Fostering mother-very preterm infant communication during skin-to-skin contact through a modified positioning.

ABSTRACT

BACKGROUND: Skin-to-skin contact (SSC) has been widely studied in NICU and several meta-analyses have looked at its benefits both for the baby and the parent. Very few studies however have investigated benefit for communication. AIMS: Investigate the immediate benefits of Supported Diagonal Flexion (SDF) positioning during SSC on the quality of mother - very-preterm infant communication and to gain insight into how mothers' and very-preterm infants' communicative behaviours are coordinated in time just a few days after birth. SUBJECTS AND STUDY DESIGN: Monocentric prospective matched-pair case-control study. Thirty-four mothers and their very preterm infants (27 to 31 + 6 weeks GA; mean age at birth 30 weeks GA) were assigned to one of the two SSC positioning, either the Vertical Control (n = 17) or the SDF Intervention positioning (n = 17). Mother and infant were filmed during the first 5 min of SSC, 15 days after the very first SSC (i.e. 18 days after very premature birth, i.e. on average 32.4 weeks GA). OUTCOME MEASURES: Infants' state of consciousness according to the Assessment of Preterm Infants' Behavior scale. Onset and duration of infants' and mothers' smiles, gazes and vocalizations, and their temporal proximity inside a 1-sec time-window. RESULTS: In the SDF Intervention Group, very preterm infants vocalized three times more and mothers vocalized, gazed at their baby's face, and smiled more than in the Vertical Control Group. Moreover, in a one-second time-frame, temporal proximity of mother-infant behaviours was greater in the SDF Intervention Group. CONCLUSIONS: Our study shows that SDF positioning creates more opportunities for mother-infant communication during SSC. SDF positioning fosters a greater multimodal temporal proximity thus supporting a more qualitative mother-infant communication.