Maturation of alertness in extremely early born preterm infants: Prior to caregiving and during a feeding protocol in the NICU.

Format:

Book

Thesis/Dissertation

Author/Creator:

McGrath, Jacqueline Marie.

Contributor:

University of Pennsylvania.

Language:

English

Subjects (All):

Developmental biology.

Developmental psychology.

Nursing.

Gynecology.

Obstetrics.

0380.

0569.

0620.

0758.

Local Subjects:

0380.

0569.

0620.

0758.

Physical Description:

150 pages

Contained In:

Dissertation Abstracts International 60-04B.

System Details:

Mode of access: World Wide Web.

text file

Summary:

Background. The sophisticated integration of sucking, swallowing and breathing with behavioral state is the one of the most highly organized behavior of the young infant. Therefore, understanding how the maturation of alertness in Extremely Early Born (EEB) preterm. infants is organized in relationship to feeding seems essential. Alertness has been correlated with successful feeding in full-term. and well preterm infants.

Objectives. To investigate the relationship between the maturation of alertness and the acquisition of nutritive sucking competency during the transition to nipple feeding in EEB preterm infants (gestational age of 27 weeks or less), while in the NICU.

Conceptual framework. The synactive theory of development was used to guide this research. This theorem articulates how the maturing infant balances input from the environment while coping with internal physiologic demands. Alertness requires maturation and integration of behavioral organization.

Method. In a non-experimental repeated measures design, 52 EEB preterm infants were recruited with informed consent from parents using a sample of convenience. Infant behavioral state was observed weekly for 15 minutes prior to caregiving for five weeks. Then once feeding was initiated, infants were observed at three intervals while in the NICU with a nutritive sucking protocol. State was collected using the Anderson Behavioral State Scale. Indicators of nutritive sucking were collected with the Krons Nutritive Sucking Apparatus.

Results. Maturation of alertness over time was not significant however, there were increasing means across the data collection points. Indicators of nutritive sucking competence clearly, demonstrated significant maturational changes over time. Alertness during and prior to feeding increased sucking abilities. However, changes in pressure of sucking appear to be more related to maturation and learning (experience) rather than behavioral state.

Conclusions. Maturation of behavioral organization with increasing alertness although not statistically significant, has much clinical significance. This research provided increased understanding of the presentation of alertness in EEB preterm infants, and how alertness matures and become more robust, as well as changes over time. Certainly, information about the relationship between alertness and nutritive sucking is pivotal to the practitioners' decision-making and will facilitate the initiation and successful acquisition of feeding.

Notes:

Source: Dissertation Abstracts International, Volume: 60-04, Section: B, page: 1533.

Adviser: Barbara Medoff-Cooper.

Thesis (Ph.D.)--University of Pennsylvania, 1999.

Local Notes:

School code: 0175.

ISBN:

9780599259300

Access Restriction:

Restricted for use by site license.