Care practices, such as family centered care, as well as the physical environment play a role in the infant's neurological outcomes. The third trimester and first three months of life, sometimes referred to as the "fourth" trimester, are critical periods of brain and neurosensory development.1 This is especially critical to the premature infant who may be going through this stage of development outside the protective environment of the mother's womb. Special attention is needed to avoid disruption, damage, or deprivation in the infant’s social and physical environment which can create permanent deficits in the developing neurosensory systems.
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There are many factors within a NICU that can either hinder or facilitate the brain development in neonates. Hilary Whyte, Professor of Pediatrics, Hospital of Sick Children in Toronto, Canada, explains in depth how certain events, medications and other stimuli affect brain development and fuction, and how can you minimize negative effects.
Stages of growth and development in the central nervous system.
Tactile system development in utero and extra utero, tactile interventions and family involvement.
Covers two systems, first the vestibular system development, equilibrium disturbances, and appropriate handling. Second, gustatory system, taste hazards, and non-nutritive sucking.
Covers two systems, first olfactory system development and scent-free environments. Second, the auditory system, negative effects of noise, and positive stimuli.
Visual system development, NICU lighting standards and overall recommendations to create a more developmentally care friendly environment.
Premature babies are exposed to vastly different sound environments in the NICU compared to the womb. Andres Maturana, Head of the Neonatal Care Unit in Santiago de Chile, explains how we need to be more aware of what sounds the preemies are hearing. Are we monitoring noise where it really matters? He goes further to explain how some sounds, especially the mother's voice, positively influence the development of premature infants.
Light is a complex topic when it comes to the NICU. Several studies have shown that a supportive light environment reduces the level of cortisol, extends sleep duration, stimulates the release of growth hormones, and encourages the early development of a circadian rhythm.2, 3 This article discusses protecting the infant from intense light and supporting the circadian sleep-wake rhythm with cyclical light exposure.
1 Marshall, Jennifer. Early Childhood Education Journal, 2011, Volume 39, Number 3, Page 175
2 Graven SN. Early neurosensory visual development of the fetus and newborn. Clin Perinatol. 2004, 31(2):199-216
3 Rivkees SA. Emergence and influences of circadian rhythmicity in infants. Clin Perinatol. 2004 Jun;31(2):217-28