Individualized Developmental Care for Very-Low-Birth-Weight Premature Infants

Abstract

Forty very-low-birth-weight neonatal intensive care unit (NICU) infants with birth weights < or = 1,250 g were randomly assigned to treatment or control groups. Behavior of the treatment infants was systematically evaluated, and individualized developmentally oriented care plans were implemented to enhance stability. Treatment babies required fewer days of intermittent mandatory ventilation and continuous positive airway pressure and achieved full enteral feedings sooner. Length of hospital stay and hospital charges were less for treatment than control infants. There were favorable effects on treatment infants' behavioral performance at 42 weeks' postconceptional age. These results support the hypothesis that behaviorally sensitive, developmentally oriented care improves medical and neurodevelopmental outcome in the NICU.

The Assessment of Preterm Infants' Behavior (APIB): Furthering the understanding and measurement of neurodevelopmental competence in preterm and full‐term infants

“…The authors concluded that in contrast to most other newborn neurobehavioral assessments available, the APIB measures not only task performance but also quality of performance. The APIB also showed consistently high sensitivity in identifying neurobehavioral differences associated with gestational ages at birth [Als et al, 1988b;; as well as with documentation of the effects of individualized behavioral intervention (NIDCAP) in the NICU Als et al, 1994Als et al, , 2003Als et al, , 2004Buehler et al, 1995;Fleisher et al, 1995]. No such sensitivity has been identified for any of the other newborn behavioral assessments available.…”

Measuring developmentally appropriate practice in neonatal intensive care units

“…[8][9][10][11][12] The implementation of developmental interventions could be integrated into a systematic method, as in the case of the Neonatal Individualized Developmental Care and Assessment Program (NIDCAP). 6 Studies on the effects of the developmental approach as manifested in individualized developmental care have demonstrated a variety of positive outcomes, including decreasing respiratory support, [13][14][15][16] advancement of oral feeding, 13,14 shorter stay in hospital, 13,14 enhancement of neurodevelopmental outcomes 14,17 and empowerment of the parents, 17 as well as enhancement of brain function and structure in premature babies who had taken part in NIDCAP. 18 However, criticism has been leveled at methodological aspects, specifically, small sample size in many of the studies, and the need to continue research to verify a consistent effect.…”

Early Experience Alters Brain Function and Structure

“…Several randomized trials have shown positive results in both behavioral and electrophysiological functioning of very premature infants (Ͻ30 weeks' gestational age) at high risk for various serious organ injuries such as chronic lung disease and intraventricular hemorrhage. [11][12][13]15,24 Despite the consistent results, a recent meta-analysis concluded that sufficient evidence did not exist at this time to warrant a multicenter clinical trial. 25 Similar developmental results have been documented also in low-risk 30-to 34-week gestational preterms.…”