Academic Commons

Articles

Family nurture intervention (FNI): methods and treatment protocol of a randomized controlled trial in the NICU

Hofer, Myron A.; Brunelli, Susan A.; Stark, Raymond I.; Andrews, Howard F.; Austin, Judy; Myers, Michael M.; Welch, Martha G.

The stress that results from preterm birth, requisite acute care and prolonged physical separation in the Neonatal Intensive Care Unit (NICU) can have adverse physiological/psychological effects on both the infant and the mother. In particular, the experience compromises the establishment and maintenance of optimal mother-infant relationship, the subsequent development of the infant, and the mother's emotional well-being. These findings highlight the importance of investigating early interventions that are designed to overcome or reduce the effects of these environmental insults and challenges. This study is a randomized controlled trial (RCT) with blinded assessment comparing Standard Care (SC) with a novel Family Nurture Intervention (FNI). FNI targets preterm infants born 26-34 weeks postmenstrual age (PMA) and their mothers in the NICU. The intervention incorporates elements of mother-infant interventions with known efficacy and organizes them under a new theoretical context referred to collectively as calming activities. This intervention is facilitated by specially trained Nurture Specialists in three ways: 1) In the isolette through calming interactions between mother and infant via odor exchange, firm sustained touch and vocal soothing, and eye contact; 2) Outside the isolette during holding and feeding via the Calming Cycle; and 3) through family sessions designed to engage help and support the mother. In concert with infant neurobehavioral and physiological assessments from birth through 24 months corrected age (CA), maternal assessments are made using standard tools including anxiety, depression, attachment, support systems, temperament as well as physiological stress parameters. Quality of mother-infant interaction is also assessed. Our projected enrolment is 260 families (130 per group). The FNI is designed to increase biologically important activities and behaviors that enhance maternally-mediated sensory experiences of preterm infants, as well as infant-mediated sensory experiences of the mother. Consequently, we are enlarging the testing of preterm infant neurodevelopment beyond that of previous research to include outcomes related to mother-infant interactions and mother-infant co-regulation. Our primary objective is to determine whether repeated engagement of the mother and her infant in the intervention's calming activities will improve the infant's developmental trajectory with respect to multiple outcomes. Our secondary objective is to assess the effectiveness of FNI in the physiological and psychological co-regulation of the mother and infant. We include aspects of neurodevelopment that have not been comprehensively measured in previous NICU interventions. Trial Registration: ClinicalTrials.gov: NCT01439269

Subjects

Files

  • thumnail for f8a6889f4824cc8f55cafbbc4b3d478a.zip f8a6889f4824cc8f55cafbbc4b3d478a.zip binary/octet-stream 472 KB Download File
  • thumnail for 1471-2431-12-14-S1.PDF 1471-2431-12-14-S1.PDF binary/octet-stream 96.1 KB Download File

Also Published In

Title
BMC Pediatrics
DOI
https://doi.org/10.1186/1471-2431-12-14

More About This Work

Academic Units
Psychiatry
Pediatrics
Biostatistics
Publisher
BioMed Central
Published Here
September 8, 2014
Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.