What can/should parents do for Premature Infants?

• If you are concerned about the possibility of having a premature infant, you should investigate the type of care offered in your hospital. IDSC is becoming the standard of care at more hospital NICUs. You should find out if/where it is practiced in your community. You should be aware that even if the ideal is not offered, hopefully certain aspects of this type of care are practiced or the attitude and philosophy of the health team reflect this new thinking.
• If you are a parent with a newborn in an NICU, you should be trained by the health care team in the correct approach to use with your infant once at home. Parents and infant do best when involved in and continuing developmentally appropriate care beyond the hospital setting.
•  If you have a child at home who was a premature infant it is important to continually monitor his developmental progress. It is currently impossible to accurately predict who will have later problems. Rather, over time, different deficits may become apparent when the child reaches different expected milestones for walking, talking, and reading. Certain difficulties may not become apparent until the school years when some premature infants will need special education services. 2 , 10 If difficulty is noted, it then becomes necessary to seek guidance on the proper intervention.
• Parents should consult their health care team to become educated about the types of services available in their state for premature infants. For example in NY state, Early Intervention Programs are provided for eligible children birth through age 3.
• The more parents know about their own child's individual style and the earlier intervention begins, the better the outcome.

"Individualized Developmentally Supportive Care (IDSC)" , is the most recent trend in the care of premature infants. In general, IDSC is based on the belief that

(1)different subsystems within the infant are interrelated, develop differently and provide feedback to one another

• autonomic (e.g. heart rate, breathing)
• motor (e.g. movement, posture)
• state of consciousness (e.g. level of sleepiness and wakefulness)
• attention (e.g. ability to attend to sound)
• self regulation (e.g. ability to calm self)

(2)the physical environment of the typical neonatal nursery is in stark contrast to the prenatal womb environment and not conducive for optimal care.

In order to create the most beneficial environment for each particular infant, parents and professionals look for signs of stress and comfort in the infant in the different system areas. For example, what is the heart rate, is he arching his back, does he seem fretful? By accurately evaluating and recognizing the infant's stress, adjustments can be made to increase comfort and minimize risk.

 

One key element of the IDSC approach involves learning the infant's own personal style of needs and wants. It is believed that infants, even at this young age, have particular preferences for comfort and can communicate these desires and needs. Thus the adults must discover the clues and respond to the communications appropriately. For example, an infant whose mother was drug addicted may be most responsive and comforted by some stimulation due to his being most familiar with such an environment in utero.

 

Ideally, in the IDSC model, structuring the infant's day around quiet times and touch times minimizes stress to the baby's developing internal systems. Necessary medical procedures would be conducted during the sanctioned touch times, while other soothing interactions are done during the quiet times when the infant may also be encouraged and helped to sleep.