Discharging the Premature Infant: Family Issues and Implications for Intervention

Abstract

When premature infants are discharged from a hospital's Neonatal Intensive Care Unit (NICU), parents are confronting the long-term implications of their child's prematurity, assuming the day-to-day caregiving responsibility for their child, regaining control over their lives, and locating appropriate community resources and services for their infant and family. Implications of these issues for providing support for families during this life cycle transition include capitalizing on family strengths and resources in order to empower parents to make informed decisions, creating opportunities for parent-to-parent contact, developing a range of service delivery and support options, and focusing intervention goals on parent-identified needs and on developing mutually satisfying parent-child interactions. A key to providing this comprehensive support is to begin providing services to families in the hospital before the infant's discharge from the NICU. In this way, families are supported throughout the transition and have uninterrupted access to professional services.

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References

Affleck, G. , Tennen, H. , & Rowe, J. (1988). Adaptational features of mothers' risk and prevention appraisals after the birth of high-risk infants. American Journal on Mental Retardation 92, 360–368.

Brachfeld, S. , Goldberg, S. , & Sloman, J. (1980). Parent-infant interaction in free play at 8 and 12 months: Effects of prematurity and immaturity. Infant Behavior and Development 3, 289–305.

Bromwich, R.M. , & Parmelee, A.H. (1979). An intervention program for preterm infants. In T.M. Field , A.M. Sostek , S. Goldberg , & H.H. Shuman (Eds.), Infants born at risk: Behavior and development (pp. 389–412. Jamaica, NY: Spectrum Publications.

Calhoun, M.L. , Calhoun, L.G. , & Rose, T.L. (1989). Parents of babies with severe handicaps: Concerns about early intervention. Journal of Early Intervention, 13, (2), 146–152.

Crawford, J.W. (1982). Mother-infant interaction in premature and full term infants. Child Development 53, 957–962.

DiVitto, B. , & Goldberg, S. (1979). The effects of newborn medical status on early parent-infant interactions. In T.M. Field , A.M. Sostek , S. Goldberg , & H.H. Shuman (Eds.), Infants born at risk: Behavior and development (pp. 311–332. Jamaica, NY: Spectrum Publications.

Dunst, C. , Trivette, C. , & Deal, C. (1988). Enabling and empowering families: Principles and guidelines for practice. Cambridge, MA: Brookline Books.

Ensher, G.L. , & Clark, D.A. (1986). Newborns at risk: Medical care and psycho-educational intervention. Rockville, MD: Aspen.

Field, T. (1977). Effects of early separation, interactive deficits, and experimental manipulation on mother-infant interaction. Child Development 48, 763–771.

10.

Goldberg, S. , & DiVitto, B.A. (1983). Born too soon: Preterm birth and early development. New York: W.H. Freeman.

11.

Harrison, H. (1983). The premature baby book. New York: St. Martin's Press.

12.

Healy, A. , Keesee, P.D. , & Smith, B.S. (1989). Early services for children with special needs: Transactions for family support. Baltimore: Paul H. Brookes.

13.

Lierman, C. , Wolff, R. , Hazelton, J. , Pesquera, K. , & Wilson, E. (1987). Multi-disciplinary treatment of feeding disorders in the home. Pediatric Nursing 13, 266–270.

14.

McCarthy, M.F. (1986). A home discharge program for ventilator-assisted children. Pediatric Nursing 12, 331–335. 380.

15.

Minde, K. , Shosenberg, N. , Marton, P. , Thompson, J. , Ripley, J. , & Burns, S. (1980). Self-help groups in a premature nursery---A controlled evaluation. Pediatrics 96, 933–940.

16.

Parmelee, A.H. , & Cohen, S.E. (1985). Neonatal follow-up services for infants at risk. In S. Harel & N.J. Anastasiow (Eds.), The at-risk infant: Psycho/socio/medical aspects (pp. 269–273. Baltimore: Brookes.

17.

Ramey, T.R. , & Trohanis, P.L. (1982). Finding and educating high-risk and handicapped infants. Austin, TX: PRO-ED.

18.

Sammons, W.A.H. , & Lewis, J.M. (1985). Premature babies: A different beginning. St. Louis, MO: C.V. Mosby.

19.

Scarr-Salapatek, S. , & Williams, M.L. (1973). The effects of early stimulation on low birthweight infants. Child Development 44, 94–101.

20.

Schmerber, R.J. (1982). Communication strategies with parents. In A. Waldstein , D. Gilderman , D. Taylor-Hershel , S. Prestridge , & J. Anderson (Eds.), Issues in neonatal care (pp. 139–146). Western States Technical Assistance Resource (WESTAR) and Technical Assistance Development System (TADS).