Premature Infants & the NICU Medical & Psychological Issues

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Presentation transcript:

Premature Infants & the NICU Medical & Psychological Issues November 13, 2007

Description 250,000 newborn infants admitted to NICU’s annually in US Most are born premature, at low birth weight, or both Premature infant = born prior to 37th week of gestation Low birth weight = less than 5.5 pounds

Description Majority of Infants born as early as 25 weeks gestation survive 5-7% of North American infants are born prematurely Most are hospitalized until approx. their due date

Causes of Prematurity Social, biological, & environmental factors

Causes of Prematurity Prenatal care, no drugs, & healthy diet reduce chances Most premature births occur in middle-class women

The Premature Infant Immature organ development Difficulties adapting to the extrauterine environment Physical appearance Lanugo Absence of fat Elongated head

Premie Development Three stages of premie development Early premie Developing premie Older premie

Impact of NICU Lack of patterning to stimulation Infants can learn to “tune out” stimuli Social signals may receive no response Fail to learn effective ways of eliciting responses from caregivers Social signaling may be diminished or extinguished through lack of response

Positive Changes in the NICU Minimize unneccesary contact Relocate or quiet noisy equipment Shield infants’ isolettes from light Provide day-night cycles in terms of light & activity Supply pleasant visual and auditory stimulation Provide gentle touch

Transition to Home Anxiety about assuming full responsibility of care for the infant Infant may be less than optimally responsive & still may be medically fragile Infant irritability Parent fatigue Parent concern for infant’s developmental progress

Prematurity & Later Development Growth & health Cognitive development

Prematurity & Later Development Socio-emotional & behavioral development Temperament Bonding & attachment Behavior problems

Parenting a Premature Infant Social risk factors Low income Lower education Minority cultural backgrounds Coping strategies Finding meaning in experience was superior t other coping methods 18 months post-discharge

Parenting a Premature Infant Other family members Fathers Grandmothers Siblings

Parenting a Premature Infant Family-focused interventions Support groups Teach parents to care & stimulate child Provide intervention beyond NICU stay

Role of Pediatric Psychologist Support & services provide to family Devote attention to PARENT needs Organize parent support groups Provide child-rearing advice Be link between families and staff Provide grief counseling, when needed

Role of Pediatric Psychologist Participation in follow-up clinics Assess developmental status of child Refer for early intervention services Design IFSP, when warranted Address parenting & family concerns (e.g., maternal depression, marital conflict, sibling adjustment)