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Background: Infants and families requiring neonatal intensive care unit (NICU) care often experience significant stress and trauma during the earliest period of the infant's life, leading to increased risks for poorer infant and family outcomes. There is a need for frameworks to guide clinical care and research that account for the complex interactions of generational stress, pain, toxic stress, parental separation, and lifelong health and developmental outcomes for infants and families. Purpose: Apply the Adverse Childhood Experiences (ACEs) framework in the context of the NICU as a usable structure to guide clinical practice and research focused on infant neurodevelopment outcomes and parental attachment. Methods: An overview of ACEs is provided along with a detailed discussion of risk at each level of the ACEs pyramid in the context of the NICU. Supportive and protective factors to help mitigate the risk of the ACEs in the NICU are detailed. Results: NICU hospitalization may be considered the first ACE, or potentially an additional ACE, resulting in an increased risk for poorer health outcomes. The promotion of safe, stable, and nurturing relationships and implementation of traumainformed care and individualized developmental care potentially counter the negative impacts of stress in the NICU. Implications for Practice and Research: Nurses can help balance the negative and positive stimulation of the NICU through activities such as facilitated tucking, skin-to-skin care, mother's milk, and active participation of parents in infant care. Future research can consider using the ACEs framework to explain cumulative risk for adverse health and well-being in the context of NICU care. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to describe and evaluate a novel one-person intravitreal injection (IVI) technique for the treatment of retinopathy of prematurity (ROP) under topical anesthesia. Patients and methods This is a retrospective study that was conducted on 44 babies who had IVI for the treatment of severe ROP under topical anesthesia. The swaddled baby’s head and body were fixed to the operating table with strips of adhesive tape, obviating the need for an assistant to hold the baby still. The calibers were used both to fix the globe and to determine the site of the injection by measuring the distance of 1.5 mm from the limbus. Results The mean gestational age of the patients was 29.6±1.5 weeks, with a mean birth weight of 1085.2±239.4 g. The mean procedure duration (between the insertion of the lid speculum at the beginning of the procedure and its removal at the end) for the right eye (64.9±15.6 s) was less than for the left eye (66.4±15.1 s), but the difference was not statistically significant (P=0.29). Inadvertent head movements occurred in 2 (4.5%) cases, with a large postmenstrual age of 37 and 38 weeks at treatment. None of the cases had inadvertent eye movements. Conclusion The technique seems safe and effective, especially in patients with a smaller postmenstrual age at the time of the injection. Additional care should be taken during taping of the head and the body in larger babies. Alternatively, giving sedation or general anesthesia may be a safer option.

The COVID-19 pandemic has necessitated innovations in data collection protocols, including use of virtual or remote visits. Although developmental scientists used virtual visits prior to COVID-19, validation of virtual assessments of infant socioemotional and language development are lacking. We aimed to fill this gap by validating a virtual visit protocol that assesses mother and infant behavior during the Still Face Paradigm (SFP) and infant receptive and expressive communication using the Bayley-III Screening Test. Validation was accomplished through comparisons of data (i.e., proportions of missing data for a given task; observed infant and maternal behaviors) collected during in-person laboratory visits and virtual visits conducted via Zoom. Of the 119 mother-infant dyads who participated, 73 participated in lab visits only, 13 participated in virtual visits only, and 33 dyads participated in a combination of lab and virtual visits across four time points (3, 6, 9, and 12 months). Maternal perspectives of, and preferences for, virtual visits were also assessed. Proportions of missing data were higher during virtual visits, particularly for assessments of infant receptive communication. Nonetheless, comparisons of virtual and laboratory visits within a given time point (3, 6, or 9 months) indicated that mothers and infants showed similar proportions of facial expressions, vocalizations and directions of gaze during the SFP and infants showed similar and expected patterns of behavioral change across SFP episodes. Infants also demonstrated comparable expressive and receptive communicative abilities across virtual and laboratory assessments. Maternal reports of ease and preference for virtual visits varied by infant age, with mothers of 12-month-old infants reporting, on average, less ease of virtual visits and a preference for in-person visits. Results are discussed in terms of feasibility and validity of virtual visits for assessing infant socioemotional and language development, and broader advantages and disadvantages of virtual visits are also considered.

The COVID-19 pandemic has necessitated innovations in data collection protocols, including use of virtual or remote visits. Although developmental scientists used virtual visits prior to COVID-19, validation of virtual assessments of infant socioemotional and language development are lacking. We aimed to fill this gap by validating a virtual visit protocol that assesses mother and infant behavior during the Still Face Paradigm (SFP) and infant receptive and expressive communication using the Bayley-III Screening Test. Validation was accomplished through comparisons of data (i.e., proportions of missing data for a given task; observed infant and maternal behaviors) collected during in-person laboratory visits and virtual visits conducted via Zoom. Of the 119 mother-infant dyads who participated, 73 participated in lab visits only, 13 participated in virtual visits only, and 33 dyads participated in a combination of lab and virtual visits across four time points (3, 6, 9, and 12 months). Maternal perspectives of, and preferences for, virtual visits were also assessed. Proportions of missing data were higher during virtual visits, particularly for assessments of infant receptive communication. Nonetheless, comparisons of virtual and laboratory visits within a given time point (3, 6, or 9 months) indicated that mothers and infants showed similar proportions of facial expressions, vocalizations and directions of gaze during the SFP and infants showed similar and expected patterns of behavioral change across SFP episodes. Infants also demonstrated comparable expressive and receptive communicative abilities across virtual and laboratory assessments. Maternal reports of ease and preference for virtual visits varied by infant age, with mothers of 12-month-old infants reporting, on average, less ease of virtual visits and a preference for in-person visits. Results are discussed in terms of feasibility and validity of virtual visits for assessing infant socioemotional and language development, and broader advantages and disadvantages of virtual visits are also considered. [ABSTRACT FROM AUTHOR]

Interpreting early life experience in the past is of considerable interest to archaeologists, yet remains fraught with difficulty. Children are sensitive barometers of population health in general. In addition, infant feeding practices, and stresses experienced during infancy and childhood, have important effects on adult health and demographic changes. Understanding how diet and physiological stress interact is therefore of significance, but most bony indicators of stress have non‐specific etiologies that cannot be tied to events during childhood. The recent advent of incremental isotopic techniques means we now have the potential to identify periods of stress and dietary change during childhood through changes to stable carbon and nitrogen isotopic ratios during tissue formation. Being able to establish these individual weaning trajectories allows us to consider individuality in past weaning choices, giving the bioarchaeologist a more nuanced picture of the past. Here, we investigate whether combining paleopathological and isotopic data can give insight into the synergy between infant feeding and stress. We present a case study of a 5‐year‐old child from an early agricultural period archaeological site in the northern Atacama Desert, Chile. We show that, despite physiological stress likely affecting isotopic ratios in this individual, a weaning curve is visible and the interpretation of weaning behaviour is possible. In addition, we suggest that there is isotopic evidence for a micronutrient deficient weaning diet that may be correlated with bony evidence for pathology. [ABSTRACT FROM AUTHOR]

Aims. The purpose of this study was to explore the relationships between specific nurse care-giving behaviours and preterm infant behavioural responses during bathing and to identify nurse behaviours associated with infant ‘stress’. Background. Although recent advances in medical technology have improved neonatal intensive care, the high mortality and morbidity rates in preterm infants have not decreased proportionally. As caregivers strive to reduce infant mortality and morbidity, a factor for consideration is which caregiver behaviours are associated with preterm infant well-being. Design. A descriptive correlational design. Method. Convenience samples of 24 preterm infants and 12 nurses were recruited. A total of 120 baths were videotaped. Infant and nurse behaviours were measured using the coding schemes developed by the researchers. Pearson coefficient correlation, non-parametric Kruskal–Wallis test, t-test and generalised linear models were methods for data analysis. Results. As nurses provided more support, stress was reduced in the infants, and their self-regulation during the bath was enhanced especially by the use of ‘containment’ and ‘positional support’. Conversely, non-therapeutic caregiver behaviours including ‘rapid and rough handling’ of the baby, ‘chatting with other people’ and ‘inappropriate handling’ increased infant ‘stress’ during the bath. Conclusion. The findings provide new information about the link between care-giving and infant responses and how caregivers can better interact with preterm infants during a very sensitive period of brain development. Relevance to clinical practice. How nurses take care of the preterm infants influences their responses to care-giving stimuli. To interact better with the infant during care-giving procedures, nurses need to provide more supportive care-giving behaviours especially ‘position support’ and ‘containment’ based on the infant’s needs, and avoid care-giving that may be too rough and occur too quickly without attending the baby’s stressful signals, positioning the baby in hyperextension posture, or chatting with other people during procedures. [ABSTRACT FROM AUTHOR]

The objective of this short-term longitudinal study was to examine the concurrent and prospective associations of infants' sleep arrangements and night waking with cortisol responses to an inoculation at 6 and 12 months, controlling for several key covariates. To our knowledge, this was the first study to concurrently and prospectively link proximity in sleep arrangements and night waking to physiological stress reactivity. A sample of 92 mother–infant dyads participated in the study when the infants were 6 and 12 months of age, although sample sizes were reduced for some analyses. Both proximal cosleeping arrangements and more frequent night wakings' were associated concurrently with an increased cortisol response to inoculations at both ages. Night waking at 6 months also was associated with a slightly increased cortisol response to inoculation at 12 months. Results aimed at exploring the direction of influence suggested that cosleeping and night waking may influence infant stress physiology rather than the reverse. Adaptive and maladaptive implications of infants' nocturnal experiences and greater stress-induced cortisol responses are discussed. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

An understanding of the complex physiological, neurological and psychological world of the infant is important in order to provide recommendations about the sensitive and consistent care needed for optimal development. However, when it comes to the subject of infant sleep, professional and lay resources are often based on misinformation and misunderstanding of developmental stages and needs. In order to provide a holistic and scientific foundation for understanding infant sleep, this paper outlines normal infant sleep mechanisms, development and patterns as defined by the literature. Biopsychological data is also presented to demonstrate the study of infant stress, attachment and caregiving routines used to engage infants in sleep. this information can be used as a guideline for determining which sleep choices and approaches are healthy for infants and those which discourage optimal development and leave infants and families at risk. [ABSTRACT FROM AUTHOR]

Calming distressed infants is a topic of interest to all who provide care to the very young. The stress literature has indicated that both stress reactivity and regulation are of interest in examining stress. A review of literature was conducted to examine indicators of infant stress, correlates of infant stress, and methods of soothing distressed infants. Current research has provided an increasing ability to determine whether infants are experiencing stress, as indicators are not always obvious. Furthermore, observing infants while they are experiencing stress provides insights into individual differences with regard to stress reactivity and regulation at the earliest of ages. Such information provides insight to providing methods and effectiveness of soothing practices. Implications for parents and practitioners are explored. [ABSTRACT FROM AUTHOR]

Having an infant in the neonatal intensive care unit (NICU) elicits maternal anxiety, which may hamper parent-child bonding. We performed a prospective cohort study to describe anxiety in mothers of infants born before 30 weeks of gestation during NICU stay in The Netherlands, and investigated the influence of infant stress and gestational age. Second, we performed a randomized-controlled live-performed music therapy trial (LPMT trial) to investigate whether music therapy applied to the infant alleviated maternal anxiety. The relation between infant stress, gestational age, and maternal anxiety was measured in 45 mother-infant dyads, using the Neonatal Infant Stressor Scale and the State-Trait Anxiety Inventory (STAI). The effect of LPMT on anxiety was assessed in 21 mothers whose infants were assigned to either LPMT ( n = 12) or waitlist ( n = 9). Mothers completed the STAI before and after this period. Maternal anxiety decreased over time in all mothers, and was strongly related with infant stress (r = 0.706, p < 0.001), but not with gestational age. Anxiety scores decreased by 12% after LMPT, and increased by 1% after a waitlist period ( p = 0.30). Our results indicate that LPMT in the weeks after birth may accelerate the reduction of maternal anxiety. Further research should focus on the effects on mother-child bonding.