Marjolaine Héon

Review and Critical Analysis of Massage Studies for Term and Preterm Infants.

ABSTRACT Purpose: To review and analyze studies evaluating the effects of massage on term and preterm infants. Design: A systematic review of literature. Results: Benefits of massage for term infants are: improved weight gain, growth, and sleep and decreased hyperbilirubinemia. Benefits for preterm infants are: improved weight gain, decreased response to pain, and increased interactions with parents. However, the few studies use different interventions related to timing and number of massages, and the outcomes vary among studies. There is not enough evidence to support the use of massage for term and preterm infants, but massage may be considered on a case-by-case basis.

An Intervention to Promote Breast Milk Production in Mothers of Preterm Infants

A pilot study was conducted to estimate the effects of a breast milk expression education and support intervention on breast milk production outcomes in mothers of very and extremely preterm infants. Forty mothers of hospitalized preterm infants (<30 weeks of gestation) were randomized to the experimental intervention or standard care for 6 weeks. Duration and frequency of breast milk expressions and volume of expressed breast milk were measured daily. Samples of breast milk were collected thrice during the study and analyzed for their lipid concentration. Mothers in the experimental group had a statistically significant higher duration of breast milk expression in min/day (p = .043). Differences observed between the two groups regarding the frequency of breast milk expression, volume of breast milk, and lipid concentration were not statistically significant. Results suggest that the experimental intervention may promote breast milk production in mothers of very and extremely preterm infants.

Acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants.

PURPOSE: A pilot study was conducted to assess the acceptability and feasibility of a breast milk expression education and support intervention in mothers of preterm infants and study procedures. SUBJECTS: Forty mothers of preterm infants born at less than 30 weeks of gestation. DESIGN: Pilot randomized controlled trial. METHODS: Mothers of preterm infants were randomly allocated to the breast milk expression education and support intervention or standard care. The experimental intervention encompassed a breast milk expression education session on 7 themes, telephone follow-up, and telephone helpline. MAIN OUTCOME MEASURES: Data related to the acceptability and feasibility of the intervention and study procedures were collected throughout the study. At the end of the study, mothers allocated to the experimental intervention completed a self-report questionnaire assessing the acceptability of each of the intervention components. RESULTS: It was feasible to recruit 70% of eligible mothers and retain 83% of mothers who consented to participate in the study. Mothers reported that all the intervention components were appropriate and effective in supporting their breast milk production. Although the reliability of the data collection method was demonstrated, the fidelity of the telephone follow-up faced some challenges. CONCLUSIONS: Both the intervention and study procedures were acceptable and feasible. Improvements related to the fidelity of the intervention would ensure the feasibility and internal validity of a larger-scale trial.

Effects of Cycled Lighting Versus Continuous Near Darkness on Physiological Stability and Motor Activity Level in Preterm Infants

Background: Preterm infants generally spend weeks in the neonatal intensive care unit where light intensity can fluctuate as well as be high, leading to physiological instability and increased motor activity in these infants. To date, 2 lighting control methods have been studied: cycled lighting and continuous near darkness. The most appropriate method of lighting is still unknown due to ambivalent results from the studies that have assessed these 2 interventions. Objective: To compare the effects of cycled lighting versus continuous near darkness on physiological stability and motor activity level in preterm infants born between 28 and 32 weeks of gestation. Methods: A randomized clinical trial was conducted to compare physiological stability and motor activity level in preterm infants assigned to cycled lighting or continuous near darkness. Thirty-eight participants were recruited and randomly assigned to one of the lighting conditions for 24 hours. Physiological stability was measured using the Stability of the Cardiorespiratory System in Premature Infants (SCRIP) score, the means, and the coefficient of variation of each physiological parameter measured. The level of motor activity was measured with an accelerometer. Results: There were no significant differences between the 2 groups with regard to physiological stability measured by the SCRIP score, means, and coefficient of variation as well as motor activity level. Participants in both groups were physiologically stable and their motor activity level was comparable. Implications for Practice and Research: Neither cycled lighting nor continuous near darkness negatively impacted infants physiologic stability and motor activity level. Further research is required to identify the most appropriate lighting control method for preterm infants born between 28 and 32 weeks of gestation.

Educational Intervention for an Evidence-Based Nursing Practice of Skin-to-Skin Contact at Birth.

ABSTRACT This article presents the development and evaluation of an educational intervention aiming at an evidence-based practice of skin-to-skin contact at birth among nurses of a maternity care unit. Based on the Iowa Model of Evidence-Based Practice to Promote Quality Care, four educational sessions were developed according to an active-learning pedagogy. Even if the nurses’ practice did not fully meet the recommendations for skin-to-skin contact, a pre- and postintervention evaluation showed some positive results, such as a longer duration of skin-to-skin contact immediately after birth, delivery of some routine care directly on mothers’ chest, and improved parent education. The educational intervention seems to have enacted some evidence-based nursing practice changes regarding skin-to-skin contact at birth.

An Educational Intervention to Support the Development of a Sense of Mastery of the Anticipated Paternal Role in Expectant Fathers: A Clinical Project

ABSTRACT This article presents a clinical project of the development and evaluation of an educational intervention that aimed at promoting the development of a sense of mastery of the anticipated paternal role in soon-to-be fathers. The preventive role supplementation conceptual framework guided the development of 4 educational sessions that were delivered to 6 expectant fathers attending prenatal classes at a local community services center in Greater Montreal area. The participants highly appreciated the content and format of the educational intervention. They also expressed to have developed a sense of mastery of the anticipated paternal role. This interactive educational intervention, which focused on the specific needs of expectant fathers, seems appropriate to support men in their transition to fatherhood.

O-038 Polyunsaturated Fatty Acid Composition Of Breast Milk From Eastern Canadian Mothers Of Preterm Infants

Background and aim Polyunsaturated fatty acids (PUFAs) are essential for early human neurodevelopment. Since breast milk represents the main dietary source of PUFAs for preterm infants, its fatty acid composition is of particular interest. Breast milk fatty acid composition fluctuates from one woman to another, by duration of gestation and stage of lactation, and among countries. As PUFA composition of breast milk from Western Canadian mothers of preterm infants has been previously described, the aim of this pilot study was to describe the compositional variations of PUFAs in breast milk of Eastern Canadian mothers of preterm infants over the first 6 weeks of lactation. Methods Samples of breast milk were collected on the 7th, 21st, and 42nd day of lactation from 40 Eastern Canadian mothers who had given birth to preterm infants of gestational age less than 30 weeks. Lipids were extracted using the Folch method (Folch et al ., 1957). Thereafter, the method of direct transesterification was performed (Lepage and Roy, 1986) and PUFAs were quantified by gas chromatography. Results Throughout the study, fatty acids from the n-3 and n-6 families, linoleic acid (C18:2n-6), α-linolenic acid (C18:3n-3), and eicosapentaenoic acid (C20:5n-3) remained stable, whereas arachidonic acid (C20:4n-6) and docosahexaenoic acid (C22:6n-3) decreased significantly. Conclusion Results on the compositional variations of PUFAs in breast milk over the first weeks of lactation are somewhat similar to results of previous European studies. However, values of PUFAs in preterm breast milk of Eastern Canadian mothers are lower than those of Western Canadian mothers.