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Premature Infants & the NICU Medical & Psychological Issues

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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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description
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
description1
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
the premature infant
The Premature Infant
  • Immature organ development
  • Difficulties adapting to the extrauterine environment
  • Physical appearance
    • Lanugo
    • Absence of fat
    • Elongated head
premie development
Premie Development
  • Three stages of premie development
    • Early premie
    • Developing premie
    • Older premie
impact of nicu
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
positive changes in the nicu
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
transition to home
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
prematurity later development
Prematurity & Later Development
  • Growth & health
  • Cognitive development
prematurity later development1
Prematurity & Later Development
  • Socio-emotional & behavioral development
    • Temperament
    • Bonding & attachment
    • Behavior problems
parenting a premature infant
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
parenting a premature infant1
Parenting a Premature Infant
  • Other family members
    • Fathers
    • Grandmothers
    • Siblings
parenting a premature infant2
Parenting a Premature Infant
  • Family-focused interventions
    • Support groups
    • Teach parents to care & stimulate child
    • Provide intervention beyond NICU stay
role of pediatric psychologist
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
role of pediatric psychologist1
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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