Breastfeeding is related to atypical autonomic and behavior regulation in infants with a history of excessive crying.

The study investigated autonomic regulation during feeding in six-month old infants with a history of excessive crying (EC) and social-behavioral development at 12 and 24 months. When contrasted with non-EC infants (NEC), EC infants had atypical autonomic responses observed as dampened reductions in respiratory sinus arrhythmia (RSA) and decreases in heart period (HP) during feeding. EC infants demonstrated atypical autonomic regulation only if they were bottle-fed, while breastfed EC infants had patterns of autonomic regulation similar to NEC infants. Behavioral data suggest that while a history of EC was related to social-emotional behaviors at 12 and 24 months, breastfeeding may buffer the behavioral effects of EC on sociability at 24 months.

Close Collaboration with Parents™ intervention to improve parents' psychological well-being and child development: Description of the intervention and study protocol.

Parents of preterm infants commonly experience separation from their infant or exclusion from their role as primary caregivers during the hospital care of their infant, which may impair parent-infant bonding and parents' psychological well-being. Therefore, we developed the Close Collaboration with Parents™ intervention to improve staff skills in communicating and collaborating with parents in neonatal intensive care units (NICU), to increase parents' presence and participation into infant care, and to improve parent-infant bonding and, thereby, parents' psychological well-being and later child development. The Close Collaboration with Parents™ intervention was developed and carried out at Turku University Hospital. The intervention was based on developmental theories about early parenthood and parent-infant attachment. The training was targeted at both doctors and nurses. The goals of the training included understanding individual behaviors and responses of infants and the uniqueness of families, using receptive listening skills in communication with parents and making decisions collaboratively with them. By increasing the sensitivity of the staff to the individual needs of infants and parents and by increasing staff-parent collaboration in daily care, the intervention supported parents' presence and parents' participation in the care of their infant. The effectiveness of the intervention is being evaluated in a prospective study comparing the post-intervention cohort (n=113) to the baseline cohort (n=232). The outcomes include bonding, long-term psychological well-being of both mothers and fathers and child development up to 5 years of age. The Close Collaboration with Parents™ intervention potentially offers a preventive and salutogenic model to integrate parents and parenting in neonatal hospital care.

Re-Evaluation of the Psychometric Properties of the Maternal-Fetal Attachment Scale in a Hungarian Sample.

OBJECTIVE: To explore the factor structure of the Maternal-Fetal Attachment Scale (MFAS) and investigate its psychosocial and demographic correlates in a Hungarian sample. DESIGN: Cross-sectional survey. SETTING: Sonography clinic in a metropolitan area. PARTICIPANTS: One hundred fourteen women over the age of 18 years in the second or third trimesters of pregnancy. METHODS: Participants completed the Hungarian version of the MFAS and provided information on demographic, socioeconomic, and pregnancy-related factors. RESULTS: The internal consistency of the MFAS total scale was acceptable (Cronbach's alpha = .87). However, the reliability of the five subscales was low (alpha coefficients between .57 and .74), and the original five-factor model was not supported by the factor analyses. Married mothers had higher scores on the MFAS than participants who were unmarried, and uncertainty about the sex of the fetus was associated with lower attachment scores. Furthermore, gestational age showed a positive correlation with MFAS scores. No significant association was found between the total score on the MFAS and such factors as age, income, or education of the parents; whether the pregnancy was planned; method of conception; number of children born previously; prior perinatal losses; and circumstances of the mother's own birth. CONCLUSION: Our study showed that marital status, uncertainty about the sex of the fetus, and gestational age were associated with maternal-fetal attachment; however, more detailed analysis was not possible because of the instability of the subscales of the instrument. Further research is warranted on the underlying factors related to maternal-fetal attachment.

Nurses' perspectives on the close collaboration with parents training program in the NICU.

PURPOSE: To describe nurses' experiences of a training program promoting family-centered care and its influence on their care practices in the Neonatal Intensive Care Unit (NICU). STUDY DESIGN AND METHODS: Descriptive qualitative interview study. A training program was used to teach nurses and physicians to collaborate closely with parents in infant care. After the program, 22 nurses were interviewed. Participants were asked to describe their current care practices and reflect on training program-initiated changes. The interviews were analyzed using thematic analysis. RESULTS: The main finding was that nurses felt the program had promoted beneficial change regarding family-centered care. The resulting new atmosphere and care practices supported increased parental involvement in infant care. Due to the nurses' increased interaction with parents, they became more aware of the parents' psychosocial situation. The role of the nurse changed from an active caretaker to a facilitator who supported the parents in infant care. CLINICAL IMPLICATIONS: The transition from professionally centered NICU care to family-centered care is achievable using a well-designed structured program that involves all staff members. The program was able to change the nurses' attitudes and care practices, signifying a successful implementation of family-centered care.

Ultrasound consultation to reduce risk and increase resilience in pregnancy.

Clinical evidence indicates the influence of viewing ultrasound on women's investment in health during pregnancy. Ongoing work on the effects of ultrasound consultation (UC) include: establishing a replicable UC and demonstrating validity of the UC by examining effects of UC on behavioral and physiological indicators of increased resilience in maternal health and pregnancy outcome. The study indicated that UC significantly increased maternal-fetal attachment, decreased maternal anxiety, and increased positive attitudes toward health during pregnancy. Ongoing research involves using UC in two protocols with pregnant women, for instance, those experiencing moderate-to-severe depression and those at risk for noncompliance in treatment for gestational diabetes.