Family-Based Intervention Improves Maternal Psychological Well-being and Feeding Interaction of Preterm Infants

Abstract

Objective. To determine the efficacy of an individualized, family-based intervention with preterm infants and their families. Design. Randomized, repeated measures intervention outcome study. Setting. Level III neonatal intensive care nursery. Patients. Random sample of 34 preterm infants ≤1500 g and their families. Interventions. Individualized, family-based intervention during the hospitalization and transition to home addressed problems identified by parents in four domains including: infant behavior and characteristics, family organization and functioning, caregiving environment, and home discharge and community resources. Measurements and Main Results. Standardized questionnaires were administered at baseline and discharge to mothers, and predischarge bottle-feeding interactions were videotaped and coded by two blinded observers. Results were in favor of intervention (Int) versus control (Con) mothers (baseline; discharge) (P < .05) on the Parental Stressor Scale Sights and Sounds subscale (Int 2.4 ± 1.0; 2.0 ± 0.8 vs Con 2.4 ± 0.9; 2.6 ± 0.8); Child's Appearance and Behavior subscale (Int 2.8 ± 1.0; 2.5 ± 1.1 vs Con 2.8 ± 0.8; 3.1 ± 0.6); and Total Stressor Score (Int 93.9 ± 36.6; 72.3 ± 41.8 vs Con 87.5 ± 26.7; 87.8 ± 26.2). On the Beck Depression Inventory, intervention mothers had significant decreases in depressive symptoms (39%; 11%) vs control mothers (31%; 44%). Maternal self-esteem in both groups improved over time. There were no significant group differences in family environment. During feeding interactions, intervention infants grimaced (P < .001) and gagged (P < .05) less than controls. Intervention mothers less frequently interrupted feedings (P < .001); less frequently stimulated infant sucking (P < .01); smiled more (P < .001); vocalized more (P < .01); demonstrated greater sensitivity to infant behavior (P < .001), better quality of physical contact (P < .001), and more positive affect (P < .01). Conclusions. Individualized, family-based intervention appears to reduce maternal stress and depression, and to enhance early mother-infant feeding interactions. Further research is needed to determine whether these short-term beneficial effects persist beyond the newborn period.

Promoting Sensitive Mother-Infant Interactions in the Neonatal Intensive Care Unit: Development and Design of a Nursing Intervention Using a Theory and Evidence-Based Approach

“…This analysis revealed that both educational and active components seem to have their importance in parent-infant interventions with a predominance of a combination of the two components (Meyer et al, 1994;Newnham et al, 2009;Teti et al, 2009;White-Traut & Nelson, 1988;Zelkowitz et al, 2011), or an active component alone (Borghini et al, 2014;Browne & Talmi, 2005;Chiu & Anderson, 2009;Glazebrook et al, 2007;Hane et al, 2015;Hoffenkamp et al, 2015;Ravn et al, 2011;Sahlen Helmer et al, 2019;Twohig et al, 2019;White-Traut et al, 2013). The educational component usually encompasses different topics, and the active-participatory component relates to maternal participation in various caregiving activities of their preterm infant with direct guidance from a healthcare professional.…”

“…Guidance is the most frequent mode of delivery of mother-infant interventions to enhance maternal sensitivity in previous studies (See Table 1, Appendix A; Borghini et al, 2014;Hoffenkamp et al, 2015;Meyer et al, 1994;Newnham et al, 2009;Ravn et al, 2011;Twohig et al, 2019;White-Traut et al, 2013). Guidance is based on the Guided Participation theory, specific on parenting, which has its origins from the Experiential Learning theory (Pridham et al, 1998).…”

“…In our systematic review, 11 out of the 18 identified interventions were mainly conducted during NICU hospitalization and finished, at the latest, one week after discharge (Browne & Talmi, 2005;Chiu & Anderson, 2009;Glazebrook et al, 2007;Hane et al, 2015;Hoffenkamp et al, 2015;Melnyk et al, 2006;Meyer et al, 1994;Milgrom et al, 2013;Sahlen Helmer et al, 2019;Twohig et al, 2019;White-Traut & Nelson, 1988). Moreover, the average number of sessions that were delivered was 5 sessions throughout the intervention, varying from one to 11 sessions.…”

Collateral benefits of the family check-up in early childhood: Primary caregivers' social support and relationship satisfaction.

“…Shaw, Connell, Dishion, Wilson, and Gardner (2009) found that engagement in the Family Check-Up (FCU), a preventive parent management skills intervention adapted for young children, was directly related to improvements in primary caregiver depression among families with 2- to 3-year-old children. Family interventions engaged in by parents of preterm infants have been shown to reduce maternal stress and depression over time (Meyer et al, 1994). A meta-analysis of the effectiveness of group-based parenting interventions applied during early childhood identified effects for parental depression and anxiety/stress, self-esteem, and partner relationship satisfaction (Barlow, Coren, & Stewart-Brown, 2002).…”

Indonesian pediatricians’ knowledge of Rome IV criteria and their therapeutic approach to infantile colic

“…12 The most important things to prevent such a dreadful outcome are for physicians to identify infant colic effectively and to provide treatment goals for infant colic to support and counsel the caregivers on how to best respond to their infant's crying. 13,14 To our knowledge, Indonesian pediatricians' usage and understanding of Rome IV criteria with regards to infantile colic has never been reported. Therefore, this study was conducted to evaluate Indonesian pediatricians' understanding of infantile colic, with the hope that our results can serve as a basis to reduce the complexity of handling infantile colic and complement educational materials for students, specialist physician trainees, and pediatricians.…”