Parent-infant interaction in the NICU: Challenges in measurement

M Richter1, K Fehringer2, J Smith3

  • 1University of Southern California, Chan Division of Occupational Science and Occupational Therapy, 1540 Alcazar St, Los Angeles, CA 90089, United States of America.

Insights

The Nursing Child Assessment Feeding Scale (NCAFS) may not effectively measure parent-infant interaction in the NICU for preterm infants. Enhanced parent education was unexpectedly linked to lower interaction scores.

Area of Science:

  • Neonatal care
  • Parent-infant interaction research
  • Developmental psychology

Background:

  • Parent-infant interaction is not well understood in Neonatal Intensive Care Unit (NICU) settings, especially for high-risk dyads.
  • Existing parent-infant interaction measures are not specifically designed for preterm infants in the NICU or tailored to educational interventions.

Purpose of the Study:

  • To investigate the relationships between parent-infant interaction scores (using the Nursing Child Assessment Feeding Scale - NCAFS) and various factors in the NICU.
  • To assess the impact of enhanced parental education on parent-infant interaction tailored to infant cues.

Main Methods:

  • Video recorded oral feedings of 26 preterm infants (born ≤32 weeks) by their parents in the NICU.
  • Scoring of parent-infant interaction using the NCAFS by a certified evaluator.
  • Analysis of relationships between NCAFS scores and socio-demographic factors, parent mental health, and enhanced parental education.

Main Results:

  • 65% of parent-infant dyads scored below the 10th percentile on the NCAFS.
  • No significant relationships were found between NCAFS scores and socio-demographic factors or parental mental health.
  • Dyads receiving enhanced parent education had significantly lower NCAFS scores compared to those receiving usual care (p=0.01).

Conclusions:

  • The study questions the utility and appropriateness of the NCAFS for assessing parent-infant interaction in preterm infants within the NICU.
  • Further research is needed to determine if the NCAFS accurately captures interaction dynamics in this high-risk population.
  • The findings suggest a need for NICU-specific measures that account for educational interventions and infant cues.
Abstract