NEURODEVELOPMENTAL CARE OF PRETERM BABIES AND ITS KEY ELEMENTS
Keywords:developmental care, NIDCAP, preterm infants.
Over the past few decades, the advancements in the perinatal and neonatal intensive care have led to a significant survival of premature infants. However neurodevelopmental outcome still remains the topical issues of concern. Developmental care is an approach that is aimed to reduce the mismatches between extra- and intra-uterine environments, decrease the stress of preterm newborns in neonative intensive care units, and thus promote optimal neurobehavioral development of the infant.
The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) model was developed as a clinical framework for the implementation of developmental care. The model focuses on detailed reading of each individual infant’s behavioral cues. By observing the child during the routine manipulation performance (before, during and after) and a detailed description of his/her behavioral responses, a professional can assess the ability of the infant’s immature nervous system to tolerate the environment and care manipulations. Such evaluation will enable to determine the adequacy of environmental conditions and care manipulations to baby’s opportunities and needs, with their subsequent correction and adaptation. NIDCAP’s aim is to support the child in its increasing tolerance to stimuli and to minimize stressful events and manipulation. With the help of NIDCAP approaches in neonatal care, medical staff study how to read infants’ behavior, hear their voice and understand them.
Ancel PY, Goffinet F, EPIPAGE 2 Writing Group. EPIPAGE 2: a preterm birth cohort in France in 2011. BMC Pediatr. 2014;14:97.
Als H, McAnulty GB. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) with Kangaroo Mother Care (KMC): Comprehensive Care for Preterm Infants. Curr Womens Health Rev. 2011;7(3):288–301.
VandenBerg KA. Individualized developmental care for high risk newborns in the NICU: A practice guideline. Early Human Development. 2007;83:433–442.
Khan MR, Maheshwari PK, Shamim H, Saleem AF, Shakeel A, Syed RA, et al. Neurodevelopmental Outcomes of Premature Infants at a Tertiary Care Center in Pakistan. Pediatric Neurology. 2012;47:109–113.
Aylward GP. Neurodevelopmental outcomes of infants born prematurely. J Dev Behav Pediatr. 2005;26:427–40.
Hack M, Flannery DJ, Schluchter M, Cartar L, Borawski E, Klein E. Outcomes in young adulthood for very low birth weight infants. N Engl J Med. 2002;346:149–57. www.ncbi.nlm.nih.gov/pubmed/11796848. Accessed 17 Jan 2002.
Saigal S, den Ouden I, Wolke D. School-age outcomes in children who were extremely low birth weight from four international population-based cohorts. Pediatrics. 2003;112:943–50.
Rushing S, Ment LR. Preterm birth: a cost benefits analysis. Semin Perinatol. 2004;28:444–50. www.ncbi.nlm.nih.gov/pubmed/15693401. Accessed Dec 2004.
Bennett FC. Developmental outcome (in) MacDonald MG, Seshia MK, Mullett MD (eds.) Avery's Neonatology: Pathophysiology and management of the newborn. 6th edition. New York: Lippincott Williams and Wilkins; 2005:1632–52.
Hellstrom-Westas L, Roson I. Continuous brain-function monitoring: State of the art in clinical practice. Semin Fetal Neonatal Med. 2006;11(6):503–11.
Als H, Lawhon G. Theoretical perspective for developmentally supportive care (in) Kenner C, McGrath JM (eds). Developmental care of newborns and infants: A guide for health professionals. St. Louis: Mosby; 2004:47–58.
Als H. and Gilkerson L. The role of relationship-based developmentally supportive newborn intensive care in strengthening outcome of preterm infants. Seminars in Perinatology. 1997;21(3):178-189. www.ncbi.nlm.nih.gov/pubmed/9205974. Accessed Jun 1997.
McLennan JE, Gilles FH, Neff R. A model of growth of the human fetal brain (in) Gilles FH, Leviton A, Dooling EC (eds). The developing human brain. Boston: John Wright; 1983:43–59.
Als H, Duffy FH, McAnulty GB, Rivkin MJ, Vajapeyam S, Mulkern RV, et al. Early experience alters brain function and structure. Pediatrics. 2004; 113(4):846–57.
Als H. Reading the premature infant (in) Goldson E (ed.) Developmental interventions in the neonatal intensive care nursery. New York: Oxford University Press; 1999:18–85.
LaRossa MM. Understanding Preterm Infant Behavior in the NICU. 2017. http://www.pediatrics.emory.edu/divisions/neonatology/dpc/nicubeh.html. Accessed 2017.
Als H. Toward a synactive theory of development: Promise for the assessment of infant individuality. Inf Mental Health J. 1982;3:229–43.
Holditch-Davis D, Blackburn ST, VandenBerg KA. Newborn and infant neurobehavioral development (in) Kenner C, Lot JW (eds). Comprehensive neonatal nursing: A physiologic perspective. 3rd edition. Philadelphia: Saunders; 2003: 236–84.
Brazelton TB. Behavioral competence (in) Avery GB, Fletcher MA, MacDonald MG (eds.) Neonatology: Pathophysiology and management of the newborn. Philadelphia: Lippincott Williams and Wilkins; 1999:321–7.
Shonkoff J, Phillips D. From neurons to neighborhoods: The Science of early childhood development. Wash DC: National Academy Press; 2000:93–124.
Schore AN. Affect dysregulation and disorders of the self. J Can Acad Child Adolesc Psychiatry. 2006;15(2):100–101.
Bjorn Westrup. Newborn Individualized Developmental Care and Assessment Program (NIDCAP) — Family-centered developmentally supportive care. Early Human Development 2007;83:443–449.
Foster JP, Psaila K, Patterson T. Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database of Systematic Reviews. 2016;10. http://www.cochrane.org. Accessed 25 Feb 2016.
Als H, Lawhon G, Duffy FH, McAnulty GB, Gibes-Grossman R, Blickman JG. Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects. JAMA. 1994;272(11):853–8.
Monterosso L, Kristjanson L, Cole J. Neuromotor Development and the Physiologic Effects of Positioning in Very Low Birth Weight Infants. J Obstet Gynecol Neonatal Nursing. 2002;31:138–46.
Van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TWJ, L’Hoir MP. Swaddling: A Systematic Review. PEDIATRICS. 2007;120(4):1097-1106. http://pediatrics.aappublications.org/content/120/4/e1097. Accessed Oct 2007.
Robert D. White. Recommended Standards for Newborn ICU Design. Report of the Eighth Census Conference on Newborn ICU Design. Committee to Establish Recommended Standards for Newborn ICU Design. Clearwater Beach, FL. 2012.
Philbin MK. The influence of auditory experience on the behaviour of preterm newborns. J Perinatol. 2000;20:77–87.
Conde-Agudelo A, Belizan JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2011;3. http://www.cochrane.org. Accessed 2011.
Mori R, Khanna R, Pledge D, Nakayama T. Meta-analysis of physiological effects of skin-to-skin contact for newborns and mothers. Pediatr Int. 2010;52(2):161 –70.
Als H, Gilkerson L, Duffy FH, McAnulty GB, Buehler DM, VandenBerg K ,et al. A three-center, randomized, controlled trial of individualized developmental care for very low birth weight preterm infants: medical, neurodevelopmental, parenting, and caregiving effects. J Dev Behav Pediatr. 2003;24:399–408.
Buehler DM, Als H, Duffy FH, McAnulty GB, Liederman J. Effectiveness of individualized developmental care for low-risk preterm infants: behavioral and electrophysiological evidence. Pediatrics. 1995;96:923–32.
Symington A, Pinelli J. Developmental care for promoting development and preventing morbidity in preterm infants. Cochrane Database Syst Rev. 2001;4. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001814.pub2/full. Accessed 2001.
Peters KL, Rosychuk RJ, Hendson L, Cote JJ, McPherson C, Tyebkhan JM. Improvement of Short- and Long-Term Outcomes for Very Low Birth Weight Infants: Edmonton NIDCAP Trial. Pediatrics. 2009;124:1009–1020. https://www.ncbi.nlm.nih.gov/pubmed/19786440. Accessed 2009.
Als H, Duffy FH, McAnulty G , Butler SC, Lightbody L, Kosta S, et al. NIDCAP improves brain function and structure in preterm infants with severe intrauterine growth restriction Journal of Perinatology. 2012;32:797–803.
Kleberg A, Westrup B, Stjernqvist K. Developmental outcome, child behaviour and mother–child interaction at 3 years of age following Newborn Individualized Developmental Care and Intervention Program (NIDCAP) intervention. Early Human Development. 2000;60:123–135.
Kleberg A, Hellstrom-Westas L, Widstrom A. Mothers’ perception of Newborn Individualized Developmental Care and Assessment Program (NIDCAP) as compared to conventional care. Early Human Development. 2007;83:403–411.
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