Infant Mental Health in Occupational Therapy Practice in the Neonatal Intensive Care Unit

Abstract

The work of supporting an infant's emotional development and mental health begins in the neonatal intensive care unit (NICU). It depends on understanding the family and uses the parallel processes involved in relationship building to maximize the environment for the optimal development of the infant in the NICU. Occupational therapy service provision is discussed in light of knowledge about the developmental work of the full-term neonates and their parents and the corresponding work of infants in the NICU and their families. A brief vignette of occupational therapy services provided in the context of a relationship-focused infant mental health model is included.

NICU Primer for Occupational Therapists: Exploring the Needs of Fragile Infants, the Context in Which They Are Cared For, and the Role of OT in This Specialized Practice Area—Part I of II

“…Disruption of parent-infant attachment may also occur as a result of the infant's difficulties with feeding (Olson & Baltman, 1994). Feeding is typically a special time for bonding between a new baby and his or her caregivers.…”

“…Feeding is typically a special time for bonding between a new baby and his or her caregivers. The premature infant who requires therapeutic intervention for feeding is often difficult to feed and gives inconsistent cues, which serve to raise parents' levels of stress and feelings of inadequacy, depriving the infant of essential emotional bonding (Einarsson-Backes et al, 1994;Glass & Wolf, 1998;Olson & Baltman). Parents of babies in the NICU often experience depression, anxiety, and feelings of helplessness, which negatively affect their interactions with their preterm baby (Melnyk et al, 2006).…”

Outcomes of Relationship-Based Early Intervention

“…The mothers identified the joint occupations of feeding/eating, getting to sleep, regulating behavior, and developing communication with their infants as the concerns that motivated their need for infant mental health interventions. In an earlier article, Olson and Baltman (1994) described a brief vignette of occupational therapy in the neonatal intensive care unit (NICU) where services were provided in the context of a relationship-focused infant mental health model. Occupational therapists working in the NICU use their knowledge and skills to understand the special developmental needs of premature infants; however, they also adapt the infants' physical and social environments to support the parent-child relationship.…”

Aller Anfang ist schwer - Möglichkeiten der ergotherapeutischen Förderung von Frühgeborenen in der Neonatologie in Deutschland

“…Das Frühgeborene entspricht nicht den unbewussten Vorstellungen und Phantasien der Eltern. Zusätzlich kann der Beziehungsaufbau zwischen Eltern und Kind durch die technische Atmosphäre, die festgelegten Abläufe und Besuchszeiten auf der Intensivstation erschwert werden [30].…”

“…Mit sinkendem Gestationsalter und Geburtsgewicht scheint die Anzahl langfristiger Entwicklungsbeeinträchtigungen in unterschiedlichen Bereichen zu steigen [4]. 30 -40 % der vor der 24. Schwangerschaftswoche Geborenen leiden unter erheblichen bleibenden Beeinträchtigungen des Gesundheitszustands [12].…”