The Light Side of Preterm Behavioral Epigenetics

2016 ◽  
pp. 107-127 ◽  
Author(s):  
Livio Provenzi ◽  
Renato Borgatti ◽  
Rosario Montirosso
Keyword(s):  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Protective Effects ◽  
Developmental Care ◽  
Early Human Development ◽  
Related Stress ◽  
The One ◽  
Light Side ◽  
Epigenetic Research ◽  
Early Human

Preterm infants need long-lasting hospitalization in the Neonatal Intensive Care Unit (NICU). On the one hand, the NICU stay constitutes an early adverse experience, due to highly stressful experiences. On the other hand, Developmental Care (DC) interventions, including caregiver engagement, can exert neuro-protective effects for preterm infants. Recent evidence in the field of behavioral epigenetics is revealing the biochemical pathways through which adverse and care experiences are embedded in early human development through epigenetic mechanisms. Nonetheless, the application of behavioral epigenetics to preterm birth and NICU stay is still at its beginning. In the present chapter, insights are provided for the application of behavioral epigenetics to the study of the biochemical underpinnings of NICU-related stress and care, with a specific focus on caregiver engagement. This contribute should be intended as a preliminary roadmap to guide future behavioral epigenetic research on the adverse and protective effects of early NICU care of preterm infants.

The Effect of Individualized Developmental Care Practices in Preterm Infants

2019 ◽  
Vol 27 (2) ◽  
pp. 97-104
Author(s):  
Dilek Küçük Alemdar ◽  
Sevil İnal
Keyword(s):  
Breast Milk ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Controlled Trial ◽  
Oral Feeding ◽  
Control Group ◽  
Developmental Care ◽  
Significant Difference ◽  
Care Practices ◽  
Maternal Voice

Background: Preterm infants are vulnerable humans requiring much care and attention. They may be exposed to irregular noise, light, and odor in the neonatal intensive care unit for a period of several weeks or months. This study was carried out to determine the effect of individualized developmental care on physiological parameters, growth, and transition to oral feeding in preterm infants. Methods: The study was a randomized controlled trial. The sample comprised premature infants meeting the inclusion criteria. They were randomly assigned to four groups: the maternal voice group, the breast milk odor (BMO) group, the incubator cover (IC) group, and the control group. Results: No statistically significant difference was found between the groups in terms of weight, height, and head circumference at time of discharge. Mean SO2 values were statistically higher in the IC group than the other groups; however, the heart rate and respiratory rate were not statistically different in a significant sense between the groups. The briefest duration of transition to total oral feeding was seen in the BMO group. Conclusion: Individualized developmental care practices based on the results of these interventions are likely to support the care of preterm infants. Breast milk odor may ease the transition to breastfeeding.

Use of Individualized Versus Standard Criteria to Identify Abnormal Levels of Heart Rate or Oxygen Saturation in Preterm Infants

2001 ◽  
Vol 9 (2) ◽  
pp. 181-200 ◽  
Author(s):  
Lynda Harrison ◽  
Michael L. Berbaum ◽  
John T. Stem ◽  
Katherine Peters
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Physiological Responses ◽  
Clinical Effectiveness ◽  
Low Oxygen ◽  
Heart Rates ◽  
Developmental Care ◽  
Physiological Indicators

Preterm infants’ physiological indicators, such as heart rate, respiratory rate, and oxygen saturation levels, are routinely monitored by devices that can alert nurses to threatening changes in condition. Most Neonatal Intensive Care Units use standard criteria as alerting algorithms to determine when an alert should be issued, and these standard criteria have been adopted uncritically in studies of preterm infants. This article presents results from a study examining preterm infants’ physiological responses to a gentle human touch (GHT) intervention in which we compared the use of standard and individualized criteria to define the percentages of abnormally low and high heart rates (HRs) and abnormally low oxygen saturation (O2 sat) levels before, during, and after periods of GHT. Results indicated that there were no differences in the percentages of abnormal HRs or O2 sat values between periods using standard criteria. However, using individualized criteria, there were significantly greater percentages of abnormally low heart rates and O2 sat levels during and after GHT periods as compared to baseline periods. The findings suggest that standard criteria may not be sensitive enough to detect subtle physiological responses to environmental stimuli such as touch. Moreover, consistent with the recognition of the value of individualized developmental care, these results suggest that the clinical effectiveness of individualized criteria for setting monitor alert limits merits further investigation.

Music as a Nursing Intervention for Preterm Infants in the NICU

2008 ◽  
Vol 27 (5) ◽  
pp. 319-327 ◽  
Author(s):  
Diana Neal ◽  
Linda Lindeke
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Nursing Intervention ◽  
Developmental Care

Although there is general agreement that noise in the neonatal intensive care unit should be reduced, there is controversy about the use of music as a developmental care strategy with preterm infants. Much literature supports using music with preterm infants, indicating that it enhances physiologic and neurobehavioral functioning, but some experts worry that music is overstimulating. This article presents evidence supporting the use of music with preterm infants as well as criticism of same. Recommendations for music interventions with preterm infants are discussed, although further research is needed before specific guidelines can be established.

Premature Infant Massage in the NICU

2003 ◽  
Vol 22 (3) ◽  
pp. 39-45 ◽  
Author(s):  
Jodi Beachy
Keyword(s):  
Intensive Care ◽  
Preterm Infant ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Care Setting ◽  
Massage Therapy ◽  
Intensive Care Setting ◽  
Parenting Skills ◽  
Infant Massage ◽  
Developmental Care

Infant massage therapy is an inexpensive tool that should be utilized as part of the developmental care of the preterm infant. Nurses have been hesitant to begin massage therapy for fear of overstimulating the infant and because there has been insufficient research to prove its safety. Recent research, however, has shown that the significant benefits of infant massage therapy far outweigh the minimal risks. When infant massage therapy is properly applied to preterm infants, they respond with increased weight gains, improved developmental scores, and earlier discharge from the hospital. Parents of the preterm infant also benefit because infant massage enhances bonding with their child and increases confidence in their parenting skills. This article discusses the benefits and risks of massage for preterm infants and their families and explains how to implement massage therapy in the neonatal intensive care setting.

Considerations for Touch and Massage in the Neonatal Intensive Care Unit

2000 ◽  
Vol 19 (1) ◽  
pp. 61-64 ◽  
Author(s):  
Joy Browne
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Short Term ◽  
Term Infants ◽  
Developmental Care ◽  
The Family ◽  
Potential Impact

AN EXPANDING BODY OF research has documented the short-term advantages of gentle touch and massage for healthy term infants and some growing and medically stable preterm infants. These findings have provided the impetus for extension of massage techniques to very small, fragile newborns, promoting the utilization of new personnel in NICUs specifically to provide massage therapy for newborns. It is important, before engaging in these approaches, for professionals in the NICU to consider the potential impact of massage on the infant and the family. It is also imperative that professionals in the NICU take into account the current growing knowledge base regarding developmental care and the implications for decision making regarding provision of stimuli of any sort to fragile, sick newborns in the NICU.

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