Maternal Holding of Preterm Infants During the Early Weeks After Birth and Dyad Interaction at Six Months

ABSTRACT

Objective: To examine whether a supportive nursing intervention that promoted kangaroo holding of healthy preterm infants by their mothers during the early weeks of the infant's life facilitated coregulation between mother and infant at 6 months of age.

Design: Randomized controlled trial.

Participants: Sixty-five mother/infant dyads with mean gestational age at birth of 33 weeks. Fifty percent of infants were male, and 50% were non-White.

Interventions: An 8-week home intervention encouraged daily 1-hour, uninterrupted holding with either blanket (baby wrapped in blanket and held in mother's arms) or the kangaroo (baby in skin-to-skin contact on mother's chest) method. In both conditions, weekly home visits by an experienced RN included encouragement to hold the infant, emotional support, and information about infant behavior and development. A control group received brief social visits, had no holding constraints, and participated in all assessments.

Main Outcome Measures: When infants were 6 months of age, the Still-Face Paradigm was used to assess mother/infant interaction. Outcome measures were coregulation of the dyad's responses during the play episodes of the Still-Face Paradigm and vitality in infant efforts to reengage the mother during the neutral face portion of the Still-Face Procedure.

Results: Significant differences among groups were found in mother/infant coregulation. Post hoc analysis showed that dyads who were supported in kangaroo holding displayed more coregulation behavior during play than dyads in the blanket-holding group. No differences were found between groups in infant vitality during the neutral face portion of the Still-Face Procedure.

Conclusion: Dyads supported in practicing kangaroo holding in the early weeks of life may develop more coregulated interactional strategies than other dyads.