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Arthur I Eidelman - One of the best experts on this subject based on the ideXlab platform.
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maternal preterm Skin to Skin Contact enhances child physiologic organization and cognitive control across the first 10 years of life
Biological Psychiatry, 2014Co-Authors: Ruth Feldman, Zehava Rosenthal, Arthur I EidelmanAbstract:Background: Maternal–newborn Contact enhances organization of the infant’s physiological systems, including stress reactivity, autonomic functioning, and sleep patterns, and supports maturation of the prefrontal cortex and its ensuing effects on cognitive and behavioral control. Premature birth disrupts brain development and is associated with maternal separation and disturbances of Contactsensitive systems. However, it is unknown whether the provision of maternal–preterm Contact can improve long-term functioning of these systems. Methods: We used the Kangaroo Care (KC) intervention and provided maternal–newborn Skin-to-Skin Contact to 73 premature infants for 14 consecutive days compared with 73 case-matched control subjects receiving standard incubator care. Children were then followed seven times across the first decade of life and multiple physiologic, cognitive, parental mental health, and mother–child relational measures were assessed. Results: KC increased autonomic functioning (respiratory sinus arrhythmia, RSA) and maternal attachment behavior in the postpartum period, reduced maternal anxiety, and enhanced child cognitive development and executive functions from 6 months to 10 years. By 10 years of age, children receiving KC showed attenuated stress response, improved RSA, organized sleep, and better cognitive control. RSA and maternal behavior were dynamically interrelated over time, leading to improved physiology, executive functions, and mother–child reciprocity at 10 years. Conclusions: These findings are the first to demonstrate long-term effects of early touch-based intervention on children’s physiologic organization and behavioral control and have salient implications for the care practices of premature infants. Results demonstrate the dynamic cascades of child physiological regulation and parental provisions in shaping developmental outcome and may inform the construction of more targeted early interventions.
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Skin to Skin Contact kangaroo care accelerates autonomic and neurobehavioural maturation in preterm infants
Developmental Medicine & Child Neurology, 2003Co-Authors: Ruth Feldman, Arthur I EidelmanAbstract:The effects of mother–infant Skin-to-Skin Contact (Kangaroo Care; KC) on autonomic functioning, state regulation, and neurobehavioural status was examined in 70 preterm infants, half of whom received KC over 24.31 days (SD 7.24) for a total of 29.76 hours (SD 12.86). Infants were matched for sex (19 males and 16 females in each group); birthweight (KC, 1229.95g [SD 320.21]; controls, 1232.17g [SD 322.15]); gestational age (GA) (KC, 30.28 weeks [SD 2.54]; controls, 30.19 weeks [SD 2.65]); medical risk; and family demographics. Vagal tone was calculated from 10 minutes of heart rate before KC and again at 37 weeks' GA. Infant state was observed in 10-second epochs during four consecutive hours before KC and again at 37 weeks' GA. Neurobehavioural status was assessed at 37 weeks' GA with the Neonatal Behavioral Assessment Scale (NBAS). Infants receiving KC showed a more rapid maturation of vagal tone between 32 and 37 weeks' GA ( p =0.029). More rapid improvement in state organization was observed in KC infants, in terms of longer periods of quiet sleep ( p =0.016) and alert wakefulness ( p =0.013) and shorter periods of active sleep ( p =0.023). Neurodevelopmental profile was more mature for KC infants, particularly habituation ( p =0.032) and orientation ( p =0.007). Results underscore the role of early Skin-to-Skin Contact in the maturation of the autonomic and circadian systems in preterm infants.
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testing a family intervention hypothesis the contribution of mother infant Skin to Skin Contact kangaroo care to family interaction proximity and touch
Journal of Family Psychology, 2003Co-Authors: Ruth Feldman, Aron Weller, Lea Sirota, Arthur I EidelmanAbstract:The provision of maternal-infant body Contact during a period of maternal separation was examined for its effects on parent-infant and triadic interactions. Participants were 146 three-month-old preterm infants and their parents, half of whom received Skin-to-Skin Contact, or kangaroo care (KC), in the neonatal nursery. Global relational style and micro-patterns of proximity and touch were coded. Following KC, mothers and fathers were more sensitive and less intrusive, infants showed less negative affect, and family style was more cohesive. Among KC families, maternal and paternal affectionate touch of infant and spouse was more frequent, spouses remained in closer proximity, and infant proximity position was conducive to mutual gaze and touch during triadic play. The role of touch as a constituent of the co-regulatory parent-infant and triadic systems and the effects of maternal Contact on mothering, co-parenting, and family processes are discussed.
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Skin to Skin Contact kangaroo care promotes self regulation in premature infants sleep wake cyclicity arousal modulation and sustained exploration
Developmental Psychology, 2002Co-Authors: Ruth Feldman, Aron Weller, Lea Sirota, Arthur I EidelmanAbstract:The effect of mother-infant Skin-to-Skin Contact (kangaroo care, or KC) on self-regulatory processes of premature infants was studied. Seventy-three infants who received KC were compared with 73 infants matched for birth weight, gestational age, medical risk, and family demographics. State organization was measured in 10-s epochs over 4 hr before KC and again at term. No differences between KC infants and controls were found before KC. At term, KC infants showed more mature state distribution and more organized sleep-wake cyclicity. At 3 months, KC infants had higher thresholds to negative emotionality and more efficient arousal modulation while attending to increasingly complex stimuli. At 6 months, longer duration of and shorter latencies to mother-infant shared attention and infant sustained exploration in a toy session were found for KC infants. The results underscore the importance of maternal body Contact for infants' physiological, emotional, and cognitive regulatory capacities.
Ruth Feldman - One of the best experts on this subject based on the ideXlab platform.
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maternal preterm Skin to Skin Contact enhances child physiologic organization and cognitive control across the first 10 years of life
Biological Psychiatry, 2014Co-Authors: Ruth Feldman, Zehava Rosenthal, Arthur I EidelmanAbstract:Background: Maternal–newborn Contact enhances organization of the infant’s physiological systems, including stress reactivity, autonomic functioning, and sleep patterns, and supports maturation of the prefrontal cortex and its ensuing effects on cognitive and behavioral control. Premature birth disrupts brain development and is associated with maternal separation and disturbances of Contactsensitive systems. However, it is unknown whether the provision of maternal–preterm Contact can improve long-term functioning of these systems. Methods: We used the Kangaroo Care (KC) intervention and provided maternal–newborn Skin-to-Skin Contact to 73 premature infants for 14 consecutive days compared with 73 case-matched control subjects receiving standard incubator care. Children were then followed seven times across the first decade of life and multiple physiologic, cognitive, parental mental health, and mother–child relational measures were assessed. Results: KC increased autonomic functioning (respiratory sinus arrhythmia, RSA) and maternal attachment behavior in the postpartum period, reduced maternal anxiety, and enhanced child cognitive development and executive functions from 6 months to 10 years. By 10 years of age, children receiving KC showed attenuated stress response, improved RSA, organized sleep, and better cognitive control. RSA and maternal behavior were dynamically interrelated over time, leading to improved physiology, executive functions, and mother–child reciprocity at 10 years. Conclusions: These findings are the first to demonstrate long-term effects of early touch-based intervention on children’s physiologic organization and behavioral control and have salient implications for the care practices of premature infants. Results demonstrate the dynamic cascades of child physiological regulation and parental provisions in shaping developmental outcome and may inform the construction of more targeted early interventions.
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Skin to Skin Contact kangaroo care accelerates autonomic and neurobehavioural maturation in preterm infants
Developmental Medicine & Child Neurology, 2003Co-Authors: Ruth Feldman, Arthur I EidelmanAbstract:The effects of mother–infant Skin-to-Skin Contact (Kangaroo Care; KC) on autonomic functioning, state regulation, and neurobehavioural status was examined in 70 preterm infants, half of whom received KC over 24.31 days (SD 7.24) for a total of 29.76 hours (SD 12.86). Infants were matched for sex (19 males and 16 females in each group); birthweight (KC, 1229.95g [SD 320.21]; controls, 1232.17g [SD 322.15]); gestational age (GA) (KC, 30.28 weeks [SD 2.54]; controls, 30.19 weeks [SD 2.65]); medical risk; and family demographics. Vagal tone was calculated from 10 minutes of heart rate before KC and again at 37 weeks' GA. Infant state was observed in 10-second epochs during four consecutive hours before KC and again at 37 weeks' GA. Neurobehavioural status was assessed at 37 weeks' GA with the Neonatal Behavioral Assessment Scale (NBAS). Infants receiving KC showed a more rapid maturation of vagal tone between 32 and 37 weeks' GA ( p =0.029). More rapid improvement in state organization was observed in KC infants, in terms of longer periods of quiet sleep ( p =0.016) and alert wakefulness ( p =0.013) and shorter periods of active sleep ( p =0.023). Neurodevelopmental profile was more mature for KC infants, particularly habituation ( p =0.032) and orientation ( p =0.007). Results underscore the role of early Skin-to-Skin Contact in the maturation of the autonomic and circadian systems in preterm infants.
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testing a family intervention hypothesis the contribution of mother infant Skin to Skin Contact kangaroo care to family interaction proximity and touch
Journal of Family Psychology, 2003Co-Authors: Ruth Feldman, Aron Weller, Lea Sirota, Arthur I EidelmanAbstract:The provision of maternal-infant body Contact during a period of maternal separation was examined for its effects on parent-infant and triadic interactions. Participants were 146 three-month-old preterm infants and their parents, half of whom received Skin-to-Skin Contact, or kangaroo care (KC), in the neonatal nursery. Global relational style and micro-patterns of proximity and touch were coded. Following KC, mothers and fathers were more sensitive and less intrusive, infants showed less negative affect, and family style was more cohesive. Among KC families, maternal and paternal affectionate touch of infant and spouse was more frequent, spouses remained in closer proximity, and infant proximity position was conducive to mutual gaze and touch during triadic play. The role of touch as a constituent of the co-regulatory parent-infant and triadic systems and the effects of maternal Contact on mothering, co-parenting, and family processes are discussed.
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Skin to Skin Contact kangaroo care promotes self regulation in premature infants sleep wake cyclicity arousal modulation and sustained exploration
Developmental Psychology, 2002Co-Authors: Ruth Feldman, Aron Weller, Lea Sirota, Arthur I EidelmanAbstract:The effect of mother-infant Skin-to-Skin Contact (kangaroo care, or KC) on self-regulatory processes of premature infants was studied. Seventy-three infants who received KC were compared with 73 infants matched for birth weight, gestational age, medical risk, and family demographics. State organization was measured in 10-s epochs over 4 hr before KC and again at term. No differences between KC infants and controls were found before KC. At term, KC infants showed more mature state distribution and more organized sleep-wake cyclicity. At 3 months, KC infants had higher thresholds to negative emotionality and more efficient arousal modulation while attending to increasingly complex stimuli. At 6 months, longer duration of and shorter latencies to mother-infant shared attention and infant sustained exploration in a toy session were found for KC infants. The results underscore the importance of maternal body Contact for infants' physiological, emotional, and cognitive regulatory capacities.
Susan M Ludingtonhoe - One of the best experts on this subject based on the ideXlab platform.
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a case study of infant physiologic response to Skin to Skin Contact after surgery for complex congenital heart disease
Journal of Cardiovascular Nursing, 2015Co-Authors: Tondi M. Harrison, Susan M LudingtonhoeAbstract:BACKGROUND Infants with complex congenital heart disease requiring surgical intervention within the first days or weeks of life may be the most seriously ill infants needing intensive nursing and medical care. Skin-to-Skin Contact (SSC) is well accepted and practiced as a positive therapeutic intervention in premature infants but is not routinely offered to infants in cardiac intensive care units. The physiologic effects of SSC in the congenital heart disease population must be examined before recommending incorporation of SSC into standard care routines. OBJECTIVE The purpose of this case study was to describe the physiologic response to a single session of SSC in an 18-day-old infant with hypoplastic left heart syndrome. METHODS Repeated measures of heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature were recorded 30 minutes before SSC, during SSC (including interruptions for bottle and breast feedings), and 10 minutes after SSC was completed. RESULTS All physiologic parameters were clinically acceptable throughout the 135-minute observation. CONCLUSION This case study provides beginning evidence that SSC is safe in full-term infants after surgery for complex congenital heart disease. Further research with a larger sample is needed to examine the effects of SSC on infant physiology before surgery and earlier in the postoperative time period as well as on additional outcomes such as length of stay, maternal-infant interaction, and neurodevelopment.
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parental oxytocin responses during Skin to Skin Contact in pre term infants
Early Human Development, 2015Co-Authors: Xiaomei Cong, Susan M Ludingtonhoe, Regina M Cusson, Stephen J Walsh, Naveed Hussain, Victoria Vazquez, Carrieellen Briere, Dorothy VittnerAbstract:article Objective: Maternal Skin-to-Skin Contact (M-SSC) has been found to reduce adverse consequences of prema- turity, however, its neurobiological mechanisms have been unknown. The purpose of the study was to examine oxytocin mechanism in modulating parental stress and anxiety during M-SSC and P-SSC (paternal SSC) with their pre-term infants. Methods: Twenty-eight stable pre-term infants and their parents (triads) were recruited in a 2-day cross-over study and 26 mothers and 19 fathers completed the study protocol. Each triad was randomly assigned to one of the two sequences: M-SSC was conducted on day-1 and P-SSC on day-2; and P-SSC on day-1 and M-SSC on day-2. Parents' saliva samples for oxytocin and cortisol assays and visual analog anxiety levels were collected pre-SSC, 30-min during-SSC, and 30-min post-SSC. Results: Both maternal and paternal oxytocin levels were significantly increased during-SSC from baseline. Maternal oxytocin dropped post-M-SSC, but paternal oxytocin continued to be maintained at a higher level during post-P-SSC. Both maternal and paternal cortisol levels significantly decreased during-SSC from baseline. Maternal cortisol continuously dropped post-M-SSC, but paternal cortisol increased post-P-SSC. Both mothers' and fathers' anxiety levels decreased during-SSC from baseline, and then increased post-SSC. Mother- father dyads also showed correlated or synchronized stress and anxiety responses in the NICU. Conclusion: M-SSC and P-SSC activated the oxytocin release and reduced stress and anxiety responses in mothers and fathers of pre-term infants. Practice implications: SSC plays a positive role in early post-partum period and patterns of maternal and paternal bio-behavioral responses to SSC with pre-term infants might be different.
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neurophysiologic assessment of brain maturation after an 8 week trial of Skin to Skin Contact on preterm infants
Clinical Neurophysiology, 2009Co-Authors: Mark S Scher, Susan M Ludingtonhoe, Farhad Kaffashi, Mark W Johnson, Diane Holditchdavis, Kenneth A LoparoAbstract:Abstract Objective Skin-to-Skin Contact (SSC) promotes physiological stability and interaction between parents and infants. Analyses of EEG-sleep studies can compare functional brain maturation between SSC and non-SSC cohorts. Methods Sixteen EEG-sleep studies were performed on eight preterm infants who received 8 weeks of SSC, and compared with two non-SSC cohorts at term (N = 126), a preterm group corrected to term age and a full-term group. Seven linear and two complexity measures were compared (Mann–Whitney U test comparisons p Results Fewer REMs, more quiet sleep, increased respiratory regularity, longer cycles, and less spectral beta were noted for SSC preterm infants compared with both control cohorts. Fewer REMs, greater arousals and more quiet sleep were noted for SSC infants compared with the non-SSC preterms at term. Three right hemispheric regions had greater complexity in the SSC group. Discriminant analysis showed that the SSC cohort was closer to the non-SSC full-term cohort. Conclusions Skin-to-Skin Contact accelerates brain maturation in healthy preterm infants compared with two groups without SSC. Significance Combined use of linear and complexity analysis strategies offer complementary information regarding altered neuronal functions after developmental care interventions. Such analyses may be helpful to assess other neuroprotection strategies.
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kangaroo care Skin Contact reduces crying response to pain in preterm neonates pilot results
Pain Management Nursing, 2008Co-Authors: Raouth R. Kostandy, Xiaomei Cong, Susan M Ludingtonhoe, Amel Abouelfettoh, Carly Bronson, Allison Stankus, Julia R JarrellAbstract:Crying commonly occurs in response to heel stick and adversely affects the infant's physiologic stability. Minimal crying in response to pain is desired. "Kangaroo Care," Skin Contact between mother and infant, reduces pain and may reduce crying in response to pain. The purpose of this pilot study was to test Kangaroo Care's effect on the preterm infant's audible and inaudible crying response to heel stick. Inaudible crying has not been previously studied. A prospective randomized cross-over study with 10 preterm infants 2-9 days old (30-32 weeks' postmenstrual age) was conducted. Infants were randomly assigned to two sequences (sequence A: day 1 heel stick in Kangaroo Care [after 30 min of prone Skin Contact upright between maternal breasts] and day 2 heel stick in incubator [inclined, nested and prone]; or sequence B: opposite of sequence A) was conducted. Videotapes of baseline, heel warming, heel stick, and recovery phases were scored for audible and inaudible crying times. Audible and inaudible crying times for each subject in each phase were summed and analyzed by repeated-measures analysis of variance. Subject characteristics did not differ between those in the two sequences. Crying time differed between the study phases on both days (p
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neurophysiologic assessment of neonatal sleep organization preliminary results of a randomized controlled trial of Skin Contact with preterm infants
Pediatrics, 2006Co-Authors: Susan M Ludingtonhoe, Mark W Johnson, Kathy Morgan, Tina Lewis, Judy Gutman, David P Wilson, Mark S ScherAbstract:BACKGROUND: Sleep is important to brain organization, but few strategies to promote sleep among premature infants have been tested. Behaviorally based measures of sleep have shown increased quiet sleep (QS) and decreased active sleep (AS) during Skin-to-Skin Contact (SSC) with the mother, but these results have not been confirmed with objective electroencephalographic/polysomnographic measures of sleep organization. Important differences exist between behavioral and electroencephalographic/polysomnographic definitions of sleep state. METHODS: Data for the first 28 relatively healthy, preterm subjects of an ongoing randomized trial of one 2- to 3-hour session of SSC or incubator care between feedings are reported here. Infants were positioned prone, inclined, and nested in an incubator during the 2- to 3-hour pretest period, were fed, and then went into the test period of SSC or incubator care. Infants were left largely undisturbed throughout testing. A mixed-model regression analysis compared the test-pretest differences in outcome measures within and between groups. RESULTS: Results showed that arousals were significantly lower in the SSC group, compared with the control group, for the entire study period and for test-pretest matched segments of QS and AS. Rapid eye movement was significantly lower for the SSC group for the study period and AS segments. Indeterminate sleep was significantly lower for the SSC group when confounding environmental variables were included in the regression analysis. When 4 subjects who experienced excessive ambient light levels during SSC were removed from analysis, QS increased during SSC. CONCLUSIONS: The patterns demonstrated by the SSC group are analogous to more-mature sleep organization. SSC may be used as an intervention to improve sleep organization in this population of preterm infants.
Alessandra Zucca - One of the best experts on this subject based on the ideXlab platform.
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tattoo conductive polymer nanosheets for Skin Contact applications
Advanced Healthcare Materials, 2015Co-Authors: Alessandra Zucca, Christian Cipriani, Sergio Tarantino, Davide Ricci, Virgilio Mattoli, Francesco Del GrecoAbstract:: Conductive tattoo nanosheets are fabricated on top of decal transfer paper and transferred on target surfaces as temporary transfer tattoos. Circuits are patterned with ink-jet printing. Tattoo nanosheets are envisioned as unperceivable human-device interfaces because of conformal adhesion to complex surfaces including Skin. They are tested as dry electrodes for surface electromyography (sEMG), which permits the control of a robotic hand.
Francesco Del Greco - One of the best experts on this subject based on the ideXlab platform.
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tattoo conductive polymer nanosheets for Skin Contact applications
Advanced Healthcare Materials, 2015Co-Authors: Alessandra Zucca, Christian Cipriani, Sergio Tarantino, Davide Ricci, Virgilio Mattoli, Francesco Del GrecoAbstract:: Conductive tattoo nanosheets are fabricated on top of decal transfer paper and transferred on target surfaces as temporary transfer tattoos. Circuits are patterned with ink-jet printing. Tattoo nanosheets are envisioned as unperceivable human-device interfaces because of conformal adhesion to complex surfaces including Skin. They are tested as dry electrodes for surface electromyography (sEMG), which permits the control of a robotic hand.
