No abstract

Because it is becoming increasingly evident that the sensitivity of mothers to their premature infants can affect the mother-infant relationship, means to assess maternal sensitivity to infants are essential. The Boston City Hospital Assessment of Parental Sensitivity (BCHAPS) was the tool used in this study to assess maternal competence and sensitivity to premature infants in the Neonatal Intensive Care Unit (NICU). The concurrent validity of the tool was determined by examining the relation between scores on the BCHAPS and several maternal characteristics (i.e., family income, education, and parity) and infant characteristics (i.e., weight, gestational age, APGAR scores, and severity of illness). The predictive validity of the BCHAPS was determined by comparing the BCHAPS scores to mother-infant interaction behaviors when infants were 8 months old. Scores obtained on the BCHAPS correlated with mother-infant interaction scores at 8 months and to parity. There was no correlation between the BCHAPS scores and other maternal-infant characteristics. The results of this study indicate that the BCHAPS is a tool that can be used clinically to assess maternal behaviors in the NICU and that can predict the mother-infant relationship long after the discharge of the infant.

Stories in the popular press about the potential damage suffered by children prenatally exposed to drugs easily arouse hostile and punitive attitudes towards the children's mothers. Concerns about the outcome of drug‐exposed infants are legitimate, but predictions about adverse outcomes are being made in the absence of reliable scientific data. The postnatal environment, particularly the parenting environment, has a significant influence on the developmental outcome of children. Any model for understanding the effects of prenatal drug exposure and parental addiction on a child's development must consider both potential biologic insult and environmental risk factors. This paper examines clinical issues related to the management of the substance‐involved mother and her infant, by understanding maternal addiction, the regulatory capacities of the infant, and how drug treatment can be a part of a mutual regulatory system between mother and child. Clinical guidelines are given to assist clinicians in their work with drug‐exposed infants and their mothers. Best practices are discussed based on a family‐centered approach to maternal drug use and its impact on infants. Les récits produits par la presse populaire à propos des préjudices éventuels subis par les enfants exposés prénatalement aux drogues déclenchent facilement des attitudes hostiles et punitives envers les méres de ces enfants. Certes, il est juste et légitime de s'inquiéter du sort des nourrissons exposés à la drogue. Cependant, les prédictions sur les coséquences néfastes de certains comportements sont faites en absence totale de données scientifiques fiables. Le milieu postnatal, en particulier le milieu de parentage, a une grande influence sur le développement des enfants. Tout modéle de compréhension des effets de l'exposition prénatale à la drogue et la toxicomanie parentale doit à la fois considérer l'affront biologique éventuel et les facteurs de risque dǔs au milieu. Cet article examine les problèmes cliniques liés à la prise en charge de la mère et de son nourrisson exposés aux stupéfiants. Nous expliquons la toxicomanie maternelle, les capacités régulatrices du nourrisson, la manière dont le traitement peut faire partie d'un système mutuel régulateur entre la mère et l'enfant. Nous offrons des lignes directrices cliniques afin d'assister les cliniciens dans leur travail avec les nourrissons et les mères exposés la drogue. Les meilleures pratiques sont discutées, basé sur une approche familiale de la toxicomanie maternelle et de son impact sur les nourrissons.

NICU nurses and developmental specialists have a unique opportunity to facilitate the beginning of a meaningful parent/infant relationship in the NICU setting. The Brazelton Neonatal Behavioral Assessment Scale (BNBAS) is one tool that can be utilized to support this process. When parents observe this assessment, they learn to recognize and understand infant cues and gain confidence for everyday routines such as diapering, feeding, general caregiving, and even taking that first trip with the baby to the grocery store. Parents become empowered when they discover not only their baby's amazing competencies, but also their own. In addition, the BNBAS provides a framework through which parents can effectively communicate and advocate for their baby.