Parental presence and holding in the neonatal intensive care unit and associations with early neurobehavior

OBJECTIVE: To investigate the effects of parental presence and infant holding in the neonatal intensive care unit (NICU) on neurobehavior at term equivalent. STUDY DESIGN: Prospective cohort enrolled 81 infants born <= 30 weeks gestation. Nurses tracked parent visitation, holding and skin-to-skin care throughout the NICU hospitalization. At term, the NICU Network Neurobehavioral Scale was administered. Associations between visitation, holding and early neurobehavior were determined using linear and logistic regression. RESULT: The mean hours per week of parent visitation was 21.33 +/- 20.88 (median 13.90; interquartile range 10.10 to 23.60). Infants were held an average of 2.29 +/- 1.47 days per week (median 2.00; interquartile range 1.20 to 3.10). Over the hospital stay, visitation hours decreased (P = 0.01), while holding frequencies increased (P<0.001). More visitation was associated with better quality of movement (P = 0.02), less arousal (P = 0.01), less excitability (P = 0.03), more lethargy (P = 0.01) and more hypotonia (P<0.01). More holding was associated with improved quality of movement (P<0.01), less stress (P<0.01), less arousal (P = 0.04) and less excitability (P<0.01). CONCLUSION: Infants of caregivers who were visited and held more often in the NICU had differences in early neurobehavior by term equivalent, which supports the need for and importance of early parenting in the NICU.