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PubMed2004

The Neonatal Intensive Care Unit Network Neurobehavioral Scale procedures.

The procedures for the Neonatal Intensive Care Unit Network Neurobehavioral Scale includes a brief background, description of the examination, key concepts, a summary of the procedures, and order of administration of the items described in "packages," information about the testing kit, scoring issues, and summary scores. This is followed by presentation of the 115 items that are scored. Each item is described, including (where appropriate) specific procedures for how to manipulate or handle the infant. Rating scales with scoring criteria are provided for each item. With training and certification, users of the manual will be able to reliably administer and score the Neonatal Intensive Care Unit Network Neurobehavioral Scale.

Female↗
PubMed2004

Summary statistics of neonatal intensive care unit network neurobehavioral scale scores from the maternal lifestyle study: a quasinormative sample.

Descriptive statistics for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores are provided based on data from 1388 1-month-old infants in the Maternal Lifestyle Study (MLS) of prenatal drug exposure and child outcome. The multisite MLS is described, followed by tables with descriptive statistics and percentile for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores. The tables include data for the entire MLS sample as well as tables by drug exposure status, gestational age, poverty status, sex, race and ethnicity, and MLS study site. These tables can be used as quasinorms for comparison with other infants of this age.

Cocaine-Related Disorders↗
PubMed2004

Normative neurobehavioral performance of healthy infants on the Neonatal Intensive Care Unit Network Neurobehavioral Scale.

Descriptive statistics for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores are provided for a sample of 125 full-term, healthy 1- to 2-day-old infants. The study sample is described, including demographic characteristics and infant and maternal medical characteristics. Descriptive statistics and percentiles are provided for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores. These tables can be used as quasinorms for comparison with other infants of this age.

Female↗
PubMed2004

Clinical use of the Neonatal Intensive Care Unit Network Neurobehavioral Scale.

Features of the Neonatal Intensive Care Unit Network Neurobehavioral Scale that make the examination useful for clinical application are described. Clinical applications in various settings and populations are described. This is followed by a summary of the clinical significance of the examination according to the packages of administration. We then explain how to use the summary scores clinically, writing a clinical summary and the clinical interpretation of the summary scores. Finally, we present a case study with a clinical summary and a work sheet that clinicians may find useful for clinical consultation with caregivers and parents.

Adolescent↗
PubMed2004

A crying shame.

Explore the source record for details and available documents.

Adult↗
PubMed2004

[Excessive crying in infants: a problem for both parents and children (only rarely caused by milk allergy)].

According to a systematic review published in 1998, hypoallergenic formula can be useful in treating infants who cry excessively. For this reason it is normal practice in the Netherlands to prescribe hypoallergenic formula for these infants. However, two of the three studies on which this systematic review was based were carried out in specialist paediatric allergy centres where there is a higher chance of encountering food allergy than in normal well-baby clinics. The third study was carried out in a well-baby clinic but only included babies who cried for more than 3 hours a day on more than 3 days per week. Experience with crying diaries has shown that by no means all babies who cry excessively according to their parents satisfy these criteria. It is not known if prescribing hypoallergenic formula is a useful intervention in infants whose parents report that they cry excessively. The tension and distress felt by the parents of infants who cry excessively are also important factors. In our opinion, support and guidance for the parents is a more effective treatment for excessive crying in infants than intervention with hypoallergenic formula.

Adult↗
PubMed2004

[Prevalence of parental behaviour to diminish the crying of infants that may lead to abuse].

OBJECTIVE: To estimate the prevalence of parental actions to stop infant crying that may threaten infant health, and to determine specific risk groups regarding these actions. DESIGN: Descriptive. METHOD: Before their visit to a well-baby clinic in the Netherlands, parents of 3345 infants aged 1-6 months (96.5% response) filled out an anonymous questionnaire on actions that they undertook to stop their child crying. RESULTS: At 6 months, 5.6% (95% confidence interval: 4.2-7.0%) of all the parents reported having smothered, slapped, or shaken their infant at least once because of its crying. The highest risks for detrimental parental actions were run by infants of parents from non-industrialised countries, of parents with no or only a part-time job, and of parents who had judged their infant's crying as excessive. CONCLUSION: Clinicians should be aware of the observed risk factors for abuse of young children known to cry a lot, in order to help parents to cope with this crying.

Child Abuse↗
PubMed2004

[Birth as a stressful experience of parents with newborns and infants showing regulatory disorders].

Parents with 0-3 years-old children seen in our outpatient clinic often report a difficult start in parenthood, with the experience of child birth overshadowed by medical complications and/or psychological stress. Besides the syndrome of posttraumatic stress disorder (PTSD), the individual perinatal stress experience of mother/father--as a factor hardly considerated up to now--may contribute to the development of postpartal psychological disturbances in the mother and to dysfunctional mother/parent-child interactions. The current state of empirical research into this area of investigation is unsatisfactory. This article approaches this subject on the basis of research in early infant development and explores the relationship between stressful or traumatic perinatal experiences of the parents and the consequences on affect regulation of the child and relational and attachment processes.

Adaptation, Psychological↗
PubMed2005

The relative kicking frequency of infants born full-term and preterm during learning and short-term and long-term memory periods of the mobile paradigm.

BACKGROUND AND PURPOSE: Infants born preterm differ in their spontaneous kicking, as well as their learning and memory abilities in the mobile paradigm, compared with infants born full-term. In the mobile paradigm, a supine infant's ankle is tethered to a mobile so that leg kicks cause a proportional amount of mobile movement. The purpose of this study was to investigate the relative kicking frequency of the tethered (right) and nontethered (left) legs in these 2 groups of infants. SUBJECTS: Ten infants born full-term and 10 infants born preterm (<33 weeks gestational age, <2,500 g) and 10 comparison infants participated in the study. METHODS: The relative kicking frequencies of the tethered and nontethered legs were analyzed during learning and short-term and long-term memory periods of the mobile paradigm. RESULTS: Infants born full-term showed an increase in the relative kicking frequency of the tethered leg during the learning period and the short-term memory period but not for the long-term memory period. Infants born preterm did not show a change in kicking pattern for learning or memory periods, and consistently kicked both legs in relatively equal amounts. DISCUSSION AND CONCLUSION: Infants born full-term adapted their baseline kicking frequencies in a task-specific manner to move the mobile and then retained this adaptation for the short-term memory period. In contrast, infants born preterm showed no adaptation, suggesting a lack of purposeful leg control. This lack of control may reflect a general decrease in the ability of infants born preterm to use their limb movements to interact with their environment. As such, the mobile paradigm may be clinically useful in the early assessment and intervention of infants born preterm and at risk for future impairment.

Analysis of Variance↗
PubMedDate not supplied

[SSRI during pregnancy and risk of fetal neurotoxicity. Follow precautions and look for other therapeutic alternatives].

Fetal exposure to SSRI are associated to transient toxic symptoms of the neonates, likely to be an expression of excess serotonin activity in the CNS. The neonatal toxicity of SSRI raise the issue of behavioural teratogenicity due to fetal exposure to SSRIs. The current body of knowledge concerning SSRIs exposure during fetal CNS development, through interference with the neurotransmittors serotonin and GABA, and behavioural teratogenicity is still inadequate. Subtle long-term effects have been reported. While awaiting new findings, physicians are advised to look for alternatives to SSRIs whenever possible during the second and third trimester.

Animals↗
PubMed2005

Temperament at 9 months of very preterm infants born at less than 29 weeks' gestation: the Epipage study.

The objective was to determine whether the temperament of very preterm singleton infants born before 29 weeks' gestation differs from their full-term counterparts at 9 months and to examine the influence of neurological sequelae on temperament in very preterm infants. The parents of very preterm infants from nine French regions and a group of full-term infants were sent the Infant Characteristics Questionnaire when the infants were 9 months old. The analysis included 266 singleton very preterm infants from the same regions born before 29 weeks' gestation and 546 full-term singleton infants. There were no significant differences for the Difficult, Unadaptable, and Unpredictable scales between very premature and term infants. Very preterm infants had a slightly higher Dull scale score than term infants. After taking into account mother's age, duration of hospitalization, and cerebral lesions found on neonatal ultrasound scans, this difference was no longer significant. Among very premature infants, those with cerebral lesions as diagnosed by neonatal ultrasound scan were rated higher on the Dull and Unadaptable scales. Delays in development at 9 months were also related to higher Dull and Unpredictable scales. These data suggest that prematurity does not affect temperament ratings at 9 months as assessed by the mother. However, very preterm infants with neurological insults, documented by the neonatal cerebral ultrasound or by a delay in development, are rated higher by their mothers on the Dull, Unadaptable, and Unpredictable scales.

Case-Control Studies↗
PubMed2004

Preterm neonatal neurological examination.

This chapter covers the purposes for which a neurological examination of a neonate may be performed. A brief description is given, of assessments currently in use. More extensive information is provided on the elements of the Neurobehavioral Assessment of the Preterm Infant (NAPI), an assessment which has been used extensively by this author and others (see references at www-med.stanford.edu/school/pediatrics/NAPI/index). Medical and environmental factors that impact on the neurobehavioral performance of an infant are outlined. Two detailed case studies give insight to the complexity of the initial hospital stay of extremely low birth weight infants of short gestational age. The results of NAPIs for each of these cases are explained and the relation to long term outcome at 18 months is presented.

Awareness↗
PubMed2004

TAC-TIC therapy with premature infants: a series of investigative studies.

This article provides a synopsis of a series of studies exploring the effects of TAC-TIC (Touching And Caressing-Tender In Caring) therapy with premature infants. Study 1 looked at the short and long-term effects and found enhanced mental development in the stroked infants at 15 months. In study 2 the physiological effects of an abbreviated version of TAC-TIC with high-risk ventilated infants were examined and it was concluded that TAC-TIC exerted no harm to these vulnerable infants. The behavioural reactions of a sample of premature and low birthweight infants to TAC-TIC and parental responses to administering it were explored in study 3. The infants were found to respond predominantly with arm and leg movements to TAC-TIC while fathers and mothers reported enjoying performing TAC-TIC and elicited a similar pattern and frequency of behavioural reactions. In study 4 the question of whether TAC-TIC benefits preterm infant learning and/or sucking behaviour was investigated. The conclusion reached was that TAC-TIC may potentially benefit cognitive performance within the neonatal period and that this may be an early indicator of long-term cognitive gains reported by previous studies. Using a matched subjects design, study 5 explored the impact of TAC-TIC upon the digestive system by analysing gastric aspirates before and after TAC-TIC and a control period of time. It was concluded that TAC-TIC appeared to induce a more suitable stomach environment for digestion.

Blood Gas Monitoring, Transcutaneous↗
PubMed2004

The impact of different types of bath in the behaviour and physiology of 'rooming in' newborn babies.

The new scientific knowledge about the behaviour of the newborn and their interactions as a developing factor, as well as the new neurosciences findings about the initial brain formation, gave us several elements for a new vision and reflection about the perinatal routines in hospitals. This study raises questions about the first experiences of the rooming in newborns during the specific act of bath, as the only determining factor in altering both behaviour and physiology. Through the monitoring of the heart rate frequency and observing the changes in the states of consciousness level, this article shows how the type of bath that the newborn is subjected to influences his/her organisation. The study showed significant results in the parameters observed during the electric shower bath, leading to unbalance of the subsystems where the individuals organise themselves; such findings made us classify this procedure as very stressing to the baby. To the contrary the bath in the "Tummy Tub" presented insignificant changes, showing a relaxed baby with normal bath behaviours and physiological status; thus this procedure appears to contribute to an energetic and interactive balance of the baby's various systems. The aggressive approach (electric shower) does not allow the newborn auto-regulation to occur and to get proper stimulation and learn basic interactive responses which would facilitate his /her healthy early infancy development.

Adolescent↗
PubMed2005

[Causes, treatment and clinical outcome in infants admitted because of excessive crying to the paediatric department of the Isala clinics, Zwolle, the Netherlands, 1997/'03].

OBJECTIVE: Evaluation of the strategy of admitting excessively crying infants after no improvement is seen following measures taken by the family physician. DESIGN: Retrospective. METHOD: By studying medical records, data were collected for all infants who were admitted to the paediatric department of the Isala clinics in Zwolle because of excessive crying in the period 1997/'03. Excessive crying here was defined as 'crying that was regarded by the parents as excessive', whereby strict time criteria did not have to be met. RESULTS: In the study period of 6.5 years, 88 children were admitted because of excessive crying: 51 boys and 37 girls, with an average age of 10 weeks (range: 0.5-40). Measures taken without success prior to referral included: hypoallergenic feeding in 51 cases (58%), alternative medical treatment in 18 (20%) and antacids in 9 (10%). In 3 patients (3%) a possible cause of the excessive crying was identified and improvement occurred after treatment: cow's milk allergy (n = 2) and recurrent respiratory tract infections caused by a humoral immunodeficiency (n = 1). Clinical indications for an underlying cause were present in another 8 patients but this could be neither confirmed nor excluded. In 77 patients (88%) the crying rapidly improved within a few days without a specific intervention. In most children, hypoallergenic feeding could be replaced by regular cow's milk formulas without any problems. After discharge, there were so re-admissions for excessive crying (11%). CONCLUSION: In the majority of infants admitted to hospital for excessive crying, no underlying cause was found and the crying rapidly improved within a few days without a specific intervention. We therefore recommend that excessively crying infants merely be observed clinically for several days. There is no indication for immediate diagnostic or therapeutic interventions. It is important, however, to counsel parents about their own anxiety and distress and the influence these may have on the infant's crying behaviour.

Crying↗