Monday, February 24th, 2014
Hearing adults talking may have a significant effect on the cognitive and language development of babies who were born prematurely, according to a new study published in the journal Pediatrics. More from WomenandInfants.org:
The goal of the study was to test the association of the amount of talking that a baby was exposed to at what would have been 32 and 36 weeks gestation if a baby had been born full term, using the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley – III) cognitive and language scores.It was hypothesized that preterm infants exposed to higher word counts would have higher cognitive and language scores at seven and 18 months corrected age.
“Our earlier study identified that extremely premature infants vocalize (make sounds) eight weeks before their mother’s due date and vocalize more when their mothers are present in the NICU than when they are cared for by NICU staff,” explained Dr. Vohr.
At 32 weeks and 36 weeks, staff recorded the NICU environment for 16 hours with a Language Environment Analysis (LENA) microprocessor. The adult word count, child vocalizations and “conversation turns” (words of mother or vocalizations of infant within five seconds) between mother and infant are recorded and analyzed by computer.
“The follow-up of these infants has revealed that the adult word count to which infants are exposed in the NICU at 32 and 36 weeks predicts their language and cognitive scores at 18 months. Every increase by 100 adult words per hour during the 32 week LENA recording was associated with a two point increase in the language score at 18 months,” said Dr. Vohr.
The results showed the hypothesis to be true.Dr. Vohr concluded, “Our study demonstrates the powerful impact of parents visiting and talking to their infants in the NICU on their developmental outcomes. Historically, very premature infants are at increased risk of language delay.The study now identifies an easy to implement and cost effective intervention – come talk and sing to your baby – to improve outcomes.”
Image: Mom holding infant’s hand, via Shutterstock
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Tuesday, January 14th, 2014
Holding babies, particularly those who are born prematurely, directly against a mother’s body in a technique called “skin-to-skin contact” or “kangaroo care” may have benefits for babies that last years into their development. More from LiveScience:
In the study, the researchers asked 73 mothers to give their babies skin-to-skin contact for one hour per day for two weeks. For comparison, the researchers also looked at 73 premature infants who only spent time in an incubator — the standard form of care for premature infants.
At age 10, the children who had received maternal contact as infants slept better, showed better hormonal response to stress, had a more mature functioning of their nervous system and displayed better thinking skills.
The results show that adding “maternal-infant contact in the neonatal period has a favorable impact on stress physiology and behavioral control across long developmental epochs in humans,” Ruth Feldman, a professor of psychology at Bar-Ilan University in Israel, and her colleagues wrote in their study, published Jan. 1 in the journal Biological Psychiatry.
About 12 percent of infants in the United States and other industrialized societies are born prematurely, which is defined as at least three weeks before their due date. Rates of preterm birth are significantly higher in developing countries. Premature babies face a higher risk of lifelong problems such as intellectual disabilities, breathing problems, hearing loss and digestive problems, according to the Centers for Disease Control and Prevention.
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Monday, December 2nd, 2013
A growing number of the smallest premature babies are surviving and, in many cases, thriving–but medical issues commonly persist long after birth. More from NBC News:
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Alexis [Clarke] was born after she’d been in the womb just over 25 weeks; a typical pregnancy lasts 40 weeks. Babies born before 37 weeks are considered premature, but with medical and technological advances, it’s no longer unusual for very preterm babies to survive. The key, in general, is a steroid for mothers and a drug for their babies.
Alexis’ journey has been marked by ups and downs. Just as her parents thought she was ready to be discharged in time for Thanksgiving, one of her doctors told them she needed emergency eye surgery. Then a small cough raised concerns that she’d contracted whooping cough, prompting her to be put into isolation (tests came back clear). But an MRI of her brain delivered the good news that her development seems to be proceeding normally.
Baby Alexis is hardly the tiniest preemie born, but her journey from neonatal intensive care to home is typical of other extremely premature babies. In 2011, less than 1 percent of live births in the U.S. were considered “extremely preterm,” delivered before 28 weeks. That represents more than 28,000 babies. Meanwhile, the total number of premature births in the U.S declined last year to 450,000, or 11.5 percent, the lowest preterm birth rate in 15 years.
“In the past six years we’ve had babies survive that we didn’t think could survive,” Dr. Krishelle Marc-Aurele, one of Alexis’ doctors, told NBC San Diego.
Some hospitals are divided on treating babies born in the “gray zone,” between 23 and 25 weeks. In the U.S, up to 90 percent of neonatal units resuscitate babies born as soon as 23 weeks. Younger than that and most doctors believe a baby is not viable. “The lower level of viability is inching down,” said Dr. John Muraskas, who resuscitated the smallest surviving baby on record, Rumaisa Rahman, born in 2004 weighing 9.2 ounces.
Muraskas, a professor of pediatrics and neonatal/perinatal medicine at Loyola University Medical Center, said the key treatments began in the 1990s and have made all the difference.
Now doctors routinely give moms on the brink of delivering too soon two doses of steroids to help the baby or babies’ lungs mature quicker and strengthen the blood vessels in the brain. That reduces the risk of a premature infant developing a brain bleed.
Once born, preemies receive surfactant, a drug administered through a breathing tube into their lungs that makes them stronger and less stiff, and able to breathe independently sooner.
Thursday, October 24th, 2013
The definition of a “full term” baby is being honed by the American College of Obstetricians and Gynecologists, who are adjusting the definition in order to better equip parents and hospitals with the knowledge they need to care for babies born between 37 and 42 weeks gestational age. More from Reuters:
“We have increasingly recognized that newborn outcomes are not uniform between 37 and 42 weeks,” Dr. Jeffrey Ecker said.
Babies delivered between 37 weeks and 39 weeks of pregnancy will now be considered “early term,” according to the American College of Obstetricians and Gynecologists.
“Full term” infants will be those born between 39 and 41 weeks.
Babies born between 41 and 42 weeks of pregnancy will be thought of as “late term.” Finally, those born at 42 weeks or later will still be considered “postterm.”
Ecker is the chair of The College’s Committee on Obstetric Practice. He is also a high-risk obstetrician at Massachusetts General Hospital in Boston.
“Language is important in communicating that it’s not just one period of time and to recognize that outcomes do differ,” he told Reuters Health.
A growing body of research has found babies born before 39 weeks are not as developed as those born later.
Babies born after 39 weeks have fewer poor outcomes such as breathing, hearing and learning problems, The College says in its joint statement with the Society for Maternal-Fetal Medicine. The statement was published Tuesday in Obstetrics and Gynecology.
The brain grows by about a third between week 35 and week 39 of pregnancy, according to The College. And a layer of fat to help keep the body warm is added during the last weeks of pregnancy.
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Wednesday, August 28th, 2013
A review of research on preterm babies reveals that super-early preemies (those born between the 22 and 25 weeks gestation) face significant health risks years later. Compared with full-term babies, these preemies had increased risk of neurological problems at 4 to 8 years of age. Care of premature infants continues to improve, but this review points to the importance of trying to keep babies in the womb as long as possible, TIME.com reports.
More from TIME.com:
It’s not the first hint that preemies are at higher risk of health issues for being born before their development was completed. Some recent studies showed, for example, that babies who were born earlier had poorer test scores in reading and math compared with those born full term. A study published in 2011 that analyzed the long-term effects of premature birth on cognitive abilities such as memory and attention span in early adulthood revealed that people who were born extremely premature performed worse on executive function tests and took longer to complete higher-order intellectual tasks. As adults, these individuals also scored an average of 8.4 points lower on IQ assessments compared with people who were born at full term.
The fact that the effects of premature birth last into adulthood is concerning, since they are not only at a disadvantage in some cognitive functions, they even have a reportedly higher risk of death in early adulthood as well. Advancements in care of premature babies have undoubtedly improved, but lessening their health risks is still a task at hand. In 2012, a team of researchers from the University College London Institute for Women’s Health reported that death rates and health problems among extremely preterm babies has remained unchanged for decades.
While the parents of preemies may find this news less-than-reassuring, this research can help children by giving “parents and clinicians a heads-up for what to look out for during development,” TIME.com says.
Image: Premature baby’s foot, via Shutterstock
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