The hammock positioning can be considered a safe method of positioning that can be used to reduce the stress levels in very low birth weight preterm newborns. We did not observe worsening in either pain or vital signs.
Kangaroo Mother Care (KMC) has been used as a technique to promote mother-child bonding. It has been discussed of its use for preterm under mechanical ventilation. The objective of this study is to assess the vital signs of preterm infants with a birth weight lower than 1500 g who are under intubation and hemodynamically stable in KMC. Forty-three preterm infants with a mean gestational age at birth of 29.1 ± 1.6 weeks and a mean birth weight of 1.1334 ± 2318 g. The preterm infants were longitudinally assessed for 90 min (15 min before, 60 min in KMC and 15 min after). These periods were compared, and the dependent variables heart rate, oxygen saturation (SpO(2)), axilary temperature and mean arterial blood pressure were statistically significant (p < 0.05). Clinically, however, the results were not significantly different. The results show that KMC is a safe method under the study conditions presented here.
The repeated painful experiences in newborns may have short- and long-time effects, especially in premature infants. The use of sweetened solutions during painful procedures has been recommended as a measure of pain relief. This study aims to evaluate the evidence of the effect of oral sucrose or glucose for acute pain relief in premature infants. An integrative review was conducted in the MEDLINE and LILACS databases. Eight articles were selected from 2005 to 2010. The analyzis of these articles revealed the analgesic effect of glucose and sucrose in acute procedures. No significant side effects were found in infants who received glucose/sucrose. We emphasize the importance of the use of the pain assessment scale most closely related to the predominant population in the Neonatal Intensive Care Unit, a scale easy to be used and handled by health professionals.
ObjectiveTo compare the neuropsychomotor development in the first year of life of
premature infants with and without bronchopulmonary dysplasia.MethodsA cross-sectional retrospective study was conducted between January 1, 2014,
and December 30, 2015, with premature infants weighing < 1,500g at birth
and diagnosed with bronchopulmonary dysplasia at the corrected ages of 6 and
9 months, assessed using the DENVER II Developmental Screening Test.
Quantitative variables were described as the means, medians and standard
deviations. Variables with normal distribution were tested using Student's
t test; otherwise, the Mann-Whitney test was used,
considering significance at p-value < 0.05. Qualitative variables were
expressed as frequencies and percentages. Logistic regression was used with
odds ratio analysis to evaluate the effects of other variables as risk
factors for changes in neuropsychomotor development.ResultsInfants with bronchopulmonary dysplasia showed greater developmental delay
compared with those without bronchopulmonary dysplasia (p-value = 0.001).
The factors associated with a higher incidence of changes in
neuropsychomotor development, in addition to bronchopulmonary dysplasia,
were antenatal steroid, gender, birth weight, 5-minute Apgar score, Score
for Neonatal Acute Physiology-Perinatal Extension, duration of oxygen
therapy, duration of mechanical ventilation and length of hospital stay.
Other variables may also have influenced the result, such as drug use by
mothers of infants with bronchopulmonary dysplasia.ConclusionBronchopulmonary dysplasia associated with other pre- and postnatal factors
may be considered a risk factor for delayed neuropsychomotor development in
the first year of life in premature infants born weighing less than
1,500g.
OBJETIVOS: descrever os estados comportamentais dos recém-nascidos com peso inferior a 1500 g, em ventilação mecânica, antes, durante e após o cuidado mãe canguru (CMC). MÉTODOS: estudo do tipo quase experimental em que os estados comportamentais definidos como sono profundo, ativo, sonolência, alerta inativo, alerta ativo e choro de acordo com a Escala Neonatal de Brazelton foram avaliados em três momentos: 15 minutos antes do CMC, 30 minutos após o início da exposição e 15 minutos após o CMC num total de uma hora de exposição. Quarenta e quatro recém-nascidos pré-termo (poder estatístico >0,9), com idade gestacional média de 29 semanas e peso médio de 1096 g, intubados e estáveis do ponto de vista hemo-dinâmico, foram selecionados por amostra de entrada contínua. RESULTADOS: evidenciou-se o favorecimento do sono, principalmente o sono profundo (52,3%), comparado aos períodos antes (6,8%) e após (13,6%) (p<0,001) o CMC. Além disso, os recém-nascidos apresentaram sinais de dor após o CMC com diferença significativa (p=0,002). CONCLUSÕES: o cuidado mãe canguru, nas condições deste estudo, pode ser considerado como uma estratégia favorecedora para o desenvolvimento neurocomportamental.
Resumo Esta revisão integrativa da literatura teve como objetivo verificar se o Método Canguru, conforme instituído no Brasil, desde a primeira etapa até o acompanhamento ambulatorial, tem influência sobre o aleitamento materno. Foram incluídas pesquisas realizadas no Brasil, publicadas em periódicos nacionais e internacionais, nas principais bases de dados, em português, inglês ou espanhol, nos anos de 2000 a 2017, disponíveis na íntegra e com a temática relacionada com o objetivo deste estudo. Foram encontrados 1328 artigos sendo excluídos artigos não realizados no Brasil, artigos de revisão da literatura e de temáticas não relacionadas com o Método Canguru, sendo então selecionados 21 estudos. As pesquisas encontradas apontaram para uma influência positiva do Método Canguru sobre o aleitamento materno e estabelecimento de vínculo entre mãe-filho. No entanto, a terceira etapa ou acompanhamento ambulatorial, não se mostrou eficaz na manutenção do aleitamento materno. Faz-se necessário maior participação da atenção básica nos cuidados domiciliares prestados ao recém-nascido pré-termo, com vistas à promoção do aleitamento materno exclusivo até os seis meses de idade e complementado até os dois anos.
Objective: To analyze the influence of the Kangaroo Position duration in the initial interactions between mothers and preterm infants.Methods: This is an exploratory prospective observational study that analyzed the mother-infant interaction during breastfeeding, before hospital discharge. All eligible newborns, with a gestational age of 28-32 weeks and a birth weight of 1,000-1,800 g from June 11 to September 31, 2014 were included. The films of the interaction were evaluated by the “Mother-Baby Interaction Protocol 0-6 months” tool. The duration of the Kangaroo Position during all the hospitalization period was correlated with the interaction between mother and preterm infant.Results: The longer the dyad spent time in the Kangaroo Position, the more the newborns made physical contact attempts with their mothers during breastfeeding (r=0.37; p=0.03); and the longer the time in the Kangaroo Position, the less the mothers talked to their children (r=-0.47; p=0.006).Conclusions: Longer periods in the Kangaroo Position stimulates the initial exchanges of contact between preterm infant with his mother, which suggests a higher alert status of the newborn and a better availability for interactions with the mother during breastfeeding.
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