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PubMedDate not supplied

Effect of phototherapy on behaviour of jaundiced neonates.

Thirty full term newborns appropriate for gestational age with icterus neonatorum were divided into two groups of 15 each. Group I (study group) newborns had serum bilirubin in the range of 12.1 to 15.0 mg/dl. Group II (control group) included neonates with serum bilirubin in the range of 8 to 12.0 mg/dl. Only the study group was given phototherapy. The comparative study of neonatal behaviour in both these groups was done using BNBAS (Brazelton's neonatal behaviour assessment scale), 24 to 48 hrs, both after initiation and cessation of phototherapy in the study group and at corresponding postnatal ages in control group. Many newborns in the study group were on top feeds and had more crying episodes. The study group scores were significantly poorer in orientation response to visual inanimate, visual animate and visual and auditory animates in the cluster interactive processes. Followup assessment showed similar results in the same items. Other items in the same cluster and all items in the other clusters showed no significant difference in the two groups in the initial as well as followup assessments. As maternal separation during phototherapy also possibly affects neonatal behaviour, the effect of this factor can be minimized by keeping the phototherapy unit with the mother of the jaundiced baby. The mother should be encouraged to breast feed her baby regularly and have more mother-baby interaction.

Female↗
PubMed2000

Motor asymmetries in the human newborn are state dependent, but independent of position in space.

Human newborns have a preference for turning and maintaining the head to one side of the body. Most studies confirm a right-sided preference in supine. Few have addressed the state dependency of this lateral bias, and even fewer have examined whether it is also expressed in the semi-upright position. We investigated whether it varies as a function of behavioural state and position in space. Kinematic recordings of head movements were made with the newborn secured on a platform in the supine or semi-upright position, which alleviated biomechanical and postural constraints imposed by gravity. Newborns differed as to whether they had a vertex, Caesarean or breech delivery. The majority of infants maintained a right-sided preference in both positions, but it was strongly mediated by state. Delivery type did not account for any lateral bias. These findings provide convincing evidence that a lateral bias in movement and positioning of the head are reflections of active neural processes rooted in the regulation of state.

Biomechanical Phenomena↗
PubMed1998

Self-perception and action in infancy.

By 2-3 months, infants engage in exploration of their own body as it moves and acts in the environment. They babble and touch their own body, attracted and actively involved in investigating the rich intermodal redundancies, temporal contingencies, and spatial congruence of self-perception. Recent research is presented, which investigates the spatial and temporal determinants of self-perception and action infancy. This research shows that, in the course of the first weeks of life, infants develop an ability to detect intermodal invariants and regularities in their sensorimotor experience, which specify themselves as separate entities agent in the environment. Recent observations on the detection of intermodal invariants regarding self-produced leg movements and auditory feedback of sucking by young infants are reported. These observations demonstrate that, early in development and long before mirror self-recognition, infants develop a perceptual ability to specify themselves. It is tentatively proposed that young infants' propensity to engage in self-perception and systematic exploration of the perceptual consequences of their own action plays an important role in the intermodal calibration of the body and is probably at the origin of an early sense of self: the ecological self.

Body Image↗
PubMed2000

[Assessment and measurement of pain].

BACKGROUND: The assessment and measurement of pain is essential in the implementation and control of pain relieving strategies. The measurement of pain in infants and children should be based on the consideration of age, cognitive level, psychological status, intercurrent diseases and the social context in order to register the child's individual situation and to avoid misinterpretation. DIAGNOSIS: In the preverbal infant, behavioral and physiological cues have to be interpreted by the caregivers. For the assessment of pain in children of four and older who have at least a basic understanding of the pain concept self assessment methods (as rating scales, specific pain interviews, diaries and questionnaires) can be used. In any case the instruments used should be age appropriate. The instruments used for the different age groups are presented with comments on quality and clinical applicability.

English Abstract↗
PubMed2003

Treatment of maternal mood disorder and infant behaviour disturbance in an Australian private mothercraft unit: a follow-up study.

Australia has a system of residential parentcraft services which offer brief admissions to mothers experiencing difficulties with infant care and postnatal mood disturbance. Most of these are state-funded public access services. In 1996 a comparable but differentiated service was opened in the private sector. Masada Private Hospital Mother Baby Unit accommodates five mother-infant pairs who are admitted to a five-night structured residential program. Care is provided by a multidisciplinary team comprising a paediatrician, general practitioner, clinical psychologist and specialist nurses. Complex maternal mood disorders as measured on standardised psychometric instruments include depression, anxiety and severe occupational fatigue. Their babies are unsettled, cry for prolonged periods, wake frequently at night and do not sleep well during the day. Many have feeding difficulties. The treatment program comprises both individualised training in infant care and settling strategies and psycho-educational groups offered in a supportive non-judgemental setting. One month post-discharge maternal mood is significantly improved and infant behaviour more manageable compared with functioning on admission.

Adult↗
PubMed2005

Selective breeding for an infant phenotype: rat pup ultrasonic vocalization (USV).

To examine processes underlying generational and developmental influences on anxiety, this laboratory produced two lines of (N:NIH strain) rats, selectively bred on the basis extreme rates of ultrasonic vocalization in 2 minutes of isolation at Postnatal Day 10. The research reviewed in this article focuses on: (1) establishment of the selectively bred lines; (2) defining infant behavioral and physiological phenotypes and (3) determining whether infantile USV phenotypes endure over development. The High and Low lines have diverged widely in their USV rates from each other and from the Random control line, which has maintained N:NIH strain rates overall from generation to generation. Beginning in the 11th generation, High USV pups have shown significantly higher frequencies of defecation and urination during isolation screening than the Low USV and random control line. Both lines show altered autonomic regulation of heart rates (HR) in response to stressors as juveniles and adults. These differences in HR responses in High and Low lines appear to be mediated by changes in the balance of sympathetic versus parasympathetic mechanisms. Other behavioral characteristics of the High line are consistent with an "anxious"/ "depressive" phenotype, such as vocalizations to touch in a novel environment, and performance in the Porsolt Swim, whereas Low line shows few differences in anxiety behavior. Future work will resolve the similarities and differences in the High and Low phenotypes and provide a developmental perspective to the growing body of information about affective regulation in humans and animals provided by selectively bred animal models.

Aging↗
PubMed2006

Imitation of intentional and accidental actions by children with autism.

To determine whether children with autism (CWA) would selectively imitate intentional, as opposed to accidental actions, an experimenter demonstrated either an "intentional" and an "accidental" action or two "intentional" actions on the same toy [Carpenter, Akhtar, & Tomasello (1998a) Infant Behavior and Development, 21, 315-330]. CWA tended to imitate the experimenter exactly. Children with developmental delay and older typically developing children (TD) reproduced only the intentional action as often as they imitated the experimenter exactly. Younger TD mostly produced only the intentional action. It is concluded that, contrary to comparison groups, the CWA did not show an appreciation of the model's intentions. Results are discussed in terms of theories of social cognition.

Accidents↗
PubMed1996

Visual motion processing in one-month-old infants: preferential looking experiments.

The ability of infants to discriminate between opposite directions of motion was assessed using forced-choice preferential looking between a random-dot pattern which was segregated into regions which moved in opposite directions, and a uniform pattern in which all the dots moved in the same direction. The first experiment measured velocity thresholds (Vmin and Vmax) for direction discrimination; between 10 and 13 weeks Vmin decreased, while at the same time Vmax increased. The second experiment explored possible implications of this expanding velocity range for direction discrimination by younger infants. One-month-olds showed no evidence for direction discrimination at any of a number of test velocities in the range 1-43 deg/sec. The 1-month-olds were also tested with two additional conditions: they could discriminate between moving and static patterns at velocities of 10 deg/sec or above, and they could also discriminate between coherent and incoherent motion at velocities of 21 deg/sec or below. Neither of these discriminations depends on sensitivity to the direction of the coherent motion. The results suggest that 1-month-olds may not be sensitive to the direction of visual motion.

Cues↗
PubMed1996

Visual motion processing in one-month-old infants: habituation experiments.

The ability of infants to discriminate between opposite directions of motion was examined in infant control habituation experiments. A group of 3-5-week-olds showed no evidence of discrimination between a random-dot pattern which was segregated into regions that moved in opposite directions, and a uniform pattern in which the dots all moved in the same direction. However, they did discriminate between segregated and uniform patterns in two additional conditions, neither of which required sensitivity to direction: in the first of these, segregation was based on the contrast between coherently moving and stationary dots, while in the second the contrast was between coherently and incoherently moving dots. Unlike the younger infants, a slightly older group of 6-8-week-olds proved capable of discriminating between the segregated and uniform patterns when the contrast was between opposite directions of motion. These results confirm and extend the results from preferential looking [Wattam-Bell, J. (1996). Motion processing in one-month-old infants: Preferential looking experiments. Vision Research, 36, 1671-1677]; they suggest that direction discrimination may not emerge until around 6-8 weeks of age. The apparent lack of direction discrimination before 6 weeks may reflect an inability to use directional cues to visually segment the segregated pattern, rather than an insensitivity to direction as such. To examine this, a further set of infants was tested for absolute direction discrimination-i.e., between leftwards- and rightwards-moving uniform patterns. However, in this case neither 3-5- nor 6-8-week-olds showed any evidence of discrimination, which suggests that direction discrimination may first emerge for relative motion. Possible reasons for this are discussed.

Age Factors↗
PubMed1995

Screening for neonatal and infant deafness in Europe in 1992.

Many methods of screening for hearing impairment are available. The aim of our study was to determine which ones were really used in 1992. At the request of the British Audiology Society, we conducted an inquiry into the organization of screening for deafness in neonates and infants in Europe. In practice all 6-9 month-old infants are tested with behavioural tests in every country. For the neonates, generally only those at risk for hearing-impairment (about 5%) were tested. The most widely used tests were behavioural ones. Only specialized centers used transient evoked otoacoustic emissions (TEOAEs). This last test assesses the active mechanical properties of the cochlea and allows detection of even mild or unilateral sensorineural deafness.

Audiometry↗
PubMed1994

Infant care practices and the investigation of physiological mechanisms.

It is strange that some aspects of infant care have been strongly promoted by modern medicine while others have been neglected. Thus prone sleeping which has been strongly promoted is now related to an increase in SIDS, whereas the promotion of breast feeding in developed countries has been less successful. Unfortunately there has not been sufficient physiological investigation of many infant care practices and some of the proposed mechanisms for SIDS and prone sleeping have not been substantiated. Thus further work is needed on hypercapnia, hypothermia and periodic breathing and respiratory control. Studying infants alone may leave out important physiological mechanisms such as the effect on body warmth when the infant is close to the mother. More investigation is needed of antenatal factors related to SIDS and it is critically important that physiological investigation should not look for single mechanisms but be concerned with the interaction of many physiological factors.

Growth↗
PubMedDate not supplied

Prenatal and perinatal lead exposures alter acoustic cry parameters of neonate.

We performed acoustic analyses on cries elicited from a subset of healthy babies born to the Mexico City Prospective Lead Study at 2 days (n = 75), 15 days (n = 176), and 30 days (n = 166). Lead was measured in maternal blood every 8 weeks during pregnancy from week 12 to delivery and in umbilical cord (1-38 micrograms/dL, 0.05-1.84 mumol/L). Percent nasalization and number of cries decreased in babies born to mothers with higher lead levels in the last two trimesters while median fundamental frequency increased in babies born to mothers with higher lead at 12 weeks of pregnancy, and with higher cord lead in multiple regression analysis. Decreased percent nasalization was related to increased brainstem auditory evoked response latencies and interpeak intervals in a subset of the sample. The results suggest an effect of gestational exposure to lead on apparatus innervated by cranial nerves and/or lead effect on cry mediated by lead-altered auditory function. Altered baby cry and auditory function associated with lead might contribute to developmental delays by affecting early communication between caretaker and baby.

Acoustics↗
PubMed2004

A systematic integrative review of infant pain assessment tools.

PURPOSE: To examine the issue of pain assessment in infants by acquiring all available published pain assessment tools and evaluating their reported reliability, validity, clinical utility, and feasibility. DESIGN AND METHODS: A systematic integrative review of the literature was conducted using the following databases: MEDLINE and CINAHL (through February 2004), and Health and Psychosocial Instruments, and Cochrane Systematic Reviews (through 2003). MeSH headings searched included "pain measurement," with limit of "newborn infant"; "infant newborn"; and "pain perception." SUBJECTS: Thirty-five neonatal pain assessment tools were found and evaluated using predetermined criteria. The critique consisted of a structured comparison of the classification and dimensions measured. Further, the population tested and reports of reliability, validity, clinical utility, and feasibility were reviewed. RESULTS: Of the 35 measures reviewed, 18 were unidimensional and 17 were multidimensional. Six of the multidimensional measures were published as abstracts only, were not published at all, or the original work could not be obtained. None of the existing instruments fulfilled all criteria for an ideal measure; many require further psychometric testing. CONCLUSIONS: When choosing a pain assessment tool, one must also consider the infant population and setting, and the type of pain experienced. The decision should be made after carefully considering the existing published options. Confidence that the instrument will assess pain in a reproducible way is essential, and must be demonstrated with validity and reliability testing. Using an untested instrument is not recommended, and should only occur within a research protocol, with appropriate ethics and parental approval. Because pain is a multidimensional phenomenon, well-tested multidimensional instruments may be preferable.

Humans↗
PubMed2005

[The pain of the newborn: between reality and perception].

UNLABELLED: A newborn hospitalized in neonatology suffers a lot of painful and fully perceived procedures. However this pain is not enough taken into consideration. There are various reasons for this failure. The objective of our study was to analyze the perception of 3 groups of participants (parents, nurses and doctors) about newborns'pain. We wanted to compare these perceptions with pain scales (EDIN and BBdol scale) and to study their connection with newborn illness severity and mortality risk scores (SNAP and CRIB). POPULATION AND METHOD: We have led a prospective study involving 80 newborns. Questionnaires assessing, with the help of a visual analogic scale, the pains' perception and the efficiency of the treatment of this pain were given to the 3 groups of participants. RESULTS: Parents assessed that their newborn feels an important pain (median: 5/10), that was not correlated with pain scales. Nurses and doctors assessed a lower level of pain (median: 2/10), greatly correlated with the pain scales. Parents assessed that the treatment of pain was better when the newborn was severely ill. The nurses, and even more the doctors, assessed the opposite effect. The nurses appeared to hold an intermediate position between parents and doctors. Nurses underlined moreover some lack of communication of the doctors about the newborns' pain. This communication problem is a major hindrance to the adequate treatment of pain.

Attitude of Health Personnel↗
PubMed2006

Massage therapy and sleep behaviour in infants born with low birth weight.

This study attempts to evaluate the impact of massage therapy on sleep behaviour in infants born with low birth weight (LBW) in St. Petersburg, Russia. Fifty infants (22 boys, 28 girls) who were born in St. Petersburg between 2000 and 2002 and defined as LBW babies (<2500g at birth) were enrolled onto the study at the age of 2 months. Of these, 41 (19 boys, 22 girls) were light and pre-term infants (gestational age < or =36 weeks), and 9 (3 boys, 6 girls) born light at term. The control group consisted of 50 healthy infants born with LBW who were cross-matched with an experimental group of babies and controlled for gender, gestational age, weight and date of birth. The groups were also matched for proximal geographical distribution in the city. Babies in the experimental group were assigned massage intervention therapy that include gentle rubbing, stroking, passive movements of the limbs and other means of kinaesthetic stimulation performed by professionals until the infant is 8 months old. The findings suggest that 8-month-old LBW infants who received massage intervention were less likely to snore during sleep, required less feeding on waking-up at night, and appeared more alert during the day. These apparent correlations remained significant after adjustment was made for major potential confounders. No statistically significant difference was found in sleep behaviour between LBW infants exposed to massage therapy who were either born pre-term or at term. It is suggested that massage may be a valuable approach to improve quality of sleep and reduce sleep-disordered breathing in infants born with LBW. It is acknowledged that whilst this study does not represent a large sample, it is felt that the findings suggest further investigation and offer an insight into an area previously relatively unexplored.

Analysis of Variance↗
PubMed2005

Psychoneuroimmunodermatology of atopic dermatitis: from empiric data to the evolutionary hypothesis.

Atopic dermatitis is a pruritic skin disease affecting predominantly young people. There is evidence that psychologic stress constitutes an increased risk for atopy and influences the disease's clinical course. This risk is believed mediated by the effects of stress on neuroimmunoregulation, which in turn modulates the hypersensitivity response and involves immunoglobulin E-mediated inflammation, helper T-cell 2 predominance, and eosinophilia. This article examines theoretic perspectives and other behavioral dimensions, such as maternal caring behavior, infant response to stress, temperament, and the so-called "hygiene hypothesis." The Darwinian framework and the mental scenario are examined. These processes may be akin to the generation of antibodies by the immune system.

Dermatitis, Atopic↗
PubMed2003

Analysis of the sounds of the child in the first year of age and a comparison to the language.

This study has the aim to analyze the acoustic characteristic features of cries and babbling in the course of the ontogenetical development of babies from the 3rd to 5th day on up to the age of 1 year and to compare the results to the acoustic characteristics of the adult language. The mean fundamental frequency of crying increased considerably from 441.8 to 502.9 Hz and the mean fundamental frequency of babbling decreased remarkably from 389.3 to 336.9 Hz. These types of melodies represent individual differences in the course of crying. The first intonations were similar to the hunger cry and later they were on par with the pain cry. The melodies of babbling remained unchanged in the first year of age. Scientific examinations proved that crying and babbling are different. The development of the mean fundamental frequency for both, crying and babbling, showed a contrary tendency within the first year of age. The melody of babbling indicated similarities to the language within the first year of age. At the age of 9 months, the fundamental frequency and the melody contained features of the language of females in labour. Crying of a newborn and infant can be regarded in direct connection with the cries of a grown-up person, particularly in situations of emotional agitation or cultic rituals. Babbling, in contrast, shows structural similarities to the language. This justifies the assumption that the human being possesses two separate communication systems that share the same acoustic channel.

Adult↗