A new study from France highlights the impact of routine practices in neonatal intensive care units (NICUs). The study, inspired by a study of newborn horses, compares one style of NICU clothing to another and finds that, while neither style of dress is harmful to the child, bodysuits seem to be less stressful than full-coverage sleep sacks.
Staying Warm in the NICU
Premature babies (born before the 38th week) typically begin life in an enclosed incubator and, as they become stronger, they’re placed in an open incubator warmed by a radiant heat source. Once the child can maintain its own body temperature, the radiant warmer is turned off and the child is clothed.
A common practice is to dress preemies in pajamas and a cardigan and then in a long-sleeved sleep sack that encompasses the body from shoulders to toes. All those layers help the preemie stay warm.
Foals Wrapped in Blankets
Equine researchers from Laboratoire Éthologie Animale et Humaine (CNRS/Université de Rennes 1) questioned the stud farm practice of wrapping a newborn horse (foal) in blankets moments after its birth. The idea is that wrapping it minimizes the foal’s fear of human contact. The researchers found this wrapping actually creates more problems than it solves.
Wrapping weakened the foal’s bond with its mother and made weaning more stressful than necessary. Wrapped foals often had problems integrating into a group of young horses and exhibited shyness and other undesirable behaviors when faced with stressful situations.
Bodysuits versus Sleep Sacks
The study on wrapped foals caught the attention of Virginie Durier, a neonatologist at the Brest University Hospital. She and her research team devised an experiment using 18 babies born between 34 and 37 weeks after conception.
Nine of the preemies were dressed in simple body suits that allowed freedom of movement; the body suits were of thin, flexible fabric with long sleeves but nothing covering the legs. The other nine wore the three-layered sleep sack outfits. All 18 babies were videotaped for several hours at a time over a period of two to four days.
[bmed_ad_r]The preemies in body suits were more active, bending their arms and frequently touching their bedding and their heads. The researchers say self-touch is a means of stress relief during infancy. Those in sleep sacks laid more still, with arms extended and hands often closed. They touched nothing. The researchers believe the weight of the sleep sack is too heavy for preemies weighing less than 5 pounds to move around as they need to and the design too confining.
The Value of Human Touch
The research team suggests that preemies confined to an incubator often lack the human touch of their parents or nursing staff so they self-touch as emotional compensation. The restriction of movement created by the heavy sleep sack causes stress and frustration but the body suit allows the preemie to comfort him/herself as needed.
The Brest research team is planning a new, larger study that involves long-term observation of preterm babies dressed in sleep sacks. Their theory is that sleep sacks may impact emotional and motor development as the child matures.
Sources:
- Durier, Virginie, et al. "Unexpected behavioural consequences of preterm newborns' clothing." Scientific Reports 5 (2015). Nature Publishing Group. Web. 27 Mar. 2015.
- "Transitioning Newborns from NICU to Home: A Resource Toolkit." AHRQ. Agency for Healthcare Research and Quality, n.d. Web. 27 Mar. 2015.
- "Model Behavior / Sample Policy & Procedures: Safe Sleep Practices for the Neonatal Intensive Care Unit." Department of Public Health. County of Los Angeles (California), 2006. Web. 27 Mar. 2015.