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Sleep Patterns of Twins
Published in Mary Nolan, Shona Gore, Contemporary Issues in Perinatal Education, 2023
The sleep patterns of twin babies generally reflect those of singletons (Bartlett & Witoonchart, 2003), the major difference being gestational age. Because twins are often born early, they follow a sleep trajectory aligned with their gestational age rather than birth age. Care should be taken to avoid comparisons with babies who were born later in their gestational development. If twin babies sleep differently from singletons, any differences generally relate to prematurity and/or the amount of time they have spent in an incubator. If babies have experienced a prolonged stay in a NICU, they are likely to be unsettled at home initially due to the dramatic change in environment. Environmental temperature, for instance, may affect their sleep, and twins may achieve better sleep and thermal stability if placed together. Preterm twins will have smaller stomachs and require more frequent feeding than babies of the same chronological age, which will affect the frequency of night waking. Many parents find that their twins’ feeding and sleeping patterns become synchronised if they are fed and slept together.
Skin-to-Skin Togetherness
Published in Michael van Manen, The Birth of Ethics, 2020
These are occasions when a parent, in being touched by the look of her child, experiences a contacting recognition. The parent is drawn nearer: to see the child and to know the child as inappropriably ‘mine.’ This is the pedagogical ethical sphere between self and other. For the family in the neonatal intensive care unit, we need to wonder how a parent finds such a space when just being with the child can be technically so difficult. The survival of prematurely born infants is conditional on coping with the situation of infants born prematurely detached from their mother’s body and needing reattachment and connection through technology and professional expertise (Landzelius 2003). Attachment between parents and their child is facilitated and emphasized while recognizing that the high technological setting of the NICU differs considerably from the usual ways an infant enters the world by being taken care of by his or her parents outside of the NICU.
The Meaning of Extremely Premature Infant Behavior
Published in Michael van Manen, Phenomenology of the Newborn, 2018
In the NICU, it is not unusual to see a premature infant in a reprise of instability in bodily tone, breathing, and circulation. While it is possible such ‘disorder’ relates ‘simply’ to prematurity, it is also possible that a compromising medical condition is evolving. We know that the presentation of instability may be seen in older infants who possess ‘limited reserve.’ For these medically fragile infants the use of medications for sedation may be necessary to keep them calm, for fear of their incapacity to tolerate physiologic lability. One wonders: how do infants experience bodily fluctuations?
Parental experiences in neonatal intensive care unit in Ethiopia: a phenomenological study
Published in Annals of Medicine, 2022
Endalkachew Worku Mengesha, Desalegne Amare, Likawunt Samuel Asfaw, Mulugeta Tesfa, Mitiku B. Debela, Fentie Ambaw Getahun
The neonatal intensive care unit (NICU) is a unit that provides day and night care for sick or preterm infants [1]. The NICU has specialist medical staff and equipment to care for premature and sick newborn babies. This part of the hospital is sometimes called the intensive care nursery [1,2]. The creation of special care units for infants was sparked by the realisation that heat, humidity, and a steady supply of oxygen could increase the survival rates of sickly babies, meaning that hospitals could intervene to help babies live as opposed to just sending them home [3]. Parental stress related to NICU admission is a worldwide healthcare issue [4]. According to the American Academy of Paediatrics, nearly 5% of all newborns require an intensive care unit stay. Another 15–20% of all newborns require specialty services [1].
Postponed Withholding: Harmful for the Infant and Increasing the Complexity of Decision-Making
Published in The American Journal of Bioethics, 2022
Lien De Proost, Eline Bunnik, Angret de Boer, E. J (Joanne) Verweij
Syltern et al. argue that PPWH contributes to balancing decision-making at the limit of viability. For several reasons, however, we think that PPWH increases rather than decreases the complexity of decision-making, ethically, legally and psychologically, and does not support parental autonomy. Literature suggests that a subgroup of parents wants to avoid suffering due to NICU treatment for their extremely premature infant (Jager et al. 2020; Keenan, Doron, and Seyda 2005; Moro et al. 2011; Tucker Edmonds et al., 2019). In the PPWH approach, these parents will not be given the freedom to do so, and are thus denied a valuable option. Also, while in the traditional approach, decision-making takes place prenatally, when the mother is still pregnant and the infant has not yet been born, in the PPWH approach, it takes place one week after birth, when the infant has become a patient. Toward their patients, HCP have fiduciary duties. Because of this, HCP have a stronger say in the decision. Despite the heterogeneity in legal frameworks surrounding the status of the (un)born infant, it does matter for decision-making whether the infant is born; HCP must act in the best interests of patients, even if the parents may wish otherwise.
Experiences and coping strategies of preterm infants’ parents and parental competences after early physiotherapy intervention: qualitative study
Published in Physiotherapy Theory and Practice, 2022
Mirari Ochandorena-Acha, Rosa Noell-Boix, Meltem Yildirim, Maria Cazorla-Sánchez, Martín Iriondo-Sanz, Maria José Troyano-Martos, Joan Carles Casas-Baroy
The present study included parents of preterm infants admitted at the NICU of the Sant Joan de Deu Barcelona Children’s Hospital (Spain), between December 2017 and May 2018. This facility is a third level hospital, with the neonatal unit open 24 hours. As usual care, the hospital provides the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), which is based on the concept of newborn or child’s competence and focuses on respecting the individuality of the very tiny human being and his or her family. The hospital also encourages breastfeeding and parents’ involvement during childcare. The hospital provides support to the families during the NICU stay through a multidisciplinary team, consisting of neonatologists, nurses, psychologists, social workers, and physiotherapists. The usual physiotherapy care offered during the NICU stay includes at least one visit aimed at guiding parents during the daily activities in the neonatal unit. Before hospital discharge, parents are invited to a session called “going home”, where a nurse and a physiotherapist provide specific reminders of the basics of infant care at home.