Journal of pediatrics and mother care最新文献

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The Development of the Mother-Infant Mutualistic Screening Scale. 母婴互惠筛选量表的编制。

Journal of pediatrics and mother care

Pub Date : 2017-01-01 Epub Date: 2017-01-20 DOI: 10.19104/japm.2017.107

Emily Zimmerman, Chantal Lau

Background: The integrity of a mother-infant dyad is essential for the proper development of maternal behavior and infant growth/ development. At present, there is a lack of objective approaches to monitor mother-infant behavioral exchanges.

Objectives: This is an exploratory prospective study designed to evaluate the Mother-Infant Mutualistic Screening Scale (MIMSS), a novel observational tool focused on monitoring the mutual/ reciprocal sensitivity and responsiveness that mother and infant express toward one another's behaviors/ actions during the obligatory setting of daily meal times.

Methods: Mother-infant interactions were assessed from videotaped feeding sessions conducted under recurrent naturalistic observations. Data were collected from 27 mother-preterm infant singleton dyads at 6 and 12 month corrected age (CA). Four levels of MIMSS are defined: Level I - both mother and infant are not responsive (NR) to one another's actions; Level II - mother is not responsive (NR) to infant, but infant is responsive (R) to mother; Level III - mother is responsive (R) to infant, but infant is not responsive (NR) to mother; Level IV - both mother and infant are responsive (R) to one another.

Results: Inter- and intra-rater reliability between two raters was 93% and ≥ 85%, respectively. At 6 and 12 month CA, 78% and 81% of the dyads were at a MIMSS Level IV, respectively. A change in mother-infant reciprocal behavioral responses or MIMSS levels was observed in 9 of the dyads between these two ages. No association was observed between MIMSS levels and infant growth/ development as monitored by percentile Weight, Length, and Weight by Length at both corrected ages.

Conclusions: The MIMSS is easy to use with high inter- and intra-rater reliabilities. With the ability to differentiate between mother and infant reciprocal behavioral responses toward one another's actions, MIMSS can help health professionals assess the quality of mother-infant interactions and identify the partner(s) who may benefit from individualized assistance. Although MIMSS uses mealtime as a recurrent setting, it offers a conceptual frame work for evaluating co-regulatory processes under different contexts.

背景:母子二联体的完整性对母亲行为的正常发展和婴儿的生长发育至关重要。目前，缺乏客观的方法来监测母婴行为交流。目的:这是一项探索性的前瞻性研究，旨在评估母婴互惠筛选量表(MIMSS)，这是一种新的观察工具，专注于监测母亲和婴儿在日常用餐时间强制性设置期间对彼此行为/动作表达的相互/互惠敏感性和反应性。方法:在经常性的自然主义观察下，通过录像喂养过程来评估母婴互动。数据来自27名6个月和12个月校正年龄(CA)的母亲早产单胎婴儿。MIMSS被定义为四个级别:一级-母亲和婴儿对彼此的行为都没有反应(NR);二级——母亲对婴儿无反应(NR)，但婴儿对母亲有反应(R);III级——母亲对婴儿有反应(R)，但婴儿对母亲无反应(NR);四级-母亲和婴儿都对对方有反应(R)。结果:两个评价者间和评价者内的信度分别为93%和≥85%。在6个月和12个月时，分别有78%和81%的夫妇处于MIMSS IV级。在这两个年龄之间，观察到9对母子的相互行为反应或MIMSS水平发生了变化。在两个矫正年龄，通过百分位体重、身高和体重比身高监测，未观察到MIMSS水平与婴儿生长/发育之间的关联。结论:MIMSS易于使用，具有较高的评分间和评分内可靠性。由于能够区分母亲和婴儿对彼此行为的相互行为反应，MIMSS可以帮助卫生专业人员评估母婴互动的质量，并确定可能从个性化援助中受益的伴侣。虽然MIMSS使用进餐时间作为循环设置，但它为评估不同背景下的共同调节过程提供了一个概念框架。

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引用次数: 9

Oral Feeding Assessment Predicts Length of Hospital Stay in Late Preterm Infants. 口腔喂养评估预测晚期早产儿住院时间。

Journal of pediatrics and mother care

Pub Date : 2016-01-26 DOI: 10.19104/JAPM.2016.102

C. Lau, K. Bhat, D. Potak, R. Schanler

BACKGROUNDWhen compared with term infants, late preterm (LP) infants have greater morbidity and mortality, longer hospital stay, and greater rate of hospital readmission. Oral feeding difficulty is one of the prominent reasons for delayed discharge in LP infants.OBJECTIVETo identify the maturity levels of LP infants' oral feeding skills (OFS) at the time of their first oral feeding and to determine the relationship between OFS maturity levels and length of hospital stay.METHODSOFS was assessed in 48 LP infants born between 340/7 and 356/7 weeks gestational age at the time of their first oral feeding within 24 h of birth. The intake at 5 minutes, at completion of the feeding, and the duration of feeding a 15 mL prescribed volume of milk were tabulated. Proficiency expressed as percent mL consumed in the first 5 min/15 mL prescribed and rate of milk transfer over the entire feeding (mL/min) were recorded. OFS were assessed using a novel 4-level scale defined by the combined proficiency and rate of milk transfer.RESULTSWhen compared with their 35-week counterparts, infants born at 34 weeks gestation had poorer OFS profiles (p = 0.035) and longer hospital stay (p < 0.001). Additionally, further analyses demonstrated that, independently, LOS was associated negatively with both GA and OFS.CONCLUSIONAssessment of OFS levels in LP infants at their first oral feeding can help identify infants at risk of oral feeding issues that may delay hospital discharge. For those infants, we speculate that provision of evidence-based efficacious interventions that improve OFS may shorten hospital stay and decrease hospital re-admissions.

背景:与足月儿相比，晚期早产儿(LP)有更高的发病率和死亡率，更长的住院时间和更高的再入院率。口腔喂养困难是LP患儿延迟出院的重要原因之一。目的探讨唇腭裂婴儿首次口腔喂养时的口腔喂养技能成熟度水平，并探讨口腔喂养技能成熟度水平与住院时间的关系。方法对48例胎龄340/7 ~ 356/7周出生的LP婴儿在出生后24小时内首次口服喂养时的sofs进行评估。将5分钟时的摄取量、喂食完成时的摄取量以及喂食15ml规定量牛奶的持续时间制成表格。熟练程度表示为前5分钟消耗的mL百分比/规定的15ml和整个喂养过程中的泌乳率(mL/min)。OFS采用一种新的4级量表进行评估，该量表由综合熟练程度和泌乳率定义。结果与35周相比，34周出生的婴儿的OFS谱较差(p = 0.035)，住院时间较长(p < 0.001)。此外，进一步的分析表明，独立地，LOS与GA和OFS呈负相关。结论对LP婴儿第一次口服喂养时的OFS水平进行评估有助于识别有可能延迟出院的口服喂养风险的婴儿。对于这些婴儿，我们推测提供循证有效的干预措施可以改善OFS，缩短住院时间，减少再入院率。

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