisms; (a) "sensitive periods", where the infancy improvement directly links with an outcome, for instance, infant attention linked with higher oxytocin and lower s-IgA; (b) "step-by-step continuity", where the infancy improvement triggers iterative changes across development, gradually shaping an outcome; for instance, mother-infant synchrony was stable across development and predicted lower anxiety/depressive symptoms; and (c) "inclusive mutual-influences", describing cross-time associations between maternal, child, and dyadic factors; for instance, from maternal mood to child executive functions and back. Findings highlight the long-term impact of a birth intervention across development and provide valuable insights on the mechanisms of "developmental continuity", among the key topics in developmental research.
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Affiliation(s)
- Adi Ulmer-Yaniv
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Karen Yirmiya
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Itai Peleg
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Orna Zagoory-Sharon
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
| | - Ruth Feldman
- Center for Developmental Social Neuroscience, Reichman University, Herzliya 4610101, Israel
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Ganji N, Alganabi M, Yamoto M, Chusilp S, Pierro A, Li B. Family care reduces the incidence of neonatal sepsis: A systematic review and meta-analysis. Front Pediatr 2023; 11:1089229. [PMID: 37124182 PMCID: PMC10130514 DOI: 10.3389/fped.2023.1089229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/29/2023] [Indexed: 05/02/2023] Open
Abstract
Purpose Family-involved care in the neonatal intensive care unit (NICU) helps to alleviate neonatal anxiety and promotes breastmilk intake, body growth and neurological development, but its effect on reducing the incidence of neonatal sepsis is not known. We conducted a systematic review and meta-analysis of randomized controlled trials (RCT) to evaluate whether neonates receiving family care have a lower incidence of neonatal sepsis compared to neonates receiving standard NICU care. Methods MEDLINE, Embase, Web of Science, and CENTRAL were searched for RCTs that compared preterm neonates receiving family care vs. standard NICU care. From 126 articles that were identified and screened, 34 full-text articles were assessed for eligibility, and 5 RCTs were included. The primary outcome was the development of sepsis. The RevMan 5.4 software was used to conduct the Meta-analysis. Results The metanalysis, based on 5 RCTs demonstrated that neonates receiving family-involved care had significantly lower incidence of sepsis (12.0% vs. 16.3%), increased body weight, and reduced length of hospital stay compared to those receiving standard NICU care. Conclusion This study suggests that family-involved care in NICU can (i) reduce the incidence of neonatal sepsis, (ii) improve growth, and (iii) reduce the length of hospital stay. This study highlights the need for evaluating whether family-involved care improves other neonatal outcomes.
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Wang F, Zhang Q, Ni ZH, Lv HT. Effects of kangaroo care on pain relief in premature infants during painful procedures: A meta-analysis. J SPEC PEDIATR NURS 2022; 27:e12390. [PMID: 35859291 DOI: 10.1111/jspn.12390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to evaluate effects of kangaroo care on pain relief in premature infants during painful procedures. DESIGN A meta-analysis. METHODS Eight databases (Cochrane Library, PubMed, Embase, Web of Science, China Biology Medicine [CBM], China Science and Technology Journal Database [CSTJ], China National Knowledge Infrastructure [CNKI], and WanFang Data) were systematically reviewed from inception to November 2021 for randomized controlled and crossover trials. RESULTS Thirteen studies, including 2311 infants (kangaroo care: 1153, control: 1158) were analyzed. Kangaroo care had a moderate effect on pain relief during painful procedures in premature infants at a gestational age of 32-36 + 6 weeks but no effect at 28-31 + 6 weeks. Furthermore, 15 or 30 min of kangaroo care had a moderate effect and could markedly relieve pain at the instant of and 30/60 s after, had a small effect at 90 s after, and no effect at 120 s after the procedure. PRACTICE IMPLICATIONS Kangaroo care may be an effective nonpharmacologic alternative therapy to relieve procedural pain in premature infants born at a gestational age of 32-36 + 6 weeks.
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Affiliation(s)
- Fang Wang
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
| | - Qing Zhang
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
| | - Zhi Hong Ni
- Department of Nursing, Children's Hospital of Soochow University, Suzhou, China
| | - Hai Tao Lv
- Neonatal Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, China
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Samsudin S, Chui PL, Kamar ABA, Abdullah KL. Maternal Kangaroo care education program in the neonatal intensive care unit improved mothers' perceptions, knowledge, perceived barriers and stress relates to premature infant. Nurs Open 2022; 10:349-357. [PMID: 36514142 PMCID: PMC9748066 DOI: 10.1002/nop2.1311] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 01/17/2022] [Accepted: 07/27/2022] [Indexed: 01/04/2023] Open
Abstract
AIM To assess the effectiveness of the maternal kangaroo care education programme over 1 month and 3 months on the mother's perception, knowledge, perceived barriers and stress. DESIGN A quasi-experimental and longitudinal study was conducted among mothers with premature infants. METHODS Forty-eight mother-infant dyads were enrolled per arm in the control and experimental groups. The control group received standard routine care, while the experimental group received a maternal kangaroo care education program. Data were collected through self-administered Kangaroo Care Questionnaires. Chi-square, the general linear model and repeated measures ANOVA were used to analyse data. RESULTS The demographics are a majority of Malay mothers with multipara, a caesarean delivery with prematurity. At 3 months post-intervention, the experimental group reported a significant reduction in stress, a positive perception and good knowledge towards kangaroo care implementation. The mothers' perceived barriers towards kangaroo care significantly decreased after 3 months in the experimental group.
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Affiliation(s)
- Sharmiza Samsudin
- Department of Nursing Science, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of MedicineUniversiti MalayaKuala LumpurMalaysia
| | | | - Khatijah Lim Abdullah
- Department of Nursing School of Healthcare and Medical SciencesSunway UniversityPetaling JayaMalaysia
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Brignoni-Pérez E, Scala M, Feldman HM, Marchman VA, Travis KE. Disparities in Kangaroo Care for Premature Infants in the Neonatal Intensive Care Unit. J Dev Behav Pediatr 2022; 43:e304-e311. [PMID: 34723932 PMCID: PMC9046459 DOI: 10.1097/dbp.0000000000001029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 09/02/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of this study was to investigate whether preterm infants whose families have lower socioeconomic status (SES) or communicate with clinical staff in a language other than English experience differences in the rate, frequency, and duration of kangaroo care (KC) in the neonatal intensive care unit (NICU) compared with preterm infants of higher SES or primarily English-speaking families. METHODS Participants were infants born <32 weeks' gestational age (GA), N = 116. We defined SES by the infants' health insurance (private/higher vs public/lower) and language by the language mothers used to communicate with clinical staff (English vs Other language). SES or language groups were compared on (1) rate of KC infants experienced during hospitalization per visitation days, (2) frequency of KC per visitation days, and (3) duration of KC events per day. RESULTS Infants in the lower SES and Other language groups experienced KC in reduced amounts, lower frequencies, and shorter durations than infants in either the higher SES or English language groups. SES and language group differences remained significant after controlling for family visitation and GA at birth. After controlling for SES, language group differences in KC duration remained significant. CONCLUSION Our findings revealed disparities in the rate, frequency, and duration of KC experienced in the NICU as a function of both SES and language. Such disparities reduced infants' access to this developmental care practice shown to stabilize clinical status and promote neurodevelopment. We recommend that hospital nurseries implement policies that minimize these disparities.
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Affiliation(s)
- Edith Brignoni-Pérez
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Melissa Scala
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, USA
| | - Heidi M. Feldman
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
| | | | - Katherine E. Travis
- Department of Pediatrics, Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
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Weber AM, Jackson YC, Elder MR, Remer SL, Parikh NA, Hofherr JJ, Voos KC, Kaplan HC. Application of a Risk Management Framework to Parent Sleep During Skin-to-Skin Care in the NICU. J Obstet Gynecol Neonatal Nurs 2022; 51:336-348. [PMID: 35288109 PMCID: PMC9086109 DOI: 10.1016/j.jogn.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/30/2022] Open
Abstract
As NICU staff work to increase the frequency, duration, and comfort of skin-to-skin care (SSC) sessions, barriers to implementation are frequently encountered. Safety concerns are often raised when parents fall asleep during SSC intentionally or unintentionally. We present a risk management framework that we use in clinical practice to address risk related to parent sleep during SSC. Our approach is based on the steps of the Risk Management Life Cycle, which include the following: establish context, identify risk, analyze risk, respond to risk, and monitor and adapt response to risk. Clinicians may use this framework in clinical practice to manage risks related to prolonged SSC, specifically when parents relax and fall asleep during SSC.
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Lilliesköld S, Zwedberg S, Linnér A, Jonas W. Parents' Experiences of Immediate Skin-to-Skin Contact After the Birth of Their Very Preterm Neonates. J Obstet Gynecol Neonatal Nurs 2021; 51:53-64. [PMID: 34767779 DOI: 10.1016/j.jogn.2021.10.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To explore parents' experiences of immediate skin-to-skin contact after the birth of their very preterm neonates and their perceptions regarding care and support from staff. DESIGN A descriptive qualitative study. SETTING Birth and neonatal units within a university hospital in Sweden. PARTICIPANTS Six parent couples who co-cared for their very preterm neonates with skin-to-skin contact throughout the first 6 hours after birth. METHODS We analyzed individual interviews using reflexive thematic analysis as described by Braun and Clarke. RESULTS The parents' experiences of immediate skin-to-skin contact with their very preterm neonates were represented by the following three themes: A Pathway to Connectedness, Just Being in a Vulnerable State, and Creating a Safe Haven in an Unknown Terrain. Skin-to-skin contact helped the parents attain their roles as essential caregivers and provided a calming physical sensation that promoted parents' feelings of connectedness with their newborns. When parents provide skin-to-skin contact at birth, staff members need to recognize and address their vulnerability. A good relationship with nursing staff, which was mediated through staff behaviors and availability, facilitated skin-to-skin contact. CONCLUSION Skin-to-skin contact initiated at birth with very preterm neonates was a valuable and empowering experience for parents and enhanced early bonding between parents and their newborns. Staff members should recognize that skin-to-skin contact between parents and neonates is an interactive process that has challenges. Future research is warranted to understand the needs of nursing staff who provide initial care in the postpartum period. Furthermore, we recommend the implementation of maternal-neonatal couplet care.
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Ünal Toprak F, Şentürk Erenel A. Impact of kangaroo care after caesarean section on paternal-infant attachment and involvement at 12 months: A longitudinal study in Turkey. Health Soc Care Community 2021; 29:1502-1510. [PMID: 33118268 DOI: 10.1111/hsc.13210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 09/29/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
The mother's first meeting with the baby after the caesarean section is usually delayed due to the reasons arising from the mother and the baby in Turkey. Although there are many benefits of kangaroo care (KC) intervention between the mother and the newborn, there is a limited number of studies on the KC intervention between the newborn and the father after caesarean section in international literature, and there are none in Turkey. This study was carried out to determine the effect of fathers and infants who participated in KC, immediately after birth by caesarean section, on paternal-infant attachment and the fathers' involvement in infant care in the 12th month. The study was conducted as a longitudinal study with a control group. Initially, the sample consisted of 60 fathers. However, the study was completed with 48 fathers. KC intervention was practised to the couple of the father and the infant in the experimental group, while no practice was given to the control group. Fathers in the experimental group were told that they should continue to practice KC intervention at least two times a week until their baby will be 1-year-old. The data collection forms were given to fathers face-to-face in the first interview, and then through phone calls and emails after 12 months. The status of the fathers in the experimental group fathers' involvement in infant care of the baby (p = .005) was significantly higher than the control group. The mean score for the Postnatal Paternal-Infant Attachment Questionnaire (PPAQ), in fathers who participated in KC intervention, was higher than that of fathers who did not participate in the KC intervention (p < .005). The results of this study demonstrated that the paternal-infant attachment and the fathers' participation in infant care were more positive in fathers and babies who performed the KC intervention.
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Affiliation(s)
- Filiz Ünal Toprak
- Bolu Abant İzzet Baysal University Faculty of Health Sciences, Bolu, Turkey
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13
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Bieleninik Ł, Ettenberger M, Epstein S, Elefant C, Arnon S. Potential Psychological and Biological Mechanisms Underlying the Effectiveness of Neonatal Music Therapy during Kangaroo Mother Care for Preterm Infants and Their Parents. Int J Environ Res Public Health 2021; 18:8557. [PMID: 34444304 PMCID: PMC8394319 DOI: 10.3390/ijerph18168557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022]
Abstract
Neonatal music therapy (MT) has become more accessible worldwide. Previous research suggests multiple benefits of MT for preterm infants and their caregivers; however, far too little attention has been paid to understanding the mechanisms of change in previous Neonatal Intensive Care Unit (NICU)-MT research so far. This perspective article describes potential mechanisms of MT interventions exposed during kangaroo mother care on the preterm infant's response (behavioral and physiological outcomes) and the mother-infant relationship. The paper focuses on the hypothalamic-pituitary-adrenal axis' role in stabilization of behavioral state, the autonomic nervous system's role in stabilization of physiologic state, as well as co-regulation as a potential mechanism for the developing of the parent-infant relationship. Mechanisms play a pivotal role in understanding variables related to the therapy course and well as in generating new knowledge regarding treatment susceptibility and optimizing resources. Understanding of the mechanisms of how interventions may lead to specific outcomes plays an important role in addressing the issue of improvement of currently available approaches of MT used in the NICU.
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Affiliation(s)
- Łucja Bieleninik
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Institute of Psychology, University of Gdansk, 80-309 Gdansk, Poland
- GAMUT—The Grieg Academy Music Therapy Research Centre, NORCE Norwegian Research Centre AS, 5029 Bergen, Norway
| | - Mark Ettenberger
- Music Therapy Service, University Hospital Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia;
- SONO—Centro de Musicoterapia, Bogotá 110221, Colombia
| | - Shulamit Epstein
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Cochavit Elefant
- School for Creative Arts Therapies, University of Haifa, Haifa 3498838, Israel; (S.E.); (C.E.)
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar Saba 44281, Israel;
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Madiba S, Sengane M. Tube Feeding Practices and Transition to Breastfeeding Experiences of Mothers of Preterm Infants at a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa. Glob Pediatr Health 2021; 8:2333794X211037032. [PMID: 34377747 PMCID: PMC8326611 DOI: 10.1177/2333794x211037032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022] Open
Abstract
To receive human milk, most preterm infants initially receive the mothers’ expressed milk through a nasogastric tube. However, breast milk feeding the preterm infant and making the transition to direct breast-feeding come with significant challenges. The study explored and described the experiences of mothers of preterm infants regarding initiation and expressing breast milk, tube feeding practices, and transition to breastfeeding during the infants’ stay in a kangaroo care unit (KMC) of an academic hospital in South Africa. Using a qualitative design, focus group interviews were conducted with 38 mothers of preterm infants after discharge from the neonatal intensive care unit (NICU). We analyzed transcripts following the 5 steps for qualitative thematic data analysis. Tube feeding and breastfeeding preterm infants was challenging and exhausting for the mothers. Many described their experiences of initiating expression and sustaining milk supply as negative. They had constant concerns about their ability to produce adequate milk volumes to feed their infants. They had immense dislike of expressing, which they described as physically exhausting, stressful, and painful. Those who had initiated breastfeeding were highly motivated to breastfeed their preterm infants. They described breastfeeding as a positive bonding experience that they derived pleasure from. The mothers’ dislike of expressing was overshadowed by their emotional obligation toward their preterm infants. Although the KMC unit promotes breastfeeding, mothers encountered problems and struggled to initiate expression and sustain milk production. Mothers of extreme and very preterm infants need support to continue with milk expression during the long NICU and KMC stay.
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Affiliation(s)
- Sphiwe Madiba
- Sefako Makgatho Health Sciences University, Pretoria, Gauteng Province, South Africa
| | - Malmsey Sengane
- Sefako Makgatho Health Sciences University, Pretoria, Gauteng Province, South Africa
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15
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Ludington-Hoe SM, Lotas M, D'Apolito K. Skin-to-Skin Contact ( Kangaroo Care) During the COVID-19 Pandemic. Neonatal Netw 2021; 40:161-74. [PMID: 34088862 DOI: 10.1891/11-T-748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2021] [Indexed: 11/25/2022]
Abstract
Early recommendations to separate mothers from their newborns during the coronavirus disease 2019 (COVID-19) pandemic have created a detrimental separation practice. This article presents a review of the latest information regarding the (1) 3 modes of transmission of the virus to the neonate; (2) incidence, clinical signs, and severity of COVID-19 in the neonate; (3) factors to be considered to balance risk and benefits of separation and skin-to-skin contact (SSC) when conducting shared decision making; and (4) compendium of published SSC guidelines; and concludes with recommendations for safe practice of SSC to prevent and/or restrict COVID-19 infection in neonates.
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Span LC, van Dokkum NH, Ravensbergen AG, Bos AF, Jaschke AC. Combining Kangaroo Care and Live-Performed Music Therapy: Effects on Physiological Stability and Neurological Functioning in Extremely and Very Preterm Infants. Int J Environ Res Public Health 2021; 18:ijerph18126580. [PMID: 34207310 PMCID: PMC8296373 DOI: 10.3390/ijerph18126580] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022]
Abstract
Interventions such as kangaroo care (KC) and live-performed music therapy (LPMT), are increasingly used to facilitate stress reduction in neonates. This study aims to investigate the effect of combining the two on physiological responses and neurological functioning in very preterm infants. Infants received six sessions of LPMT. KC was added to one LPMT session. Physiological responses included heart rate, respiratory rate and oxygen saturation. We videotaped infants for 30 min before and after two sessions to assess general movements (GMs). We included 17 infants, gestational age median 26.0 weeks (IQR 25.6–30.6 weeks), of whom six were males. Combined interventions showed a decrease in heart rate from mean 164 bpm before to 157 bpm during therapy, p = 0.001. Oxygen saturation levels increased during combination therapy from median 91.4% to 94.5%, p = 0.044. We found no effects of LPMT or combined interventions on GMs. Infants with a postnatal age (PNA) <7 days generally seem to display less optimal GMs after therapy compared with infants with a PNA >7 days. In conclusion, combining interventions is equally beneficial for physiological stability and neurological functioning as LPMT alone. Future studies should focus on the effects of this combination on parent-infant bonding.
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Affiliation(s)
- Loïs C. Span
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (N.H.v.D.); (A.-G.R.); (A.F.B.); (A.C.J.)
- Correspondence: ; Tel.: +31-050-3614215
| | - Nienke H. van Dokkum
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (N.H.v.D.); (A.-G.R.); (A.F.B.); (A.C.J.)
| | - Anne-Greet Ravensbergen
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (N.H.v.D.); (A.-G.R.); (A.F.B.); (A.C.J.)
- Department of Music Therapy, ArtEZ University of the Arts, 7523 WB Enschede, The Netherlands
| | - Arend F. Bos
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (N.H.v.D.); (A.-G.R.); (A.F.B.); (A.C.J.)
| | - Artur C. Jaschke
- Division of Neonatology, Department of Pediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (N.H.v.D.); (A.-G.R.); (A.F.B.); (A.C.J.)
- Department of Music Therapy, ArtEZ University of the Arts, 7523 WB Enschede, The Netherlands
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Abstract
BACKGROUND Decades of research supports the benefits of kangaroo care (KC) for the parent and newborn. Supportive KC devices may be an important tool clinicians can use to assist parents with KC. In recent years, there has been a rise in the availability of KC devices. However, the use, needs, and preferences for these supportive devices by neonatal clinicians have not been documented. PURPOSE To survey clinicians' use, needs, and preferences of KC supportive devices, and examine whether differences exist based on clinician and organizational characteristics. METHODS A cross-sectional, online survey was sent through neonatal organization Web sites, conferences, and social media. RESULTS Many clinicians (n = 68, 43%; N = 158) facilitated KC with a supportive device, with 81% of devices provided by the clinician's employer. The most important "Must Have" feature of a KC device was "Safety: Reduces patient falls if caregiver sleeps or needs to use hands" (84% of respondents) followed by washability (82%), and "immediate, effective access to the baby" (78%). Clinicians' responses did not differ based on hospital setting, type of unit, KC experience, or experience using a KC device. IMPLICATIONS FOR PRACTICE To support safe use of KC devices in neonatal intensive care unit (NICU) clinical care, a device must hold the proper KC position consistently, allow immediate access to the infant, and hold the infant in place without the parent's hands to prevent falls. Training is needed to ensure safe device use. IMPLICATIONS FOR RESEARCH Future research should evaluate the safety, efficacy, and cost-effectiveness of these devices.
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Affiliation(s)
- Ashley Weber
- University of Cincinnati, Proctor Hall, College of Nursing,
3110 Vine Street, Cincinnati OH, 45221 USA
| | - Yamile Jackson
- Nurtured by Design, P.O. Box 3276 Sugar Land, TX, 77487
USA
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18
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Ionio C, Ciuffo G, Landoni M. Parent-Infant Skin-to-Skin Contact and Stress Regulation: A Systematic Review of the Literature. Int J Environ Res Public Health 2021; 18:4695. [PMID: 33924970 PMCID: PMC8124223 DOI: 10.3390/ijerph18094695] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/20/2021] [Accepted: 04/26/2021] [Indexed: 12/18/2022]
Abstract
Several studies have focused on neonatal maternal separation (MS) to investigate behavioural and neuroendocrine reactions to lack of contact, but only a few have focused on early separation in the first days or weeks after birth. This literature review investigates the vital importance of contact and touch by exploring how skin-to-skin contact (SSC) regulates stress in the mother-infant relationship. Various databases such as PubMed, Scopus, and ScienceDirect were searched for literature published between 2015 and 2020. From 1141 articles, 22 were declared eligible. The reviewed articles showed how SSC regulates child stress by biological indicators such as the autonomic nervous system (ANS), heart rate variability (HRV), cortisol, and oxytocin. This research concludes the importance of SSC for stress regulation, especially during the COVID-19 pandemic. With no research to date indicating a possible risk of neonatal COVID-19 transmission following SSC, SSC should continue to be practiced for all women, as recommended by the WHO.
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Affiliation(s)
- Chiara Ionio
- CRIdee, Psychology Department, Università Cattolica, del Sacro Cuore, 20123 Milan, Italy; (G.C.); (M.L.)
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Gettler LT, Kuo PX, Sarma MS, Trumble BC, Burke Lefever JE, Braungart-Rieker JM. Fathers' oxytocin responses to first holding their newborns: Interactions with testosterone reactivity to predict later parenting behavior and father-infant bonds. Dev Psychobiol 2021; 63:1384-1398. [PMID: 33860940 DOI: 10.1002/dev.22121] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 11/09/2022]
Abstract
Little is known about human fathers' physiology near infants' births. This may represent a period during which paternal psychobiological axes are sensitive to fathers' new experiences of interacting with their newborns and that can provide insights on how individual differences in fathers' biology relate to post-partum parenting. Drawing on a sample of men in South Bend, IN (U.S.), we report results from a longitudinal study of fathers' oxytocin, cortisol, and testosterone (N = 211) responses to their first holding of their infants on the day of birth and men's reported caregiving and father-infant bonding at 2-4 months post-partum (N = 114). First-time fathers' oxytocin was higher following first holding of their newborns, compared to their pre-holding levels. Contrasting with prior results, fathers' percentage change in oxytocin did not differ based on skin-to-skin or standard holding. Drawing on psychobiological frameworks, we modeled the interactions for oxytocin reactivity with testosterone and cortisol reactivity, respectively, in predicting father-infant outcomes months later. We found significant cross-over interactions for (oxytocin × testosterone) in predicting fathers' later post-partum involvement and bonding. Specifically, we found that fathers whose testosterone declined during holding reported greater post-partum play if their oxytocin increased, compared to fathers who experienced increases in both hormones. We also observed a similar non-significant interaction for (oxytocin × cortisol) in predicting fathers' post-partum play. Fathers whose testosterone declined during holding also reported less involvement in direct caregiving and lower father-infant bonding if their oxytocin decreased but greater direct care and bonding if their testosterone increased and oxytocin decreased. The results inform our understanding of the developmental time course of men's physiological responsiveness to father-infant interaction and its relevance to later fathering behavior and family relationships.
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Affiliation(s)
- Lee T Gettler
- Department of Anthropology, University of Notre Dame, Notre Dame, IN, USA.,Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.,William J. Shaw Center for Children and Families, University of Notre Dame, South Bend, IN, USA
| | - Patty X Kuo
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Mallika S Sarma
- Department of Otolaryngology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Benjamin C Trumble
- School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, USA.,Center for Evolution and Medicine, Arizona State University, Tempe, AZ, USA
| | | | - Julia M Braungart-Rieker
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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20
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Du Plessis J, Kirk M, Quilatan M, Mehta S. Continuous pulse oximetry during skin-to-skin care: An Australian initiative to prevent sudden unexpected postnatal collapse. Acta Paediatr 2021; 110:1166-1170. [PMID: 32866301 DOI: 10.1111/apa.15552] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/10/2020] [Accepted: 08/20/2020] [Indexed: 11/27/2022]
Abstract
AIM To examine the use of continuous pulse oximetry monitoring (CPOM) of newborns as a non-invasive and non-intrusive standard of care for promoting early and safe skin-to-skin contact between mothers and newborns immediately after birth and to gather acceptability feedback from midwifery staff and mothers. METHODS All babies receiving skin-to-skin contact (SSC) had continuous pulse oximetry monitoring (CPOM) for the first-hour postbirth. Staff were trained with education sessions before implementation. Midwives and mothers were surveyed post-implementation and again after distribution of an education brochure regarding CPOM. RESULTS Seventy per cent of midwives and 66% of mothers responded to the survey. The majority of midwives received the practice positively and felt reassured by the use of CPOM in the immediate postpartum period. The survey identified gaps in maternal knowledge of the risk and benefits of SSC which improved significantly after the distribution of the educational brochure (P = .01). CONCLUSION Continuous pulse oximetry monitoring with a compact monitor in the first-hour postbirth is a simple, non-invasive and innovative approach to enhance safe skin-to-skin care by improving vigilance of newborns. Our study confirmed the acceptance of such approach by midwives and mothers in our population.
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Affiliation(s)
- Jean Du Plessis
- Department of Neonatology Fiona Stanley Hospital Murdoch Western Australia Australia
- School of Medicine University of Notre Dame Fremantle Western Australia Australia
| | - Michael Kirk
- Department of Neonatology Fiona Stanley Hospital Murdoch Western Australia Australia
| | - Myra Quilatan
- Department of Neonatology Fiona Stanley Hospital Murdoch Western Australia Australia
| | - Shailender Mehta
- Department of Neonatology Fiona Stanley Hospital Murdoch Western Australia Australia
- School of Medicine University of Notre Dame Fremantle Western Australia Australia
- School of Medicine Curtin University Perth Western Australia Australia
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21
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Roberge CL, Wallin CM, Tilson K, Brummelte S. A nutty idea: Exploring a novel method using a hazelnut cocoa spread to temporarily increase maternal care behavior within a rat litter. Dev Psychobiol 2021; 63:1606-1610. [PMID: 33641158 DOI: 10.1002/dev.22114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/21/2021] [Accepted: 02/10/2021] [Indexed: 11/08/2022]
Abstract
Maternal care plays a crucial role for infant development. In humans, skin-to-skin care is often used for preterm infants to reduce acute stress and improve long-term developmental outcome. Here we propose a new translational approach to study the effects of acute increases in maternal care on offspring development in rodents. First, pilot studies determined that dams spent more time licking pups covered in hazelnut cocoa spread (Nutella® )) than any other studied substance. For the main experiment, Sprague-Dawley rats were bred in-house, and Nutella® was applied four times a day to treatment pups (2 males/females per litter) of seven litters from PN2 to 5. Control pups (2 males/females per litter) were handled similarly without applying any substance. Maternal licking and grooming behavior was observed for 30 min following each Nutella® application. Nutella® -covered pups received significantly more licking and grooming compared to control pups within each litter. There was no difference in body weight or basal serum corticosterone levels between Nutella® -covered and control pups on PN5, suggesting that the Nutella® application and subsequent increased maternal licking was not stressful for the pups. Future studies will investigate whether this increase in maternal care can protect pups from stress- or pain-induced rises in corticosterone.
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Affiliation(s)
| | - Chela M Wallin
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Kristy Tilson
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Suanne Brummelte
- Department of Psychology, Wayne State University, Detroit, MI, USA
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22
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Affiliation(s)
- Aoife Hurley
- General paediatrics, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
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23
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Weber A, Elder M, Voos KC, Lambert JW, Kaplan HC, Jackson YC. Clinician Opinions and Approaches to Manage Risk Related to Safe Sleep During Skin-to-Skin Care. J Obstet Gynecol Neonatal Nurs 2020; 49:464-474. [PMID: 32726581 PMCID: PMC7492480 DOI: 10.1016/j.jogn.2020.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2020] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE To understand the opinions of clinicians about the risks, benefits, barriers, and facilitators to the practice of parent sleep during skin-to-skin care in hospital settings. DESIGN Cross-sectional survey. SETTING Online survey. PARTICIPANTS Clinicians who self-identified as infant care providers, that is, neonatal clinicians (N = 158). METHODS We sent an online survey invitation to neonatal clinicians through neonatal websites, conferences, and social media sites in the United States and used snowball recruitment. We used a risk management framework to analyze qualitative data. We used descriptive statistics and the chi-square and Fisher's exact tests to determine if opinions differed based on clinician and organizational characteristics. RESULTS Respondents' support of parent sleep during skin-to-skin care (yes/no) did not differ on the basis of whether the clinician had taken a formal course on skin-to-skin care, facilitated skin-to-skin care more than 100 times, or frequently promoted skin-to-skin care in current practice. Respondents who supported parent sleep (n = 93, 59% of respondents) reported greater implementation of risk control strategies than nonsupporters (n = 53 [57%] vs. n = 3 [5%]; p < .001), such as frequent monitoring of vital signs (n = 33 [35%] vs. n = 2 [3%]; p < .001), use of devices to support skin-to-skin care (n = 49 [53%] vs. n = 19 [29%]; p = .003), and proper positioning (n = 20 [22%] vs. n = 0 [0%]; p < .001). Nonsupporters more frequently reported that parent sleep during skin-to-skin care violates safe sleep recommendations, is habit forming for home, poses a fall risk, and jeopardizes the infant's airway. CONCLUSION Most respondents supported parent sleep during skin-to-skin care, but concerns regarding safety for the infant remained a barrier. The use of a risk management framework may help facilitate a systematic approach to improve the implementation of safe skin-to-skin practices.
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Sehgal A, Nitzan I, Jayawickreme N, Menahem S. Impact of Skin-to-Skin Parent-Infant Care on Preterm Circulatory Physiology. J Pediatr 2020; 222:91-97.e2. [PMID: 32389414 DOI: 10.1016/j.jpeds.2020.03.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/28/2020] [Accepted: 03/18/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To ascertain the impact of skin-to-skin care between parents and infants on cardiac function and cerebral blood flow in preterm infants. STUDY DESIGN We undertook a prospective study of 40 self-ventilating preterm infants at a quaternary center and assessed cardiac performance and cerebral blood flow. Assessments were carried out two hours before skin-to-skin care and then 60 minutes after skin-to-skin care (with the infant still on parent and turned supine). RESULTS Infants were 30.5 ± 0.6 weeks' gestational age and 1378 ± 133 g birthweight. Axillary temperature noted a nonsignificant increase during skin-to-skin care from 36.7 ± 0.07°C to 36.9 ± 0.07°C (P = .07). Cardiac contractility (right ventricular fractional area change [26.5% ± 0.3% vs 27.8% ± 0.4; P < .001] and tricuspid annular plane systolic excursion [0.73 ± 0.03 cm vs 0.77 ± 0.03 cm; P = .02]) increased significantly, coincident with decreased measures of pulmonary vascular resistance. An increase in systemic cardiac output was associated with increased cerebral blood flow and reduced middle cerebral artery resistive index (0.81 ± 0.02 vs 0.74 ± 0.02; P = .0001). CONCLUSIONS We documented a significant circulatory beneficial adaptation to a common neonatal practice. These findings align with previously documented physiologic benefits in cardiorespiratory stability and cardiac rhythm in preterm infants, and may be mediated through modulation of the autonomic nervous system.
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Affiliation(s)
- Arvind Sehgal
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia; Department of Pediatrics, Monash University, Melbourne, Australia.
| | - Itamar Nitzan
- Monash Newborn, Monash Children's Hospital, Melbourne, Australia
| | | | - Samuel Menahem
- Pediatric and Fetal Cardiac Units, Monash Medical Centre, Monash Health, Melbourne, Australia
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Miller RR, Bedwell S, Laubach LL, Tow J. What Is the Experience of Babywearing a NICU Graduate? Nurs Womens Health 2020; 24:175-184. [PMID: 32389582 DOI: 10.1016/j.nwh.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/20/2019] [Accepted: 03/01/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To understand the experiences of caregivers using baby carriers to hold their infant after discharge from the NICU. DESIGN The qualitative research design was transcendental phenomenology. SETTING/LOCAL PROBLEM Caregiving of NICU graduates is associated with greater incidence of depression, anxiety, and posttraumatic stress disorder, which can impair caregivers' abilities to form secure attachments with their infants. In addition, lack of paid parental leave, especially among those of low socioeconomic status, can result in prolonged separations between infants and caregivers in the NICU, producing toxic stressors. PARTICIPANTS Eight caregivers ages 21 to 41 years whose infants were discharged from the NICU of a regional referral academic medical center in Oklahoma City, Oklahoma. Homogenous convenience sampling was used by posting recruitment flyers in common areas of the NICU frequented by family members. INTERVENTION/MEASUREMENTS Participants were educated before discharge on using baby carriers that held their infants in kangaroo position. They were asked to carry their infant in the carrier for 3 hours a day for the 2-month study period. RESULTS Six total themes were identified; four were previously identified in kangaroo care and skin-to-skin care research: Decreased Stress and Anxiety, Calmness and Sleep, Attachment, and Parental Empowerment; two were independent to this study: Ease of Work and Self-Care. CONCLUSION The themes identified indicate that babywearing has the potential to address harms-such as stress, fear, depression, anxiety, and posttraumatic stress disorder-that may be experienced by caregivers of infants discharged from the NICU. Babywearing can be used as an intervention to support caregivers and promote positive health outcomes after a NICU discharge.
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Coşkun D, Günay U. The Effects of Kangaroo Care Applied by Turkish Mothers who Have Premature Babies and Cannot Breastfeed on Their Stress Levels and Amount of Milk Production. J Pediatr Nurs 2020; 50:e26-e32. [PMID: 31672261 DOI: 10.1016/j.pedn.2019.09.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/20/2019] [Accepted: 09/20/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to examine the effects of kangaroo care applied by Turkish mothers who have premature babies and cannot breastfeed on their stress levels and amount of milk production. DESIGN AND METHODS This open-label, multicentre, randomised controlled trial included preterm infants not breastfed by their mothers and the mothers of the infants. The mothers were randomised at a 1:1 ratio into the kangaroo care group and the standard care group. The mothers in the kangaroo care group applied kangaroo care to their babies once a day for three weeks. The mothers in the standard care group saw their infants for 15-20 min once a day for five days a week for three weeks, which was standard care in the newborn intensive care unit. The mothers milked their breasts with breast milking machines or pumps every day for three weeks. RESULTS The mothers in the kangaroo care group had higher breast milk production averages than the standard care group in all measurements. The mothers who applied kangaroo care had lower Parental Stressor Scale, subdimensions and total scale average scores than the mothers in the standard care group. CONCLUSIONS Kangaroo care is effective at stimulating breast milk production and decreasing maternal stress levels. PRACTICE IMPLICATIONS Kangaroo care decreases mothers' stress levels and increases breast milk production by mothers who cannot breastfeed their premature infants.
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Affiliation(s)
- Didem Coşkun
- Research Assistant, Fırat University, Faculty of Health Sciences, Elazığ, Turkey
| | - Ulviye Günay
- Assistant Professor, Inonu University, Faculty of Health Sciences, Malatya, Turkey.
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Abstract
OBJECTIVE The objective was to assess stress in fathers of preterm infants and use of "Kangaroo Father Care (KFC)" to mitigate it. STUDY DESIGN Stress levels of 30 fathers of preterm infants admitted in the NICU were assessed using the parental stressor scale: neonatal intensive care unit (PSS: NICU) before and after three sessions of KFC. The data was analysed using Wilcoxon signed rank sum test. RESULT There was a statistically significant reduction in stress levels after KFC (p = 0.006). Amongst all the four subscales, stress levels were found to be reduced in 'staff behaviour and communication' (p = 0.001) domain and 'baby looks and behaves' domain (p = 0.05). CONCLUSION Fathers of preterm infants admitted in the NICU experience a lot of stress, which can adversely affect their mental health. Kangaroo care is very effective in reducing this paternal stress levels.
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Affiliation(s)
- S Dongre
- Neonatology Department, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India
| | - S Desai
- Neonatology Department, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India
| | - R Nanavati
- Neonatology Department, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, India
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Harrison TM. Improving neurodevelopment in infants with complex congenital heart disease. Birth Defects Res 2019; 111:1128-1140. [PMID: 31099484 DOI: 10.1002/bdr2.1517] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Worldwide, more than 400,000 infants are born each year with complex congenital heart disease (CCHD) requiring surgical intervention within the first months of life. Although improvements in perioperative care have resulted in increased rates of survival, more than half of infants with CCHD have neurodevelopmental impairments affecting subsequent educational achievements, job opportunities, and mental health. Brain maturity and impaired outcomes in infants with CCHD are similar to those of prematurely born infants. Developmentally supportive care, including foundational application of kangaroo care (KC), improves neurodevelopment in premature infants. Provision of developmentally supportive care with KC during the early hospitalization of infants with CCHD has the potential to similarly improve neurodevelopment. The purposes of the article are to describe common congenital heart defects, describe developmentally supportive care with an emphasis on KC, and to offer specific recommendations for KC and research in infants with CCHD.
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Abstract
Infant medical trauma in the NICU is associated with serious and lasting consequences. Skin-to-skin contact (SSC) of infants with their parents is a nursing intervention that provides significant benefits and can mitigate the negative consequences of the infant's traumatic experiences in the NICU. The purpose of this article is to explain how SSC aligns with the concept of trauma-informed age-appropriate care (TIAAC) in the NICU. The evidence supporting SSC will be reviewed and discussed using TIAAC as a framework. SSC is an effective and evidence-based care strategy that reduces the infant's traumatic NICU experiences by improving parental proximity, attachment, and lactation; decreasing stress and pain; improving physiologic stability; supporting sleep; and enhancing neurologic outcomes.
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30
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Kow S, Groot J, Puthenparampil J, Faruqi J, Naqvi F, Ali I, Verma A, Naqvi M. The Impact of "Mom/Dad of the Day" Cards, Newborn Heart Auscultation, and Father Skin-to-Skin Care on Parent-Newborn Bonding. Clin Pediatr (Phila) 2019; 58:349-353. [PMID: 30526013 DOI: 10.1177/0009922818817312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Texas Tech Pediatrics at Northwest Texas Hospital System in Amarillo, Texas, currently practices giving "Mom/Dad of the Day" cards to all new parents, offering the opportunity for fathers to auscultate the newborn heart sound, and encouraging maternal and paternal skin-to-skin contact. New parents were asked to fill out 2 anonymous surveys regarding these practices. Survey results showed statistically significant positive responses by the parents for subjective improvement in fetal sleep and feeding as well as parental confidence and preparedness for taking care of their newborn. Additionally, these practices are desired by parents, with 96% fathers recommending that the hospital routinely offering opportunities for heart auscultation and 94% parents recommending "Mom/Dad of the Day" cards for all future parents in the hospital. Small, nonmedical initiatives such as these are well received and can be feasibly adopted in more hospitals to improve patient quality of care.
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Affiliation(s)
- Sean Kow
- 1 Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | | | | | - Jordana Faruqi
- 1 Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | - Fizza Naqvi
- 1 Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | | | - Arushi Verma
- 4 Northwest Texas Healthcare System, Amarillo, TX, USA
| | - Mubariz Naqvi
- 1 Texas Tech University Health Sciences Center, Amarillo, TX, USA
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Pados BF. Physiology of Stress and Use of Skin-to-Skin Care as a Stress-Reducing Intervention in the NICU. Nurs Womens Health 2019; 23:59-70. [PMID: 30590016 DOI: 10.1016/j.nwh.2018.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 09/18/2018] [Accepted: 11/01/2018] [Indexed: 06/09/2023]
Abstract
Advances in neonatal care have allowed for the increasing survival of critically ill infants. These infants experience significant stress related to painful procedures and physical separation from their parents. The purpose of this article is to describe the physiologic stress mechanisms that contribute to mortality and morbidity in infants in the NICU and the physiologic mechanisms by which skin-to-skin care (SSC) acts on the stress response system. Findings from current literature supporting the use of SSC and barriers and facilitators to implementation are reviewed. SSC is a safe and effective intervention to reduce stress for infants and their parents. Nurses play a key role in facilitating SSC to optimize outcomes of care in the NICU.
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Abstract
In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate. Furthermore, we stratified this coupling based on decelerations and accelerations of the heart rate and by inspiration and expiration during respiration while contrasting periods of kangaroo care, an intervention known to enhance autonomic regulation, with periods in the incubator. We identified that preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling. We demonstrate coupling from decelerations and accelerations of the heart rate to exhalation and inhalation, respectively, both on a beat-to-beat basis as well as with sustained decelerations and accelerations. On the other hand, on average, we also observed coupling from both inspiration and expiration to marginal decelerations in the heart rate. These phenomena, especially coupling from the changes in the heart rate to respiratory oscillations, were sensitive to whether the infant was receiving kangaroo care. NEW & NOTEWORTHY Preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling; coupling from fluctuations in the heart rate to respiratory oscillations and vice versa are asymmetric. On average, coupling is observable from decelerations or accelerations in the heart rate to inhalation or exhalation, respectively, whereas, on average, both peaks and troughs of respiration exhibit coupling to marginal decelerations in the heart rate.
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Affiliation(s)
- Rohan Joshi
- Department of Industrial Design, Eindhoven University of Technology , Eindhoven , The Netherlands.,Department of Clinical Physics, Máxima Medical Centre , Veldhoven , The Netherlands.,Department of Fertility, Pregnancy and Parenting Solutions, Philips Research, Eindhoven , The Netherlands
| | - Deedee Kommers
- Department of Neonatology, Máxima Medical Centre , Veldhoven , The Netherlands.,Department of Applied Physics, Eindhoven University of Technology , Eindhoven , The Netherlands
| | - Xi Long
- Department of Fertility, Pregnancy and Parenting Solutions, Philips Research, Eindhoven , The Netherlands
| | - Loe Feijs
- Department of Industrial Design, Eindhoven University of Technology , Eindhoven , The Netherlands
| | - Sabine Van Huffel
- KU Leuven, Department of Electrical Engineering, Division Stadius, and IMEC, Leuven , Belgium
| | - Carola van Pul
- Department of Clinical Physics, Máxima Medical Centre , Veldhoven , The Netherlands.,Department of Applied Physics, Eindhoven University of Technology , Eindhoven , The Netherlands
| | - Peter Andriessen
- Department of Neonatology, Máxima Medical Centre , Veldhoven , The Netherlands
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Abstract
OBJECTIVE Kangaroo care (KC), a well-established parent-based intervention in neonatal intensive care units (NICUs), with documented benefits for infants and their parents. However, in China there remains a lack of knowledge and a reluctance to implement KC in hospitals. Therefore, our aim was to investigate the current knowledge, beliefs and practices regarding KC among NICU nurses in China using the 'Kangaroo Care Questionnaire'. METHODS A quantitative descriptive survey was designed. This questionnaire comprised 90 items classified according to four domains: knowledge, practice, barriers and perception. Data were analysed using SPSS V.20.0, and content analysis was used to summarise data derived from open-ended questions. RESULTS The survey involved 861 neonatal nurses from maternity and general hospitals across China (response rate=95.7%). The findings showed that 47.7% (n=411) of the nurses had participated in the implementation of KC. Neonatal nurses in the 'experienced in KC' group showed an overall better understanding of KC and its benefits with a higher 'correct response' rate than those in the 'not experienced in KC' group. In the 'experienced in KC' group, over 90% considered KC beneficial to the parent-baby relationship and attachment, and over 80% believed that KC positively affected outcomes of preterm infants. The 'not experienced in KC' group perceived more barriers to KC implementation than did the 'experienced in KC' group. CONCLUSION Although most nurses working in NICUs in China were aware of the benefits of KC, there remain substantial barriers to its routine use in practice. Education for both staff and parents is necessary, as is the provision of appropriate facilities and policies to support parents in providing this evidence-based intervention.
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Affiliation(s)
- Yao Zhang
- Nursing Faculty, School of Medicine, Zhejiang University, Hangzhou, China
| | - Qingqi Deng
- Nursing Faculty, School of Medicine, Zhejiang University, Hangzhou, China
| | - Binghua Zhu
- Nursing Faculty, School of Medicine, Zhejiang University, Hangzhou, China
- The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, China
| | - Qiufang Li
- Neonatal Intensive Care Units, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fang Wang
- Nursing Department, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hua Wang
- Neonatal Intensive Care Units, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xinfen Xu
- Nursing Department, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Haining Maternal and Child Health Hospital, Haining, China
| | - Linda Johnston
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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Abadía-Barrero CE. Kangaroo Mother Care in Colombia: A Subaltern Health Innovation against For-profit Biomedicine. Med Anthropol Q 2018; 32:384-403. [PMID: 29363780 DOI: 10.1111/maq.12430] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 11/29/2022]
Abstract
This ethnographic study presents the origins, growth, and collapse of the first Kangaroo Mother Care (KMC) program, a well-established practice for neonatal care created in 1978 in Colombia. The WHO and UNICEF praised this zero-cost revolutionary technique for its promotion of skin-to-skin contact between premature and low-birth-weight newborns and family members. KMC facilitates early hospital discharge, brings many clinical and psychological benefits, and constitutes an excellent alternative to placing babies in incubators. However, these benefits and political potential against biomedical interventions were undermined after being relabeled as a "reverse innovation," a business concept that encourages corporate investments in low-income countries to develop technologies that can both solve global health problems and boost multinational corporations profits. In response, I propose "subaltern health innovations" as a label for KMC that accounts for the power dynamics in global health between health care initiatives that originate in the Global South and neoliberal configurations of for-profit biomedicine.
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35
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Adeli M, Aradmehr M. A comparative study of maternal-neonate abdominal and kangaroo (skin-to-skin) skin contact immediately after birth on maternal attachment behaviors up to 2 months. J Educ Health Promot 2018; 7:42. [PMID: 29619393 PMCID: PMC5868216 DOI: 10.4103/jehp.jehp_46_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 01/10/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Early skin-to-skin maternal-neonate contact during the 1st h following birth prepares both mother and baby to establish a two-way, interactive pattern of interaction. There are few studies on the use of kangaroo care method in term infants and maternal postpartum behavior. OBJECTIVE The present study aimed to compare abdominal and kangaroo skin contact on maternal attachment behaviors. SETTINGS AND DESIGN This single-blind randomized clinical trial was performed on 68 eligible pregnant women in Torbat Heydariyeh in 2015. MATERIALS AND METHODS Individuals were randomly divided into experimental groups (kangaroo skin contact) and control group (abdominal skin contact). Maternal attachment behaviors were observed for 15 min during 1 h postpartum. Each minute was divided into two 30 s, during the first and second 30 s of which the maternal behavior was observed and recorded using a checklist of behavior. Attachment behaviors were assessed using an attachment behavior checklist (including three types of emotional, proximity-seeking, and caring behaviors). STATISTICAL ANALYSIS USED After data coding, the analysis was performed using Kruskal-Wallis test, Chi-square test, t-test, and Mann-Whitney test in SPSS ver. 14. P < 0.05 was considered the significant level. RESULTS Among emotional, proximity-seeking, and caring behaviors 1 h and 2 months' postpartum in the two groups, only proximity-seeking behaviors were significantly different 2 months' postpartum (P = 0.033). The attachment behavior of 1 h (0.134) and 2 months' postpartum (0.051) did not differ significantly between the two groups. CONCLUSIONS Kangaroo skin contact has an effect, similar to the abdominal skin contact, on the maternal attachment behaviors and has a positive effect on proximity-seeking behaviors and some components of emotional behaviors compared to abdominal skin contact.
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Affiliation(s)
- Mohadse Adeli
- MSc of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat-e Heydariyeh, Iran
| | - Maryam Aradmehr
- MSc of Midwifery, Department of Midwifery, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
- Address for correspondence: Miss. Maryam Aradmehr, MSc of Midwifery, School of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran. E-mail:
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36
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Jones H, Santamaria N. Physiological benefits to parents from undertaking skin-to-skin contact with their neonate, in a neonatal intensive special care unit. Scand J Caring Sci 2017; 32:1012-1017. [PMID: 29131378 DOI: 10.1111/scs.12543] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/18/2017] [Indexed: 11/28/2022]
Abstract
There has been increased focus on the use of family-centred care interventions, such as skin-to-skin contact (SSC) in Neonatal Intensive Special Care (NISC) Units over the past two decades. SSC between a parent and their neonate has previously shown to promote positive mental and emotional health in parents and assist in bonding and attachment between parent and neonate. The purpose of this study was to investigate the effect that SSC between parent and their neonate has on the parent's heart rate (HR) and blood pressure (BP). There has been a lack of prior research investigating the physiological responses from SSC on parents, hence the need to conduct this study. The study was conducted as an observational cohort study at The Royal Women's Hospital NISC Unit in Melbourne, Australia. One SSC between parent and neonate was recorded, and three repeated measures analysis of variance (anova) were conducted to investigate the relationship between SSC and the parent's HR, systolic BP and diastolic BP. The study found statistically significant differences between the parent's initial HR and BP, to measurements taken during the SSC (p < 0.05). This may suggest that parents' find SSC with their neonate to be a stress-reducing intervention, whilst they are in a NISC Unit. This may in turn promote associated benefits, such as a decrease in parental depression and anxiety, whilst they are in the NISC Unit, physical health benefits, as well as increased feelings of bonding between parent and their neonate. Based on the findings, it is suggested that SSC should be promoted in NISC Units as a family-centred care intervention that lowers parent's HR and BP and may provide associated health benefits.
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Affiliation(s)
- Hannah Jones
- University of Melbourne, Melbourne, Vic., Australia.,Newborn Intensive Care, The Royal Women's Hospital, Parkville, Vic., Australia
| | - Nick Santamaria
- Nursing Research, Translational Research, University of Melbourne, Melbourne, Vic, Australia
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37
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Kommers DR, Joshi R, van Pul C, Atallah L, Feijs L, Oei G, Bambang Oetomo S, Andriessen P. Features of Heart Rate Variability Capture Regulatory Changes During Kangaroo Care in Preterm Infants. J Pediatr 2017; 182:92-98.e1. [PMID: 27989406 DOI: 10.1016/j.jpeds.2016.11.059] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/01/2016] [Accepted: 11/22/2016] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator. STUDY DESIGN Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions. Eight HRV features (5 in the time domain and 3 in the frequency domain) were used to visually and statistically compare the pre-kangaroo care and during-kangaroo care periods. Two of these features, capturing the percentage of heart rate decelerations and the extent of heart rate decelerations, were newly developed for preterm infants. RESULTS A total of 191 kangaroo care sessions were investigated in 11 preterm infants. Despite clinically irrelevant changes in vital signs, 6 of the 8 HRV features (SD of normal-to-normal intervals, root mean square of the SD, percentage of consecutive normal-to-normal intervals that differ by >50 ms, SD of heart rate decelerations, high-frequency power, and low-frequency/high-frequency ratio) showed a visible and statistically significant difference (P <.01) between stable periods of kangaroo care and pre-kangaroo care. HRV was reduced during kangaroo care owing to a decrease in the extent of transient heart rate decelerations. CONCLUSION HRV-based features may be clinically useful for capturing the dynamic changes in autonomic regulation in response to kangaroo care and other changes in environment and state.
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Affiliation(s)
- Deedee R Kommers
- Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Rohan Joshi
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Clinical Physics, Máxima Medical Center, Veldhoven, The Netherlands.
| | - Carola van Pul
- Department of Clinical Physics, Máxima Medical Center, Veldhoven, The Netherlands; Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Louis Atallah
- Patient Care and Measurements Department, Philips Research, Eindhoven, The Netherlands
| | - Loe Feijs
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Guid Oei
- Department of Gynecology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Sidarto Bambang Oetomo
- Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Peter Andriessen
- Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Bonner O, Beardsall K, Crilly N, Lasenby J. 'There were more wires than him': the potential for wireless patient monitoring in neonatal intensive care. ACTA ACUST UNITED AC 2017; 3:12-18. [PMID: 28250963 PMCID: PMC5293857 DOI: 10.1136/bmjinnov-2016-000145] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 11/12/2016] [Accepted: 12/04/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND The neonatal intensive care unit (NICU) can be one of the most stressful hospital environments. Alongside providing intensive clinical care, it is important that parents have the opportunity for regular physical contact with their babies because the neonatal period is critical for parent-child bonding. At present, monitoring technology in the NICU requires multiple wired sensors to track each baby's vital signs. This study describes the experiences that parents and nurses have with the current monitoring methods, and reports on their responses to the concept of a wireless monitoring system. METHODS Semistructured interviews were conducted with six parents, each of whom had babies on the unit, and seven nurses who cared for those babies. The interviews initially focused on the participants' experiences of the current wired system and then on their responses to the concept of a wireless system. The transcripts were analysed using a general inductive approach to identify relevant themes. RESULTS Participants reported on physical and psychological barriers to parental care, the ways in which the current system obstructed the efficient delivery of clinical care and the perceived benefits and risks of a wireless system. The parents and nurses identified that the wires impeded baby-parent bonding; physically and psychologically. While a wireless system was viewed as potentially enabling greater interaction, staff and parents highlighted potential concerns, including the size, weight and battery life of any new device. CONCLUSIONS The many wires required to safely monitor babies within the NICU creates a negative environment for parents at a critical developmental period, in terms of physical and psychological interactions. Nurses also experience challenges with the existing system, which could negatively impact the clinical care delivery. Developing a wireless system could overcome these barriers, but there remain challenges in designing a device suitable for this unique environment.
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Affiliation(s)
- Oliver Bonner
- Department of Engineering , University of Cambridge , Cambridge , UK
| | | | - Nathan Crilly
- Department of Engineering , University of Cambridge , Cambridge , UK
| | - Joan Lasenby
- Department of Engineering , University of Cambridge , Cambridge , UK
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Araki S, Saito T, Ichikawa S, Saito K, Takada T, Noguchi S, Yamada M, Nakagawa F. [Family-Centered Care in Neonatal Intensive Care Units: Combining Intensive Care and Family Support]. J UOEH 2017; 39:235-240. [PMID: 28904275 DOI: 10.7888/juoeh.39.235] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Advances in treatment in neonatal intensive care units (NICU) for preterm and sick newborns have improved the mortality rate of patients, but admission to the NICU may disrupt parent-infant interaction, with adverse consequences for infants and their families because of physical, psychological, and emotional separation. The concept of family centered care (FCC), in which family members are part of the care team and infants are close to the family, is important and has become popular in NICU. In 2013, we created a team called "Kodomo-Kazoku Mannaka" to promote FCC in Japan, and visited the NICU at Uppsala University Hospital in Sweden, which is internationally famous for FCC. Since this fruitful visit, we have been promoting FCC in Japan by exhibitions and presentations of the FCC ideas at academic conferences and using internet services. A questionnaire survey conducted in 2015 revealed that the importance and the benefits of FCC in NICU are recognized, although there are some barriers to FCC in each facility. It is hard to change facilities and social systems right away, but it is easier and more important to change people's minds. Our role is to spread the concept of FCC and to help each facility find its own way to adopt it. We will continue to make efforts encourage to promote FCC in Japan.
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Affiliation(s)
- Shunsuke Araki
- Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Japan
| | - Tomoko Saito
- Department of Pediatrics, School of Medicine, Faculty of Medicine, Niigata University, Japan
| | | | - Kaori Saito
- Division of Nursing, Kanagawa Children's Medical Center, Japan
| | | | - Satoko Noguchi
- Department of Neonatology, Kanagawa Children's Medical Center, Japan
| | - Miki Yamada
- Division of Nursing, Kanagawa Children's Medical Center, Japan
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Abstract
Kangaroo care (KC), also known as skin-to-skin contact, saves lives, but fewer than 50% of newborns and mothers in U.S. hospitals receive KC because of lack of knowledge and skill competency. Because nurses can increase knowledge and skill competency through a certification course, the value of certification as a kangaroo caregiver and administrative incentives for certification as a kangaroo caregiver were evaluated in 71 neonatal intensive care and maternal-newborn unit nurses who completed an electronic questionnaire and the Perceived Value of Certification Tool. Nurses highly valued their KC certification, agreeing with 17 of 18 positive value statements. KC certification increased salary for a few, but institution-based incentives for KC certification are still limited and recognition of KC certification is needed.
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Pierrat V, Coquelin A, Cuttini M, Khoshnood B, Glorieux I, Claris O, Durox M, Kaminski M, Ancel PY, Arnaud C. Translating Neurodevelopmental Care Policies Into Practice: The Experience of Neonatal ICUs in France-The EPIPAGE-2 Cohort Study. Pediatr Crit Care Med 2016; 17:957-967. [PMID: 27518584 PMCID: PMC5049969 DOI: 10.1097/pcc.0000000000000914] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To describe the implementation of neurodevelopmental care for newborn preterm infants in neonatal ICUs in France in 2011, analyze changes since 2004, and investigate factors associated with practice. DESIGN Prospective national cohort study of all births before 32 weeks of gestation. SETTING Twenty-five French regions. PARTICIPANTS All neonatal ICUs (n = 66); neonates surviving at discharge (n = 3,005). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Neurodevelopmental care policies and practices were assessed by structured questionnaires. Proportions of neonates initiating kangaroo care during the first week of life and those whose mothers expressed breast milk were measured as neurodevelopmental care practices. Multilevel logistic regression analyses were used to investigate relationships between kangaroo care or breast-feeding practices and unit policies, taking into account potential confounders. Free visiting policies, bed availability for parents, and kangaroo care encouragement significantly improved between 2004 and 2011 but with large variabilities between units. Kangaroo care initiation varied from 39% for neonates in the most restrictive units to 68% in less restrictive ones (p < 0.001). Individual factors associated with kangaroo care initiation were gestational age (odds ratio, 5.79; 95% CI, 4.49-7.48 for babies born at 27-31 wk compared with babies born at 23-26 wk) and, to a lesser extent, single pregnancy, birthweight above the 10th centile, and mother's employment before pregnancy. At unit level, policies and training in neurodevelopmental care significantly influenced kangaroo care initiation (odds ratio, 3.5; 95% CI, 1.8-7.0 for Newborn Individualized Developmental Care and Assessment Program implementation compared with no training). Breast milk expression by mothers was greater in units with full-time availability professionals trained for breast-feeding support (60% vs 73%; p < 0.0001). CONCLUSIONS Dissemination of neurodevelopmental practices occurred between 2004 and 2011, but large variabilities between units persist. Practices increased in units with supportive policies. Specific neurodevelopmental care training with multifaceted interventions strengthened the implementation of policies.
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Affiliation(s)
- Veronique Pierrat
- 1Obstetrical, Perinatal, and Pediatric Epidemiology Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center (U1153), INSERM, Paris, France.2Paris Descartes University, Paris, France.3CHU Lille, Department of Neonatal Medicine, Jeanne de Flandre Hospital, Lille, France.4Research Unit of Perinatal Epidemiology, Pediatric Hospital Bambino Gesù, Rome, Italy.5Department of Neonatology, Toulouse University Hospital, Toulouse, France.6Department of Neonatology, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Bron, France.7EAM 4128, Claude Bernard University Lyon 1,Villeurbanne, France.8Clinical Research Unit, Center for Clinical Investigation P1419, Cochin Broca Hôtel-Dieu Hospital, Paris, France.9Inserm U 1027, Toulouse, France.10Paul-Sabatier University, Toulouse, France.11Purpan, Clinical epidemiology Unit, Toulouse, France
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42
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Abstract
Blood sampling for a newborn screening test is necessary for all neonates in South Korea. During the heel stick, an appropriate intervention should be implemented to reduce neonatal pain. This study was conducted to identify the effectiveness of kangaroo care (KC), skin contact with the mother, on pain relief during the neonatal heel stick. Twenty-six neonates undergoing KC and 30 control neonates at a university hospital participated in this study. Physiological responses of neonates, including heart rate, oxygen saturation, duration of crying and Premature Infant Pain Profile (PIPP) scores were measured and compared before, during and 1 min and 2 min after heel sticks. The heart rate of KC neonates was lower at both 1 and 2 min after sampling than those of the control group. Also, PIPP scores of KC neonates were significantly lower both during and after sampling. The duration of crying for KC neonates was around 10% of the duration of the control group. In conclusion, KC might be an effective intervention in a full-term nursery for neonatal pain management.
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Affiliation(s)
- Young Sun Seo
- Department of Nursing, Eulji University Hospital, Daejeon, 302-799 South Korea
| | - Joohyun Lee
- College of Nursing, Eulji University, Seongnam, 461-713 South Korea
| | - Hye Young Ahn
- College of Nursing, Eulji University, Daejeon, 301-746 South Korea
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43
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Tully KP, Holditch-Davis D, White-Traut RC, David R, O'Shea TM, Geraldo V. A Test of Kangaroo Care on Preterm Infant Breastfeeding. J Obstet Gynecol Neonatal Nurs 2016; 45:45-61. [PMID: 26815798 DOI: 10.1016/j.jogn.2015.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To test the effects of kangaroo care (KC) on breastfeeding outcomes in preterm infants compared with two control groups and to explore whether maternal-infant characteristics and the mother's choice to use KC were related to breastfeeding measures. DESIGN Secondary analysis of a multisite, stratified, randomized three-arm trial. The treatment groups used KC, auditory-tactile-visual-vestibular (ATVV) intervention, or received preterm infant care information. SETTING Neonatal intensive care units from 4 hospitals in the United States from 2006 to 2011. PARTICIPANTS Racially diverse mothers (N = 231) and their preterm infants born weighing less than 1,750 g. METHODS Mothers and their infants were enrolled once the infants were no longer critically ill, weighed at least 1,000 g, and could be safely held outside the incubator by parents. Participants were instructed by study nurses; those allocated to the KC or ATVV groups were asked to engage in these interactions with their infants for a minimum of 3 times a week in the hospital and at home until their infants reached age 2 months adjusted for prematurity. RESULTS Feeding at the breast during hospitalization, the duration of postdischarge breastfeeding, and breastfeeding exclusivity after hospital discharge did not differ statistically among the treatment groups. Regardless of group assignment, married, older, and more educated women were more likely to feed at the breast during hospitalization. Mothers who practiced KC, regardless of randomly allocated group, were more likely to provide their milk than those who did not practice KC. Breastfeeding duration was greatest among more educated women. CONCLUSION As implemented in this study, assignment to the KC group did not appear to influence the measured breastfeeding outcomes.
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44
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Abstract
Skin-to-skin contact, or kangaroo care (KC), has benefits for babies and parents, improving clinical outcomes, temperature control, breastfeeding rates and child-parent bonding; it reduces morbidity and mortality. Barriers to KC for neonates may include a lack of training for nurses, lack of time, maternal or child physical or mental ill health, and inappropriate settings. With education and helpful management, neonatal nurses can advocate for KC for all babies. Parents may need information and encouragement to begin with. Therefore, nurses can improve the experiences of their patients and, in the long run, free time to perform clinical procedures.
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Affiliation(s)
- Sarah Penn
- Special care baby unit, Cumberland Infirmary, Carlisle
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45
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Abstract
PURPOSE OF REVIEW Over 300,000 infants are hospitalized in a neonatal intensive care unit (NICU) in the United States annually during a developmental period critical to later neurobehavioral function. Environmental exposures during the fetal period and infancy have been shown to impact long-term neurobehavioral outcomes. This review summarizes evidence linking NICU-based environmental exposures to neurodevelopmental outcomes of children born preterm. RECENT FINDINGS Preterm infants experience multiple exposures important to neurodevelopment during the NICU hospitalization. The physical layout of the NICU, management of light and sound, social interactions with parents and NICU staff, and chemical exposures via medical equipment are important to long-term neurobehavioral outcomes in this highly vulnerable population. SUMMARY Existing research documents NICU-based exposure to neurotoxic chemicals, aberrant light, excess sound, and restricted social interaction. In total, this creates an environment of co-existing excesses (chemicals, light, sound) and deprivation (touch, speech). The full impact of these co-exposures on the long-term neurodevelopment of preterm infants has not been adequately elucidated. Research into the importance of the NICU from an environmental health perspective is in its infancy, but could provide understanding about critical modifiable factors impacting the neurobehavioral health of hundreds of thousands of children each year.
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46
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Abstract
The holding of an infant with ventral skin-to-skin contact typically in an upright position with the swaddled infant on the chest of the parent, is commonly referred to as kangaroo care (KC), due to its simulation of marsupial care. It is recommended that KC, as a feasible, natural, and cost-effective intervention, should be standard of care in the delivery of quality health care for all infants, regardless of geographic location or economic status. Numerous benefits of its use have been reported related to mortality, physiological (thermoregulation, cardiorespiratory stability), behavioral (sleep, breastfeeding duration, and degree of exclusivity) domains, as an effective therapy to relieve procedural pain, and improved neurodevelopment. Yet despite these recommendations and a lack of negative research findings, adoption of KC as a routine clinical practice remains variable and underutilized. Furthermore, uncertainty remains as to whether continuous KC should be recommended in all settings or if there is a critical period of initiation, dose, or duration that is optimal. This review synthesizes current knowledge about the benefits of KC for infants born preterm, highlighting differences and similarities across low and higher resource countries and in a non-pain and pain context. Additionally, implementation considerations and unanswered questions for future research are addressed.
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Affiliation(s)
- Marsha L Campbell-Yeo
- School of Nursing, Dalhousie University
- Department of Pediatrics, IWK Health Centre
- Department of Psychology and Neuroscience, Dalhousie University
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS
| | | | | | - C Celeste Johnston
- Department of Pediatrics, IWK Health Centre
- Centre for Pediatric Pain Research, IWK Health Centre, Halifax, NS
- Ingram School of Nursing, McGill University, Montréal, QC, Canada
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47
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Abstract
Mothers and babies have a physiologic need to be together at the moment of birth and during the hours and days that follow. Keeping mothers and babies together is a safe and healthy birth practice. Evidence supports immediate, uninterrupted skin-to-skin care after vaginal birth and during and after cesarean surgery for all stable mothers and babies, regardless of feeding preference. Unlimited opportunities for skin-to-skin care and breastfeeding promote optimal maternal and child outcomes. This article is an updated evidence-based review of the "Lamaze International Care Practices That Promote Normal Birth, Care Practice #6: No Separation of Mother and Baby, With Unlimited Opportunities for Breastfeeding," published in The Journal of Perinatal Education, 16(3), 2007.
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48
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Abstract
BACKGROUND/AIMS Kangaroo care (KC) has possible benefits for promoting physiological stability and positive developmental outcomes in preterm infants. The purpose of this study was to compare bradycardia and oxygen desaturation events in preterm infants in standard incubator care versus KC. METHODS Thirty-eight infants 27 to 30 weeks gestational age were randomly assigned to 2 hours of KC daily between days of life 5 to 10 or to standard incubator care. Infants were monitored for bradycardia (heart rate <80) or oxygen desaturation (<80%). Analysis of hourly events was based on three sets of data: standard care group 24 hours daily, KC group during incubator time 22 hours daily, and KC group during holding time 2 hours daily. RESULTS The KC group had fewer bradycardia events per hour while being held compared to time spent in an incubator (p = 0.048). The KC group also had significantly fewer oxygen desaturation events while being held than while in the incubator (p = 0.017) and significantly fewer desaturation events than infants in standard care (p = 0.02). CONCLUSION KC reduces bradycardia and oxygen desaturation events in preterm infants, providing physiological stability and possible benefits for neurodevelopmental outcomes.
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Affiliation(s)
- A J Mitchell
- College of Nursing, University of Arkansas for Medical Sciences (UAMS), AR, USA
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49
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Holditch-Davis D, White-Traut R, Levy J, Williams KL, Ryan D, Vonderheid S. Maternal satisfaction with administering infant interventions in the neonatal intensive care unit. J Obstet Gynecol Neonatal Nurs 2013; 42:641-54. [PMID: 25803213 PMCID: PMC4531372 DOI: 10.1111/1552-6909.12255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To examine mothers' satisfaction with administering interventions for their preterm infants and with the helpfulness of the study nurse by comparing massage with auditory, tactile, visual, and vestibular stimulation (ATVV intervention), kangaroo care, and education about equipment needed at home and to explore whether mother and infant characteristics affected maternal satisfaction ratings. DESIGN Three-group experimental design. SETTING Four neonatal intensive care units (NICUs) (two in North Carolina, two in Illinois). PARTICIPANTS Two hundred and eight (208) preterm infants and their mothers. METHODS When the infant was no longer critically ill, mother/infant dyads were randomly assigned to ATVV, kangaroo care, or the education group all taught by study nurses. At discharge and 2 months corrected age, mothers completed questionnaires. RESULTS All groups were satisfied with the intervention and with nurse helpfulness, and the degree of satisfaction did not differ among them. Intervention satisfaction, but not nurse helpfulness, was related to recruitment site. Older, married, and minority mothers were less satisfied with the intervention but only at 2 months. Higher anxiety was related to lower intervention satisfaction at discharge and lower ratings of nurse helpfulness at discharge and 2 months. More depressive symptoms were related to lower nurse helpfulness ratings at 2 months. CONCLUSIONS Mothers were satisfied with interventions for their infants regardless of the intervention performed. Maternal satisfaction with the intervention was related to recruitment site, maternal demographic characteristics, and maternal psychological distress, especially at 2 months. Thus, nursing interventions that provide mothers with a role to play in the infant's care during hospitalization are particularly likely to be appreciated by mothers.
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50
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Abstract
Jaundice develops in most newborn infants and is one of the most common reasons infants are rehospitalized after birth. American Academy of Pediatrics clinical practice guidelines strongly support the recommendation that clinicians promote and support breastfeeding. Recognizing that the disruptions associated with phototherapy interfere with breastfeeding, the challenge often faced by clinicians is how to provide effective phototherapy while supporting evidence-based practices, such as rooming-in, skin-to-skin contact, and breastfeeding. We report here on a case that reflects a common clinical scenario in newborn medicine in order to describe a technique for providing phototherapy while maintaining evidence-based practices. This approach will assist clinicians in providing best-practices and family-centered care.
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Affiliation(s)
- Kinga A Szucs
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
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