Correction: The effect of peer-led education on the quality of life of mothers of premature infants in neonatal intensive care units: a quasi-experimental study

Objective To assess the prevalence and related factors of postpartum depression in mothers of preterm infants in neonatal intensive care unit (NICU). Methods A total of 83 mothers who met the inclusion and exclusion criteria were investigated by using Edinburgh Postnatal Depression Scale (EPDS) and the comprehensive questionnaire for mothers of preterm infants in NICU, and the analysis was performed on SPSS 13.0 using the Spearman correlation analysis and Logistic regression analysis. Results Among the 83 mothers, 38 got the EPDS score of 10 and above, which accounted for 45.78% (38/83). The disease severity (OR = 3.318, P < 0.01), the worry about disease prognosis (OR = 4.348, P <0.01), the worry about mental development of the newborn (OR = 5.420, P < 0.01) were the risk factors for postpartum depression in mothers of preterm infants in NICU. Conclusions It's different from the correlation to postpartum depression in mothers of full-term newborns, the correlation to postpartum depression in mothers of preterm infants in NICU are closely related to premature and admission in NICU. The mothers of preterm infants in NICU are the high -risk population for postpartum depression. Routine screening mechanism for mothers of preterm infants should be established for early detection and treatment of postpartum depression, and to promote maternal and infant health. Key words: Intensive care units, neonatal; Depression, postpartum; Prematurity

Background. Premature birth, in addition to causing health problems in infants, increases stress in the mother and reduces attachment between mother and baby. Therefore, the present study was conducted to determine the effect of guided visualization on stress and attachment of mothers of preterm infants in the neonatal intensive care unit (NICU). Methods. This quasi-experimental study was performed on 35 mothers with premature infants admitted to the NICU of Mahdieh Hospital of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mothers were selected by available sampling method and randomly assigned into intervention and control groups. For mothers in the intervention group, the intervention was performed from the first to the fifth day of birth through training and sending guided imagery files. On the day of admission and discharge, the parental stress questionnaire and the postpartum attachment questionnaire were completed by the mother. SPSS software (version 20) was used to analyze the data. Results. The mean total score of maternal attachment on the fifth day of the intervention was significantly higher in the intervention group (P&lt;0.001). Also, the mean total score of mothers' attachment status on the day of discharge was significantly higher in the intervention group (P&lt;0.001). Conclusion. Implementation of guided visualization program reduced stress in mothers with premature infants admitted to the NICU, and consequently increased the level of attachment. Practical Implications. Mothers are the primary caregivers of infants, and promoting maternal health has an effect on infants. In addition to reducing stress in preterm infants, this study can help improve the quality of infant care and increase attachment and parenting. The present study offers a completely cost-effective way to reduce the costs of long-term hospitalization and improve the quality of nursing.

This study established an app-based visitation program for mothers of infants admitted to the neonatal intensive care unit (NICU)-constrained by COVID-19 visitation restrictions-and assessed its impact on neonatal perception, maternal-infant attachment, and parental stress. High-risk infants in the NICU encounter heightened challenges, exacerbated by COVID-19 restrictions, leading to heightened maternal stress, impaired neonatal perception, and hindered mother-infant attachment. A quasi-experimental study was conducted with 40 mothers (20 in the experimental group and 20 in the control group) unable to visit the NICU of a tertiary general hospital in South Korea. The experimental group utilized the Dodam-Dodam smartphone application, while the control group received neonatal information through telephone calls and text messages. Data collection occurred in July 2022 (control) and September 2022 (experimental) using research instruments (parent's neonatal perception, maternal-infant attachment, and parental stressor scale: NICU, visiting program satisfaction). Descriptive statistics and tests (χ 2 , Fisher's exact, Shapiro-Wilk, parametric independent t and paired t tests, and nonparametric tests: Mann-Whitney and Wilcoxon's signed-rank) were employed for analysis. The Dodam-Dodam application significantly impacted maternal-infant attachment parental stress scores and program satisfaction in the experimental group, except for neonatal perception. The Dodam-Dodam application was more efficacious than traditional visiting programs in enhancing maternal-infant attachment, increasing maternal satisfaction and reducing parental stress within NICU settings amid restricted visitation. Recommendations include app-based NICU visitation, exploring app variations, studying diverse populations, and providing optimal information provision.

This paper is a report of a concept analysis of transition to motherhood for mothers with infants in a neonatal intensive care unit. Mothers with infants in a neonatal intensive care unit have more difficulty in their transition to motherhood compared with mothers of healthy infants. The concept of transition to motherhood in the neonatal intensive care unit is not well-understood in nursing, often being confused with mothers' psychological responses in the neonatal intensive care unit. The concept analysis combined Rodgers' evolutionary method with Schwartz-Barcott & Kim's Hybrid method. Thirty-eight studies were reviewed and a purposive sample of 10 Korean mothers with infants in a neonatal intensive care unit was interviewed. Three critical attributes of transition to motherhood in the neonatal intensive care unit were identified: (1) time-dependent process, (2) psycho-emotional swirling and (3) hovering around the edge of mothering. These are caused by the antecedents (1) unexpected outcome of pregnancy, (2) awareness of the situation and (3) mother-infant separation. The consequences were: (1) delayed motherhood and (2) developing a sense of meaning concerning family and life. Additionally, five influencing factors to be alleviated were identified: (1) negative meaning attribution, (2) uncertainty, (3) social prejudice, (4) lack of opportunities to make contact with the infant and (5) the neonatal intensive care unit environment. This concept analysis should help nurses to understand the process of becoming a mother in a neonatal intensive care unit and plan appropriate interventions for mothers with special needs.

Mothers of infants in most Sri Lankan neonatal units are required to be "inpatients" during the entirety of their infant's stay. This traditional practice is closely aligned to the relatively newer model of family-integrated care. Exploration of parent's views regarding the expectation for mothers to remain in hospital for the entire duration of their infant's neonatal unit stay. Cross-sectional study of parents of infants admitted to the University neonatal unit of Colombo North Teaching Hospital, Ragama, Sri Lanka, using self-administered questionnaires in 2017. We found that 40% (19/48) of mothers and 43% (16/37) of fathers preferred that mothers traveled from home, rather than being inpatients continuously, in order to care for older children, receive psychological support from family, and also due to other practical inconveniences of living in the hospital. The main barriers to women being able to travel from home were the need to safely provide expressed human milk for their hospitalized infants and current hospital administrative and societal attitudes. We found that a considerable number of parents with infants in the neonatal intensive care unit in Sri Lanka would like the option of the mother being able travel from home, rather than being confined to hospital. To facilitate this option, changes in hospital protocols and further research into storage and transportation of expressed mother's milk will be required. Improving facilities in hospital and providing more opportunities for families to interact with infants in neonatal intensive care unit will encourage mothers to remain in hospital continuously.

Effects of web neonatal intensive care unit diaries on the mental health, quality of life, sleep quality, care ability, and hormone levels of parents of preterm infants in the neonatal intensive care unit: A randomized controlled trial

To systematically examine the effectiveness of music therapy on preterm infants in neonatal intensive care unit. In recent years, the application of music therapy for preterm infants in neonatal intensive care unit has attracted more and more attention because of its clinical effects. However, there still exist disputes among different studies. A systematic review and meta-analysis. Eleven databases were searched over the period from 1910 -4 November 2019. Papers were selected for analysis in accordance with the PRISMA guidelines. The meta-analysis was carried out by using Review Manager 5.3 software. A total of 13 trials involving 1,093 participants were included. Meta-analysis showed music therapy had a significant influence on preterm infant's heart rate, respiratory rate, oral feeding volume, stress level, and maternal anxiety with moderate-to-high heterogeneity among studies. Also, music therapy had no influences on oxygen saturation and behavioural state. Music therapy can not only effectively improve preterm infant's heart rate, stable respiratory rate, and attenuate stress level but also exert positive impact on oral feeding volume. In addition, music therapy also plays a role in reducing maternal anxiety. However, due to the heterogeneity across studies in some outcomes, further studies with larger sample size and more stringent design should be conducted before recommendation. Music therapy can significantly improve preterm infant's heart rate, respiratory rate, and stress level, as well as increase oral feeding volume. These results may exert a positive impact on well-being and quality of life in preterm infants in the neonatal intensive care unit. Hospitals can apply music therapy which has been considered a non-pharmacological and no-invasive treatment to preterm infants in the neonatal intensive care unit.

Aim: Mothers of infants in the neonatal intensive care unit (NICU) have very low breastfeeding rates and these high-respiratory-risk (HRR) NICU infants may benefit from breastfeeding through decreased risk for respiratory illnesses. This population’s increased risk for maternal depression and high rates (22%) of maternal smoking may negatively affect breastfeeding.Objective: This exploratory study investigated associations of breastfeeding with depressive symptoms and maternal smoking in mothers of HRR NICU infants (i.e. presence of one household smoker and birth weight <1500 g or mechanical ventilation ≥12 h).Methods: Breastfeeding, depression and smoking data were collected from 104 mothers in the NICU following delivery.Results: Fifty-five (52.9%) mothers reported breastfeeding, 39 (37.5%) had a Center for Epidemiological Studies Depression Scale (CES-D) score (≥16) suggestive of depression, and 36 (34.6%) reported smoking. Mothers with CES-D scores ≥16 were less likely to breastfeed compared to those with scores <16 (38.5% versus 61.5%; p = 0.02). Breastfeeding and smoking were not significantly associated (p < 0.10). Mothers of HRR infants with significant depressive symptoms who smoke have significantly lower breastfeeding rates (21%) than mothers who are not depressed and do not smoke (65%).Conclusions: Interventions to improve breastfeeding initiation and continuation that target depression and smoking are necessary.

ObjectiveThe hospitalization of a premature infant in a neonatal intensive care unit (NICU) is a stressful experience for mothers, often reducing their quality of life (QoL). This study evaluated the effect of a peer-led educational and supportive program on the QoL of mothers with premature infants. A quasi-experimental study was conducted in the NICUs of Hazrat Vali-e-Asr Hospital, Tehran, Iran. Seventy mothers were enrolled and non-randomly assigned to an intervention group (n = 35) or a control group (n = 35) based on the ward where their infant was hospitalized. The intervention group attended three peer-led sessions over ten days. The control group received standard NICU education from nurses. QoL was measured using the Short Form Health Survey (SF-36) at baseline and one month after the intervention. Data were analyzed using independent t-tests and ANCOVA.ResultsAt baseline, there was no significant difference in QoL scores between groups (P = 0.89). Post-intervention, the intervention group showed significantly higher total QoL scores than the control group (P < 0.001). Significant improvements were noted in mental health, vitality, social functioning, and role limitations due to emotional problems (all P < 0.001). These findings suggest peer-led programs can improve maternal QoL in NICUs and support their integration into neonatal care.Trial registrationThis study was retrospectively registered in the Iranian Registry of Clinical Trials on July 20, 2025 (IRCT20230816059164N4; https://irct.behdasht.gov.ir/trial/84566).

Vital Human Milk: Implementing a Donor Milk Program

Aim:To synthesize and integrate current international knowledge regarding nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit.Methods:A systematic review and meta-analysis was undertaken. Four English-language databases including EMBASE, PubMed (including MEDLINE), Scopus, and Web of Science were searched from January 2010 to October 2021. Original quantitative studies that were written in English and focused on nursing strategies for the provision of emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit were included. Eligibility assessment, data extraction, and methodological quality appraisal were conducted independently by the review authors. A narrative synthesis of the review results and a meta-analysis were performed.Results:Twenty studies that were published from 2010 to 2021 were included in the review. Three categories concerning the review aims were identified: ‘nursing strategies related to mothers’ emotions and infant-mother attachment’, ‘nursing strategies related to mothers’ empowerment’, and ‘nursing strategies related to mothers’ participation in care process and support’. Eight interventional studies that reported mothers’ stress as the study outcome were entered into the meta-analysis. Interventions consisted of the educational programme, spiritual care, telenursing, parent support programme, skin-to-skin care, and guided family centred care. Significantly lower maternal stress was found in the intervention group compared with that of the control group (g: −1.06; 95% confidence interval: −1.64, −0.49; Z = 3.62, p < 0.001).Conclusion:This review identified and highlighted key nursing strategies used to provide emotional and practical support to the mothers of preterm infants in the neonatal intensive care unit. They included family centred care, skin-to-skin care, parent support and education programmes, interpersonal psychotherapy, spiritual care, newborn individualized developmental care and assessment programme, and telenursing.

Preterm birth and prolonged neonatal hospitalization are potential sources of stress for mothers of preterm and low birth weight infants. To evaluate maternal stress and its association with neurobehavioral indicators of preterm infants during hospitalization in the neonatal intensive care unit. A cross-sectional study was conducted in a neonatal intensive care unit of a hospital in Goiânia, Brazil. The study included preterm and low birth weight infants of both genders and their mothers. The Parental Stressor Scale: Neonatal Intensive Care Unit and the Neurobehavioral Assessment of the Preterm Infant were respectively applied to mothers and infants in the neonatal intensive care unit. The study involved 165 premature infants and their mothers. The mean age of the mothers was 26.3 years and most had a high school education level (57.6%). Mothers perceived the experience of having an infant in the neonatal intensive care unit as moderately stressful (2.96 ± 0.81). The parental role alteration (4.11 ± 1.03) and sights and sounds (2.15 ± 0.90) subscales exhibited the highest and lowest stress levels, respectively. Significant correlations (rho < -0.3; p < 0.05) were found between maternal stress and neurobehavioral indicators of infants. In the multivariate analysis, low leg tone was a predictor of higher maternal stress. Low tone and limited arm movement were predictors of higher maternal stress in the maternal role item. The experience of having a preterm infant hospitalized was considered moderately stressful for mothers. Maternal stress levels were significantly correlated with low scores on neonatal neurobehavioral indicators.

Mothers of infants in neonatal intensive care units (NICUs) experience significant psychological stress and anxiety, disrupting maternal-infant bonding, impairing breastfeeding, and maternal well-being. This randomized controlled trial investigated the effects of mandala coloring activities on maternal stress and state anxiety among mothers with infants hospitalized in the NICU. This randomized controlled trial was conducted among mothers residing in the mother hotel of a state hospital in southeast Turkey, whose infants were hospitalized in the NICU. Seventy-two mothers of NICU infants were randomly assigned to either the mandala coloring group (n=36) or the control group (n=36). Data were collected using the socio-demographic information form, Visual Analog Scale (VAS), and the State-Trait Anxiety Inventory-State Subscale (STAI-State). Stress and anxiety levels were assessed at baseline (T1), Day 4 (T2), and Day 7 (T3). No significant differences were found between groups at T1 for VAS and STAI-State scores ( P > .05). At T2 and T3, the mandala coloring group exhibited significantly lower stress and anxiety scores compared to the control group ( P < .001). Large effect sizes were observed for both stress ( ηp2 =0.867) and anxiety ( ηp2 =0.798), demonstrating the significant impact of mandala coloring on reducing maternal distress over time. Mandala coloring is a simple, low-cost, non-pharmacological intervention that may reduce stress and anxiety in mothers with infants in the NICU. Integrating structured art activities into psychosocial support programs for NICU mothers may enhance maternal mental health and promote mother-infant bonding.

Nurses' Expectations of Using Music for Premature Infants in Neonatal Intensive Care Unit

Research Article| May 01 2010 Storage of Human Milk in NICUs AAP Grand Rounds (2010) 23 (5): 60. https://doi.org/10.1542/gr.23-5-60 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Storage of Human Milk in NICUs. AAP Grand Rounds May 2010; 23 (5): 60. https://doi.org/10.1542/gr.23-5-60 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: milk, human, neonatal intensive care units Source: Slutzah M, Codipilly CN, Potak D, et al. Refrigerator storage of expressed human milk in the neonatal intensive care unit. J Pediatr. 2010; 156(1): 26– 28; doi: https://doi.org/10.1016/j.jpeds.2009.07.023Google Scholar Investigators from Schneider Children’s Hospital in New York investigated the safety of human milk refrigerated for up to 96 hours by analyzing bacterial counts and concentrations of lactoferrin, secretory (s)IgA, fat, fatty acids, protein, pH, and white blood cell count (WBC). Milk was collected by breast pump from mothers of infants in a neonatal intensive care unit (NICU), refrigerated at 4° C, and tested after 0, 24, 48, 72, and 96 hours. Milk from 36 mothers was obtained when their infants had a median age of 28 days. These neonates had been born at a median gestational age of 32 weeks. There were no significant changes in milk osmolality, sIgA, lactoferrin, total fat, total bacterial counts, or gram-negative colony counts in the milk over the 96 hours of refrigeration. Gram-positive bacteria colony counts declined significantly over the 96 hours. The WBC decreased by 16%, milk pH declined from 7.21 to 6.68, and total protein declined by 5% while free fatty acid concentration increased from 1.3% to 4.8% of total fat. There were no significant associations between gestational age, postpartum age, and other milk component measurements at baseline or with duration of storage. The authors conclude that human milk can be safely refrigerated for 96 hours without an increase in the bacterial cell counts or major change in the macronutrients and immune factors. As noted by the authors, guidelines on the safe storage of refrigerated breast milk have been limited by studies that have focused solely on bacterial colony counts and have not measured changes in other milk component concentrations. The current study was done in a NICU with a highly educated, middle class population, who may have been very careful in pumping and storing the milk under “very clean” conditions. It may not represent how the average mother expresses and stores her milk. Therefore, one should be careful in generalizing these results to other NICUs with different populations. One should be even more careful in applying the results of this study to mothers of infants at home, where cleanliness may be even less of a concern and refrigeration may not be ideal. Another issue, for mothers of full-term infants, is that this study was performed in mothers of premature infants. Premature breast milk possibly has more white blood cells and antibacterial activity than mature milk.1 Despite these caveats, the overall integrity of milk seems to be preserved for up to 96 hours of refrigerator storage. The physical and psychological benefits of breastfeeding for the infant, mother, and community need not be reiterated to AAP Grand Rounds readers. Breast milk is also recommended as optimal nutrition for premature infants. As previously reported in these pages (see AAP Grand Rounds, March 2002;7:292), however, both asymptomatic... You do not currently have access to this content.