Family Nurture Intervention (FNI) in Neonatal Intensive Care Unit (NICU)
| Status: | Completed |
|---|---|
| Conditions: | Women's Studies |
| Therapuetic Areas: | Reproductive |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/20/2018 |
| Start Date: | June 2008 |
| End Date: | January 9, 2018 |
Enhancement of Co-regulation Between Mother and Infant Via Family Nurture Intervention (FNI) in the NICU: Short and Long Term Effects on Development
The purpose of this study is to test the efficacy of a family nurture intervention in the
neonatal intensive care unit (NICU). Infants receiving enhanced mother-infant and family
nurture are compared to infants receiving standard NICU care. The intervention enhances
mother/infant interactions that are vital to early development in the infant. The main goal
is to get the mother and infant into biological synchrony, emotional attunement and mutual
calm through an activity referred to as a "calming cycle". Mother's are encouraged to engage
in the calming cycle activities as much as possible. Her increased effectiveness in calming
her infant is hypothesized to improve the mother's view of her baby, reduce negative emotions
about having delivered a baby prematurely, and help her gain confidence in her care-taking
abilities, which in other studies predicted shorter length of stay and fewer
re-hospitalizations. Another goal is to assist mothers in repeating the calming cycle
activities providing appropriate types of stimulation for their babies that are important for
social, emotional, and neurobehavioral development. Since preterm babies are often easily
upset, mothers will be taught how to comfort and calm their babies. Assessments in the NICU
and in follow-up visits for two years will test the immediate and long-term effects of this
new approach to the nurture of prematurely born infants.
neonatal intensive care unit (NICU). Infants receiving enhanced mother-infant and family
nurture are compared to infants receiving standard NICU care. The intervention enhances
mother/infant interactions that are vital to early development in the infant. The main goal
is to get the mother and infant into biological synchrony, emotional attunement and mutual
calm through an activity referred to as a "calming cycle". Mother's are encouraged to engage
in the calming cycle activities as much as possible. Her increased effectiveness in calming
her infant is hypothesized to improve the mother's view of her baby, reduce negative emotions
about having delivered a baby prematurely, and help her gain confidence in her care-taking
abilities, which in other studies predicted shorter length of stay and fewer
re-hospitalizations. Another goal is to assist mothers in repeating the calming cycle
activities providing appropriate types of stimulation for their babies that are important for
social, emotional, and neurobehavioral development. Since preterm babies are often easily
upset, mothers will be taught how to comfort and calm their babies. Assessments in the NICU
and in follow-up visits for two years will test the immediate and long-term effects of this
new approach to the nurture of prematurely born infants.
The stress that results from preterm birth, requisite acute care and prolonged physical
separation in the NICU can have adverse physiological/psychological effects on both the
infant and the mother. In particular, the experience compromises the establishment and
maintenance of an optimal mother-infant relationship. Within the neonatal intensive care unit
(NICU), parental involvement in care is necessarily superseded by the healthcare staff. Thus,
a necessary but detrimental separation between mother and infant is created at a critical
period when mother-infant bonding and synchrony should be developing. The physiological
challenges associated with being born too soon, along with disturbances in normal
mother-infant interactions are key factors underlying the risks of premature infants for a
broad range of early and midlife disorders. This study aims to highlight the importance of
investigating early interventions that are designed to overcome or reduce the effects of
these environmental insults and challenges by implementing a randomized controlled trial of
Family Nurture Intervention in the NICU. The most important source of regulatory input is
through contact with the mother and her nurturing behavior. Mother-infant interactions are
the foundation for the organization of the infant's neurobiological, sensory, perceptual,
emotional, physical, and relational systems. The infant's responses to the mother provide
critical feedback which shapes her behavior as well. There are many co-regulatory processes
embedded in these synchronous and reciprocal interactions which cross neurophysiological and
neurobehavioral domains. The intervention is designed to increase biologically important
activities and behaviors that enhance maternally-mediated sensory experiences of preterm
infants, as well as the infant-mediated sensory experiences in the mother. The investigators
hypothesize that repeated engagement of the mother and her infant in the intervention's
calming activities will increase the effectiveness of co-regulation and have immediate and
long-term beneficial effects for both. The study is assessing the physiological and
behavioral outcomes of the infants and mothers receiving Family Nurture Intervention versus
Standard Care over the course of the NICU stay.
separation in the NICU can have adverse physiological/psychological effects on both the
infant and the mother. In particular, the experience compromises the establishment and
maintenance of an optimal mother-infant relationship. Within the neonatal intensive care unit
(NICU), parental involvement in care is necessarily superseded by the healthcare staff. Thus,
a necessary but detrimental separation between mother and infant is created at a critical
period when mother-infant bonding and synchrony should be developing. The physiological
challenges associated with being born too soon, along with disturbances in normal
mother-infant interactions are key factors underlying the risks of premature infants for a
broad range of early and midlife disorders. This study aims to highlight the importance of
investigating early interventions that are designed to overcome or reduce the effects of
these environmental insults and challenges by implementing a randomized controlled trial of
Family Nurture Intervention in the NICU. The most important source of regulatory input is
through contact with the mother and her nurturing behavior. Mother-infant interactions are
the foundation for the organization of the infant's neurobiological, sensory, perceptual,
emotional, physical, and relational systems. The infant's responses to the mother provide
critical feedback which shapes her behavior as well. There are many co-regulatory processes
embedded in these synchronous and reciprocal interactions which cross neurophysiological and
neurobehavioral domains. The intervention is designed to increase biologically important
activities and behaviors that enhance maternally-mediated sensory experiences of preterm
infants, as well as the infant-mediated sensory experiences in the mother. The investigators
hypothesize that repeated engagement of the mother and her infant in the intervention's
calming activities will increase the effectiveness of co-regulation and have immediate and
long-term beneficial effects for both. The study is assessing the physiological and
behavioral outcomes of the infants and mothers receiving Family Nurture Intervention versus
Standard Care over the course of the NICU stay.
Inclusion Criteria:
- Infant is born a singleton or twin in the Morgan Stanley Children's Hospital in New
York City
- Infant is born 26 and 34 weeks post-conceptional age (PCA)
Exclusion Criteria:
- Mothers cannot understand or speak English
- Mother has history of drug addiction, psychosis or other severe mental illness
- There is not at least one adult other than the mother in the home
- Infant birth weight is below the third percentile for gestational age
- Infant has significant congenital defects
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