Fostering mother-very preterm infant communication during skin-to-skin contact through a modified positioning. (February 2020)

• Record Type: Journal Article
• Authors: Buil, Aude; Sankey, Carole; Caeymaex, Laurence; Apter, Gisèle; Gratier, Maya; Devouche, Emmanuel
• Is Part Of: Early human development. Volume 141(2020)
• Publication Date: 2020-02
• Subjects: IFCDC Infant and Family Centred Developmental Care -- GA gestational age -- NICU Neonatal Intensive Care Unit -- NIDCAP Newborn Individualized Developmental Care and Assessment Program -- SDF Supported Diagonal Flexion -- SSC skin-to-skin contact; Skin-to-skin contact, kangaroo care -- SDF positioning -- NICU -- Premature birth -- Mother-very preterm infant interaction -- Multisensory communication; Fetus -- Periodicals; Neonatology -- Periodicals; Prenatal influences -- Periodicals; 612.65
• DOI: 10.1016/j.earlhumdev.2019.104939
• Languages: English
• ISSNs: 0378-3782

Abstract

Abstract: Background: Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits both for the baby and the parent. Very few studies however have investigated benefit for communication. Aims: Investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother - very-preterm infant communication and to gain insight into how mothers' and very-preterm infants' communicative behaviours are coordinated in time just a few days after birth. Subjects and study design: Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA; mean age at birth 30: weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control (n = 17) or the SDF Intervention positioning (n = 17). Mother and infant were filmed during the first 5 min of SSC, 15 days after the very first SSC (i.e. 18 days after very premature birth, i.e. on average 32.4 weeks GA). Outcome measures: Infants' state of consciousness according to the Assessment of Preterm Infants' Behavior scale. Onset and duration of infants' and mothers' smiles, gazes and vocalizations, and their temporal proximity inside a 1-sec time-window. Results: In the SDF Intervention Group, very preterm infants vocalized three times more and mothers vocalized, gazed at their baby's face, and smiled more than in the Vertical Control Group. Moreover, in a one-second time-frame, temporal proximity of mother-infant behaviours was greater in the SDF Intervention Group. Conclusions: Our study shows that SDF positioning creates more opportunities for mother-infant communication during SSC. SDF positioning fosters a greater multimodal temporal proximity thus supporting a more qualitative mother-infant communication. Highlights: The study explores the under-investigated question of parent-preemie communication during skin-to-skin contact. Very preterm, only 18 days after birth, is able to enter a quiet awake state and to smile, vocalize and gaze at mother. Skin-to-skin care with SDF positioning fosters a more active mother-very preterm infant communication. During skin-to-skin care with SDF positioning mother's and infant's communicative behaviours were more often contingent. Modifying positioning of both parent and preemie may promote the relational experience intrinsic to skin-to-skin contact.