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PubMedDate not supplied

Analgesia for circumcision: effects on newborn behavior and mother/infant interaction.

OBJECTIVE: To test the effectiveness of acetaminophen for pain management during and after circumcision. DESIGN: A randomized, double-blind, placebo controlled, pretest-posttest design. SETTING: Level III nursery at a Midwestern hospital. PARTICIPANTS: Sixty full-term newborns, whose mothers had uncomplicated pregnancies and vaginal deliveries. INTERVENTIONS: Administration of 10 mg/kg acetaminophen or placebo 1 hour before circumcision. MAIN OUTCOME MEASURES: Behaviors (clarity of cues and responsiveness) were observed in newborns during a feeding interaction, and pain distress (percentage of time crying and heart rate) was assessed during and after the circumcision. RESULTS: ANCOVA revealed significant group differences in subscales of the NCAFS (Nursing Child Assessment Feeding Scale) for newborns, whereas statistically significant differences for mothers were found in the sensitivity to cues and social-emotional growth-fostering scales. A significant increase in heart rate and crying time during the circumcision was noted; however, no significant difference was observed between groups. At the diaper change after the circumcision, the percentage of cry did suggest an effect from the analgesia. CONCLUSIONS: These findings reinforce the reciprocal, synchronous nature of mother-infant interactions during the early postpartum period and the need for pain control after circumcision to promote neonatal comfort and improve mother-infant interaction.

Acetaminophen↗
PubMed2005

Pain response of neonates to venipuncture.

OBJECTIVE: To study the physiological and behavioral response to pain. METHODS: 80 healthy neonates requiring bilirubin estimation, blood sugar etc, were randomly assigned to receive a venous puncture. All parameters were recorded 10 minutes prior, during and 10 minutes after the procedure. Evaluated NIPS score and RR. HR, NIBP and O2 saturation observed on Datex-Ohmeda multimonitor. RESULTS: After the venepuncture, heart rate (p<0.001) and blood pressure (p<0.001) were significantly increased in both the groups but more significant increase was present in Group I (>2.5 kg) as compared to Group II (>2.5 kg). Respiratory rate was also increased but more significant in Group II (p<0.001) whereas oxygen saturation was decreased in both the groups but more significant in Group I (p<0.001). Median Neonatal Infant Pain Scale (NIPS) score was higher in both the Groups (p<0.001). CONCLUSION: The outcome measures appear to be reliable indices of term neonates responses to painful stimulation. NIPS are suitable instruments for neonatal pain evaluation.

Blood Pressure↗
PubMed1996

The effect of soothing music on neonatal behavioral states in the hospital newborn nursery.

Most newborns born in Western countries spend their first transitional hours in hospital nurseries. Noxious noise levels in the nursery can interfere with neonatal efforts to achieve physiological and behavioral homeostasis. Literature indicates that music has been used to induce relaxation states and reduce stress responses. This study used a one-group, pretest, posttest design. A convenience sample of 20 term, Caucasian neonates was recruited. The number of high arousal behavioral states and the number of state changes of the newborns was recorded for a control and an experimental period. Soothing, lyrical music was played in the baby's bed during the experimental period. The data was compared using McNemar's test statistic. A significant difference (p < .01) was observed. The results suggest that soothing music may be a feasible intervention to help newborns demonstrate fewer high arousal states and less state lability.

Arousal↗
PubMed2006

Identification of pain indicators for infants at risk for neurological impairment: a Delphi consensus study.

BACKGROUND: A number of infant pain measures have been developed over the past 15 years incorporating behavioural and physiologic indicators; however, no reliable or valid measure exists for infants who are at risk for neurological impairments (NI). The objective of this study was to establish consensus about which behavioural, physiologic and contextual indicators best characterize pain in infants at high, moderate and low levels of risk for NI. METHODS: A 39- item, self-administered electronic survey that included infant physiologic, behavioral and contextual pain indicators was used in a two round Delphi consensus exercise. Fourteen pediatric pain experts were polled individually and anonymously on the importance and usefulness of the pain indicators for the 3 differing levels of risk for NI. RESULTS: The strength of agreement between expert raters was moderate in Round 1 and fair in Round 2. In general, pain indicators with the highest concordance for all three groups were brow bulge, facial grimace, eye squeeze, and inconsolability. Increased heart rate from baseline in the moderate and severe groups demonstrated high concordance. In the severe risk group, fluctuations in heart rate and reduced oxygen saturation were also highly rated. CONCLUSION: These data constitute the first step in contributing to the development and validation of a pain measure for infants at risk for NI. In future research, we will integrate these findings with the opinions of (a) health care providers about the importance and usefulness of infant pain indicators and (b) the pain responses of infants at mild, moderate and high risk for NI.

Attitude of Health Personnel↗
PubMedDate not supplied

Effects of allocare-givers on fitness of infants and parents in callitrichid primates.

The effects of callitrichid primate helpers (allocare-givers other than an infant's father) on the survival, reproduction or behavior of infants and parents are reviewed, using both published studies and data from free-ranging golden lion tamarins (Leontopithecus rosalia). Three lines of evidence suggest that helpers may increase their own inclusive fitness: (1) The number of adult males acting as helpers in free-ranging groups is correlated with the number of surviving infants in 3 callitrichid species. However, the lack of a negative correlation with number of infants dying suggests that activities other than direct infant care (e.g. territory defense) may be more important, especially in newly formed groups. (2) In 2 species, captive groups with helpers carry infants for longer periods of time than do groups without helpers. Whether such differences would translate into meaningful survival differences in free-ranging groups is unclear. (3) Helpers reduce the energetic burden of parents by reducing the amount of time they spend transporting or provisioning infants in at least 4 species. Reproductive males are more likely than reproductive females to benefit from the presence of helpers, reducing their investment in infant care activities as the number of helpers in the group increases. In free-ranging golden lion tamarins, the reproductive tenure of males, but not females, increases with the number of helpers in the group, suggesting that a reduction in energetic investment may translate into increased survival. 'Decisions' made by helpers to participate in infant transport are weighed against competing needs for foraging, vigilance, territory defense and, in some cases, prospecting for breeding opportunities. Given this complexity, a sophisticated model may be required to answer the question of how helpers 'decide' to participate in infant care versus other activities.

Animals↗
PubMed2002

Facilitating postural control: effects on the reaching behavior of 6-month-old infants.

In this study, 3-D kinematic as well as 2-D videorecordings were made of the reaching behavior of infants aged about 6 months who were not yet able to sit. Detailed analyses of these recordings were directed toward specifying the effects of providing additional postural support to the lower body on the spatial and temporal features of such behavior. To detect these effects, reaching and associated head movements in this modified condition were compared to those made while the infants sat in an age-appropriate and commercially available chair lacking the supplementation of support for the pelvic region and upper legs. Findings consistent with predictions included better head stabilization and smoother reaching movements when the infants were in the modified chair. In addition, these two achievements were negatively related to reaching experience. These, and other findings, underscore the infrequently investigated supposition that changes in postural control induce improvements in the control of reaching movements during infancy. Recommendations are made about how the procedure adopted in the present study could be used in subsequent research to give further insights into the codevelopment of posture and action.

Biomechanical Phenomena↗
PubMed1997

Infants with autism: an investigation of empathy, pretend play, joint attention, and imitation.

Systematic studies of infants with autism have not been previously carried out. Taking advantage of a new prospective screening instrument for autism in infancy (S. Baron-Cohen et al., 1996), the present study found that, compared with developmentally delayed and normally developing children, 20-month-old children with autism were specifically impaired on some aspects of empathy, joint attention, and imitation. Infants with autism failed to use social gaze in the empathy and joint attention tasks. Both the infants with autism and the infants with developmental delay demonstrated functional play, but very few participants in either group produced spontaneous pretend play. In the developmental delay group, but not the autism group, pretend play was shown following prompting. The implications of these findings for developmental accounts of autism and for the early diagnosis of the disorder are discussed.

Analysis of Variance↗
PubMed2005

Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates.

OBJECTIVE: To study the effect of oil massage on growth and neurobehavior in preterm babies less than 1500 g. DESIGN: Randomized Controlled Trial. SETTING: Tertiary level neonatal unit of a teaching hospital. SUBJECTS: Neonates with birth weight <1500 grams, gestation >37 weeks, receiving enteral feeds of at least 100 mL/kg/day and less than 10 days of age. OUTCOME VARIABLES: Primary-Weight gain 28 days after enrolment. Secondary-Neonatal neurobehavior, change in other anthropometry and serum triglycerides. METHODS: Eligible neonates were randomized to one of the three groups (a) massage with oil (b) massage without oil and (c) no massage. Weight, length, head circumference and triceps skin fold thickness were measured in the three groups at regular intervals. Serum triglyceride levels were measured at enrolment and at completion. Neurobehavior using Brazeltons Neonatal Behavior Assessment Scale (NBAS) was assessed at enrolment and after 10 days of intervention. RESULTS: Weight gain in the oil massage group (365.8 +/- 165.2g) was higher compared to the only massage group (290.0 +/- 150.2g) and no massage group (285.0 +/- 170.4g). This difference and the difference in other anthropometric parameters was not statistically significant. Serum triglycerides and neonatal neurobehavior were comparable in the three groups. CONCLUSION: Oil application may have a potential to improve weight gain among preterm very low birth weight neonates.

Female↗
PubMed2006

Does maternal control during feeding moderate early infant weight gain?

OBJECTIVE: Our objective with this study was to examine whether observed maternal control during feeding at 6 months of age moderates the development of early infant weight gain during the first year of life. METHODS: Sixty-nine women were observed feeding their 6-month-old infants during a standard meal. Mealtimes were coded for maternal use of controlling feeding behavior. All infants were weighed at birth and at 6 and 12 months of age, and weight gain was calculated from birth to 6 months and from 6 to 12 months. Weight scores and weight gain scores were standardized for prematurity, age, and gender. RESULTS: Infant weight gain between 6 and 12 months of age was predicted by an interaction between early infant weight gain (birth to 6 months) and observed maternal control during feeding at 6 months. When maternal control was moderate or low, there was a significant interaction with weight gain from birth to 6 months in the prediction of later infant weight gain from 6 to 12 months, such that infants who showed slow early weight gain accelerated in their subsequent weight gain, and those with greater early weight gain decelerated. Conversely, when maternal control was high, infant weight gain followed the opposite pattern. CONCLUSION: Maternal control of solid feeding can moderate infant weight gain.

Adult↗
PubMed1987

Hormonal and behavioral attachment responses in infant guinea pigs.

Infant guinea pigs, 11/12 and 18/19 days of age, exhibited high rates of vocalizing and increases in plasma concentrations of cortisol when separated from their mothers for 30 min in a novel environment (unfamiliar cage in an unfamiliar room). Levels of vocalizations and plasma cortisol were significantly reduced when the pup was exposed to the novel environment with its own conscious or anesthetized mother, but not when it was exposed with an unfamiliar anesthetized lactating female. Pups spent equivalent amounts of time in physical contact with their own conscious mother, their own anesthetized mother and an unfamiliar anesthetized lactating female. Unexpectedly, when the unfamiliar cage was placed in an environmental chamber during separation, pups showed negligible increases in vocalizations and plasma cortisol levels, even when administered footshock just prior to exposure. These findings demonstrate that guinea pig pups exhibit adrenocorticoid as well as behavioral responses to maternal separation, provide further evidence for the existence of filial attachment in this species, and document an unexpected role of the test environment in determining responses during maternal separation. The guinea pig may afford a rodent model for examining the effects of attachment-object separation on the activity of the pituitary-adrenal system.

Age Factors↗
PubMed2005

Labeling guides object individuation in 12-month-old infants.

A new manual search method was used to investigate the impact of naming on object individuation in 12-month-old infants. In Experiment 1, on a two-word trial, an experimenter looked into a box while the infant was watching and provided two labels (e.g., "Look, a fep!" and "Look, a wug!"). On a one-word trial, the experimenter instead repeated the same label (e.g., "Look, a zav!"). After the infant retrieved one object from the box, subsequent search behavior was recorded. Infants searched more persistently (i.e., for a longer duration) after hearing two labels than one, suggesting that hearing two labels led the infants to expect two objects inside the box. In Experiment 2, infants' search behavior did not differ depending on whether they heard one or two emotional expressions, suggesting that the facilitation effect observed in Experiment 1 may be specific to linguistic expressions. Thus, we provide the first evidence that infants as young as 12 months are able to use intentional and referential cues to guide their object representations. These findings also suggest that a rudimentary version of the mutual-exclusivity constraint may be functional by the end of the first year.

Child Language↗
PubMed2003

Neurobehavioral assessment of appropriate for gestational and small for gestational age babies.

he present study was conducted to evaluate the neurobehaviour of term appropriate for gestational aland small for gestational age babies during the first two weeks of life in a tertiary care hospital. Forty eight appropriate and thirty small for gestation age babies were evaluated using Brazelton Neurobehavioural Assessment Scale on 3rd, 7th and 14th day of life. The behaviour of AGA babies is characterized by optimal performance in habituation, range of state, regulation of state and autonomic stability. The behavior is at low to mid-range in orientation and in motor clusters. All the behavior clusters showed improvement over first 14 days except for regulation of state which showed a lower performance on day 7 and 14. The behavior performance of SGA babies on day 3, compared to AGA babies, was lower in all the clusters except orientation where they performed much better. The percentage improvement of scores in SGA babies is higher than in AGA babies and by day 14 SGA babies are scoring higher than AGA babies in orientation, autonomic stability and regulation of state. The difference in the neurobehavior pattern of babies in relation to their intrauterine growth suggests need for appropriate care.

Apgar Score↗
PubMedDate not supplied

Response to pain in a group of healthy term newborns: behavioral and physiological aspects.

Various reports have documented the difficulty in assessing neonatal response to painful stimuli. The aim of our study was to evaluate previously described scales for assessing pain in a group of 18 healthy term newborns selected according to Prechtl's optimality criteria and subjected to a routine metabolic screening blood test performed on the 5th day of life. Both a modified CHEOPS scale and Grunau-Craig Scale, to assess pain behavior response before, during and after a painful stimulus, revealed definite modifications in scores. Response to pain was also evaluated by measuring variations in decreases in transcutaneous oxygen pressure in all newborns during application of the stimulus and in returns to baseline or higher values upon removal of the stimulus. Our study confirms that healthy term newborns feel pain when subjected to limited painful stimuli such as the routine blood test and suggests useful and easy methodological tools to evaluate pain in the newborn.

Blood Gas Monitoring, Transcutaneous↗
PubMedDate not supplied

[Method of continuous intravenous postoperative analgesia with promedol in newborn children].

Continuous intravenous infusion of promedol, 0.1 mg/kg, with additional boluses, 0.5 mg/kg, was used as postoperative analgesia in 20 newborns. Fifteen (25%) children were operated for congenital gastrointestinal defects or peritonitis, 2 children (10%)--for chylothorax, and tumor was eradicated in 3 (15%) children. On the basis of behavioral reactions, physiological indices (cardiac rate, arterial pressure, SpO2, and respiration rate/artificial pulmonary ventilation--APL) as well as of laboratory "stress" tests (blood glucose and cortisol and acid-base balance) it was proven that analgesia with continuous intravenous promedol infusion was effective. It was shown as possible to administer the promedol infusion in newborns while switching them from APL to independent breathing until the spontaneous breathing with constant positive pressure is ensured provided the pO2, pCO2 and SpO2 respiration indices are satisfactory.

Analgesics, Opioid↗
PubMed1994

Neonatal behavior in full-term small for date.

Fifty newborns, 25 full term SFDs (small for date) and 25 full term AGAs (appropriate for gestational age) were taken up for comparative study of their behavior using BNBAS (Brazelton's neonatal behavior assessment scale). The study revealed that full term SFDs performed significantly poorly on all items under cluster interactive processes compared to their counterparts full term AGAs on day 1. They also showed similar poor performance in clusters of motor processes and organizational processes (State control). Follow up assessment on day 30 revealed significantly better performance in these clusters. However, the performance of SFD babies in all items of cluster of organizational processes (physiological response) was comparable to that of AGA babies in the initial as well as follow up assessments.

Birth Weight↗
PubMed1998

Quantization of human motions and learning of accurate movements.

This paper presents a mathematical model for the learning of accurate human arm movements. Its main features are that the movement is the superposition of smooth submovements, the intrinsic deviation of arm movements is considered, visual and kinesthetic feed-back are integrated in the motion control, and the movement duration and accuracy are optimized with practice. This model is consistent with the jerky arm movements of infants, and may explain how the adult motion behavior emerges from the infant behavior. Comparison with measurements of adult movements shows that the kinematics of accurate movements are well predicted by the model.

Adult↗
PubMed1992

Effects of beta-carboline on fear-related behavioral and neurohormonal responses in infant rhesus monkeys.

We examined the effects of the inverse benzodiazepine agonist ethyl-beta-carboline-3-carboxylate (beta-CCE) on behavioral, hormonal, and neurochemical responses in infant rhesus monkeys exposed to fearful situations. Our paradigm elicits three distinct adaptive patterns of defensive behavior. From previous work, we hypothesized that behaviors induced by attachment bond disruption are predominantly mediated by opiate systems, whereas behaviors induced by the threat of attack are mediated by benzodiazepine systems. When beta-CCE (0, 125, 250, and 500 micrograms/kg) was administered immediately after maternal separation, the 500 micrograms/kg dose increased freezing and the 250 and 500 micrograms/kg doses reduced environmental exploration. Test conditions produced increased plasma ACTH and cortisol concentrations and increased cerebrospinal fluid (CSF) concentrations of MHPG and DOPAC; beta-CCE did not further affect these metabolites. A dose of 1000 micrograms/kg of beta-CCE increased CSF concentrations of DOPAC and MHPG in infants left with their mothers. During test conditions, it further increased CSF MHPG (but not DOPAC) concentrations, and reduced cooing while increasing freezing and barking and other hostile behaviors. Our results thus confirm that benzodiazepine systems mediate threat-related behaviors and suggest that coos, which were thought to predominantly reflect the degree of distress during separation, can be modulated by the infant's level of fear. beta-CCE also activated stress-related pituitary-adrenal hormonal systems and brain norepinephrine (NE) and dopamine (DA) systems. These effects occurred when animals remained undisturbed in their home cages with their mothers, suggesting that benzodiazepine receptors directly modulate brain NE and DA systems.

3,4-Dihydroxyphenylacetic Acid↗