Developmental care of low birth weight infants. 1993

J M Oehler
Division of Medical Psychology, Duke University Medical Center, Durham, NC 27710.

Nurses are the key to the implementation of developmentally focused care for LBW infants. There seems to be a sufficient research base to support reduced lighting in the hospital setting and consideration of cycled lighting. Face-to-face visual stimulation would seem sufficient for infants less than 40 weeks old until further research is done. In regard to sound, it seems clear that failure to reduce noise created by personnel, faculty equipment, radios, and so on represents negligence. Talking to infants who are in states other than sleep is to be encouraged, and planned interventions such as taped music and vocal selections need continued exploration. There seems to be a sufficient research base to support handling and caretaking that considers the state of the infant and aims to disrupt sleep as little as possible. Similarly, there appears to be ample support for placing infants in ways that promote a balance of flexion and extension or in the prone position whenever possible. NNS should be used during feeding and to reduce stress. Attention to reducing pain should be as much a part of the care of LBW infants as it is for adults. The potential negative effects of drugs on the developing brain must be considered and studied. Finally, the family, including siblings, should be encouraged to participate in the infant's plan of care as much as possible and prepared for discharge well in advance of the actual date. A note of caution should be entertained for stimulation programs not based on sufficient research. It is possible, perhaps even probable, that excessive sensory input at critical times can do harm. Interventions may be recommended with great enthusiasm but without research support. Thus, until the relative merits and possible adverse effects of various interventions are known, they should be approached with caution. Perhaps remembering that the first consideration in giving care is to "Do not harm" should facilitate our care of LBW infants.

UI MeSH Term Description Entries
D007230 Infant, Low Birth Weight An infant having a birth weight of 2500 gm. (5.5 lb.) or less but INFANT, VERY LOW BIRTH WEIGHT is available for infants having a birth weight of 1500 grams (3.3 lb.) or less. Low Birth Weight,Low-Birth-Weight Infant,Birth Weight, Low,Birth Weights, Low,Infant, Low-Birth-Weight,Infants, Low-Birth-Weight,Low Birth Weight Infant,Low Birth Weights,Low-Birth-Weight Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D008029 Lighting The illumination of an environment and the arrangement of lights to achieve an effect or optimal visibility. Its application is in domestic or in public settings and in medical and non-medical environments. Illumination
D009622 Noise Any sound which is unwanted or interferes with HEARING other sounds. Noise Pollution,Noises,Pollution, Noise
D009725 Nurseries, Hospital Hospital facilities which provide care for newborn infants. Hospital Nurseries,Hospital Nursery,Nursery, Hospital
D010290 Parents Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent. Step-Parents,Parental Age,Parenthood Status,Stepparent,Age, Parental,Ages, Parental,Parent,Parental Ages,Status, Parenthood,Step Parents,Step-Parent,Stepparents
D010347 Patient Care Planning Usually a written medical and nursing care program designed for a particular patient. Nursing Care Plans,Goals of Care,Plans, Nursing Care,Care Goal,Care Goals,Care Plan, Nursing,Care Planning, Patient,Care Plans, Nursing,Nursing Care Plan,Plan, Nursing Care,Planning, Patient Care
D010812 Physical Stimulation Act of eliciting a response from a person or organism through physical contact. Stimulation, Physical,Physical Stimulations,Stimulations, Physical
D011597 Psychomotor Performance The coordination of a sensory or ideational (cognitive) process and a motor activity. Perceptual Motor Performance,Sensory Motor Performance,Visual Motor Coordination,Coordination, Visual Motor,Coordinations, Visual Motor,Motor Coordination, Visual,Motor Coordinations, Visual,Motor Performance, Perceptual,Motor Performance, Sensory,Motor Performances, Perceptual,Motor Performances, Sensory,Perceptual Motor Performances,Performance, Perceptual Motor,Performance, Psychomotor,Performance, Sensory Motor,Performances, Perceptual Motor,Performances, Psychomotor,Performances, Sensory Motor,Psychomotor Performances,Sensory Motor Performances,Visual Motor Coordinations
D002657 Child Development The continuous sequential physiological and psychological maturing of an individual from birth up to but not including ADOLESCENCE. Infant Development,Development, Child,Development, Infant

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