Anneliese F. Korner

Visual alertness in neonates as evoked by maternal care

Abstract The object of this study was to explore, within the context of common maternal ministrations, the relative efficacy of contact and of vestibular stimulation, with and without the upright position, in producing visual alertness in neonates. The subjects were 40 crying and 24 sleeping 2- to 3-day-old healthy full-term newborns, equally divided into males and females, breast and bottle-fed infants. Each subject was given, in random order, six interventions which entailed singly, or in combination, contact and vestibular stimulation with or without the upright position. A six-point scale assessing levels of alertness with high interobserver reliability was devised. There were highly significant individual differences in alerting response between the infants, but no differnces due to sex or mode of feeding. In the context of soothing the infant, vestibular stimulation had a highly significant effect on alerting. Contact had little effect on evoking alertness except when combined with vestibular stimulation and the upright. The infants responded minimally when stimulated in the context of rousing. The findings imply that, at least during the neonatal period, the vestibular stimulation which attends most caretaking activities may be more crucial than contact for certain aspects of early human development.

Prediction of the development of low birth weight preterm infants by a new neonatal medical index

A new neonatal medical index (NMI) was used to predict the mental and motor development of low birth weight, preterm infants up to 3-years-old. The NMI is a summary score of only a few clinically salient items that are readily available on brief chart review. The sample consisted of 512 of 608 infants randomly assigned to the control group of the eight-site Infant Health and Development Program and on whom the complete set of developmental outcome measures was available. The developmental tests administered were the Bayley Scales at 12 and 24 months and the Stanford-Binet at 3 years. The findings indicated the NMI was predictive of later cognitive and motor development, and in infants born weighing less than 1500 g, the effects of neonatal medical complications continued to adversely influence these childrens development to at least 3 years of age. In the heavier babies the developmental effects of sociodemographic factors predominated by 24 months and beyond.

Does a vigorous feeding style influence early development of adiposity

A prospective study of a cohort of healthy infants observed from birth to 2 years of age was carried out to investigate factors influencing the development of early adiposity. Infant suckling was measured in the laboratory twice during the first month of life. Multiple regression analyses revealed that parental educational level and a measure of feeding behavior, the interval between bursts of suckling, accounted for 18% of the variance in triceps skinfold measures at 1 year of age. A lower level of education and shorter interburst interval were associated with increased adiposity. Two feeding variables, pressure of suckling and the number of reported feeds per day, accounted for 21% of the variance in skinfold thickness at 2 years of age. Fewer, but larger, feeds and a higher sucking pressure were associated with a greater degree of adiposity. It seems that a vigorous infant feeding style, consisting of sucking more rapidly, at higher pressure, with a longer suck and burst duration, and a shorter interval between bursts of sucking, is associated with higher caloric intake and greater adiposity. The early development of this feeding style suggests that it may be a genetically endowed behavior. Breast-feeding protected against early adiposity only to the age of 6 months in this cohort of infants.

VISUAL ALERTNESS AS RELATED TO SOOTHING IN NEONATES: IMPLICATIONS FOR MATERNAL STIMULATION AND EARLY DEPRIVATION.

Observation of neonates revealed that when crying infants are picked up and put to the shoulder, they not only stop crying but they frequently alert and scan the environment. In order to explore the relations between soothing and visual alertness, 12 2-3-day-old healthy females were picked up while crying and put alternately to the right and left shoulder and propped to a sitting position. For 30 seconds following these interventions, incidences of alerting and scanning were recorded. For control trials the same was done without any intervention. Results reflect significant differences between positions in alerting and scanning. Each infant alerted and scanned in the majority of trials when put to the shoulder. Handling alone did not induce alertness significantly more often than control trials. The implications of the findings were discussed, particularly with respect to animal and human research on the effects of early stimulation.

Physical activity and adiposity: A longitudinal study from birth to childhood

Physical activity was reassessed in cohort of 52 children aged 4 to 8 years whose activity had been measured during the first 3 days of life. Neonatal adiposity was not significantly correlated with parental adiposity, neonatal physical activity, or gender, nor was neonatal activity significantly correlated with adiposity in childhood. Neonatal adiposity did not predict adiposity in childhood. However, in a stepwise multiple regression, parental adiposity and the childrens daytime high activity levels were significantly associated with childhood adiposity. The age or gender of the child did not significantly correlate with childhood adiposity. As parental adiposity increased or daytime high activity of a child decreased, the adiposity in a 4- to 8-year-old child was likely to increase.

The Relation between Neonatal and Later Activity and Temperament.

Evidence from several longitudinal studies suggests that individual activity characteristics tend to persist over time and to influence the development of temperamental style. The activity of 50 children whose motility had been monitored by an electronic activity monitor when they were neonates was again monitored by an ambulatory microcomputer when they were 4-8 years old. Additionally, the parents of these children filled out the Behavioral Style Questionnaire by McDevitt and Carey. The results showed that the level of the childrens day and night activity was unrelated. The vigor of neonatal movements was later positively related to high daytime activity. Also, the least vigorous infants tended to become the most inactive children during the day. The results further showed that the most active neonates became children who, as perceived by their parents, tended to approach rather than withdraw from new experiences.

Stable Individual Differences in Developmentally Changing Preterm Infants: A Replicated Study.

In a longitudinal study with the Neurobehavioral Maturity Assessment (NB-MAP), developmental changes and stability of individual differences were assessed in 2 independent samples of preterm infants ranging from 32 weeks conceptional age to term. Individual stability of response was assessed using regression analysis with repeated measures on subjects. The large majority of the functions tested showed highly significant developmental gains with age and highly significant individual stability of performance across age. These findings replicated well across the 2 cohorts. The results are discussed in the light of the neurobiological stage of development of preterm infants during the last 8 weeks prior to term.

Effects of compensatory movement stimulation on the sleep-wake behaviors of preterm infants.

The sleep-wake behaviors and the motility of 12 preterm infants were compared on and off a waterbed which oscillated in the pattern of a maternal biological rhythm. There was a pervasive increase in the day-to-day consistency of behaviors on the waterbed compared to the control condition. Whereas most of the behaviors tested were not significantly increased or decreased by waterbed flotation, two significant differences between the experimental and control conditions were found. While on the waterbed, the infants had significantly more sustained quiet sleep, and fussiness and crying were significantly reduced.

Early stimulation and maternal care as related to infant capabilities and individual differences

Recent research on the capabilities of newborns and their individual differences is reviewed. Experimental results suggest that the newborn is a great deal. more capable of organized responses than has been assumed and that he is most responsive to stimulus configurations which are inherent in the mother and her care. In the earliest weeks of life, the mother is thus a sufficient source of both affective and cognitive stimulation for the “average expectable” infant. In cases of unavoidable or avoidable deficit in maternal care, compensatory stimulation may be beneficial. The stimulation requirements differ in kind with the premature, the institutional infant, the ghetto child, and the neglected child. For optimal development and to counteract special vulnerabilities, differences in the infants’ innate endowment also differentially affect stimulation requirements. Illustrations are given. For the studies of individual differences to be most useful, they should not only pinpoint special vulnerabilities, but...

Relation between prenatal maternal blood pressure and infant irritability

Chisholm et al. [4], using samples of Navajo and Malaysian newborns, found a significant positive relation between maternal normotensive blood pressures during the second trimester of pregnancy and at delivery and infant irritability in response to the Brazelton Examination. Measuring spontaneous crying with an electronic activity monitor and using a white middle-class American population, this relation was replicated for mothers with normotensive blood pressures during the third trimester of pregnancy. The combined findings of the 3 studies seem to suggest that maternal blood pressure in the latter part of pregnancy, even when within normal limits, is a factor in how irritable normal newborn infants are.