Abstract

BackgroundStudies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant. This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. The disruption of an optimal parent-infant bond -on its turn- may predispose to distorted parent-infant interactions and thus facilitate abusive or neglectful behaviours. Video Interaction Guidance (VIG) is expected to promote the bond between parents and newborns and is expected to diminish non-optimal parenting behaviour.Methods/designThis study is a multi-center randomised controlled trial to evaluate the effectiveness of Video Interaction Guidance in parents of premature infants. In this study 210 newborn infants with their parents will be included: n = 70 healthy term infants (>37 weeks GA), n = 70 moderate term infants (32–37 weeks GA) which are recruited from maternity wards of 6 general hospitals and n = 70 extremely preterm infants or very low birth weight infants (<32 weeks GA) recruited by the NICU of 2 specialized hospitals. The participating families will be divided into 3 groups: a reference group (i.e. full term infants and their parents, receiving care as usual), a control group (i.e. premature infants and their parents, receiving care as usual) and an intervention group (i.e. premature infants and their parents, receiving VIG). The data will be collected during the first six months after birth using observations of parent-infant interactions, questionnaires and semi-structured interviews. Primary outcomes are the quality of parental bonding and parent-infant interactive behaviour. Parental secondary outcomes are (posttraumatic) stress symptoms, depression, anxiety and feelings of anger and hostility. Infant secondary outcomes are behavioral aspects such as crying, eating, and sleeping.DiscussionThis is the first prospective study to empirically evaluate the effect of VIG in parents of premature infants. Family recruitment is expected to be completed in January 2012. First results should be available by 2012.Trail registration numberNTR3423

Highlights

  • Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children

  • This is the first prospective study to empirically evaluate the effect of Video Interaction Guidance (VIG) in parents of premature infants

  • Half of the mothers of very preterm infants felt that they had to cope with negative feelings when first seeing their infant and 65% had negative or ambivalent feelings in the first weeks at home after hospital discharge. These results suggest that these mothers may require support in coping with negative feelings concerning these early experiences

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Summary

Introduction

Studies have consistently found a high incidence of neonatal medical problems, premature births and low birth weights in abused and neglected children. One of the explanations proposed for the relation between neonatal problems and adverse parenting is a possible delay or disturbance in the bonding process between the parent and infant This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded. One of the explanations proposed for the relation between neonatal problems and non-optimal parenting is a delay or disturbance in parent-infant bonding This hypothesis suggests that due to neonatal problems, the development of an affectionate bond between the parent and the infant is impeded [5]. The disruption of an optimal parent-infant bond -in its turn- may pre-dispose distorted parent-infant interactions and facilitate abusive or neglectful behaviours This hypothesis has not been tested empirically in a prospective study

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