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• W212038873 abstract "INTRODUCTION Bronchopulmonary Dysplasia (BPD) is a chronic lung disease of premature infants who are given oxygen via a ventilator for treatment of respiratory distress. Increasing numbers of surviving infants with BPD strain the capacity of the health care system to provide for their needs and those of their families. Improvements in antenatal and postnatal care, as well as the development of highly effective technological equipment, result in the survival of smaller and younger premature infants who are susceptible to developing this condition. In 1984, approximately 240,000 infants were born with a birthweight of under 2500 grams. Nine thousandthree hundred of the survivors developed BPD (see Table 1).1 Of the infants whose birthweights were under 1500 grams, Avery and colleagues found that about four percent still required supplemental oxygen at three months of age.2 Many of these infants spend the first three to six months of life in a hospital setting and many are discharged with sophisticated life-supporting equipment such as tracheostomy tubes, oxygen tanks, suction apparatus, and respiratory monitors. While these infants are in the hospital, they develop an aversive personality characterized by social withdrawal, inability to form attachments to a primary caregiver, and inappropriate self-stimulatory behaviors. Activities involving the oral cavity, such as sucking and swallowing, become distasteful and unpleasant to these infants, and this leads to prolonged delay of normal feeding behaviors. These infants have plastic feeding catheters inserted through their noses on a long term basis, and often require the additional placement of nasal prongs to deliver oxygen. The extra months that these BPD infants spend in intensive care creates the potential for severe emotional, social and developmental delays. Studies have shown that these infants may significantly benefit from individualized behavioral and environmental care in the neonatal intensive care unit. A controlled investigation by Als and colleagues compared two groups of nursing care procedures for the very low birthweight premature infant at risk for developing BPD.3 One group received carefully controlled sensory input to minimally disrupt the infant's homeostasis. The three major areas of caregiving that were addressed included 1. the physical environment of the infant, 2. the direct care given to the infant, and 3. discharge planning. In the experimental group, the researchers found that these babies showed significantly briefer stays on the respirator, that their feeding behaviors normalized earlier, and that they showed significantly better behavioral regulation at one month of age adjusted for degree of prematurity, and significantly better Mental and Psychomotor Developmental Indices at three, six and nine months post estimated date of conception as measured with the Bay ley Scales of Infant Development. The stability of coping behavior may be established by six months of age. If this is true, the interaction between the infant and early caretakers may define the future behaviors and possibly the developmental outcome. The milieu of the neonatal intensive care unit is not conducive to the development of self-regulatory behaviors for the infant, nor is it supportive of parental attempts to successfully form attachments with their infant. In the early lifesaving phase of treatment, repeated painful procedures such as intubation and blood drawing are required on a frequent basis. Endotracheal tubes and oxygen lines inhibit neck and body movements, limiting the development of normal movement patterns. Sleep cycles are disrupted by continuous light, and the constant din of medical personnel engaging in their daily activities does not allow for a daily period of peace and quiet. These infants do not respond in any observable way to their parents' concern and bedside attention. Their poor muscle tone, lack of movement and weak reflexes are often interpreted as a distinterest in the environment. …" @default.
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• W212038873 date "1988-07-01" @default.
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• W212038873 title "A Program for Improving the Psychosocial Outcome of Infants with Bronchopulmonary Dysplasia (BPD)" @default.
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