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Neonatal Intensive Cars Unit
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Neonatal lntensive Cars Unit
The mother's role in nursing her premature newborn infant varied during the past century. Rooming-in was prevalent in the American Hospital of the 1880's. The Johns Hopkins Hospital built without a separate nursery continued rooming-in as standard procedure until 1890. The Nursery and Children's Hospital did so until after 1898, and the New York Hospital until after 1898 (Quoted from klaus and Kennell, 1970)
At the turn of this century, the French obstetrician "Budin" (1895) put the basic principles of caring for the newborn and hence considered the most famous of the early neonatologists. He welcomed the mother’s participation in the nursery care of her premature baby (Quoted from klaus and kennell, 1970).
Cooney was sent to the Berlin's Exposition of 1896 to display the survival of the premature infants. In most respects, cooney's handling of the infants was similar to that of Budin. However, mothers did not participate in the care of the infants in the exhibits but were allowed to attend with free passes (Quoted from Klaus and kennell, 197O).
A strict isolation techniques and the development of separate wards were involved by the early 1900’s due to the high morbidity and mortality of infants - as a result of epidemic diarrhea, respiratory infections and inadequate equipment (Quoted from Klaus and kennell, 197O).
The first hospital premature infant center was started at the Sarah Morris Hospital in Chicago in 1973 by Hess. Hess encouraged the production of milk by the mother for her own infant. He also used wet nurses as a source of milk. As soon as the infant's condition warranted, the mother was instructed in his hospital care and was permitted to nurse him at breast (Quoted from klaus and kenell, 1970).
Rooming-in for the mother was renewed by the work of Edith Jackson, (1948) especially for the full term infants. Khan, (1948) arranged for the mothers to remain in the hospital and with supervision, care for their premature infants (Quoted form Klaus and Kennel, 1970).
Several models of rooming-in were explained by Mandl (1981). An early model utilized crib-drawers built into a separating wall between mother's room and nursery. This allowed the mother to pull the baby's crib into her room or to push it back into the nursery as desired. Another model utilized a small sound proof nursery within a larger mother's room (capacity 4-5). In other courses, cribs were equipped with rollers and mothers allowed free access to the nursery.
Main Concerns of Neonatal Intensive Care The technological revolution had a profound effect on a preterm health. With the knowledge recently favored about nature of fetal and neonatal life, the chance of survival of premature and ill neonates had gradually increasing (Fitz-Hardinge, 1980). Fitz-Hardinge, (1980) identified three main concerns involved in the neonatal intensive care unit issues: 1) Resource allocation, funds to equip and physician and nursing staff which are much expensive leading to over crowded units. This may result in less comprehensive and individualized care for the infants. Also, this may increase frustration and dissatisfaction for nursing staffs. 2) The appropriate intervention, extreme prematurity and long hospitalizations are resulting in iatrogenic problems - now endemic in perinatal care - including not only the physical side effects of treatment but possible psychological and behavioral consequences. 3) The treatment decisions which should be considered to the short and long-term effects on the child; also, the effects on his development and his rearing. The family's responses to the use of technological intervention to save an infant who may have complex sequela, yet who will otherwise die.
On the other hand costs of neonatal intensive care unit were studied as follows: 1) Cost to the caretakers: They should deal with the daily bombardment of stimuli from the equipments, numbers of people crowded in a relatively small place, parents in crisis and the babies themselves (Richardson, 1976). 2) Cost to the families: neonatal intensive care unit may heighten the parent’s fear, anxiety, guilt, concern and feelings of helplessness. Being separated from their infants, parents have to work harder to establish contact (Richardson, 1978). 3) Cost to the infants: In addition to the sudden environmental changes from the intrauterine environment into bright light, noise, cold hands, the infant suffers from instrument applications. This may affect the infant physically and behaviorally (Ross, 1978 and Stavis, 1980)
Early interaction in the neonatal intensive care Effects of early caretaker-infant interactions on the infant were studied by Sander, (1980) and Sander and others, (1978). These effects involve the infant's behavioral organization and development of diurnal rhythms. They also concluded that certain care-giving activities facilitate infant's ability to modulate his behavior.
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