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Premature Infants & the NICU Medical & Psychological Issues

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 37 th week of gestation

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Premature Infants & the NICU Medical & Psychological Issues

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  1. Premature Infants & the NICUMedical & Psychological Issues November 13, 2007

  2. 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

  3. 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

  4. Social, biological, & environmental factors Causes of Prematurity

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

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

  7. Premie Development • Three stages of premie development • Early premie • Developing premie • Older premie

  8. 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

  9. 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

  10. 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

  11. Prematurity & Later Development • Growth & health • Cognitive development

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

  13. 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

  14. Parenting a Premature Infant • Other family members • Fathers • Grandmothers • Siblings

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

  16. 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

  17. 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)

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