Nursery-based intervention with prematurely born babies and their mothers: Are there effects?

Brown, Josephine V.; LaRossa, Maureen Mulligan; Aylward, Glen P.; Davis, Diane; Rutherford, Paul; Bakeman, Roger

doi:10.1016/s0022-3476(80)80215-0

Cited by 38 publications

(17 citation statements)

References 14 publications

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“…One study did find a decrease in ventilator days in infants receiving developmental care [Fleisher et al, 1995]. There were no differences in 12 month developmental outcome [Brown et al, 1980].…”

Section: Nidcapmentioning

confidence: 98%

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Neurodevelopmental care in the NICU

Aucott

Donohue

Atkins

et al. 2002

Ment. Retard. Dev. Disabil. Res. Rev.

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Neurodevelopmental care, which is any NICU intervention undertaken to improve neurodevelopmental outcome, includes NICU design, nursing routines, nursing care plans, management of pain, feeding methods and, most importantly, encouraging parental involvement with their NICU infant. Recognition that sensory stimulation can overwhelm preterm infants and increase physiologic signs of stress led to attempts to reduce sensory input. More recent approaches judiciously add back soothing sensory input (e.g., therapeutic touch, soft music). Circadian light/dark cycles and physical activity improve preterm growth. Attention to infant positioning and handling affects physiologic variables and joint mobility, if not functional motor abilities. A highly organized system of care for NICU infants is Als' NIDCAP (i.e., Neonatal Individualized Developmental Care and Assessment Program). Although NIDCAP may reduce need for respiratory support and hospital length of stay, it does not significantly influence neurodevelopmental outcome at 2-3 years. Pain management includes benign interventions (e.g., nonnutritive sucking, oral glucose), but the prolonged use of narcotics must be balanced against the consequences of sedation and dependency. The foremost challenge for NICUs remains parent disenfranchisement. Kangaroo care, which involves parent/infant skin-to-skin contact, improves preterm growth, decreases nosocomial infections and may shorten hospital length of stay. A great deal of work needs to be done to identify and demonstrate efficacy of specific interventions and changes that humanize the NICU, encourage parental involvement, support infant development and optimize preterm neurodevelopmental outcomes.

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Section: Nidcapmentioning

confidence: 98%

“…Studies evaluating other individualized developmental care programs not based on NIDCAP have found no differences in weight gain, hospital charges or length of stay [Brown et al, 1980;Fleisher et al, 1995]. One study did find a decrease in ventilator days in infants receiving developmental care [Fleisher et al, 1995].…”

Section: Nidcapmentioning

confidence: 99%

Neurodevelopmental care in the NICU

Aucott

Donohue

Atkins

et al. 2002

Ment. Retard. Dev. Disabil. Res. Rev.

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“…Three trials had inclusion criteria that specified a disease state, such as bronchopulmonary dysplasia or cranial abnormalities (that is, grade III/IV intraventricular hemorrhage and/or periventricular leukomalacia). 61,68,73 Finally, there were study variations in the socioeconomic status of parents, where two studies (Widmayer et al 77 and Brown et al 58 ) selected only preterms born to teenaged, lower socioeconomic status, black teenage mothers.…”

Section: Identification Of Relevant Studiesmentioning

confidence: 99%

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

et al. 2009

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Objective: To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older.Study Design: Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported.Result: Identified studies (n ¼ 25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N ¼ 2198 infants) found significantly higher mental (N ¼ 2198) and physical (N ¼ 1319) performance scores favoring the intervention group. At 24 months, the mental (N ¼ 1490) performance scores were improved, but physical (N ¼ 1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N ¼ 961) and 5 years (N ¼ 1017). Conclusion:Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

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“…); (d) parent-infant interaction (observations during feeding and play using coding schemes or rating scales); (e) quality of home environment (HOME Scores, family functioning measures, social support measures); and (f) infant cognitive development (Bayley Scales, McCarthy Scales, and prevalence of developmental delays). Only a few studies incorporated more than two or three types of outcome indicators over (a longitudinal period of) time (Barnard et al, 1987;Brown et al, 1980;Field et al, 1980;Nurcombe et al, 1983;Resnick et al, 1987;Ross, 1984).…”

Section: Measuring Outcomesmentioning

confidence: 99%

Parenting of low birth weight infants: A review of issues and interventions

Patteson

Barnard

1990

Infant Ment. Health J.

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Factors that may adversely affect parenting of low birth weight infants, including infant characteristics, parental emotional responses to premature birth, and patterns of parent‐infant interaction, are reviewed. In addition, intervention studies designed to improve infant developmental outcomes through influencing parenting behaviors are examined. There was great diversity in theoretical frameworks, in timing of onset and frequency of interventions, and in measurement of outcomes. The interventions that were most effective in influencing behaviors and infant developmental outcomes were those in which there were multiple long‐term contacts with parents and/or those that actively involved them in the intervention. The specific theoretical framework upon which the interventions were based appeared to be of less importance in influencing results. In order to increase our knowledge and ability to provide costeffective programs, there is a need to focus attention and data collection efforts on the process and intermediary steps of intervention as well as on outcome measures. There is also a need to improve our ability to recruit and retain those families who are most at risk for parenting and infant developmental problems including those with very low birth weight infants, those whose infants have serious perinatal complications, and those with indications of high social risk such as poverty‐level incomes and problems of substance abuse.

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Nursery-based intervention with prematurely born babies and their mothers: Are there effects?

Cited by 38 publications

References 14 publications

Neurodevelopmental care in the NICU

Neurodevelopmental care in the NICU

Early interventions involving parents to improve neurodevelopmental outcomes of premature infants: a meta-analysis

Parenting of low birth weight infants: A review of issues and interventions

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