Parent-infant interaction in the NICU: Challenges in measurement

Parent and Therapist Perceptions of the Feasibility, Acceptability, and Benefits of a Weekly Therapist-Led Massage Program for Extremely Preterm Infants in Neonatal Intensive Care

“…Ultimately, therapists did not see infants at a higher frequency than standard of care practice, but they enjoyed providing more intensive therapeutic care with parents through the TEMPO intervention. In alignment with best practice in clinical care [12][13][14]35], TEMPO provided the structure to ensure that parents were delivering recommended interventions at each stage of the infant's development. Therapists felt that they were optimizing what they could offer the infant through regular interactions with parents.…”

“…As parents practice these interventions with their infant, the infant develops muscles that support postural control and endurance while the parent gains comfort holding and interacting with their preterm infant [13]. Therefore, the therapist's ongoing presence from birth up to hospital discharge promotes parental engagement by teaching the parent how to respond to infant behavioral cues and facilitate developmental techniques [14]. In this way, the therapist not only plays a critical role in the early social and motor development of the preterm infant, but may also support parent mental health through fostering parent competence.…”

“…Using a family-centered approach to facilitate maternal-infant attachment [7], the therapist trains mothers of extremely preterm infants to deliver motor and massage interventions from birth throughout hospitalization. The goal of TEMPO is to support mothers to become integral members of the care team who are empowered to regularly engage with their infant in safe, meaningful ways that could lead to improved maternal mental health [14]. The primary goal of the parent study was to establish feasibility of the TEMPO intervention based on numerous benchmarks including enrollment, retainment, data collection adherence, and intervention adherence, and secondarily, objective measures of maternal mental health and infant development-all reported in a separate manuscript.…”

Preterm infant mental health in the neonatal intensive care unit: A review of research on NICU parent‐infant interactions and maternal sensitivity

“…Furthermore, a preterm infant's brain might be more susceptible to negative environmental factors, and therefore, preterm infants might benefit from a higher degree of sensitivity and engagement than full-term infants. Due to the lack of validated parent-infant interaction measurement tools in the NICU, Richter et al (2022) studied whether the Nursing Child Assessment Feeding Scale, a commonly used assessment of dyadic interaction and caregiving for full-term infants, could be translated to the preterm population. They found that a population of 23 preterm dyads did not show the same trends in results that are seen in full-term samples, with scores neither increasing with parental coaching nor correlating with socioeconomic status as had been expected, thus raising concerns about applying this scale to the NICU population (Richter et al, 2022).…”

“…Due to the lack of validated parent-infant interaction measurement tools in the NICU, Richter et al (2022) studied whether the Nursing Child Assessment Feeding Scale, a commonly used assessment of dyadic interaction and caregiving for full-term infants, could be translated to the preterm population. They found that a population of 23 preterm dyads did not show the same trends in results that are seen in full-term samples, with scores neither increasing with parental coaching nor correlating with socioeconomic status as had been expected, thus raising concerns about applying this scale to the NICU population (Richter et al, 2022). These considerations and findings raise questions about applying the same framework and measurements used to interpret and code parentinfant interactions in the general population to the NICU population, and point towards the need for a modified framework with different criteria to be used in this setting.…”