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Naturalistic parental touch in the NICU: Developmental changes in preterm infants' behavioural and physiological responses
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NATURALISTIC PARENTAL TOUCH IN THE NICU: DEVELOPMENTAL CHANGES IN PRETERM INFANTS’ BEHAVIOURAL PHYSIOLOGICAL RESPONSES. Fearon, I.*, Harrison, L., Muir, D.W., & Kisilevsky, B.S. * Department of Psychology, Queen’s University, Kingston, Ontario,
AND
Canada
Much of the human contact experienced by preterm infants in the neonatal intensive care unit (NICU) is inherently stressful. Nursing contacts frequently precipitate undesirable changes in physiological measures such as blood oxygen saturation (Long, Philip & Lucey, 1980). Consequently, many NICUs have adopted no-touch or minimal touch policies. However, blanket no-touch policies may not be an effective solution to this problem, since tactile deprivation is known to cause suboptimal changes in the pattern of endocrine activity in rat pups (Schanberg & Field, 1987). In recent years, some researchers have begun to promote gentle, nonaversive touch as an important component of developmentally sensitive care. Parents may be the best candidates for providing this type of stimulation. Unfortunately, there have been few studies which have systematically evaluated the effect of parental touch during unstructured interventions. In the present study, 7 preterm infants between 27 and 33 weeks gestational age (GA) were videotaped during unstructured parental visits to the neonatal intensive care nursery. Heart rate (HR) and blood oxygen saturation (Sa02) were measured in real time and recorded directly on the videotapes. Videotapes were then scored for type, amount, and location of parental touch, and gmount and location of infant movement. Data were analyzed both within individual subjects and across 2 age groups (Group 1: GA < 31 weeks; Group 2: GA 2 31 weeks). Results indicate a relationship between the incidence of touch and infant movement. This “Activation Effect” was apparent in 5 of the 7 subjects, including both oldest and youngest subjects, but appeared to decrease in magnitude with increasing gestational age. In both age groups, brief episodes of touch were associated with increased HR. However, older subjects continued to show increasing HR following prolonged episodes of touch; younger subjects did not. Younger subjects showed a negative linear relationship between duration of stimulation and Sa02. Older subjects, however, showed an initial drop in Sa02 following brief episodes of touch, but a recovery following prolonged episodes. These results suggest that policies regarding parental touch may need to be flexible to ensure sensitivity to the needs of the developing preterm infant.
NATURALISTIC PARENTAL TOUCH IN THE NICU: DEVELOPMENTAL CHANGES IN PRETERM INFANTS’ BEHAVIOURAL PHYSIOLOGICAL RESPONSES. Fearon, I.*, Harrison, L., Muir, D.W., & Kisilevsky, B.S. * Department of Psychology, Queen’s University, Kingston, Ontario,
AND
Canada
Much of the human contact experienced by preterm infants in the neonatal intensive care unit (NICU) is inherently stressful. Nursing contacts frequently precipitate undesirable changes in physiological measures such as blood oxygen saturation (Long, Philip & Lucey, 1980). Consequently, many NICUs have adopted no-touch or minimal touch policies. However, blanket no-touch policies may not be an effective solution to this problem, since tactile deprivation is known to cause suboptimal changes in the pattern of endocrine activity in rat pups (Schanberg & Field, 1987). In recent years, some researchers have begun to promote gentle, nonaversive touch as an important component of developmentally sensitive care. Parents may be the best candidates for providing this type of stimulation. Unfortunately, there have been few studies which have systematically evaluated the effect of parental touch during unstructured interventions. In the present study, 7 preterm infants between 27 and 33 weeks gestational age (GA) were videotaped during unstructured parental visits to the neonatal intensive care nursery. Heart rate (HR) and blood oxygen saturation (Sa02) were measured in real time and recorded directly on the videotapes. Videotapes were then scored for type, amount, and location of parental touch, and gmount and location of infant movement. Data were analyzed both within individual subjects and across 2 age groups (Group 1: GA < 31 weeks; Group 2: GA 2 31 weeks). Results indicate a relationship between the incidence of touch and infant movement. This “Activation Effect” was apparent in 5 of the 7 subjects, including both oldest and youngest subjects, but appeared to decrease in magnitude with increasing gestational age. In both age groups, brief episodes of touch were associated with increased HR. However, older subjects continued to show increasing HR following prolonged episodes of touch; younger subjects did not. Younger subjects showed a negative linear relationship between duration of stimulation and Sa02. Older subjects, however, showed an initial drop in Sa02 following brief episodes of touch, but a recovery following prolonged episodes. These results suggest that policies regarding parental touch may need to be flexible to ensure sensitivity to the needs of the developing preterm infant.