by Kalena Babeshoff, Consultant/Professional Trainer
The incidence of premature births continues to grow in the United States, (27% since 1980). Currently, in California alone, 650 babies are born each week weighing less than 51/2 pounds and 117 are born each week weighing less than 3 ½ pounds. The birth of a pre-term or sick infant can have a profound effect on parents’ ability to successfully transition to parenthood, including attachment and bonding. In addition, premature infants are at risk for developmental delays, cerebral palsy, and complex medical disorders creating additional challenges for parenting and, unfortunately, placing these infants in jeopardy of neglect and abuse.
The need for Compassionate Beginnings™ has never been greater. Touch is the baby’s primary means of communication, and parent-infant touch is critical in establishing the foundation of a child’s psychological well-being. Humans are created in nature’s perfect cradle: the womb, a fluid-filled environment, which provides constant touch as the brain and body are formed. By 20 weeks gestation the sense of touch is fully functional and being processed in the cortex in the normally developed fetus.
Compassionate Beginnings™ educates NICU staff in methodology, attuned to the biological needs of the infant, as well as Healthy Family Living’s (HFL) philosophy and approach to educate and respectfully empower parents in providing care that is individualized and sensitively appropriate for their unique baby(s). This optimally builds parents confidence as they serve their infant(s) not yet mature and developmentally ready for parenting or massage strokes as done with a term baby. HFL’s innovative Compassionate Beginnings™ program has been developed from over 20 years of experience in innovative approaches to massage/touch communication bringing integrated understanding and wisdom in approaches that respect both Family Centered and Developmental Care delivered in the high tech environment of the NICU. Compassionate Beginnings™ is a program for NICU’s believing that parents provide care and parenting while in the NICU – they don’t just visit. Compassionate Beginnings™ modeled and taught by trained staff enables babies and their parent/caregiver to be in the bonding process to support the formation of early secure attachments that are vital to optimal brain development. It helps parents establish their unique parent/child relationship and build competence as they are become knowledgeable in practicing positive, nurturing parenting skills with their baby who is premature &/or medically fragile while in the NICU, prior to discharge.
Committed to this approach and evidence-based care, HFL researched and discovered numerous studies supporting the importance of positive touch, including containment, Kangaroo Care and massage in the NICU. For example, studies have shown the benefits include higher hematocrit levels (reducing need for frequent blood transfusions or 3-times weekly injections to promote red blood cell production); greater weight gain; less supplemental oxygen requirements; more defined sleep/wake cycles; and decreased cortisol levels. Weiss suggests early positive tactile experiences can influence development of control over body movement, visual coordination, and language skills. Nurturing touch has been associated with improved social adaptation and fewer behavioral problems. Siegel suggests that secure attachments seem to occur when children have consistent emotionally attuned communication with their parents/caregivers. Als has noted that when infants receive appropriate developmental care, including touch, their EEGs and MRIs show improved neurodevelopmental and neurophysiological functioning. The March/ April 2000 edition of American Journal of Maternal/ Child Nursing summed up 25 years of research as follows: “There is enough evidence to support integrating infant massage into neonatal intensive care”.
Unfortunately, positive touch in the NICU is the exception, not the rule. For example, Werner and Conway observed 11 NICU infants - gestational ages of 23 to 28 weeks. They noted only 3 of the 11 received any care that could be described as comfort measures including soothing touch, which occurred only 4% of the time. Conversely, 96% of the time infants received touch associated with tasks or painful procedures. In another study, Barker and Rutter observed over 3,000 painful procedures for 54 infants (23-41 weeks gestation) during their NICU stay.
Studies have also established the consequences of negative or painful touch. For example, it can alter physiological parameters such as heart rate, respiratory rate, blood pressure and oxygenation. Long-term effects of pain in neonates can include altered expression of pain responses (either dampened or exaggerated), decreased weight gain, decreased ability to learn and remember new information and, with age, an increased preference for alcohol. Emerging evidence also indicates that prolonged exposure to painful experiences in the neonatal period may be associated with depression and violent suicide. Perry has stated that neglect and abuse in the first 3 years of life can result in a lifetime of lost potential. He defines neglect, as “whenever a developmental need is not met. A 1994-1996 government-sponsored infant massage project in Douglas County, Oregon, demonstrated that babies and parents bond strongly through touch and that the risk and incidence of child neglect and abuse greatly declined as a result of the infant massage program (confirmed cases fell from 104 to 15).
Compassionate Beginnings™ has been designed for NICU’s to further fulfill their mission to bring the baby back within the family’s embrace by developing and nurturing the family’s rightful role as primary caregiver. Compassionate Beginnings™ is rooted in the recognition that the parent-child relationship is the most essential component in the long-term outcome of an infant. Compassionate Beginnings™ is designed to be considerate of the unique needs of both families and staff in the NICU in order to become a central component in the environment and delivery of patient care. This supports the integration of Compassionate Touch™ in becoming a vital element of the culture of the NICU environment improving quality of life for staff, babies and families.
For more information please contact:
Healthy Family Living
Consultant and Director of Education
707 996 3545
Copyright Foundation for Healthy Family Living® 2001 All Rights Reserved
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