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The prolonged and total separation of a premature infant from its parents in a Neonatal Intensive Care Unit is an additional element of anxiety in a family already upset by the premature birth itself. However, while encouraging parents to participate in the care of their child lessens some problems, it also tends to create others. The environment of intensive care and continuous contact with the nursing of the infant may give rise to distress, and parental reactions may interfere with the running of the department. We report some results from 60 semistructured interviews between a clinical psychologist and 30 couples whose preterm infants had spent at least 10 days in the Neonatal Intensive Care Unit (NICU) of the 2nd School of Medicine of Naples. For more than 4 years we have encouraged parents to take care of their infants, to touch them, change them and feed them. The results of our study appear to suggest that allowing parents unrestricted access to the Unit stimulates paternal interest in the child.

We studied the behaviour of 20 preterm infants (average gestational age 33 weeks) brought to term, without any serious disorder. These infants were compared with a group of 21 healthy term infants. To evaluate behaviour we used the 26 items of the Brazelton Neonatal Behavioural Assessment Scale (BNBAS). Our preterm infants had on the whole better scores than those reported in the literature for preterm infants with various disorders. Apart from lower ability to bring hand to mouth and in getting used to visual stimuli (these differences are statistically significant) they had, in the items of orientation a lower score only in ability to follow a voice and a face (not statistically significant). These results show that preterm infants reaching term without any serious disorder do on the whole as well as full-term infants. This correlates with the observations of Dubowitz on behaviour and particularly on visual function of preterm infants and confirms the preliminary report of Daum regarding the influence of the type of neonatal pathology on the ability of orientation at the moment of term.

The effect of nonnutritive sucking bursts (NNSBs) on respiratory frequency was sequentially evaluated in 12 healthy preterm infants. Studies were performed during active sleep in infants between 32 and 37 weeks postconceptional age. The duration of NNSBs was classified as follows: (a) less than 3 s, (b) between 3 and 6 s, and (c) greater than 6 s. NNSBs of each duration were found at all ages, although NNSBs greater than 6 s were the least frequently observed. Respiratory rate increased significantly during NNSBs of less than 3 s, and also in those of 3-6 s duration. There was no significant effect on respiratory frequency of sucking bursts longer than 6 s. Our results document an early interaction between these two motor rhythms, which is influenced by the length of the NNSB. Moreover, they indicate that the decrease in respiratory frequency reported in a similar group of preterm infants during feeding should not be interpreted as an effect of sucking per se.

In this study 17 male and 13 female infants with gestational ages between 27 and 34 weeks (mean 30.7) and birthweights between 750 and 2020g (mean 1545) were evaluated with the Brazelton Neonatal Behavioral Assessment Scale at 35, 38, 40 and 44 weeks postconceptional age. All were in room air at the time of observation and none was being treated with mechanical ventilation. In the motor performance cluster, all five items improved with advancing postconceptional age and in the orientation cluster four of six items improved with age: these show better behavioural evolution compared with other clusters. There was no change in auditory response, with good response from 35 weeks onward. Behavioural development did not proceed evenly in all areas, and within the same cluster certain features developed earlier than others. From 35 to 44 weeks, auditory responsiveness was similar to that of previously evaluated healthy term infants.

The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants.

The authors assume that an appropriate sensory input care can improve the conditions of the very-low-birth-weight (VLBW) infant with RDS. The VLBW preterm infant, in the intensive care unit, takes advantage both medically and developmentally of an individualized behavioral care. The authors present their positive experience with the auditory, visual and tactile stimulations of the preterm infant, after the period of intensive care, with the method of Brazelton.