The proposed research is a randomized controlled trial with 100 mothers and their preterm infants who are 32-35 weeks gestation, 1500-2500 grams, and healthy at birth. The overall premise is that these infants, even though vulnerable, have the potential to stabilize physiologically, avoid admission to the neonatal 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. ECSR care is desgined to minimize newborn crying, eliminate startles, ensure thermoregulation and maximize regular respiration, thereby promoting a broad parasympathetically governed (vagal) response. The broad long term objective is to develop an effective, acceptable, and easy to implement model of mother-infant care which begins at birth and incorporates self-regulatory care and kangaroo (skin-to-skin) care. The purpose of this research is to determine the effect of ECSR on preterm infant health, maternal health and satisfaction, and health care costs. The biostatistician has had an ongoing role in the design of this study. During this reporting period, this newly funded study has required intensive work on the part of several other GCRC resources. The nursing staff have been inserviced on several new techniques in order to be prepared to care for the infants and mothers and make the required measurements. The GCRC core lab has also devoted major effort to the development of assays for saliva amylase, breast milk cortisol, and breast milk IgA . This project is scheduled to initiate patient activity in January, 1997.
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