Principle # 1: (continued)

  • This model provides a template for designing a developmentally supportive plan of care for a pre-term infant. As autonomic stability is a prerequiste for further development, an effective plan of care will aim to stabilize autonomic function by reducing the sensory context of the neonates environment.
  • The neonatal intensive care unit (NICU) can be very stressful on a fragile pre-term infant, as illustrated in the following video clip. 
INFANT IN THE NICU
 
  • An infant's stress can be reduced by organizing the sensory context of the NICU; this has been shown to improve autoregulation of the autonomic system in pre-term neonates. 
  • Suggested modifications include: the use of diurnal light cycles; the clustering of care; the use of specific rest times; promoting skin-to-skin contact, and presentation of an organizing environment (music, sent of mother on clothing, odor of milk on pacifier, co-bedding of multiple-birth neonates).
  • Parent(s) must also be educated to respect the plan of care, and learn to provide the 'most favourable' sensory inputs to their infant.
  • Skin-to-skin contact, also known as Kangaroo care, has been shown to promote the self-organization of neurobehaviour, as well as improving bonding of the infant to the parent(s). Measured benefits of Kangaroo care include improved physiological outcomes of the neonate and earlier discharge from the NICU.
EXAMPLE OF KANGAROO CARE OF A VERY PRE-TERM INFANT
DURING A PERIOD OFF CPAP
Notice the alertness of the infant and attempt to maintain interaction with mother.
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