Socio-demographic factors related to parent engagement in the NICU and the impact of the SENSE program

Whitehill, Laura; Smith, Joan; Colditz, Graham A.; Le, Tiffany; Kellner, Polly; Pineda, Roberta

doi:10.1016/j.earlhumdev.2021.105486

Cited by 15 publications

(15 citation statements)

References 29 publications

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“…These disparities in MM provision between Black and White women is consistent with broader public health trends in breastfeeding rates [ 31 ], which show that Black infants have a significantly lower rate of any breastfeeding at 3 months (58%) than White infants (73%) [ 32 ]. We also found that White mothers report greater positive interaction/engagement with their infants ( Table 4 ) replicating findings that White mothers appear to be more engaged with their infants in the NICU than Black mothers and also with healthcare in general [ 33 , 34 ]. This raises critical questions about structural barriers associated with systemic racism that pose disproportionate impacts on Black mothers’ ability to access quality care, interact and engage with trusted providers including lactation consultants in the NICU, and also initiate and continue pumping MM.…”

Section: Discussionsupporting

confidence: 76%

Maternal Milk Provision in the Neonatal Intensive Care Unit and Mother–Infant Emotional Connection for Preterm Infants

et al. 2022

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Maternal milk (MM) intake during neonatal intensive care unit (NICU) hospitalization is associated with improved neurodevelopment in preterm infants. Underlying mechanisms may include stronger mother–infant emotional connection. This paper examines associations between MM provision in the NICU with maternal connection to her infant using three factors validated in our sample: maternal sensitivity, emotional concern, and positive interaction/engagement. We studied 70 mothers of infants born <1500 g and/or <32 weeks’ gestation. Associations between MM provision and mother–infant connection were modeled using median regression adjusted for clustering. Mothers who provided exclusive MM (i.e., 100% MM, no other milk) reported higher levels of maternal sensitivity by a median score of 2 units (β = 2.00, 95% CI: 0.76, 3.24, p = 0.002) than the mixed group (i.e., MM < 100% days, other milk ≥1 days), as well as greater emotional concern (β = 3.00, 95% CI: −0.002, 6.00, p = 0.05). Among mothers of very preterm infants, greater milk provision was associated with greater maternal sensitivity, but also with greater emotional concern about meeting the infant’s needs. These findings highlight the importance of supporting MM provision and early infant care as an integrated part of lactation support. The findings may also provide insight into links between MM provision in the NICU and infant neurodevelopment.

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Section: Discussionsupporting

confidence: 76%

Maternal Milk Provision in the Neonatal Intensive Care Unit and Mother–Infant Emotional Connection for Preterm Infants

et al. 2022

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“…There were relationships between parent–infant engagement related to sociodemographic factors, which is consistent with other reports (Pineda et al, 2018). Previous studies have noted that families experiencing sociodemographic challenges may face significant barriers to being present in the NICU (Sigurdson et al, 2020; Whitehill et al, 2021). Families who perceive the NICU as more stressful may have lower presence during their infants’ hospitalization (Head Zauche et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…The actual act of engaging in co-occupations could potentially have a positive impact on all involved parties (Harris et al, 2018; Pineda et al, 2018). Finally, it has been noted that sociodemographic factors may impact parental engagement within the NICU (Pineda et al, 2018; Whitehill et al, 2021). Such contextual factors related to parental occupational engagement within the NICU are important to consider.…”

Section: Introductionmentioning

confidence: 99%

Infant and Parent Outcomes Related to NICU-Based Co-occupational Engagement

Richter

Angell

Kellner

et al. 2023

OTJR: Occupational Therapy Journal of Research

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Neonatal intensive care unit (NICU) co-occupations may impact parent–infant outcomes. The main objective of this study was to explore relationships between parent and infant outcomes based on whether sensory-based interventions (co-occupations) occurred most often between parent–infant dyads or provider/volunteer–infant dyads. Thirty-five families received the Supporting and Enhancing NICU Sensory Experiences (SENSE) program, which includes education defining specific amounts of sensory exposures for infants to receive each day of NICU hospitalization (with a preference for parent delivery). Infant sensory experiences in the NICU were logged, and dyads were grouped based on who conducted most of the sensory interventions with the infant in the NICU into a Parent–Infant Co-occupation group or Other Administered group. The Parent–Infant Co-occupation group had infants with less lethargy on the NICU Network Neurobehavioral Scale ( p = .04), and parents with lower scores on the Parental Stress Scale ( p = .003) and State-Trait Anxiety Inventory-state ( p = .047). Parent–infant engagement in co-occupations was related to parental mental health and infant neurobehavior.

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“…Parental engagement at the bedside, especially early in an infant's NICU course, is shown to reduce parent and infant stress and increase infant-parent bonding, allowing for improved neurodevelopmental outcomes. 11,12 For parents with socioeconomic disparities affecting their ability to travel to the hospital or secure childcare for siblings, their infants are at a greater risk for poorer health and neurodevelopmental outcomes due to inconsistent visitation. 13 Prolonged neonatal hospitalization offers the opportunity for the interprofessional NICU team to identify and address a family's unique SDOH, but only about 23% of level 2 to 4 NICUs utilize SDOH screening, 14 allowing for disparities in care to persist.…”

mentioning

confidence: 99%

“…Additionally, parental visitation is not only influenced by stress related to hospitalization and birth trauma,9 but also by the aforementioned external factors that impede the parental ability to participate in their infant's care,10 including oral feeding. Parental engagement at the bedside, especially early in an infant's NICU course, is shown to reduce parent and infant stress and increase infant–parent bonding, allowing for improved neurodevelopmental outcomes 11,12. For parents with socioeconomic disparities affecting their ability to travel to the hospital or secure childcare for siblings, their infants are at a greater risk for poorer health and neurodevelopmental outcomes due to inconsistent visitation 13…”

mentioning

confidence: 99%

Considering the Influence of Social Determinants of Health on Parent Feeding Practices

LaManna,

Hatfield,

McCann

2024

Advances in Neonatal Care

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Background: Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. SDOH can be grouped into 5 domains: economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. SDOH impact people's health and quality of life but may also contribute to disparities in access to food, education, and healthcare. SDOH uniquely influence parent feeding practices in the neonatal intensive care unit (NICU) in a variety of ways, ranging from logistical considerations for parent visitation to cultural beliefs such as family perception of human milk feeding. Evidence Acquisition: A hypothetical case example of a preterm infant with a feeding disorder in the NICU is used to connect SDOH that influence prenatal health, parental lived experience, and postnatal medical care to maternal and infant outcomes with implications for feeding practices. Barriers and facilitators to successful feeding practices in the NICU and at discharge are considered for each SDOH domain. Results: This case example increases awareness of SDOH and how they influence parent feeding practices in the NICU, focusing on the intersection of SDOH, parent stress, and oral feeding outcomes. Examples were provided for how to support applying findings into practice. Implications for Practice and Research: By being creating a culture of SDOH awareness, NICU staff can assist families in overcoming barriers by putting supports in place to increase equitable participation in developmentally supportive feeding practices during the NICU stay.

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Socio-demographic factors related to parent engagement in the NICU and the impact of the SENSE program

Cited by 15 publications

References 29 publications

Maternal Milk Provision in the Neonatal Intensive Care Unit and Mother–Infant Emotional Connection for Preterm Infants

Maternal Milk Provision in the Neonatal Intensive Care Unit and Mother–Infant Emotional Connection for Preterm Infants

Infant and Parent Outcomes Related to NICU-Based Co-occupational Engagement

Considering the Influence of Social Determinants of Health on Parent Feeding Practices

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