Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: A randomized controlled trial in the NICU

Welch, Martha G.; Myers, Michael; Grieve, Philip G.; Isler, Joseph R.; Fifer, William P.; Sahni, Rakesh; Hofer, Myron A.; Austin, Judy; Ludwig, Robert J.; Stark, Raymond I.

doi:10.1016/j.clinph.2013.08.021

Cited by 86 publications

(72 citation statements)

References 72 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Results from analyses of brain activity at term age give biological support to the effectiveness of this approach (Welch et al 2014). The present study demonstrates that FNI is also effective in alleviating self-reported depressive symptoms and anxiety in mothers of preterm infants at 4 months CA, well beyond the time when FNI mothers were engaged in the facilitated intervention.…”

Section: Discussionsupporting

confidence: 52%

“…The study was approved by the Institutional Review Board of the Columbia University Medical Center, overseen by a Data Safety Monitoring Board and registered at ClinicalTrials.gov (#NCT01439269). FNI has been found to be safe and feasible (Welch et al 2013) and to significantly increase frontal brain activity during sleep at term corrected age (CA) (Welch et al 2014). …”

Section: Methodsmentioning

confidence: 99%

“…Family Nurture Intervention (FNI), described previously (Welch et al 2012), is based on animal and human research, which has identified key roles of olfactory, sensorimotor, and nurturing activities in the development of normal mother-infant relationships (Hofer 1975(Hofer , 1994(Hofer , 1996Myers et al 1989a, b). We have demonstrated that FNI is safe and feasible to implement in the NICU (Welch et al 2013) and that electroencephalographic activity at term age is increased in infants who received FNI compared with those having standard NICU care (Welch et al 2014). As compared with other interventions in this patient population, this is the first trial to assess the effects of facilitated affective communication between mother and infant using a randomized controlled trial design and which initiates mother-infant interactions early in the NICU stay while the infant is confined to the isolette and continues outside the isolette until discharge.…”

Section: Introductionmentioning

confidence: 94%

See 2 more Smart Citations

Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU

Welch

Halperin

Austin

et al. 2015

Arch Womens Ment Health

Self Cite

View full text Add to dashboard Cite

Preterm delivery can precipitate maternal psychological morbidities. Family Nurture Intervention (FNI) was designed to minimize these by facilitating the emotional connection between mother and infant, beginning early in the infant's neonatal intensive care unit (NICU) stay. We examined depression and anxiety symptoms of mothers of preterm infants at 4 months infant corrected age (CA). One hundred fifteen mothers who delivered between 26 and 34 weeks gestational age were randomized to receive standard care (SC) or standard care plus FNI. Mothers' self-reported depressive symptoms (Center for Epidemiologic Studies Depression Scale: CES-D) and state anxiety (Spielberger State-Trait Anxiety Inventory: STAI) symptoms were assessed at enrollment, near to term age, and 4 months (CA). At 4 months CA, mean CES-D and STAI scores were significantly lower in FNI mothers compared to SC mothers. Effectiveness of FNI can only be evaluated as an integrated intervention strategy as it was not possible to control all aspects of FNI activities. Although there was considerable loss to follow-up, analyses suggest that resulting biases could have masked rather than inflated the measured effect size for depressive symptoms. FNI may be a feasible and practicable way to diminish the impact of premature delivery on maternal depressive and anxiety symptoms.

show abstract

Section: Discussionsupporting

confidence: 52%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

See 1 more Smart Citation

Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU

Welch

Halperin

Austin

et al. 2015

Arch Womens Ment Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…Results of the trial showed that an average of four facilitated calming sessions per week between mother and infant significantly improved FNI maternal caregiving behaviors at 36 weeks and decreased maternal depressive and anxiety symptoms in infants assessed at 4 months of age (Welch, Halperin et al, 2016). FNI infants showed highly significant increases in EEG power and decreases in EEG coherence at term age in frontal areas associated with socio-emotional outcomes that predict improved outcomes Myers et al, 2015;Welch, Myers et al, 2014). FNI infants also showed significantly improved social relatedness, attention, neurodevelopment, and decreased risk for autism spectrum disorder at 18 months corrected age (Welch et al, 2015).…”

Section: Family Nurture Interventionmentioning

confidence: 99%

Calming Cycle Theory and the Co-Regulation of Oxytocin

Welch

Ludwig

2017

Psychodynamic Psychiatry

Self Cite

View full text Add to dashboard Cite

Abstract:The biological functions of oxytocin in attachment and bonding between mother and infant in parturition and breastfeeding and between adults have been studied extensively. However, most current authors have proposed that infant attachment to the mother is learned through operant conditioning mechanisms via the infant's brain and central nervous system. We propose that oxytocin levels in the mother and infant are co-regulated by emotional connection or disconnection, and that the autonomic co-conditioning learning mechanism can be exploited to change a negative physiological and behavioral response between mother and infant into a positive one. Lack of efficacy and scalability of child development therapies that have come out of the attachment theoretical framework have prompted calls for new ideas. Here, we review calming cycle theory, which takes a new view of the emotional relationship of mother and infant, and predicts ways to positively intervene when problems arise. The theory builds upon the research and ideas of Pavlov and his followers and proposes that subcortical Pavlovian co-conditioning of the autonomic nervous systems of mother and infant is the key to maintaining emotional connection between the two and to shaping emotional behavior of the infant into adulthood. We review evidence in support of calming cycle theory from a randomized controlled trial of Family Nurture Intervention (FNI), which is designed to overcome adverse emotional, behavioral, and developmental outcomes in prematurely born infants. Finally, we discuss the role of visceral oxytocin and emotional behavior, and that the conditional motherinfant relationship may affect behavioral changes through anti-inflammatory gut-brain stem vagal signaling.

show abstract

“…In every study on developmental care, family has been considered the main component in providing appropriate neonatal care. Family-oriented cares have been able to improve frontal brain activity in sleep, weight gain, discontinuation of incubation, and onset of breast-feeding (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

Assessing Factors Influencing the Quality of Developmental Care in Neonatal Intensive Care Units of Tehran

et al. 2016

View full text Add to dashboard Cite

Background: Neonatal intensive care unit (NICU) developmental care refers to interventions in the infant's environment in neonatal intensive care unit to reduce environmental stresses and provide greater family-infant compatibility. Objectives: The aim of this study was to assess current developmental care performance and factors influencing implementation of this care at NICUs in Tehran, Iran. Methods: This cross-sectional study as part of a larger mixed method study assessed the quality of developmental care in Tehran NICUs. The study was performed on 400 nurses working in level III NICUs in 27 hospitals of Tehran during years 2014 and 2015. Data were collected using two scales, "NICU developmental care assessment (NDCA) scale " and "NICU developmental care structural (NDCS) checklist". The scales validity was detected by content, face and construct and reliability by internal consistency and testretest. The overall and each domain score were calculated in percentages. Data were analyzed using the SPSS-21 software using descriptive statistics tests and regression analysis. Results: The total score of quality of providing developmental care was 74.84%. Among all domains, "daily routine care" had the highest score (85.67%) and "sleep and pain care" had the lowest score (66.63%). Total score of structure was 43.06%. The number of neonates admitted per day (B -0.328, P = 0.019) and number of infants managed by each nurse (B -2.543, P = 0.019) were significant predictor variables for better quality of total developmental care. Conclusions: The number of infants cared and admitted were the only significant factors contributing to high quality of developmental care. Therefore, it is reasonable to assume that in case of Tehran, work-load and structure of services should receive greater attention.

show abstract

Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: A randomized controlled trial in the NICU

Cited by 86 publications

References 72 publications

Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU

Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU

Calming Cycle Theory and the Co-Regulation of Oxytocin

Assessing Factors Influencing the Quality of Developmental Care in Neonatal Intensive Care Units of Tehran

Contact Info

Product

Resources

About