Parental Participation in Preterm Infant Feeding in the Neonatal Intensive Care Unit.

PURPOSE: To identify factors associated with parental participation in the feeding care of hospitalized preterm infants and determine associations between parental participation in feeding and infant neurobehavioral outcomes. STUDY DESIGN AND METHODS: Secondary analysis of data collected during a larger study of preterm infants. Parental participation in gavage and oral feeding was measured as a proportion of all feeding opportunities. Neurobehavioral outcomes were measured using a neurobehavioral assessment and feeding milestones. Other data were collected from the electronic health record. RESULTS: Parental participation in feeding was low. There were associations between parental participation in gavage feeding and infant sex, insurance type, maternal race, infant gestational age at birth, and birthweight. There were associations between parental participation in oral feeding and infant sex, insurance type, maternal race, and study group. Greater parental participation in feeding was associated with earlier achievement of some feeding milestones. CLINICAL IMPLICATIONS: Parental participation in feeding can decrease the time required for infants to achieve feeding milestones, possibly leading to decreased length of hospitalization. Nurses should encourage parents to participate in caregiving for their preterm infants. Interventions are needed to remove barriers to parental participation in caregiving.

An integrative review of clinician-administered comforting touch interventions and acute stress responses of preterm infants.

PROBLEM: Preterm infants experience numerous stressors in the neonatal intensive care unit. Non-pharmacological interventions, including maternal comforting touch, reduce stress responses of preterm infants; however, the effects of clinician-administered comforting touch are unclear. The purpose of this integrative review was to synthesize findings from clinical trials to determine the effect of clinician-administered comforting touch on preterm infants' acute stress responses. ELIGIBILITY CRITERIA: Eligible clinical trials were published in English between 2001 and October 2021 and reported effects of clinician-administered comforting touch on acute stress responses in preterm infants. SAMPLE: Thirty clinical trials were included. RESULTS: Researchers tested the effect of comforting static touch, massage, massage with kinesthetic stimulation, sensorial saturation, and Yakson. There was significant heterogeneity in study design, comparison condition, and context of intervention delivery. Results varied; some studies demonstrated efficacy of comforting touch in reducing acute stress responses and others showed no effect. Generally, comforting touch provided during stressful procedures was associated with lower stress responses compared to standard care and was an effective adjunct to other stress management strategies. However, comforting touch alone was insufficient for managing pain, especially during skin-breaking procedures. CONCLUSIONS: While comforting touch may be a useful part of stress management plans for preterm infants, additional research is needed to determine when comforting touch is appropriate and effective. IMPLICATIONS: Comforting touch is beneficial to preterm infants and should be provided for stress management. For highly intrusive or painful procedures, comforting touch can be provided as part of a comprehensive stress management plan.

Losing touch.

The need for human touch is universal among critical care patients and is an important component of the nurse-patient relationship. However, multiple barriers to human touch exist in the critical care environment. With little research to guide practice, we argue for the importance of human touch in the provision of holistic nursing care.