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Children
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Family Centered Neonatal and Maternity Care
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Family Centered Neonatal and Maternity Care

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Nursing".

Deadline for manuscript submissions: closed (5 August 2024) | Viewed by 23315

Special Issue Editors

Dr. Karen D. Hendricks-Muñoz

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Guest Editor
Division of Neonatal Medicine, Department of Pediatrics, Children’s Hospital of Richmond at VCU and School of Medicine, Virginia Commonwealth University, Richmond, VA 23298-02761, USA
Interests: neonatal intensive care; infant microbiome development; neonatal neurodevelopment; family centered and developemental care; kangaroo mother care; pulmonary health
Dr. Juan Gabriel Ruiz Pelaez

E-Mail Website
Guest Editor
Division of Medical and Population Health Sciences Education and Research, Florida Int Univ, Herbert Wertheim Coll Med, Miami, FL 33199, USA
Interests: kangaroo mother care; evidence-based neonatal care; evidence-based quality improvement; high risk neonates growth and development; clinical economics/preterm infant care

Special Issue Information

Dear Colleagues,

In the lasty 50 or so years, with exponential improvements in survival of mothers and sick newborns, a movement towards bringing back mothers and families to the side of their infants while receiving specialized care has gradually spread. Family centered care, where provider collaboration with the family holds an important and vital role in ensuring the ultimate health and well-being of the infant and mother, has become a fundamental care practice in the neonatal intensive care unit and maternity care service. Though the definition of family centered neonatal and maternity care differs somewhat between the various disciplines, the common concepts include individualized care, which promotes infant–parent engagement, is culturally sensitive, and actively involves the parents/family in decision making. This Special Issue will cover a variety of topics related to family-centered neonatal and maternity care including, but not limited to, scientific outcomes, barriers and interventional engagement in early development and postpartum to later implementation; spanning from infant and maternal practices that influence success and outcomes, pedagogy related to psychosocial influences, cultural implications and family or provider perceptions or disparities. Article types will include research articles, review articles, perspective articles, mini-reviews, opinion papers, case studies, and short communications.

Dr. Karen D. Hendricks-Muñoz
Dr. Juan Gabriel Ruiz Pelaez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • family centered care
  • maternal
  • neonatal
  • kangaroo mother care
  • microbiome
  • neurodevelopment
  • postpartum mental health disorders
  • maternal health
  • health disparities
  • infant developmental care

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Published Papers (7 papers)

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Research

Jump to: Review, Other

10 pages, 429 KiB  
Article
Peripartum Traumas and Mental Health Outcomes in a Low-Income Sample of NICU Mothers: A Call for Family-Centered, Trauma-Informed Care
by Allison Williams, Anna Beth Parlier-Ahmad, Erin Thompson, Rachel Wallace, Paul B. Perrin, Alyssa Ward and Karen D. Hendricks-Muñoz
Children 2023, 10(9), 1477; https://doi.org/10.3390/children10091477 - 30 Aug 2023
Cited by 3 | Viewed by 2096
Abstract
Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and [...] Read more.
Postpartum depression (PPD), postpartum anxiety (PPA), and post-traumatic stress disorder (PTSD) among birthing people have increased substantially, contributing to adverse maternal/infant dyad outcomes, with a high prevalence in the neonatal intensive care unit (NICU). Despite calls for trauma-informed care in the NICU and high rates of post-traumatic stress, little research has examined the rates of or the relationships between peripartum mood and adverse child experiences (ACEs) in NICU mothers or evaluated which peripartum traumas are most distressing. This study employed structural equation modeling (SEM) to explore whether peripartum-related traumas and NICU-related stressors mediated the associations between ACEs and mental health outcomes in 119 lower-income, racially diverse mothers in a Level IV NICU. Mental health concerns were prevalent and highly comorbid, including 51.3% PPA, 34.5% PPD, 39.5% post-traumatic stress, and 37% with ≥4 ACEs. The majority (53.8%) of mothers endorsed multiple peripartum traumas; NICU admission was the most common trauma (61%), followed by birth (19%), pregnancy (9%), and a medical event in the NICU (9%). Our SEMs had good fit and demonstrated that ACEs predicted peripartum distress. Trauma-informed care efforts should employ transdiagnostic approaches and recognize that women commonly present to the NICU with childhood trauma history and cumulative peripartum traumas. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
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25 pages, 300 KiB  
Article
Parent and Therapist Perceptions of the Feasibility, Acceptability, and Benefits of a Weekly Therapist-Led Massage Program for Extremely Preterm Infants in Neonatal Intensive Care
by Dana B. McCarty, Stacey C. Dusing, Alana Gilbert, Kristen D. LeBlond, Meredith Soucie and T. Michael O’Shea
Children 2023, 10(9), 1453; https://doi.org/10.3390/children10091453 - 25 Aug 2023
Cited by 3 | Viewed by 2146
Abstract
Mothers of extremely preterm infants experience high rates of mental health disorders that impair maternal–infant interaction and lead to worse infant developmental outcomes. Therapist Education and Massage for Parent–Infant Outcomes (TEMPO) is a therapist-led program that standardizes the nature and frequency of parent [...] Read more.
Mothers of extremely preterm infants experience high rates of mental health disorders that impair maternal–infant interaction and lead to worse infant developmental outcomes. Therapist Education and Massage for Parent–Infant Outcomes (TEMPO) is a therapist-led program that standardizes the nature and frequency of parent education through weekly scheduled therapy sessions. Using a family-centered approach, the therapist facilitates positive maternal–infant interactions and massage interventions from birth throughout hospitalization with the goal of improving maternal mental health. This qualitative study presents the results of 19 parent interviews and of a focus group of four TEMPO interventionists to elicit feedback about the program. Overall, parents and therapists viewed the program positively. Parents and therapists valued the focus on parent education and engagement to increase parent competence and bonding opportunities. Both groups acknowledged that infant massage had both infant-centered and parent-centered benefits. One area where parent and therapist views did not align was regarding feasibility of TEMPO. Parents noted multiple logistical challenges to regular NICU visitation, but ultimately agreed that attending weekly therapy sessions was feasible. Therapists noted increased time and effort required of TEMPO and felt that institutional and system-level changes would be necessary to implement weekly parent education as standard of care. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
13 pages, 277 KiB  
Article
Supporting and Enhancing NICU Sensory Experiences (SENSE), 2nd Edition: An Update on Developmentally Appropriate Interventions for Preterm Infants
by Roberta Pineda, Polly Kellner, Carolyn Ibrahim, SENSE Advisory Team Working Group and Joan Smith
Children 2023, 10(6), 961; https://doi.org/10.3390/children10060961 - 28 May 2023
Cited by 7 | Viewed by 6888
Abstract
The Supporting and Enhancing NICU Sensory Experiences (SENSE) program promotes consistent, age-appropriate, responsive, and evidence-based positive sensory exposures for preterm infants each day of NICU hospitalization to optimize infant and parent outcomes. The initial development included an integrative review, stakeholder input (NICU parents [...] Read more.
The Supporting and Enhancing NICU Sensory Experiences (SENSE) program promotes consistent, age-appropriate, responsive, and evidence-based positive sensory exposures for preterm infants each day of NICU hospitalization to optimize infant and parent outcomes. The initial development included an integrative review, stakeholder input (NICU parents and healthcare professionals), and feasibility focus groups. To keep the program updated and evidence-based, a review of the recent evidence and engagement with an advisory team will occur every 5 years to inform changes to the SENSE program. Prior to the launch of the 2nd edition of the SENSE program in 2022, information from a new integrative review of 57 articles, clinician feedback, and a survey identifying the barriers and facilitators to the SENSE program’s implementation in a real-world context were combined to inform initial changes. Subsequently, 27 stakeholders (neonatologists, nurse practitioners, clinical nurse specialists, bedside nurses, occupational therapists, physical therapists, speech-language pathologists, and parents) carefully considered the suggested changes, and refinements were made until near consensus was achieved. While the 2nd edition is largely the same as the original SENSE program, the refinements include the following: more inclusive language, clarification on recommended minimum doses, adaptations to allow for variability in how hospitals achieve different levels of light, the addition of visual tracking in the visual domain, and the addition of position changes in the kinesthetic domain. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
11 pages, 276 KiB  
Article
“I’ll Be There”: Informal and Formal Support Systems and Mothers’ Psychological Distress during NICU Hospitalization
by Miri Kestler-Peleg, Varda Stenger, Osnat Lavenda, Haya Bendett, Shanee Alhalel-Lederman, Ayala Maayan-Metzger and Tzipora Strauss
Children 2022, 9(12), 1958; https://doi.org/10.3390/children9121958 - 13 Dec 2022
Cited by 2 | Viewed by 1655
Abstract
Mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) are at a high risk for psychological distress, which is of concern to health and social professionals due to the negative implications for mothers and infants. A model for explaining maternal psychological [...] Read more.
Mothers of infants hospitalized in the Neonatal Intensive Care Unit (NICU) are at a high risk for psychological distress, which is of concern to health and social professionals due to the negative implications for mothers and infants. A model for explaining maternal psychological distress, consisting of intolerance to uncertainty and support from informal (spouse, family, and friends) and formal (medical staff) systems was examined. Data was collected from one of the largest NICUs in Israel; 129 mothers of 215 preterm infants completed self-report questionnaires regarding their background variables, intolerance to uncertainty, perceived informal support and perceived medical staff support. The NICU’s medical staff provided indicators for the infants of participating mothers. A hierarchical multiple regression analysis was conducted. The examined model explained 29.2% of the variance in maternal psychological distress. Intolerance of uncertainty positively predicted psychological distress. Informal support, and in particular, spousal support negatively predicted psychological distress above and beyond intolerance of uncertainty. Medical staff support negatively predicted psychological distress above and beyond intolerance to uncertainty and informal support. Our findings suggest that maternal psychological distress is reduced through a family-centered care approach in NICUs. Medical professionals and social services should develop further solutions for addressing preterm mothers’ need for certainty and support. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
13 pages, 236 KiB  
Article
Parents’ Experience in an Italian NICU Implementing NIDCAP-Based Care: A Qualitative Study
by Natascia Bertoncelli, Licia Lugli, Luca Bedetti, Laura Lucaccioni, Arianna Bianchini, Alessandra Boncompagni, Federica Cipolli, Anna Cinzia Cosimo, Giovanna Cuomo, Michela Di Giuseppe, Tamara Lelli, Veronica Muzzi, Martina Paglia, Lucia Pezzuti, Claudia Sabbioni, Francesca Salzone, Maria Cristina Sorgente, Fabrizio Ferrari and Alberto Berardi
Children 2022, 9(12), 1917; https://doi.org/10.3390/children9121917 - 7 Dec 2022
Cited by 5 | Viewed by 3459
Abstract
Background: The birth of a preterm infant and his/her immediate admittance to the Neonatal Intensive Care Unit (NICU) are sudden, unexpected, stressful and painful events for parents. In the last decade, in response to the increased awareness of the stressful experiences of [...] Read more.
Background: The birth of a preterm infant and his/her immediate admittance to the Neonatal Intensive Care Unit (NICU) are sudden, unexpected, stressful and painful events for parents. In the last decade, in response to the increased awareness of the stressful experiences of parents, much attention has been paid to Family-Centered Care (FCC) and the implementation of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). According to the NIDCAP model, the infant–parents’ dyad is the core of the care provided by the NICU professionals to reduce the stress experienced by parents. So far, the literature does not show a clear correlation between parental experiences and the NICU practices according NIDCAP principles. Aims: To explore how parents of preterm infants experienced the NIDCAP-based care from admission to discharge, in particular, their relationships with NICU professionals and with other parents, and the organization of the couple’s daily activities during this process. Design: Qualitative exploratory study. Methods: Twelve parents of preterm infants born between January 2018 and December 2020 at the NICU of Modena, with a gestational age at birth of less than 30 weeks and/or a birth weight of less than 1250 g, were recruited. Three couples had twins, and the total number of infants was 15. All infants were followed for up to 24 months post-term age (PTA) for neurological outcomes. Each couple was given a semi-structured online interview about their experience during their infant’s hospitalization in the NICU up to discharge. The interview was developed around three time points: birth, hospitalization and discharge. The data analysis was conducted according to the template analysis method. Results: The admission to the NICU was unexpected and extraordinary, and its impact was contained by the skilled staff who were capable of welcoming the parents and making them feel they were involved and active collaborators in the care of their infant. The emotional experience was compared to being in a blender; they were overwhelmed by changing emotions, ranging from terrible fear to extreme joy. The couple’s activities of daily life were reorganized after the infant’s birth and admission to the NICU. Fathers felt unbalanced and alone in taking care of their partners and their children. Conclusions: This is the first study in Italy to explore parental experience in an NICU implementing NIDCAP-based care. The NIDCAP approach in the NICU of Modena helps parents to be involved early, to develop parental skills, and to be prepared for the transition home; and it also facilitates and enhances the relationship between parents and NICU staff. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)

Review

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18 pages, 1078 KiB  
Review
Family-Centered Care for LGBTQ+ Parents of Infants in the Neonatal Intensive Care Unit: An Integrative Review
by Olivia Swedberg Yinger, Aubrey Jones, Keisa Fallin-Bennett, Chelsea Gibbs and Rachel H. Farr
Children 2024, 11(6), 615; https://doi.org/10.3390/children11060615 - 21 May 2024
Cited by 1 | Viewed by 3007
Abstract
Background: Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, [...] Read more.
Background: Having an infant in the Neonatal Intensive Care Unit (NICU) can disrupt parent well-being, the transition to parenthood, and the typical trajectories of infant and child health. For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, this stress may be compounded by health disparities and fear of stigma and discrimination; however, research is lacking about LGBTQ+ parents of infants in the NICU. Objectives: The purpose of this integrative review was to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on experiences of stigma and discrimination, sources of strength and resilience, and provision of family-centered care. Method: We searched EBSCOHost, ProQuest, Web of Science, and Google Scholar between 30 May 2023 and 18 September 2023 for empirical studies published in English in peer-reviewed scholarly journals in which LGBTQ+ parents shared their experiences with having infants admitted to the NICU. Results: We identified six articles that met inclusion criteria, all of which were qualitative studies that included 12–14 LGBTQ+ parents of NICU infants. Conclusions: LGBTQ+ parents in all studies reported instances of perceived stigma and discrimination while their infants were in the NICU, whereas parents in two studies mentioned strength and resilience, and parents in three studies described elements of family-centered care. There is a need for rigorous research on family-centered NICU care that includes questions about sources of strength and resilience in addition to challenges. We propose that future researchers use community engaged methods to center perspectives of LGBTQ+ parents. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
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Graphical abstract

Other

Jump to: Research, Review

8 pages, 225 KiB  
Brief Report
Project BETTER: A Family-Centered, Technology-Delivered Intervention for Pregnant People with Opioid Use Disorder
by Anna Beth Parlier-Ahmad, Michelle Eglovitch, Sarah Martin, Dace S. Svikis and Caitlin E. Martin
Children 2023, 10(2), 359; https://doi.org/10.3390/children10020359 - 11 Feb 2023
Cited by 1 | Viewed by 2595
Abstract
Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that can negatively impact the maternal–infant dyad. This study aimed to describe the development of a family-centered, technology-delivered intervention tailored to help pregnant people receiving medication [...] Read more.
Birthing people with opioid use disorder (OUD) face unique stressors during the transition from pregnancy to postpartum that can negatively impact the maternal–infant dyad. This study aimed to describe the development of a family-centered, technology-delivered intervention tailored to help pregnant people receiving medication for OUD (MOUD) prepare for this transition. Formative data from patients and providers identified intervention content: (1) recovery-oriented strategies for the pregnancy-to-postpartum transition; (2) guidance around caring for an infant with opioid withdrawal symptoms; and (3) preparation for child welfare interactions. The content was reviewed in successive rounds by an expert panel and modified. Pregnant and postpartum people receiving MOUD pre-tested the intervention modules and provided feedback in semi-structured interviews. The multidisciplinary expert panel members (n = 15) identified strengths and areas for improvement. Primary areas for improvement included adding content, providing more structure to help participants navigate the intervention more easily, and revising language. Pre-testing participants (n = 9) highlighted four themes: reactions to intervention content, navigability of the intervention, feasibility of the intervention, and recommendation of the intervention. All iterative feedback was incorporated into the final intervention modules for the prospective randomized clinical trial. Family-centered interventions tailored for pregnant people receiving MOUD should be informed by patient-reported needs and multidisciplinary perspectives. Full article
(This article belongs to the Special Issue Family Centered Neonatal and Maternity Care)
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