Book Review: Foundations of Developmental Care

Abstract

Foundations of Developmental Care Joy V. Browne, PhD, and Robert D. White, MD (Eds.) Clinics in Perinatology, 2011, Volume 38, No. 4. W. B. Saunders Co. ISSN: 0095-5106; ISBN-13: 978-1-4557-1119-2Does form follow function-or does function follow form? Nowhere is this question more pertinent than in the design of the care environment for the premature or sick neonate. In the early days of neonatology, the pediatric medical specialty focusing on neonates, the challenge was to reduce mortality, especially for infants born very prematurely. At that time, more than 90% of infants born weighing under 1 kilogram (kg) (2.2 pounds) did not survive. Because this challenge required frequent assessments of the infant at various times by physicians, nurses, respiratory therapists, and multitudes of other professionals and ancillary personnel, early neonatal intensive care units (NICUs) were most similar to post-anesthesia recovery areas: large, brightly lit, multipatient rooms bustling with activity throughout the day and night and accented by the sounds of monitor alarms, conversations, and equipment.As survival improved with advances in healthcare (currently about 90% survival is expected among babies born at However, some longer-term problems did not require a history of antecedent medical diseases or complications of prematurity; they evolved from prematurity itself-or at least we thought so! Perhaps first among these was retrolental fibroplasia, later renamed retinopathy of prematurity. This condition emerged among premature infants and initially was deemed to be multifactorial, but subsequently it was shown to be a complication of the excessive use of oxygen. When oxygen use was thereafter limited, the ocular complication was replaced by increased instances of cerebral palsy, a complication of hypoxemia.Studies of survivors followed and showed both physical and cognitive dysfunction to be prominent among those survivors, even among those whose medical course had been uncomplicated. Could it be that function, or in this case dysfunction, was the result of adverse effects from the form, i.e., the environment, in which the extrauterine fetus was forced to develop? Could innovations in the environment reduce or eliminate adverse effects and/or facilitate infants' adaptation to the unexpected extra-uterine world?Developmental care for the neonate embodies the concept that understanding neurodevelopmental stages, interrelationships, and influences not only explains some adverse and unwanted outcomes, but it also can inform care processes themselves and help define the form of the caregiving environment, the NICU. …