¶ … systematic literature review addresses the topic of what parents need to know and can do to enhance the developmental outcomes of their very low birth weight babies, following discharge from the neonatal intensive care unit. This topic is significant as very low birth weight babies, as a group, have special needs. And, by addressing these items, parents can enhance their child's development. Systematic Literature Review: What Parents Need to Know and Can do to Enhance the Developmental Outcomes of Their Very Low Birth Weight Babies

This systematic literature review addresses the topic of what parents need to know and can do to enhance the developmental outcomes of their very low birth weight babies, following discharge from the neonatal intensive care unit. This topic is significant as very low birth weight babies, as a group, have special needs. And, by addressing these items, parents can enhance their child's development.

This paper will critically evaluate several key pieces of literature regarding this topic. It will explore topics including the direct and indirect effects of the infants' biological condition and experience, care giving environment and caloric intake, the factors influencing pre-term infants language development, infant health care giving at home, the improvement of verbal and cognitive abilities in very low birth weight babies, and the effects of Kangaroo Care on pre-term infant development.

Background:

Previously, research on the topic of what parents need to know and can do to enhance the developmental outcomes of their very low birth weight babies has been narrowly focused. As an example, Pridham et al.'s (2002) research centered on the biological conditions, which included the care giving environment and caloric intake, as it applied to weight-for-age and motor development for both full-term and premature infants. This research compared 52 full-term and 47 pre-term infants at 12 months post-term age to determine the direct and indirect effects of the care giving environment and caloric intake variables.

Factors influencing pre-term infant language development were investigated, in 2003, by Cusson. These included low socio-economic status in pre-term infants during the first two years of their life. Focus was given on what information could be given to parents of pre-term infants to help improve their infant's language development. Cusson's research covered the importance of communication, normal hearing and language development of infants, and how language develops despite the common barriers. In addition, a need for adults to support the emergence of speech with positive reinforcement was identified. Opposing viewpoints were also addressed, specifically that the theory of language development does not explain all phenomena, such as the manifestation of novel speech sounds.

The seeking of help by mothers of low birth weight infants was investigated in comparison to those of normal birth weight infants by May and Hu (2000). They're research focused on the relationships between the mother's perceptions of infant health, care giving confidence, and caregiver burden. The researchers also studied how mother of low birth weight infants compared in the types of assistance they used, in contrast to normal birth weight infant mothers.

Ment et al. (2003) also provides background on the topic of the needed information for parents of very low birth weight babies. Their research objective was to determine if there was cognitive improvement for very low birth weight babies as they aged. These included cognitive abilities, in these children, as they matured into middle childhood.

Lastly, the investigation regarding the effects of Kangaroo Care on the development of pre-term infants was conducted, in 2002, by Feldman, Eidelman, Sirota, and Weller. These researchers examined how Kangaroo Care affected three areas of child development. These areas of development included, maternal and paternal perceptions of their infant, mother-infant and father-infant interactions, and the pre-term infant's cognitive development.

Research Question:

The research question that guided this systematic literature search was: What do parents of very low birth weight (less than 1500 grams) premature babies need to know/do to enhance the developmental outcomes of their baby following discharge from the neonatal intensive care unit? It was this guiding question that was the basis for determining if the articles reviewed point to specific elements that one may build a study on.

After review of the literature to date, one common thread was found to occur. Research to date is most often narrowly focused, when it comes to enhancing the developmental outcomes of very low birth weight babies. One might build a study on a more comprehensive platform, investigating a variety of variables and factors to see how they interplay with one another. In...

The inclusive wording did not limit the infant's development to a specific facet of development, and therefore allowed for the use of a variety of studies to be utilized. These studies have allowed for a better understanding on the topic of important information for parents of very low birth weight babies, however, as noted, more comprehensive research needs to be done and analyzed.
This information can be utilized as the beginning of a more encompassing recommendation programs for parents, about their child's potential developmental issues and how they can best help support development, as soon as they leave the neonatal care unit. Intervention programs can be developed to teach parents ways they can help facilitate their infant's development. Periodic check ups of these infants can determine areas where more support may be needed, and the intervention program can be customized to fit that infant's specific needs and age. However, there are certain areas that are not fully addressed, such as motor development, and those, such as language development, where questions still have been raised. These areas need to be approached with caution.

Method:

A scooping search was used primarily to determine what was to be searched. It was determined that peer-reviewed journals concerning research on very low birth weight and pre-term infant development would be most appropriate. These journals were than screened for what appeared to be appropriate articles, for the research question. Next, an assessment of the articles were performed, with the extraction of the findings to determine if they were of sufficient quality for inclusion in this systematic literature review.

The scoping search allowed the plethora of publications to be narrowed down to those that would be most relevant to the topic at hand. The screening assignment further narrowed down the search to specific articles. And, finally, the assessment of each article ensured that the articles that were included in this review were appropriate to the research question.

Findings:

Several significant barriers to development were identified in very low birth weight and pre-term infants. At 12 months of age, it was found that pre-term infants still were significantly smaller in weight, then their full-term peers. The severity of acute illness was also greater in these pre-term infants. Although the only significant factor to support motor development was found to be maternal responsiveness (Pridham et al., 2002). Cusson (2003) found that infant development was within the normal range, by 26 months corrected age, however. Yet, language development was delayed 3 to 5 months on average.

Like Pridham et al., May and Hu (2000) found that there was a relationship between care giving and infant health. It was noted that infant health was perceived as better when the mother had greater confidence in care giving. In contrast, mothers with low birth weight infants, who did not have as much confidence in care giving had a poorer perception of infant health. These mothers also experienced a greater caregiver burden, than their normal birth weight peers. Normal birth weight mothers experienced a further decrease in this burden, where low birth weight mothers did not. Interestingly, there were no statistically significant differences between the two groups of mother, in preparation for care giving or the experience of caregiver burden.

Improvement in both PPVT-R and IQ scores in very low birth weight infants was discovered to be made as the infant aged, in the data analyzed by Ment et al. (2003). Those infants from two-parent households and had educated mothers were shown to do better, in general, in testing scores.

Special services were found to effectively balance the scales for mothers with less education, as well as early intervention services.

The specific technique of Kangaroo Care was found to have a several positive effects on the maternal perceptions of the child, as well as the child's perceptions of his or her parent. Furthermore, Feldman et al. note, parents related being more satisfied in terms of emotions towards their infant, while using Kangaroo Care. In addition to these emotional aspects, infant development was positively and significantly effected. The infants placed in the Kangaroo Care group demonstrated improved cognitive development, at the age of six months, in comparison to peers who had not been using Kangaroo Care.

All five researchers note the need for effective programs regarding developmental support for very low birth weight pre-term infants. However, each approached this vast subject from different perspectives. Pridham et al. examined…