SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Although infant screaming and crying can be a symptom of medical or surgical pathology, it is also a way for the baby to express himself towards his family circle. Once excluded a possible organic disease, infant crying must be interpreted by assessing the family interaction and the way parents listen to their child; that does not mean substituting oneself to the parent's capacity for analysing and replying to the child's needs.
Explore the source record for details and available documents.
The aim of this study was to examine adverse reactions to the withdrawal of opioids and benzodiazepines among critically ill children. Although withdrawal reactions have been well documented in relation to substance abusers and their newborn infants, there has been little study of this phenomenon as an iatrogenic problem. We developed a graphical case study method for examining patterns over time, and applied this to five cases referred to us by the nursing staff of a 10-bed paediatric intensive care unit. A striking pattern of behavioural distress was clearly associated with the diminution of opioids and benzodiazepines. These adverse reactions were characterized by various combinations of inconsolable crying, tremors, jitteriness, irritability, gagging, vomiting, and feeding problems. These signs appeared as early as 1 h and as late as 24 h following a significant reduction in opioid and benzodiazepine infusion rates, sometimes following very short-term therapy. We elaborate an interpretation of this distress, in light of the multiple disruptions undergone by critically ill children, and conclude by outlining our recommendations for preventing/minimizing these adverse reactions.
The neonatal intensive care environment exposes the developing immature newborn to many sources of stress and pain at a time when the infant is developmentally least able to cope with it. Animal and human evidence suggest that effects of stress, mediated through permanent changes in the brain and neuroendocrine responses, may result in changes in behaviour and information processing, which persist throughout childhood. These changes impact on the dynamics of the mother infant dyad and infant learning. Interactional styles arising in the newborn period tend to persist throughout childhood but may be amenable to intervention focusing on maternal recognition of infant cues, social stimulation of the infant, and family integration. Developmental care may promote better family, infant and child outcomes by both reducing neonatal stress and its neurobiological sequelae, and fostering an appropriate interactional relationship between mother and infant.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The moment an infant is diagnosed with a congenital heart defect, parents experience a mixture of shock, disbelief, fear, anger, and often a profound sense of sadness. In the midst of these emotions they must learn to provide for the special needs of their infant. Providing parents with the knowledge and skills to care for their infant during this stressful time requires the concerted effort of a multidisciplinary team who can provide clear, concise, and consistent communication. This article provides a step-by-step guide to the information needs of families who are preparing to take their infants home after cardiac surgery. Parents must understand the underlying cardiac defect and the goals and objectives of the surgical repair. In addition to normal newborn care, parents need to learn about care of the incision, nutritional support, and how to safely administer prescribed medications. Potential complications and when to call their health care provider or seek emergency care are an important focus of teaching. Information about infant development, challenges specific to their infant, and pragmatic strategies to support normal development are of prime interest to parents. Written reference materials, a Web resource list, and a family discharge teaching tool provide tangible resources for the family after discharge.
OBJECTIVES: To determine the frequency of neonatal abstinence syndrome (NAS) among unselected term newborns, using newborn behaviour data only. METHODS: This hospital-based prospective exploratory study used clinical observations of newborn behaviours, mothers' observations of their newborns, and newborn chart data to determine the prevalence of suspected and confirmed cases of NAS in a convenience sample of unselected term newborns "rooming in" with their mothers in a large central city acute-care referral hospital. Over a 4-month period, 824 out of 1008 newborns were observed at between 8 and 30 hours of life by specially trained nurse observers. Behaviours recorded and their weighting were adapted from the Neonatal Abstinence Scoring System (NASS) by Finnegan and Kaltenbach. Newborns with scores of 5 or greater and "suspect for NAS" were referred to their physicians for confirmation or refutation of the clinical findings. The prevalence of "suspect for NAS" and confirmed NAS, as well as of individual neonatal behaviours, was calculated. RESULTS: Thirty-one (3.8%) of 824 term "rooming in" newborns were identified with findings suggestive of NAS. Four newborns were positively identified as having NAS and treated. The identification was confirmed by post hoc affirmation of maternal drug use. Individual behaviours occurring in 10% or more of newborns included excessive sneezing, nasal stuffiness, unsustained suck, tremor, and abnormal nipple latch. CONCLUSIONS: Clinical observation of newborn behaviour may identify NAS. Further studies are recommended to correlate this methodology with laboratory findings, as are more in-depth maternal questionnaires concerning use of mood-altering substances. The prevalence of NAS is likely underestimated because of early hospital discharge. A coordinated system of early identification and infant-specific assessment and treatment, both in hospital and following discharge home, is advocated.
BACKGROUND AND OBJECTIVE: For many, the administration of additional oxygen to the women receiving regional anaesthesia for Caesarean section is traditional, but for others it is controversial because of doubts about its efficacy. The aim of our study was to determine if beneficial effects of maternal oxygen therapy on the fetus could be revealed using a neonatal behavioural scoring system. METHODS: Sixty women with a normal singleton pregnancy beyond 36 weeks gestation, undergoing elective Caesarean section under spinal anaesthesia were randomized into two groups: Group 1 received air and oxygen mixture through a Hudson style face mask (FiO2 of 0.21-0.25). Group 2 received FiO2 of 0.40-0.60 through an identical Hudson style face mask. Neurologic Adaptive Capacity Score on all the infants within 5 min of birth and between 10 and 24 h after the Caesarean delivery was performed. Apgar score, umbilical venous blood oxygen tension and umbilical artery standardized base excess were recorded. RESULTS: Initial Neurologic Adaptive Capacity Scores at birth in Groups 1 and 2 were 32.6 (SD 4.6) and 31.3 (SD 4.3), respectively. Latter scores were 36.0 (SD 3.0) and 36.5 (SD 1.9), respectively. Neither were statistically significant. There were no significant differences between the groups for any of the recorded variables. CONCLUSIONS: Administering maternal oxygen using a standard commercial Hudson style face mask does not appear to significantly improve oxygen delivery to, nor does it influence acidosis or behavioural effects in, the normal neonate at elective Caesarean delivery with spinal anaesthesia.
This paper provides an overview of the effects of in vitro fertilization (IVF) on the children born from it. One of the main problems with IVF to date remains the high incidence of multiple pregnancies, which carry an inherent higher risk of preterm delivery and, therefore, of increased morbidity and mortality in newborns. Further, singleton pregnancies and twin pregnancies from IVF compared to control singleton or twin pregnancies appear to be at higher risk of preterm birth and low birth weight. Whether this is an effect of the procedure per se or is related to maternal factors, or a combination of both, remains to be studied. The risk of congenital malformations does not, with the available data, seem to be elevated. As of now, it remains unclear whether embryo freezing is a safe procedure. Psychomotor development of children born through IVF does not seem to be disturbed. Until further and more extensive studies are conducted, it remains unclear whether IVF poses long-term risks for the children.
The present study sought to document an example of how maternal and infant vulnerabilities interact in contributing to the quality of early attachment relationships. Maternal depressive symptoms, neonatal health characteristics, and infant mother attachment were assessed for 42 preterm, low birth weight infants and 42 full-term infants at 12 months postterm. Results indicated that preterm birth moderated the relation between maternal depressive symptoms and quality of infant-mother attachment, even controlling for level of neonatal health complications. Preterm infants with more symptomatic mothers were most likely to be classified as insecurely attached to their mothers, whereas no direct relation between subclinical depressive symptoms and attachment was found for full-term infants.
In this paper, a remote-controlled and microcontroller-based cradle is designed and constructed. This system is also called Remote Control of Microcontroller-Based Infant Stimulation System or the RECOMBIS System. Cradle is an infant stimulating system that provides relaxation and sleeping for the baby. RECOMBIS system is designed for healthy full-term newborns to provide safe infant care and provide relaxation and sleeping for the baby. A microcontroller-based electronic circuit was designed and implemented for RECOMBIS system. Electromagnets were controlled by 8-bit PIC16F84 microcontroller, which is programmed using MPASM package. The system works by entering preset values from the keyboard, or pulse code modulated radio frequency remote control system. The control of the system and the motion range were tested. The test results showed that the system provided a good performance.
Adult referential behavior (gaze direction) and salience (target activation) were independently manipulated in a study of novel word learning. Children (seventy-five 18-month-olds and seventy-two 24-month-olds) were trained in different conditions with a novel word in the context of 2 remote-controlled toys. In response to the novel word at test, 24-month-olds tended to pick out the toy to which the adult referred in all conditions. They also tended to use the novel word appropriately. Comprehension by 18-month-olds was good when the salience of the toy did not conflict with the adult's referential intent, but it was disrupted when referential and salience cues conflicted and when referential cues were not available. Results imply that, at 24 months, children use the referential intent of the speaker to learn new words, but when first learning words, children may have a less secure grasp on the meaning of speakers' referential cues.
In his meta-analysis of studies demonstrating the predictive validity of the Adult Attachment Interview (AAI), van IJzendoorn (1995) relies on current thinking in attachment theory. Although the data he presents are forceful, there are alternate explanations for the relations he finds that are ignored. Narrative about personal memories may be a function of personal theories about developmental processes as well as current psychological state (e.g., personal self-esteem). There is currently no evidence that the coherency of discourse about early childhood experiences is a function of either actual early experience or reworkings of that experience. In the absence of such evidence, the data indicating that maternal personality influences infant behavior are not theoretically surprising.
There is converging evidence for fetal retention of auditory experience into early postnatal life, but critical tests with appropriate controls are rare due to methodological hurdles. Research has been conducted on newborn response to naturally occurring stimuli such as heartbeats, intrauterine recordings, pre- and postnatal versions of the maternal voice, father's voice, and unfamiliar voices. Postnatal experience cannot be ruled out as a possible explanation for many results. Only one critical prenatal exposure experiment with postnatal testing has been carried out and published in a peer-reviewed scientific journal. Interpretation of acoustic and linguistic information on intrauterine recordings suggests that the prosodic features of speech (pitch contours, rhythm, and stress) are available to the fetus. This is compatible with newborn responses and may contribute to language acquisition during the first year. There is no sound evidence that providing extra prenatal auditory stimulation benefits the developing child, and there are potential risks.
OBJECTIVE: To evaluate the impact of birth weight on development of very low birth weight (VLBW) infants using the Neurobehavioral Assessment of the Preterm Infant (NAPI) before hospital discharge, and to show the relation to follow-up outcomes at 12, 18 and 30 months of age. STUDY DESIGN: In total, 113 preterm infants were assessed with the NAPI at 36 weeks postmenstrual age. Later, neurodevelopment was examined using the Bayley Infant Neurodevelopmental Screener (BINS) at 12 months and the Bayley Scales of Infant Development, at 18 and 30 months. The cohort was divided into two groups, based on birth weight, extremely low birth weight (ELBW) (<1000 g) and VLBW (1000 to 1500 g). RESULTS: ELBW infants showed significantly lower NAPI scores compared with VLBW infants at 36 weeks. The predischarge NAPI scores correlated with the 12, 18 and 30 months scores when the ELBW infants continue to have lower performance than the VLBW infants. In all, 14 infants developed cerebral palsy. These infants had significantly lower NAPI, BINS and Bayley scores compared with all other preterm infants. CONCLUSION: NAPI before discharge provides clinically meaningful information related to later neurodevelopmental outcome.
This study investigates whether the crying pattern of infants reared in institutions is different from those reared at home in the same cultural backgrounds. Ninety-five institutional infants and 143 home infants, aged 2-18 weeks were studied through diaries, recorded by children's care-givers or mothers. Results showed that the crying duration of the infants in institutions was almost double that of infants at home (86 vs 45 min/day) and contact period with the care-givers was half that of home infants (136 vs 279 min/day). In addition, the duration of periods when the babies were alone was much longer in the institution group (1089 vs 1002 min/day). There was a tendency for both groups of institution and home infants to cry more during the evening (from 18.00 to 24.00 h) but there was no definite peak of crying at any age except the slight increase of crying after 12 weeks for the institution group. When compared with research on Western infants, the daily crying durations of both institution and home infants fall short of those of their Western counterparts. The effect of care-giving style on the crying pattern, including physical proximity, is discussed.