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Published on: January 7, 2020
UNPACKING THE BURDEN OF CARE FOR INFANTS IN THE NICU
Amy L D'Agata1, Marilyn R Sanders2, Damion J Grasso3
1University of Connecticut, Storrs, and University of South Florida.
Insights
The neonatal intensive care unit (NICU) environment can cause infant medical trauma (IMTN) due to extreme stressors like painful procedures and separation. This article introduces IMTN and suggests neuroprotective strategies to mitigate these adverse experiences.
Area of Science:
- Neonatal Medicine
- Developmental Psychology
- Pediatric Trauma
Background:
- Neonatal intensive care units (NICUs) expose infants to chronic, extreme stressors.
- Parental separation and painful medical procedures are significant stressors for newborns.
- The preverbal stage of development in infants complicates understanding and linking NICU experiences to long-term outcomes.
Purpose of the Study:
- To propose the terminology Infant Medical Trauma in the NICU (IMTN) to describe the infant experience.
- To frame the NICU environment as a potential adverse childhood event.
- To offer recommendations for neuroprotective strategies to support infants in the NICU.
Main Methods:
- Conceptual review of the NICU environment as an adverse childhood event.
- Discussion of critical factors defining the newborn period.
- Presentation of the IMTN conceptual model.
Main Results:
- The NICU environment presents unique stressors impacting infant development.
- The proposed IMTN model provides a framework for understanding infant experiences in the NICU.
- Identification of key areas for intervention to support infant well-being.
Conclusions:
- The term Infant Medical Trauma in the NICU (IMTN) offers a new perspective on infant experiences.
- Addressing NICU-related trauma is crucial for infant development.
- Neuroprotective strategies can help moderate the intensity of adverse experiences for infants in the NICU.
Abstract:
Infants who begin early life in the medicalized environment of the neonatal intensive care unit (NICU) experience disruption to numerous fundamental expectancies. In the NICU, infants are exposed to chronic, extreme stressors that include painful medical procedures and parental separation. Due to their preverbal stage of development, infants are unable to fully express these experiences, and linking these experiences to long-term outcomes has been difficult. This clinical article proposes the terminology Infant Medical Trauma in the NICU (IMTN) to describe the infant experience. Following a discussion of the NICU as an adverse childhood event, the article has three sections: (a) the unique and critical factors that define the newborn period, (b) a review of the IMTN conceptual model, and (c) recommendations for supportive neuroprotective strategies to moderate the intensity of adverse NICU infant experiences.
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