The proposed research is randomized controlled trial with 100 mothers and their preterm infants who are 32 to 35 weeks gestation , 1500 to less than 2500 grams, and healthy at birth. The overall premise is that these infants, even though vulnerable, have the potential to stabilize pphysiologically, avoid admission to the neonetal intensive care unit, and develop normally, provided they stay with their mothers postbirth and receive a comprehensive model of nurse-supported,. early, and continuous self-regulatory (ECSR) care. Self-regulatory means timely and appropriate responses to cues such as hand-mouth activity. ECSR care is designed to minimize newborn crying, eliminate startles, ensure thermoregulation and maximize regular respirations, thereby promoting a broad parasympathetically governed (vagal) response. This unique and comprehensive intervention has been strengthened by the addition of skin- to-skin (kangaroo) care. The broad long term objective is to develop an effictive acceptable, and easy to implement model of mother-infant care which begins at birth and incorporates self-regulatory care and kangaroo care to assure a comprehensive approach. The purpose of this research is to determine the effect af ECSR on preterm infant health, maternal health and satisfaction, and health care costs. At 10 minutes postbirth each mother-infant dyad will be randomly aasign by minimization method to the standard care (control) group and the early coninuous self-regulatory care (ECSR) group. Hospital staff will provide standard nursery and postpartum care to control dyads. Each ECSR mother will be able to stay with' her infant in the hospital for 5 days postbirth in order to provide ECSR. We expect this to average 2 days on the postpartum ward and 3 days in the General Clinical Research Center (GCRC). Data will be collected in hospital on infant health, maternal health1 and cost variables. Dyads in both groups will have a home visit 2 days post- discharge and physical psychosocial, and developmental assessments in the GCRC at 6 weeks and 6, 12, and 18 months. Post-discharge health and costs will be assessed through 18 months.
| Chiu, Sheau-Huey; Anderson, Gene Cranston (2009) Effect of early skin-to-skin contact on mother-preterm infant interaction through 18 months: randomized controlled trial. Int J Nurs Stud 46:1168-80 |
| Hake-Brooks, Sara J; Anderson, Gene Cranston (2008) Kangaroo care and breastfeeding of mother-preterm infant dyads 0-18 months: a randomized, controlled trial. Neonatal Netw 27:151-9 |
| Chiu, Sheau-Huey; Anderson, Gene Cranston; Burkhammer, Maria D (2005) Newborn temperature during skin-to-skin breastfeeding in couples having breastfeeding difficulties. Birth 32:115-21 |
| Anderson, Gene Cranston; Radjenovic, Doreen; Chiu, Sheau-Huey et al. (2004) Development of an observational instrument to measure mother-infant separation post birth. J Nurs Meas 12:215-34 |
| Swinth, Joan Y; Anderson, Gene Cranston; Hadeed, Anthony J (2003) Kangaroo (skin-to-skin) care with a preterm infant before, during, and after mechanical ventilation. Neonatal Netw 22:33-8 |
| Anderson, Gene Cranston; Chiu, Sheau-Huey; Dombrowski, Mary Alice et al. (2003) Mother-newborn contact in a randomized trial of kangaroo (skin-to-skin) care. J Obstet Gynecol Neonatal Nurs 32:604-11 |
| Anderson, G C; Dombrowski, M A; Swinth, J Y (2001) Kangaroo care: not just for stable preemies anymore. Reflect Nurs Leadersh 27:32-4, 45 |
| Dombrowski, M A; Anderson, G C; Santori, C et al. (2001) Kangaroo (skin-to-skin) care with a postpartum woman who felt depressed. MCN Am J Matern Child Nurs 26:214-6 |
| Swinth, J Y; Nelson, L E; Hadeed, A et al. (2000) Shared kangaroo care for triplets. MCN Am J Matern Child Nurs 25:214-6 |
| Dombrowski, M A; Anderson, G C; Santori, C et al. (2000) Kangaroo skin-to-skin care for premature twins and their adolescent parents. MCN Am J Matern Child Nurs 25:92-4 |
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