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PubMed1987

[Medical behavior and sudden infant death].

The authors recall some hypothesis about factors of risk which are acknowledged as possible element of SIDS and may receive a treatment: gastroesophageal reflux, vagal hyperexcitability and enzymatic deficit.

France↗
PubMedDate not supplied

The early social environment of premature and fullterm infants.

The behaviors of 10 mothers of prematures and 29 mothers of fullterms were compared from 7-h observations made in the home when the infants were 2, 3, 4 and 5 weeks post-term. The observation day was divided into four mutually exclusive interactional contexts that together made up the total day: feeding time, changing or bathing time, time when the mother and infant were in physical contact but the mother was not caretaking, and time the infant was alone. Measures of ten maternal behaviors were also compared: moving, rocking, patting, caressing, talking, looking, engaging in vis-a-vis with the baby, holding or carrying, smiling or laughing, and stimulating the baby to suck. Mothers of prematures left their infants alone more and changed them less than mothers of fullterms. In addition, mothers of prematures moved their infants less often, talked to their infants less, looked at their infants less, and held their infants less. These results indicate that, over the 7-h day, prematures receive markedly less stimulation than fullterms. Since the neurobehavioral characteristics of premature and fullterm infants are known to differ, it is suggested that these differences in maternal behaviors may be in response to infant cues and appropriate for the infants.

Adolescent↗
PubMedDate not supplied

Effect of nonnutritive sucking on behavioral state in preterm infants before feeding.

To describe the effect of nonnutritive sucking (NNS) on behavioral state (BSt) in preterm infants before feedings 24 preterm infants were randomly assigned and studied before each of their first 16 bottle feedings. Twelve received NNS by pacifier for 5 minutes; 12 did not receive a pacifier. BSt was measured with a 12-category scale for 30 seconds before the 5-minute period (BSt1) and for 30 seconds after (BSt2). Sleep states decreased for both groups. BSts considered more optimal for feeding increased more during NNS (86 vs. 46). Restless states were three times less frequent after NNS (23 vs. 68). Differences between groups were nonsignificant at BSt1, but were significant at BSt2, p less than .001. In the absence of self-regulatory feeding policies based on early hunger cues, NNS for 5 minutes prefeeding is simple, brief, and suitable for implementation in busy neonatal intensive care units. Nonnutritive sucking was an effective modulator of behavioral state for this sample.

Child Behavior↗
PubMed1984

Information needs and problem solving behavior of parents of infants.

Two approaches were used to investigate the problems or issues that parents of infants encounter: the study of circumstances that are naturally recognized by the parent as an issue, and the study of simulated problems concerning commonly occurring infant care issues. A paradigm of problem solving behavior was used to formulate the component of a descriptive study for the purpose of examining the problem solving behavior of mothers during their infants' first 3 months. Mothers who participated in both studies were married or living with a partner, were 17 years or older, and had healthy infants. The objective of the first study was to capture in the mothers' own terms their specification and description of the issues on which they were working and the nature of the infant care task, including the types of help mothers used and the stressors and supports they experienced. Logs were used by 62 mothers (38 primiparae and 24 multiparae) for 90 days after their infants' births to record these issues, types of help, stressors, and supports. Predetermined categories were used to code the data. The type of help used varied significantly by category of issue. Books were used most frequently for issues of growth and development and baby care, and they were used more often than all types of clinicians combined for these types of issues. For over one-third of issues, no help of any type was used. Multiparae and primiparae did not differ significantly in the total number of issues reported, nor in the frequency with which help was used. The objective of the second study was to examine the types of goals and decision making rules that mothers applied to two simulated infant care problems: one concerning the amount of the feeding, and the second concerning noncontingent crying. Four simulated problem exercises were presented to 22 mothers (14 primiparae and 8 multiparae), using a telephone interview in the infants' first 3 months. The results of the study revealed that mothers gave a variety of names to the same problem. The types of goals that mothers identified varied by type of problem. More mothers cited competence as a goal for the crying than the feeding problem. More mothers were able to state the decision rule they had used for naming the problem than for choice of action to solve the problem (implementing).(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗
PubMed1989

Young infants' feeding patterns when sick and well.

Observations of sick infants' feeding patterns suggest that changes occur which are specific to certain illness conditions. These changes may disrupt the feeding synchrony that had been established early in the infant's development. Little research has been done on differences in feeding behaviors of infants when they become sick with a specific illness condition. This research study investigated the differences in specific feeding behaviors of infants when they were sick with an acute respiratory condition compared to when they were well. In this comparative descriptive study, infants 1 to 4 months of age were observed in their homes. The study sample consisted of 16 full-term infants who were bottlefed and became ill with a respiratory infection. Infants were videotaped during two feedings when they were ill and one feeding when they were well. Caregiver questionnaires and videotapes were the data collection tools. The videotapes were analyzed using an Infant Feeding Behavior Assessment Checklist which measures four categories of feeding behaviors: type of seal around nipple, suck-pause pattern, suck-swallow pattern, and respiratory pattern. Descriptive statistics assisted in the exploration of differences that existed between the infants' sick and well feeding behaviors. Analysis indicated that there were differences in the infants' sick and well feeding behaviors. When well, infants appeared to smoothly coordinate their suck-swallow and breathe cycle. When sick, the infants had an erratic suck-pause pattern, loosened their seal around the nipple, and had an irregular respiratory pattern with some degree of respiratory distress.

Bottle Feeding↗
PubMedDate not supplied

The impact of two transfer techniques used during skin-to-skin care on the physiologic and behavioral responses of preterm infants.

BACKGROUND: Conservation of energy assumes an important role in the care of infants requiring assisted ventilation, yet little research has been conducted on this group of infants in terms of thermoregulation, oxygenation, heart rate, or sleep states during skin-to-skin care. OBJECTIVES: To compare the impact of two different transfer techniques used in skin-to-skin care (nurse transfer and parent transfer) on physiologic stability and other descriptive measures of physiologic stability related to energy conservation in ventilated preterm infants during and after skin-to-skin care. METHOD: Fifteen ventilated preterm infants weighing a mean of 1,094 g were randomly assigned to receive either parent or nurse-to-parent transfer on the first of 2 consecutive days and the alternate method the following day. Temperature was taken before and after skin-to-skin care. Oxygen saturation and heart rate were recorded minute by minute, and the Assessment of Behavioral Systems Observation (ABSO) scale scores was used to measure physiologic organization, motor organization, self-regulation, and need for caregiver facilitation during transfer to and from the parent and during pre, post, and skin-to-skin periods. RESULTS: Temperature remained stable. Oxygen saturation decreased and heart rate increased when the infant was transferred to and from the parent, but returned to baseline levels during and after skin-to-skin care regardless of the transfer method. Infants showed more physiologic and motor disorganization, less self-regulation, and more need for caregiver facilitation during transfers to and from the parent than during the pre, post, and skin-to-skin care periods. CONCLUSIONS: Both transfer methods resulted in physiologic disorganization. However, during and after skin-to-skin care, infants exhibited no signs of energy depletion.

Adult↗
PubMed1996

Structural and neurobehavioral delay in postnatal brain development of preterm infants.

Postnatal brain development of healthy prematurely born infants was assessed to study possible influence of premature birth and early extrauterine environment on structural, biochemical, and functional brain development. Myelination and differentiation of gray and white matter were studied by in vivo magnetic resonance (MR) imaging (MRI), changes in cerebral metabolism by 1HMR spectroscopy (MRS), and changes in early human neurobehavior by the assessment of preterm infant's behavior (APIB). The stage of intrauterine and extrauterine brain development in prematurely born infants at term was compared with the stage of mainly intrauterine brain development in a group of full-term infants. Eighteen preterm infants unremarkable with respect to neurologic and medical status were studied at approximately 2 wk of postnatal age [gestational age (GA) 1: 32.5 +/- 1.2 wk] and again at term (GA 2: 40.0 +/- 1.1 wk). For comparison a group of 13 full-term born infants (GA T: 40.6 +/- 2.1 wk) were studied by MR and six by APIB. When GA 2 to GA 1 was compared, significant maturational changes were found with MRI in gray and white matter and myelination, with 1H MRS in the concentration of N-acetylaspartate and with all scores of APIB. In preterm infants at term (GA 2) compared with full-term infants (GA T) significantly less gray and white matter differentiation and myelination was observed as well as significantly poorer performance in four neurobehavioral parameters (autonomic reactivity, motoric reactivity, state organization, attentional availability). We conclude that MRI and 1H MRS can be used to study postnatal brain development in preterm infants. Structural and biochemical maturation is accompanied by functional maturation as shown with the neurobehavior assessment. Preterm infants at term compared with full-term infants show a structural as well as a functional delay in brain development assessed at 40 wk of postconceptional age.

Age Factors↗
PubMed2001

Maternal postpartum behaviors and mother-infant relationship during the first year of life.

OBJECTIVE: To assess the hypothesis that maternal postpartum behaviors toward the newborn may predict the quality of the maternal-infant relationship during the first year. DESIGN: Prospective, non-randomized, longitudinal cohort study of 174 maternal-infant dyads. METHODS: A Postpartum Parenting Behavior Scale (PPBS) was formulated to measure clearly defined observed maternal behaviors toward the infant shortly after birth. The quality of the maternal-infant relationship was assessed at 6 months after birth with the Nursing Child Assessment Satellite Training (NCAST) Feeding Scale and at 12 months after birth with the NCAST Teaching Scale and Ainsworth Strange Situation. RESULTS: The PPBS score correlated significantly with the Feeding Scale score (r =.27, P <.005) and with the Teaching Scale score (r =.23, P <.01). Mothers whose infants were later classified as securely attached in the Ainsworth Strange Situation had higher PPBS scores than mothers of infants classified as insecurely attached (mean +/- SD: 5.18 +/- 1.51 vs 4.63 +/- 1.69, respectively, P <.05). In regression models adjusting for social and demographic factors, the PPBS remained a significant predictor of the Feeding Scale score, the Teaching Scale score, and security of attachment. CONCLUSIONS: Maternal behaviors in the immediate postpartum period may aid in predicting quality of the maternal-infant relationship during the subsequent 12 months, suggesting the potential for early identification of suboptimal parenting.

Adolescent↗
PubMed1984

Developmental changes in infant pain expression during immunization injections.

Developmental changes in pain expression provoked by routine immunization injections during the first 2 years of life were examined. An interval-sampling, behavioral observation system was developed to code categories of expressive behavior in infants, their mothers and the nurse responsible for the injection. Qualitative changes were observed in the infants' behavior, with those less than 12 months of age responding in a more spontaneous, diffuse manner, whereas the older infants displayed more anticipatory distress, descriptive language and goal-directed movement. Mothers and the nurse actively interacted with each other and the infant with a range of vocal and nonvocal actions. The findings justified the use of unobtrusive, naturalistic observation as a means of assisting practitioners who suffer from an inadequate knowledge-base on pain in children.

Age Factors↗
PubMed1996

Psychophysiological correlates of infant temperament: stability of behavior and autonomic patterning from 5 to 18 months.

The stability of infant temperament and autonomic patterning (heart period and cardiac vagal tone) was examined longitudinally when infants were 5, 10, and 18 months of age. Behavioral measures of reactivity and regulation to frustration tasks, and maternal perceptions of infant temperament were obtained at each age along with baseline measures of cardiac activity. No stability was found from 5 to 10 months while some stability of behavior and autonomic patterning was identified from 10 to 18 months, with the exception of negative reactivity. High levels of cardiac vagal tone (V) were associated with negative reactivity at 18 months. When examining groups based on degrees of reactivity and regulation, we found infants who responded negatively to frustration but who also displayed more regulatory behavior to have higher V.

Arousal↗