Thank you for registering for "In Touch With Experts, LIVE" January edition. Find the description of the topic and Dr. McGrath’s bio at https://tinyurl.com/KCDJan13
Let's talk about evidence-based practice in plain English.
GUEST:
Our speaker is the highly accomplished, Dr. Jacqueline M. McGrath.
TOPIC:
"Is Parent-Baby PLAY Possible in the NICU?"
RESOURCES:
BOOK: Print date is 2/01/2022 (I don’t have the ISBN # yet)
Kenner, C., & McGrath, J. M. (Eds). (2022, in press). Developmental Care of Newborns and Infants: A Guide for Health Professionals (3rd ed.). National Association of Neonatal Nurses. Philadelphia: Lippincott.
- "STATE-OF-THE-ART The neonatal intensive parenting unit: an introduction" SL Hall, MT Hynan, R Phillips, S Lassen, JW Craig, E Goyer, RF Hatfield, and H Cohen
- "Why do we hunger for touch? The impact of daily gentle touch stimulation on maternal-infant physiological and behavioral regulation and resilience" by Martine Van Puyvelde et al.
- "Why play equals learning: Comparison as a learning mechanism in play" by Stella Christie
- "Massage intervention for preterm infants by their mothers: A randomized controlled trial" by Xiaoning Zhang, Jun Wang
- Copy of the presentation will be available after the session.
FEBRUARY 09, 2022 "IN TOUCH WITH EXPERTS" SESSION:
Mary Coughlin will be our guest and her session is “Where is the love; getting to the heart of trauma informed care”
February 9th, 2022 at 11am CST
Handout – Recommendations for Implementation of PLAY
Parent-Participative
Loving Gentle Infant Massage
Age Appropriate Touch
Your Cue-Based Assessment
General Recommendations for Skin-to-skin care, Touch and/or infant massage
- During touch and/or massage the caregiver is mentally and emotionally engaged with each infant in his/her care, continually guided by the behavior of the infant.
- The caregiver makes ongoing judgments about the necessity of interventions for each infant and makes collaborative decisions to delay or eliminate interventions that may create unnecessary stress.
- If an infant has difficulty remaining stable and organized in spite of the caregiver’s careful handling, the caregiver slows down or stops, helping the infant recover completely, and reconsiders his/her approach before continuing.
- The healthcare provider stays with the infant and supports a smooth transition back to restful sleep before stepping away from the bedside after touching or handling the infant.
Issues to address with Families BEFORE providing Touch and Skin-to-skin care
- Help the parents to respond to the infant’s physiological needs before considering touch or skin-to-skin: Is the infant hungry or tired? Consider the infant’s sleep/wake cycle.
- Decrease extraneous visual or auditory stimuli before beginning the session.
- Assess infant’s readiness and reactivity. Are they in a state where they are easily over-stimulated?
- Has the infant had a stressful day and touch needs to be considered at a different time or day? Consider infant state before handling.
- Place the infant in a comfortable position prior to beginning touch.
Issues to address with Families DURING Touch and Skin-to-Skin care
- Fragile or ill preterm infants can be potentially hypersensitive to tactile input so proceed cautiously.
- Check in with parent. Are they relaxed? Stressed? Infants will respond to these emotions.
- Use a unimodal approach to begin with, sensory processing can be limited in the preterm infant progress to multi-modal as the infant demonstrates increase tolerance for touch and handling.
- Offer comforting pressure by laying the relaxed hand on the child’s forehead or abdomen, or other part while waiting for the infant to become less distressed.
- Provide swaddling for natural warmth especially if the infant is fragile or easily over-stimulated.
- Initial reactivity to touch is common among sensitive infants proceed slowly.
- Touch should begin gradually and be rhythmical in nature.
- Duration of the touch should depend on the infant’s cues, responses and developmental maturity.
- Re-assess the infant with each movement.
- Talk to the infant using a predictable approach but watch for tolerance.
- If the infant seems distressed, consider decreasing or increasing the pressure being used during touch.
- If the infant seems distressed change the location of the tactile input, consider going back to a location that has been comfortable for the infant in the past.
- Use different type of stroke such as long sweeping strokes instead of wringing motions, avoid light stroking this can be irritating to the infant.
Issues to address with Families DURING and AFTER touch and skin-to-skin care
- Discontinue the massage and use an alternative calming technique, such as vestibular input (slow rocking), proprioceptive input, or rhythmical music if the infant is distressed.
- Provide skin to skin holding (kangaroo care) for the preterm infant who is fragile and easily overstimulated.
- If the infant has high tone consider firm, soft, gentle movement; clockwise for relaxation.
- Discontinue touch until a later time if the infant becomes distressed or unstable.
- Tactile stimulation such as touch should not be just another task but should be administered when and if the infant’s cue are indicative of the infant’s availability for stimulation.
- After touch make sure the infant is repositioned and supported, assess organization of the infant, continue to reassess for delayed reactivity to the stimulation.
Emails:
Guest: Dr. Jacqueline McGrath: mcgrathj@uthscsa.edu
Moderators:
Yamile Jackson: yamile@thezaky.com
and Marie Boone-Clark Marie@AntoniaandGrace.com
Questions? Contact Us or email info@kangaroo.care
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