FAMILY-BASED INTERVENTION IMPROVES MATERNAL PSYCHOLOGICAL WELL-BEING AND FEEDING INTERACTION OF PRETERM INFANTS

Objective. To determine the efficacy of an individualized, family-base d intervention with preterm infants and their families. Design. Random ized, repeated measures intervention outcome study. Setting. Level III neonatal intensive care nursery. Patients. Random sample of 34 preter m infants less than or equal to 1500 g and their families. Interventio ns. Individualized, family-based intervention during the hospitalizati on and transition to home addressed problems identified by parents in four domains including: infant behavior and characteristics, family or ganization and functioning, caregiving environment, and home discharge and community resources. Measurements and Main Results. Standardized questionnaires were administered at baseline and discharge to mothers, and predischarge bottle-feeding interactions were videotaped and code d by two blinded observers. Results were in favor of intervention (Int ) versus control (Con) mothers (baseline; discharge) (P < .05) on the Parental Stressor Scale Sights and Sounds subscale (Int 2.4 +/- 1.0; 2 .0 +/- 0.8 vs Con 2.4 +/- 0.9; 2.6 +/- 0.8); Child's Appearance and Be havior subscale (Int 2.8 +/- 1.0; 2.5 +/- 1.1 vs Con 2.8 rt:0.8; 3.1 /- 0.6); and Total Stressor Score (Int 93.9 +/- 36.6; 72.3 +/- 41.8 vs Con 87.5 +/- 26.7; 87.8 c 26.2). On the Beck Depression Inventory, in tervention mothers had significant decreases in depressive symptoms (3 9%; 11%) vs control mothers (31%; 44%). Maternal self-esteem in both g roups improved over time. There were no significant group differences in family environment. During feeding interactions, intervention infan ts grimaced (P < .001) and gagged (P < .05) less than controls. Interv ention mothers less frequently interrupted feedings (P < .001); less f requently stimulated infant sucking (P < .01); smiled more (P < .001); vocalized more (P < .01); demonstrated greater sensitivity to infant behavior (P < .001), better quality of physical contact (P < .001), an d more positive affect (P < .01). Conclusions. Individualized, family- based intervention appears to reduce maternal stress and depression, a nd to enhance early mother-infant feeding interactions. Further resear ch is needed to determine whether these shortterm beneficial effects p ersist beyond the newborn period.