Psychosocial effects of intensive care on infants and families after discharge.
The neonatal intensive care environment exposes the developing immature newborn to many sources of stress and pain at a time when the infant is developmentally least able to cope with it. Animal and human evidence suggest that effects of stress, mediated through permanent changes in the brain and neuroendocrine responses, may result in changes in behaviour and information processing, which persist throughout childhood. These changes impact on the dynamics of the mother infant dyad and infant learning. Interactional styles arising in the newborn period tend to persist throughout childhood but may be amenable to intervention focusing on maternal recognition of infant cues, social stimulation of the infant, and family integration. Developmental care may promote better family, infant and child outcomes by both reducing neonatal stress and its neurobiological sequelae, and fostering an appropriate interactional relationship between mother and infant.
Department of Paediatrics, Children's and Women's Health Centre of British Columbia, University of British Columbia, 4480 Oak Street, Vancouver, BC, Canada V6H 3V2. mwhitfield@cw.bc.ca
Michael F
MF
Whitfield
D000359:Aftercare; D002648:Child; D002657:Child Development; D006801:Humans; D018730:Infant Behavior / Q000523:psychology*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D007363:Intensive Care Units, Neonatal / Q000592:standards; D015931:Intensive Care, Neonatal / Q000592:standards; D009034:Mother-Child Relations; D010146:Pain / Q000523:psychology*; D010351:Patient Discharge / Q000592:standards; D013315:Stress, Psychological / Q000150:complications