Infant Mental Health for the Pediatric Nurse Practitioner

Preterm Infant
Preterm birth is a risk factor for infant mental health issues.  Unresolved grief may affect parenting effectiveness. Preterm infants may be less responsive in his or her social interactions, thus not providing clear or reinforcing behaviors. This provides an additional challenge to parents ability to understand the infants needs.

Infants born preterm can have underdeveloped sucking skills or unsynchronized suck-swallow-breathing. After extended NICU stays preterm infants may also exhibit oral tactile defensiveness that impacts feeding abilities.

Bonding and attachment are separate, but somewhat related concepts. Bonding is a process that goes from mother to infant and is thought to be somewhat time sensitive, however, parents who have adopted children and those who have had a delayed bonding experience due to required medical interventions still feel bonded to their child (http://www.askdrsears.com/topics/pregnancy-childbirth/tenth-month-post-partum/bonding-your-newborn/bonding-what-it-means). In all birth experiences and subsequently, opportunities for parent-infant interaction, skin-to-skin contact (e.g., kangaroo care), and breastfeeding should be explored and encouraged. It is important to reinforce to parents that in no way are their feelings less for their infant because early contact has been delayed or absent.

Extended NICU stays present a major disruption to the family unit. PNPs need to encourage frequent visitation, explore barriers to visitation and hands-on care experiences, and support parents through-out their infant's hospitalization. 

Reflection:  

What resources are available in my community for parents of preterm infants?  How do I help parents of preterm infants recognize the challenges the family may face while helping them keep a positive outlook?  

References and Resources:

Premies face greater mental health risks:  http://thechart.blogs.cnn.com/2012/06/02/risk-of-mental-illness-higher-for-premature-babies/

Dodrill, P. Feeding difficulties in preterm infants.  ICAN Infant Child Adolescent Nutrition, 3: 324-331.

​Samra, H., McGrath, J., & Webbe, M. (2011). An integrated review of developmental outcomes and late-preterm birth. Journal of Obstetric & Gynecologic Nursing, 40: 399-411. 

Sparrow, J. (2011). Pediatricians' role in supporting parents as they care for infants and young children. Current Problems in Pediatrics and Adolescent Health Care, 41: 207-209

Vanderbilt, D. & Gleason, M. (2010). Mental health concerns of the prematue infant through the lifespan. Child and Adolescent Psychiatric Clinics of North America, 19: 211-218.