Comforting Touch in the Very Preterm Hospitalized Infant

Smith, Joan

doi:10.1097/anc.0b013e31826093ee

Cited by 40 publications

(20 citation statements)

References 43 publications

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“…30 Although very preterm babies can become stressed by repeated contact and stimulation, the evidence suggests comforting touch (such as from parents) does not adversely affect the baby and may result in benefits when done carefully and taking account of infant behavioural cues. 31 In addition, the results extend research by providing original insights, such as the opposing emotions felt by different parents prior to seeing and holding their baby. The finding that parents were either anxious/avoidant or desperate/excited is consistent with research showing different individuals have approach or avoidant coping styles and this affects both responses to care and outcomes.…”

Section: Discussionsupporting

confidence: 57%

Parents’ first moments with their very preterm babies: a qualitative study

et al. 2013

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ObjectivesTo assess parents’ first experiences of their very preterm babies and the neonatal intensive care unit (NICU).DesignQualitative study using semistructured interviews.Participants32 mothers and 7 fathers of very preterm babies (<32 weeks gestation).SettingThree neonatal units in tertiary care hospitals in South East England.ResultsFive themes were identified. The first describes parents’ blurred recall of the birth. The second shows the anticipation of seeing and touching their baby for the first time was characterised by contrasting emotions, with some parents feeling scared and others excited about the event. The third theme describes parents’ first sight and touch of their babies and their ‘rollercoaster’ of emotions during this time. It also highlights the importance of touch to trigger and strengthen the parent–baby bond. However, some parents were worried that touching or holding the baby might transmit infection or interfere with care. The fourth theme captures parents’ impressions of NICU and how overwhelming this was particularly for parents who had not toured NICU beforehand or whose first sight of their baby was on NICU. The final theme captures unique experiences of fathers, in particular that many felt excluded and confused about their role.ConclusionsThis study informs family-centred care by providing insight into the experiences of parents of very preterm infants at a time when they are most in need of support. Clinical implications include the importance of offering parents preparatory tours of the NICU and including fathers.

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Section: Discussionsupporting

confidence: 57%

Parents’ first moments with their very preterm babies: a qualitative study

et al. 2013

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“…The possibility that infant massage could provide a form of comforting touch with positive effects on growth and neurodevelopment is described in a number of studies [16, 17]. Evidence supporting positive effects of massage in preterm infants include increased weight gain [18–20], improved growth and gastrointestinal function [21, 22], improved body fat deposition [23], improved neurobehavioural outcomes [17, 24–26], pain attenuation [27, 28], reduction of infant stress and stress-related factors [29, 30], reduction of late-onset sepsis [31], improved immune system [32], reduced jaundice [33] and improved heart rate variability [34] as well as a reduction in maternal depression and anxiety [35]. Studies investigating the use of specific oils in massage versus no oil suggest improved weight gain [36–38].…”

Section: Introductionmentioning

confidence: 99%

“…Overall the evidence remains weak, mainly due to small sample sizes, heterogeneity and poor methodology in some studies. The current level of evidence does not support wider use of infant massage without further research [17, 39]. Two key aspects of infant massage as an early intervention have received little attention.…”

Section: Introductionmentioning

confidence: 99%

PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants

et al. 2016

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BackgroundPreterm infants follow an altered neurodevelopmental trajectory compared to their term born peers as a result of the influence of early birth, and the altered environment. Infant massage in the preterm infant has shown positive effects on weight gain and reduced length of hospital stay. There is however, limited current evidence of improved neurodevelopment or improved attachment, maternal mood or anxiety. The aim of this study is to investigate the effects of infant massage performed by the mother in very preterm (VPT) infants. Effects on the infant will be assessed at the electrophysiological, neuroradiological and clinical levels. Effects on maternal mood, anxiety and mother-infant attachment will also be measured.Methods/DesignA randomised controlled trial to investigate the effect of massage therapy in VPT infants. Sixty VPT infants, born at 28 to 32 weeks and 6 days gestational age, who are stable, off supplemental oxygen therapy and have normal cranial ultrasounds will be recruited and randomised to an intervention (infant massage) group or a control (standard care) group. Ten healthy term born infants will be recruited as a reference comparison group. The intervention group will receive standardised massage therapy administered by the mother from recruitment, until term equivalent age (TEA). The control group will receive care as usual (CAU). Infants and their mothers will be assessed at baseline, TEA, 12 months and 24 months corrected age (CA), with a battery of clinical, neuroimaging and electrophysiological measures, as well as structured questionnaires, psychoanalytic observations and neurodevelopmental assessments.DiscussionOptimising preterm infant neurodevelopment is a key aim of neonatal research, which could substantially improve long-term outcomes and reduce the socio-economic impact of VPT birth. This study has the potential to give insights into the mother-baby relationship and any positive effects of infant massage on neurodevelopment. An early intervention such as massage that is relatively easy to administer and could alter the trajectory of preterm infant brain development, holds potential to improve neurodevelopmental outcomes in this vulnerable population.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12612000335897. Date registered: 22/3/2012.

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“…(59, 60) Other reported beneficial effects of preterm massage therapy include improved digestion and gastric motility,(61) reduced hospital stay and incidence of late-onset sepsis,(62) decreased pain and stress,(63-65) improved immune function,(66) and improved motor development. (67) Arora et al .…”

Section: The Social Environmentmentioning

confidence: 99%

“…(76) Various reviews summarize the findings of the multitude of touch techniques on preterm infants. (59, 74)…”

Section: The Social Environmentmentioning

confidence: 99%

Impact of hospital-based environmental exposures on neurodevelopmental outcomes of preterm infants

Santos

Pearce

Stroustrup

2015

Current Opinion in Pediatrics

106

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Purpose of review Over 300,000 infants are hospitalized in a neonatal intensive care unit (NICU) in the United States annually during a developmental period critical to later neurobehavioral function. Environmental exposures during the fetal period and infancy have been shown to impact long-term neurobehavioral outcomes. This review summarizes evidence linking NICU-based environmental exposures to neurodevelopmental outcomes of children born preterm, Recent findings Preterm infants experience multiple exposures important to neurodevelopment during the NICU hospitalization. The physical layout of the NICU, management of light and sound, social interactions with parents and NICU staff, and chemical exposures via medical equipment are important to long-term neurobehavioral outcomes in this highly vulnerable population. Summary Existing research documents NICU-based exposure to 1) neurotoxic chemicals, 2) aberrant light, 3) excess sound, and 4) restricted social interaction. In total, this creates an environment of co-existing excesses (chemicals, light, sound) and deprivation (touch, speech). The full impact of these co-exposures on the long-term neurodevelopment of preterm infants has not been adequately elucidated. Research into the importance of the NICU from an environmental health perspective is in its infancy, but could provide understanding about critical modifiable factors impacting the neurobehavioral health of hundreds of thousands of children each year.

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Comforting Touch in the Very Preterm Hospitalized Infant

Cited by 40 publications

References 43 publications

Parents’ first moments with their very preterm babies: a qualitative study

Parents’ first moments with their very preterm babies: a qualitative study

PREMM: preterm early massage by the mother: protocol of a randomised controlled trial of massage therapy in very preterm infants

Impact of hospital-based environmental exposures on neurodevelopmental outcomes of preterm infants

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