Highlights
- •Caregiving timing, frequency, and buffering modifies infant toxic stress.
- •Little progress has been made since the technical report on toxic stress.
- •Implementation science must fuel evidence-based practice that reduces toxic stress.
- •Public policies like paid family leave will be more efficient in reducing toxic stress.
- •Use your voice and your vote to speak up for our children!
Abstract
In 2011, the American Academy of Pediatrics (AAP) published a technical report on
the lifelong effects of early toxic stress on human development, and included a new
framework for promoting pediatric health: the Ecobiodevelopmental Framework for Early
Childhood Policies and Programs. We believe that hospitalization is a specific form
of toxic stress for the neonatal patient, and that toxic stress must be addressed
by the nursing profession in order to substantially improve outcomes for the critically
ill neonate. Approximately 4% of normal birthweight newborns and 85% of low birthweight
newborns are hospitalized each year in the highly technological neonatal intensive
care unit (NICU). Neonates are exposed to roughly 70 stressful procedures a day during
hospitalization, which can permanently and negatively alter the infant's developing
brain. Neurologic deficits can be partly attributed to the frequent, toxic, and cumulative
exposure to stressors during NICU hospitalization. However, the AAP report does not
provide specific action steps necessary to address toxic stress in the NICU and realize
the new vision for pediatric health care outlined therein. Therefore, this paper applies
the concepts and vision laid out in the AAP report to the care of the hospitalized
neonate and provides action steps for true transformative change in neonatal intensive
care. We review how the environment of the NICU is a significant source of toxic stress
for hospitalized infants. We provide recommendations for caregiving practices that
could significantly buffer the toxic stress experienced by hospitalized infants. We
also identify areas of research inquiry that are needed to address gaps in nursing
knowledge and to propel nursing science forward. Finally, we advocate for several
public policies that are not fully addressed in the AAP technical report, but are
vital to the health and development of all newborns.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Nursing OutlookAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Analysis of 23 million US hospitalizations: Uninsured children have higher all-cause in-hospital mortality.Journal of Public Health. 2010; 32: 236-244
- The newborn communicates.The Journal of Communication. 1977; 27: 66-73
- Individualized behavioral and environmental care for the very low birth weight preterm infant at high risk for bronchopulmonary dysplasia: Neonatal intensive care unit and developmental outcome.Pediatrics. 1986; 78: 1123-1132
- Individualized developmental care for the very low-birth-weight preterm infant. Medical and neurofunctional effects.JAMA. 1994; 272: 853-858
- AGA preemies can be Kangaroo infants too.The American Journal of Nursing. 1986; 86: 1000
- Effectiveness of home visiting in improving child health and reducing child maltreatment.Pediatrics. 2013; 132: S90-S99
- The calming effect of maternal breast milk odor on premature infants.Pediatrics and Neonatology. 2013; 54: 322-325
- Association between congenital anomalies and area-level deprivation among infants in neonatal intensive care units.American Journal of Perinatology. 2013; 30: 225-232
- Analgesic effect of maternal human milk odor on premature neonates: A randomized controlled trial.Journal of Human Lactation. 2017; 33: 300-308
- Developmental risk of depression: Experience matters.Child and Adolescent Psychiatric Clinics of North America. 2012; 21 (vii): 261-278
- Evaluating the mediating effects of social support upon life events and depressive symptoms.Journal of Community Psychology. 1982; 10: 325-340
- WHO commission on the social determinants of health: A bold new venture.European Journal of Public Health. 2008; 18: 547
- Vulnerability of the developing brain. Neuronal mechanisms.Clinics in Perinatology. 2002; 29: 357-372
- Provision of Kangaroo mother care: Supportive factors and barriers perceived by parents.Scandinavian Journal of Caring Sciences. 2013; 27: 345-353
- Changes in U.S. family finances from 2013 to 2016: Evidence from the survey of consumer finances (Survey of Consumer Finances No. 103, 3).Federal Reserve, Washington (DC)2017 (Retrieved from)
- Improving neonatal care with the help of veteran resource parents: An overview of current practices.Seminars in Fetal & Neonatal Medicine. 2018; 23: 44-51
- Implementing family-integrated care in the NICU: A parent education and support program.Advances in Neonatal Care. 2013; 13: 115-126
- Global Wealth Report (Economic Research).Allianz, 2015 (Retrieved from)
- The social determinants of health: It's time to consider the causes of the causes.
- Early mother-infant reciprocity.Ciba Foundation Symposium. 1975; : 137-154
- Noise and the premature infant: Physiological effects and practice implications.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2003; 32: 447-454
- Exploring parental and staff perceptions of the family-integrated care model: A qualitative focus group study.Advances in Neonatal Care. 2017; 17: E12-E19
- Population health and paid parental leave: What the United States can learn from two decades of research.Healthcare. 2016; 4
- Sound level exposure of high-risk infants in different environmental conditions.Neonatal Network. 2006; 25: 25-32
- Qualitative analysis of barriers to breastfeeding in very-low-birthweight infants in the hospital and postdischarge.Advances in Neonatal Care. 2005; 5: 93-103
- Epidemiology and treatment of painful procedures in neonates in intensive care units.JAMA. 2008; 300: 60-70
- Effects of prone and supine positions on sleep state and stress responses in mechanically ventilated preterm infants during the first postnatal week.Journal of Advanced Nursing. 2002; 40: 161-169
- Postpartum depression screening in the Neonatal Intensive Care Unit: Program development, implementation, and lessons learned.Journal of Multidisciplinary Healthcare. 2016; 9: 59-67
- Review of interventions to reduce stress among mothers of infants in the NICU.Advances in Neonatal Care. 2014; 14: 30-37
- Parents and the high cost of childcare.Childcare Aware of America, Arlington, VA2017 (Retrieved from)
- Randomised study showed that recorded maternal voices reduced pain in preterm infants undergoing heel lance procedures in a neonatal intensive care unit.Acta Paediatrica. 2017; 106: 1564-1568
- The effects of Kangaroo Care in the Neonatal Intensive Care Unit on the physiological functions of preterm infants, maternal-infant attachment, and maternal stress.Journal of Pediatric Nursing. 2016; 31: 430-438
- A modified developmental care bundle reduces pain and stress in preterm infants undergoing examinations for retinopathy of prematurity (ROP): A randomized controlled trial.Journal of Clinical Nursing. 2018;
- “Try not to judge”: Mothers of substance exposed infants.MCN The American Journal of Maternal Child Nursing. 2013; 38: 200-205
- Quantitative in vivo MRI measurement of cortical development in the fetus.Brain Structure & Function. 2011;
- Basic facts about low-income children: Children under 18 years.(Retrieved March 12, 2018, from)
- Universal postpartum mental health screening for parents of newborns with prenatally diagnosed birth defects.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2018; 47: 84-93
- Household food security in the United States in 2016.United States Department of Agriculture, Washington (DC)2017: 44 (Economic Research Service No. ERR-237Retrieved from)
- Postural support improves distress and pain during diaper change in preterm infants.Journal of Perinatology: Official Journal of the California Perinatal Association. 2009; 29: 504-507
- Kangaroo mother care to reduce morbidity and mortality in low birthweight infants.The Cochrane Database of Systematic Reviews. 2016; 8CD002771
- Randomized crossover trial of kangaroo care to reduce biobehavioral pain responses in preterm infants: A pilot study.Biological Research for Nursing. 2011; 13: 204-216
- Transformative nursing in the NICU: Trauma-informed age-appropriate care.Springer Publishing Company, 2014
- Early impacts of the affordable care act on health insurance coverage in medicaid expansion and non-expansion states.Journal of Policy Analysis and Management. 2017; 36: 178-210
- Recommendations for involving the family in developmental care of the NICU baby.Journal of Perinatology. 2015; 35: S5-S8
- Healthy birth practice #6: Keep mother and baby together – it's best for mother, baby, and breastfeeding.The Journal of Perinatal Education. 2014; 23: 211-217
- Translating research findings to clinical nursing practice.Journal of Clinical Nursing. 2017; 26: 862-872
- US housing insecurity and the health of very young children.American Journal of Public Health. 2011; 101: 1508-1514
- Adverse childhood experiences, allostasis, allostatic load, and age-related disease.Physiology & Behavior. 2011;
- A Case Study of the Environmental Experience of a Hospitalized Newborn Infant With Complex Congenital Heart Disease.The Journal of Cardiovascular Nursing. 2016; 31: 390-398
- Association of the affordable care act dependent coverage provision with prenatal care use and birth outcomes.JAMA. 2018; 319: 579-587
- The stress-buffering role of social support. Problems and prospects for systematic investigation.The Journal of Nervous and Mental Disease. 1977; 165: 403-417
- Insurance + access not equal to health care: Typology of barriers to health care access for low-income families.Annals of Family Medicine. 2007; 5: 511-518
- The association between medicaid coverage for children and parents persists: 2002–2010.Maternal and Child Health Journal. 2015; 19: 1766-1774
- Uncertain health insurance coverage and unmet children's health care needs.Family Medicine. 2010; 42: 121-132
- Children's receipt of health care services and family health insurance patterns.Annals of Family Medicine. 2009; 7: 406-413
- The effects of health insurance and a usual source of care on a child's receipt of health care.Journal of Pediatric Health Care. 2012; 26: e25-e35
- The effects of Kangaroo Mother Care and Swaddling on venipuncture pain in premature neonates: A randomized clinical trial.Iranian Red Crescent Medical Journal. 2016; 18: e29649
- Exposure to biological maternal sounds improves cardiorespiratory regulation in extremely preterm infants.The Journal of Maternal-Fetal & Neonatal Medicine. 2012; 25: 1591-1594
- Early childhood home visiting.Pediatrics. 2017; 140
- Guidelines for feeding very low birth weight infants.Nutrients. 2015; 7: 423-442
- Infant Medical Trauma in the Neonatal Intensive Care Unit (IMTN): A proposed concept for science and practice.Advances in Neonatal Care. 2016; 16: 289-297
- Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study.Journal of Clinical Nursing. 2015; 24: 717-727
- The state of America's children. 2017; (Retrieved from)
- Record inequality: The top 1% controls 38.6% of America's wealth.
- Does exposure of premature infants to repetitive recorded mother sounds improve neurodevelopmental outcome.Proceedings of the National Academy of Sciences of the United States of America. 2015; 112: E4166
- An integrative review of technology to support communication with parents of infants in the NICU.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2017; 46: 357-366
- Testing the feasibility of skype and facetime updates with parents in the Neonatal Intensive Care Unit.American Journal of Critical Care. 2015; 24: 290-296
- Disruptions in insurance coverage: Patterns and relationship to health care access, unmet need, and utilization before enrollment in the State Children's Health Insurance Program.Pediatrics. 2007; 120: e1009-e1016
- Family income and the impact of a children's health insurance program on reported need for health services and unmet health need.Pediatrics. 2002; 109: E29
- Sensitive periods in human social development: New insights from research on oxytocin, synchrony, and high-risk parenting.Development and Psychopathology. 2015; 27: 369-395
- Systematic review of maternal voice interventions demonstrates increased stability in preterm infants.Acta Paediatrica. 2017; 106: 1220-1229
- Here's a map of the countries that provide universal health care (America's Still Not on It).The Atlantic. 2012; (Retrieved from)
- The health and healthcare impact of providing insurance coverage to uninsured children: A prospective observational study.BMC Public Health. 2017; 17: 553
- A cross-sectional study of parental awareness of and reasons for lack of health insurance among minority children, and the impact on health, access to care, and unmet needs.International Journal for Equity in Health. 2016; 15: 44
- Guide to the code of ethics for nurses with interpretive statements: Develo (Second).American Nurses Association, Silver Spring, MD2017 (Retrieved from)
- The child and family hospital experience: Is it influenced by family accommodation?.Medical Care Research and Review. 2015; 72: 419-437
- The influence of family accommodation on pediatric hospital experience in Canada.BMC Health Services Research. 2017; 17: 561
- Toxic stress: Effects, prevention and treatment.Children. 2014; 1: 390-402
- Cortical responses to alien odors in newborns: An fNIRS study.Cerebral Cortex. 2017; : 1-12
- Cuddler program provides soothing answers.Neonatal Network. 1990; 8: 45-49
- Being uninsured: Impact on children's healthcare and health.Current Opinion in Pediatrics. 2005; 17: 753-758
- Implementing family-integrated care in the NICU: Educating nurses.Advances in Neonatal Care. 2013; 13: 335-340
- Out-of-pocket financial burden for low-income families with children: Socioeconomic disparities and effects of insurance.Health Services Research. 2005; 40: 1722-1736
- Paid parental leave in the United States: What the data tell us about access, usage, and economic and health benefits.(Retrieved August 8, 2017, from)
- Hospital-based interventions: A systematic review of staff-reported barriers and facilitators to implementation processes.Implementation Science. 2018; 13: 36
- Effect of dedicated lactation support services on breastfeeding outcomes in extremely-low-birth-weight neonates.Journal of Human Lactation. 2017; (890334417741304)
- The prevention of depression in children and adolescents: A review.Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2009; 54: 212-221
- Behavioral science at the crossroads in public health: Extending horizons, envisioning the future.Social Science & Medicine. 2006; 62 (1982): 1650-1671
- The use of short message services (SMS) to provide medical updating to parents in the NICU.Journal of Perinatology. 2016; 36: 739-743
- Factors associated with maternal visitation and participation in skin-to-skin care in an all referral level IIIc NICU.Acta Paediatrica. 2013; 102 (1992): e53-e56
- Universal health care coverage in the United States: Barriers, prospects, and implications.Health & Social Work. 1997; 22: 223-230
- Baby CareLink: Using the internet and telemedicine to improve care for high-risk infants.Pediatrics. 2000; 106: 1318-1324
- Maternal psychological distress and visitation to the neonatal intensive care unit.Acta Paediatrica. 2015; 104 (1992): e306-e313
- Comparison of motor self-regulatory and stress behaviors of preterm infants across body positions.The American Journal of Occupational Therapy. 2003; 57: 289-297
- Is patient-centredness in European hospitals related to existing quality improvement strategies? Analysis of a cross-sectional survey (MARQuIS study).Quality & Safety in Health Care. 2009; 18: i44-i50
- Patient centredness and quality improvement efforts in hospitals: Rationale, measurement, implementation.International Journal for Quality in Health Care. 2011; 23: 531-537
- The social buffering of the hypothalamic-pituitary-adrenocortical axis in humans: Developmental and experiential determinants.Social Neuroscience. 2015; 10: 479-488
- Out-of-pocket health care expenses for non-elderly families by income and family structure, 2015.Agency for Healthcare Research and Quality (US), Rockville (MD)2018 (Statistical Brief No. 507Retrieved from)
- The neonatal intensive parenting unit: An introduction.Journal of Perinatology. 2017; 37: 1259-1264
- Recommendations for peer-to-peer support for NICU parents.Journal of Perinatology. 2015; 35: S9-S13
- Breastfeeding promotion interventions and breastfeeding practices: A systematic review.BMC Public Health. 2013; 13: S20
- Skin conductance as a measure of pain and stress in hospitalised infants.Early Human Development. 2006; 82: 603-608
- Epidemiologic trends in neonatal intensive care, 2007–2012.JAMA Pediatrics. 2015; 169: 855-862
- Facilitated tucking to reduce pain in neonates: Evidence for best practice.Advances in Neonatal Care. 2015; 15: 201-208
- The use of multi-parametric biomarker profiles may increase the accuracy of ASD prediction.Journal of Molecular Neuroscience. 2018; 66: 85-101
- Infant distress: Moving toward concept clarity.Clinical Nursing Research. 2012; 21: 164-182
- Factors affecting parents’ presence with their extremely preterm infants in a neonatal intensive care room.Acta Paediatrica. 2013; 102 (1992): 695-702
- Barriers to provision of developmental care in the neonatal intensive care unit: Neonatal nursing perceptions.American Journal of Perinatology. 2007; 24: 71-77
- Social buffering of the stress response: Diversity, mechanisms, and functions.Frontiers in Neuroendocrinology. 2009; 30: 470-482
- Human touch effectively and safely reduces pain in the newborn intensive care unit.Pain Management Nursing. 2014; 15: 107-115
- Medicaid and home visiting: Best practices from states.Center for American Progress, Washington (DC)2017 (Retrieved from)
- Effects of facilitated tucking during routine care of infants born preterm.Pediatric Physical Therapy. 2005; 17: 158-163
- Parent-Infant Skin-to-Skin Contact Following Birth: History, Benefits, and Challenges.Neonatal Network: NN. 2017; 36: 89-97
- Psychosocial program standards for NICU parents.Journal of Perinatology. 2015; 35: S1-S4
- Recommendations for mental health professionals in the NICU.Journal of Perinatology. 2015; 35: S14-S18
- The richest 1 percent now owns more of the country's wealth than at any time in the past 50 years.(December 6) Washington Post, 2017 (Retrieved from)
- Preterm birth: Causes, consequences, and prevention.in: Behrman R.E. Butler A.S. Preterm birth: Causes, consequences, and prevention. National Academies Press (US), Washington (DC)2007 (Retrieved from)
- Effects of prone and supine positions on sleep state and stress responses in preterm infants.Infant Behavior & Development. 2011; 34: 257-263
- Growth delay as an index of allostatic load in young children: Predictions to disinhibited social approach and diurnal cortisol activity.Development and Psychopathology. 2011; 23: 859-871
- Valuing breastfeeding: A qualitative study of women's experiences of a financial incentive scheme for breastfeeding.BMC Pregnancy and Childbirth. 2018; 18: 20
- Skin-to-skin care for procedural pain in neonates.The Cochrane Database of Systematic Reviews. 2014; CD008435
- The effects of single-family rooms on parenting behavior and maternal psychological factors.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2016; 45: 359-370
- The Model for Understanding Success in Quality (MUSIQ): Building a theory of context in healthcare quality improvement.BMJ Quality & Safety. 2012; 21: 13-20
- The social determinants of infant mortality and birth outcomes in Western developed nations: A cross-country systematic review.International Journal of Environmental Research and Public Health. 2013; 10: 2296-2335
- Cue-based oral feeding clinical pathway results in earlier attainment of full oral feeding in premature infants.Journal of Perinatology. 2007; 27: 572-578
- The Affordable care act's impacts on access to insurance and health care for low-income populations.Annual Review of Public Health. 2017; 38: 489-505
- Kangaroo Care (skin contact) reduces crying response to pain in preterm neonates: Pilot results.Pain Management Nursing. 2008; 9: 55-65
- Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly.Paediatric and Perinatal Epidemiology. 2000; 14: 194-210
- Quality of health insurance coverage and access to care for children in low-income families.JAMA Pediatrics. 2016; 170: 43-51
- Exploring the olfactory environment of premature newborns: A French survey of health care and cleaning products used in neonatal units.Acta Paediatrica. 2011; 100 (1992): 334-339
- Family income gradients in the health and health care access of US children.Maternal and Child Health Journal. 2010; 14: 332-342
- Improving family-centered care practices in the NICU.Neonatal Network. 2014; 33: 125-132
- Single-family room care and neurobehavioral and medical outcomes in preterm infants.Pediatrics. 2014; 134: 754-760
- 18-Month follow-up of infants cared for in a single-family room Neonatal Intensive Care Unit.The Journal of Pediatrics. 2016; 177: 84-89
- NICU parent-to-parent partnerships: A comprehensive approach.Neonatal Network. 2014; 33: 66-73
- The influence of social factors on the response to stress.Psychotherapy and Psychosomatics. 1993; 60: 33-38
- Impact of hands-on care on infant sleep in the neonatal intensive care unit.Pediatric Pulmonology. 2016;
- Single-payer, universal health insurance: Still sound after all these years.CMAJ: Canadian Medical Association Journal. 2004; 171: 600-601
- Experience with videoconferencing between a neonatal unit and the families’ home from the perspective of certified paediatric nurses.Journal of Telemedicine and Telecare. 2009; 15: 275-280
- Social conditions as fundamental causes of disease.Journal of Health and Social Behavior. 1995; (Spec No. 80–84)
- The gustatory and olfactory systems during infancy: Implications for development of feeding behaviors in the high risk neonate.Clinics in Perinatology. 2011; 38: 627-641
- Comparing sound measurements in the single-family room with open-unit design neonatal intensive care unit: The impact of equipment noise.Journal of Perinatology. 2012; 32: 368-373
- Does skin-to-skin contact reduce stress during diaper change in preterm infants?.Early Human Development. 2014; 90: 169-172
- Implementing family-integrated care in the NICU: Engaging veteran parents in program design and delivery.Advances in Neonatal Care. 2013; 13 (quiz 270–271): 262-269
- Nasal continuous positive airway pressure: A multisite study of suctioning practices within NICUs.Advances in Neonatal Care. 2013; 13: E1-E9
- Anxiety screening during assessment of emotional distress in mothers of hospitalized newborns.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2018; 47: 105-113
- Steroid hormones and the chemistry of behavior.Advances in Behavioral Biology. 1972; 4: 41-59
- Steroid hormones and the brain: Cellular mechanisms underlying neural and behavioral plasticity.Psychoneuroendocrinology. 1980; 5: 1-11
- Stress, adaptation, and disease. Allostasis and allostatic load.Annals of the New York Academy of Sciences. 1998; 840: 33-44
- What's in a name? Integrating homeostasis, allostasis and stress.Hormones and Behavior. 2010; 57: 105
- Evaluating nurse staffing patterns and neonatal intensive care unit outcomes using Levine's Conservation Model of Nursing.Journal of Nursing Management. 2011; 19: 998-1011
- Reducing premature infants’ length of stay and improving parents’ mental health outcomes with the Creating Opportunities for Parent Empowerment (COPE) neonatal intensive care unit program: A randomized, controlled trial.https://doi.org/10.1542/peds.2005-2580Date: 2006
- Effect of neonatal complications in premature infants on early parent-infant interactions.Developmental Medicine and Child Neurology. 1983; 25: 763-777
- Does daily kangaroo care provide sustained pain and stress relief in preterm infants?.Journal of Neonatal-Perinatal Medicine. 2013; 6: 45-52
- Prohibit, constrain, encourage, or purchase: How should we engage with the private health-care sector?.Lancet. 2016; 388: 613-621
- Interventions to reduce the impact of unemployment and economic hardship on mental health in the general population: A systematic review.Psychological Medicine. 2017; 47: 1062-1084
- Cycled light in the intensive care unit for preterm and low birth weight infants.The Cochrane Database of Systematic Reviews. 2016; CD006982
- A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding.Early Human Development. 2015; 91: 63-70
- Benefits of incentives for breastfeeding and smoking cessation in pregnancy (BIBS): A mixed-methods study to inform trial design.Health Technology Assessment. 2015; 19 (vii–viii): 1-522
- Performance of private sector health care: Implications for universal health coverage.Lancet. 2016; 388: 606-612
- Measuring preterm cumulative stressors within the NICU: The Neonatal Infant Stressor Scale.Early Human Development. 2009; 85: 549-555
- Prevalence of perceived food and housing security – 15 states, 2013.MMWR. Morbidity and Mortality Weekly Report. 2017; 66: 12-15
- Use of facilitated tucking for nonpharmacological pain management in preterm infants: A systematic review.The Journal of Perinatal & Neonatal Nursing. 2009; 23: 372-377
- The parental experience of having an infant in the Newborn Intensive Care Unit.The Journal of Perinatal Education. 2009; 18: 23-29
- Evaluation of the Family Integrated Care model of neonatal intensive care: A cluster randomized controlled trial in Canada and Australia.BMC Pediatrics. 2015; 15: 210
- Surveillance for health care access and health services use, adults aged 18–64 years – Behavioral risk factor surveillance system, United States, 2014.Morbidity and Mortality Weekly Report. Surveillance Summaries. 2017; 66: 1-42
- Effects of home visits by paraprofessionals and by nurses on children: Follow-up of a randomized trial at ages 6 and 9 years.JAMA Pediatrics. 2014; 168: 114-121
- Impact of income and income inequality on infant health outcomes in the United States.Pediatrics. 2010; 126: 1165-1173
- United States: 2016 overview.OECD Economic Surveys. Organisation for Economic Co-operation and Development, Paris, France2016 (Retrieved from)
- OECD Income Distribution Database (IDD): Gini, poverty, income, Methods and Concepts – OECD.Income Distribution Database. Organisation for Economic Co-operation and Development, Paris, France2017 (Retrieved from)
- The Stockholm Neonatal Family Centered Care Study: Effects on length of stay and infant morbidity.Pediatrics. 2010; 125: e278-e285
- Effect of procedure light on the physiological responses of preterm infants.Japan Journal of Nursing Science. 2010; 7: 76-83
- [Handling of preterm infants in a neonatal intensive care unit].Revista Da Escola De Enfermagem Da U S P. 2013; 47: 1272-1278
- A model of neurodevelopmental risk and protection for preterm infants.The Journal of Perinatal & Neonatal Nursing. 2010; 24: 356-365
- Non-pharmacological management of infant and young child procedural pain.The Cochrane Database of Systematic Reviews. 2015; CD006275
- Differences that matter: Developing critical insights into discourses of patient-centeredness.Medicine, Health Care, and Philosophy. 2016; 19: 501-515
- The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system.Cleveland Clinic Journal of Medicine. 2009; 76 (Journal Article): S86-S90
- United States flunks an international health care analysis.The American Journal of Nursing. 2017; 117: 16
- Effectiveness of early intervention programs for parents of preterm infants: A meta-review of systematic reviews.BMC Pediatrics. 2018; 18
- Barriers and facilitators to preparing families with premature infants for discharge home from the neonatal unit. Perceptions of health care providers.Investigación Y Educación En Enfermería. 2014; 32: 379-392
- Progress toward universal health coverage: A comparative analysis in 5 South Asian Countries.JAMA Internal Medicine. 2017; 177: 1297-1305
- Parents’ presence and parent-infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries.Acta Paediatrica. 2017; 106 (1992): 878-888
- Family-centered care in neonatal intensive care unit: A concept analysis.International Journal of Community Based Nursing and Midwifery. 2014; 2: 268-278
- The struggle of translating science into action: Foundational concepts of implementation science.Journal of Evaluation in Clinical Practice. 2017;
- A universal healthcare system: Is it right for the United States?.Nursing Forum. 2007; 42: 3-11
- Effect of financial incentives on breastfeeding: A cluster randomized clinical trial.JAMA Pediatrics. 2018; 172e174523
- Breastfeeding promotion for infants in neonatal units: A systematic review and economic analysis.Health Technology Assessment. 2009; 13 (iii–iv): 1-146
- Parental presence and holding in the neonatal intensive care unit and associations with early neurobehavior.Journal of Perinatology. 2013; 33: 636-641
- Web camera use of mothers and fathers when viewing their hospitalized neonate.Advances in Neonatal Care. 2015; 15: 440-446
- Rationing of nursing care interventions and its association with nurse-reported outcomes in the neonatal intensive care unit: A cross-sectional survey.BMC Nursing. 2016; 15: 46
- The role of peer support in the development of maternal identity for “NICU Moms.”.Journal of Obstetric, Gynecologic, and Neonatal Nursing. 2015; 44: 3-16
- Why paid family and medical leave matters for the future of America's families, businesses and economy.Maternal and Child Health Journal. 2016; 20: S8-12
- Policies to assist parents with young children.The Future of Children. 2011; 21: 37-68
- Probabilistic return-on-investment analysis of single-family versus open-bay rooms in neonatal intensive care units-synthesis and evaluation of early evidence on nosocomial infections, length of stay, and direct cost of care.Journal of Intensive Care Medicine. 2017; (885066616689774)
- The Inclusive Growth and Development Report (Economic Research).World Economic Forum, Geneva, Switzerland2017 (Retrieved from)
- Trauma-informed care in the newborn intensive care unit: Promoting safety, security and connectedness.Journal of Perinatology. 2017; 38: 3-10
- Family pediatrics: Report of the task force on the family.Pediatrics. 2003; 111: 1541-1571
- The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology.Development and Psychopathology. 1996; 8: 59-87
- Food and housing insecurity and health status among U.S. adults with and without prior military service.SSM – Population Health. 2016; 2: 244-248
- Breastfeeding and the use of human milk.Pediatrics. 2012; 129: e827-e841
- Barriers and enablers of kangaroo mother care practice: A systematic review.PLoS One. 2015; 10e0125643
- Can hospitalization precipitate toxic stress?.Pediatrics. 2016; 137
- Impact of the design of neonatal intensive care units on neonates, staff, and families: A systematic literature review.The Journal of Perinatal & Neonatal Nursing. 2012; 26 (quiz 267–268): 260-266
- Cue-based feeding in the NICU: Using the infant's communication as a guide.Neonatal Network. 2013; 32: 404-408
- Paid leave benefits among a national sample of working mothers with infants in the United States.Maternal and Child Health Journal. 2014; 18: 286-295
- Characterising the ambient sound environment for infants in intensive care wards.Journal of Paediatrics and Child Health. 2016; 52: 436-440
- The lifelong effects of early childhood adversity and toxic stress.Pediatrics. 2012; 129: e232-e246
- Neonatal intensive care unit stress is associated with brain development in preterm infants.Annals of Neurology. 2011; 70: 541-549
- Longitudinal analysis of neural network development in preterm infants.Cerebral Cortex. 2010; 20: 2852-2862
- Functional connectivity MRI in infants: Exploration of the functional organization of the developing brain.NeuroImage. 2011; 56: 1437-1452
- Changes in utilization and health among low-income adults after Medicaid expansion or expanded private insurance.JAMA Internal Medicine. 2016; 176: 1501-1509
- Changes in self-reported insurance coverage, access to care, and health under the affordable care act.JAMA. 2015; 314: 366-374
- Neonatal morbidity and 1-year survival of extremely preterm infants.Pediatrics. 2017; 139
- Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.Pediatrics. 2010; 126: 443-456
- Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012.JAMA. 2015; 314: 1039-1051
- The scientific evidence for child health insurance.Academic Pediatrics. 2009; 9: 4-6
- Impact of NICU design on environmental noise.Journal of Neonatal Nursing. 2014; 20: 77-81
- Kangaroo mother care and the bonding hypothesis.Pediatrics. 1998; 102: e17
- Strategic partnerships to address adverse social determinants of health: Redefining health care.Nursing Outlook. 2018; 66: 233-236
- Effects of single-family rooms on nurse-parent and nurse-infant interaction in Neonatal Intensive Care Unit.Early Human Development. 2017; 106–107: 59-62
- A developmental care framework for a cardiac intensive care unit: a paradigm shift.Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses. 2012; 12: S28-S32
- A descriptive study of nurse-reported missed care in neonatal intensive care units.Journal of Advanced Nursing. 2015; 71: 813-824
- Measuring the quality of patient-centered care: Why patient-reported measures are critical to reliable assessment.Patient Preference and Adherence. 2015; 9: 831-835
- Access to and use of leave – 2011 Data from the American Time Use Survey.US Department of Labor, Washington (DC)2012 (American Time Use Survey No. USDL-12-1648Retrieved from)
- Family-centered care to complement care of sick newborns: A randomized controlled trial.Indian Pediatrics. 2017; 54: 455-459
- Uninsurance and insurance transitions before and after 2014: Estimates for U.S., non-elderly adults by health status, presence of chronic conditions and state Medicaid expansion status.Agency for Healthcare Research and Quality (US), Rockville (MD)2016 (Statistical Brief No. 490Retrieved from)
- Differential effects of the single-family room Neonatal Intensive Care Unit on 18– to 24-month bayley scores of preterm infants.The Journal of Pediatrics. 2017; 185 (e1): 42-48
- The efficacy of facilitated tucking for relieving procedural pain of endotracheal suctioning in very low birthweight infants.MCN The American Journal of Maternal Child Nursing. 2004; 29 (quiz 157–158): 151-156
- Designing artificial environments for preterm infants based on circadian studies on pregnant uterus.Frontiers in Endocrinology. 2013; 4: 113
- Associations between nurse-guided variables and plasma oxytocin trajectories in premature infants during initial hospitalization.Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurse. 2018; 18: E12-E23
- Schore's regulation theory: Maternal-infant interaction in the NICU as a mechanism for reducing the effects of allostatic load on neurodevelopment in premature infants.Biological Research for Nursing. 2012; 14: 375-386
- Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: A randomized controlled trial in the NICU.Clinical Neurophysiology. 2014; 125: 675-684
- Randomized controlled trial of Family Nurture Intervention in the NICU: Assessments of length of stay, feasibility and safety.BMC Pediatrics. 2013; 13: 148
- The role of public health insurance in reducing child poverty.Academic Pediatrics. 2016; 16: S98-S104
- Cue-based feeding in the NICU.Nursing for Women's Health. 2016; 20: 507-510
- U.S. ranks 23rd out of 30 developed countries for inequality.The Atlantic. 2017; (Retrieved from)
- Recommended standards for newborn ICU design, eighth edition.Journal of Perinatology. 2013; 33: S2-16
- Effect of auditory, tactile, visual, and vestibular intervention on length of stay, alertness, and feeding progression in preterm infants.Developmental Medicine and Child Neurology. 2002; 44: 91-97
- The Neonatal Intensive Care Unit: Environmental stressors and supports.International Journal of Environmental Research and Public Health. 2018; 15
- Trauma-informed care.In Encyclopedia of Social Work. 2013; (Retrieved from)
- Representing residence, living situation, and living conditions: An evaluation of terminologies, standards, guidelines, and measures/surveys.AMIA Annual Symposium Proceedings. 2017; 2016: 2072-2081
- Overview of hospital stays for children in the United States, 2012: Statistical brief #187.Healthcare Cost and Utilization Project (HCUP) statistical briefs. Agency for Healthcare Research and Quality (US), Rockville (MD)2006 (Retrieved from)
- Parent participation in pediatric intensive care unit rounds via telemedicine: Feasibility and impact.The Journal of Pediatrics. 2017; 185 (e3): 181-186
- Virtual visitation in the neonatal intensive care: Experience with the use of internet and telemedicine in a tertiary neonatal unit.The Permanente Journal. 2011; 15: 32-36
- Effects of maternal visitation to preterm infants in the neonatal intensive care unit.Child Development. 1984; 55: 1887-1893
Article info
Publication history
Published online: November 21, 2018
Accepted:
November 16,
2018
Received in revised form:
October 27,
2018
Received:
April 16,
2018
Footnotes
The authors declare no conflicts of interest or commercial interests in this work. Funding: This work was supported by the National Institutes of Health Postdoctoral Fellowship (1T32NR015433-01).
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
