Shedding
Light on Premature Infant Health
Excerpt
By
Colette
Bouchez, HealthScoutNews
(HealthScoutNews) -- The dark, quiet surroundings thought to
promote fetal development in the womb may not work once an infant
enters the real world -- particularly if that entry comes sooner
than expected.
So suggests a new study published in the current Journal of Pediatrics.
Recreating the dark, intimate environment of a mother's womb
was once thought beneficial for babies born prematurely, but this
latest study says fragile infants may do better when exposed to
naturally cycled light.
"Once the pre-term infant is born, it has different physiologic
demands that are not like the womb," explains Debra H. Brandon,
study author and assistant professor at the Duke University School
of Nursing.
In the uterus, babies don't have to use their lungs to oxygenate
their body. Likewise, the kidneys don't face the same demands
and the digestive system does not have to work, she adds.
Once born, a baby's systems must function independently of the
mother, and here's where Brandon says exposure to light can be
critical.
"Cycled light probably promotes the development of circadian
rhythms, which may, in turn, aid digestion, through the secretion
of digestive enzymes, and the development of sleep-wake states,"
Brandon explains.
If pre-term infants can use their food better and sleep more,
she says, they should gain weight faster, and the study showed
they did.
A circadian rhythm is the internal clock that controls many
body functions. It can be influenced by environmental cues, particularly
light and darkness. Although our world runs on a 24-hour cycle,
circadian rhythms can run anywhere from 22 to 28 hours in length.
In the womb, babies are connected to their mother's circadian
rhythm. When born full-term, they quickly begin to develop their
own internal body clock. Infants born prematurely, however, fall
somewhere in the middle, and receive treatments that vary widely,
Brandon says.
In many neonatal units, babies are continuously exposed to bright
hospital light, which can be stressful, or relegated to near darkness,
to simulate conditions in the womb. Neither, she says, is conducive
to developing circadian rhythms.
At New York University Medical Center, doctors help premature
infants by integrating light therapy into a unique form of treatment
known as "Kangaroo Care," says Dr. Karen Hendricks-Munoz,
director of the neonatal care program. Babies are taken out of
incubators and placed on the bare chest of either parent for up
to three hours at a time, using the warmth and "rhythm"
of Mom or Dad's body to encourage growth and development.
"'Kangaroo Care' allows our premature infants to be held
and touched regularly, which, naturally places them in a variety
of lighting conditions and exposes them to other environmental
cues. And we see a real difference in how well they do,"
Hendricks-Munoz says.
The idea that scientific attention is now being paid to these
"non-medical cues" is important, she says.
"I think it's wonderful that an institution as prestigious
as Duke has done this study, and given us the science behind one
of the many things that we intuitively have always believed was
right for the baby," Hendricks-Munoz says.
The Duke study involved 62 infants, all premature and all of
similar weight. Babies were randomly assigned to one of three
groups. The first group received cycled light every day soon after
birth. The second group had 24 hours daily of near darkness soon
after birth, followed by cycled light beginning at 32 weeks post-conceptual
age -- equal to the gestational age if the baby had not been born
prematurely. The third group also had near darkness almost from
birth, followed by cycled light starting at 36 weeks post-conceptual
age, not long before the infants went home.
The cycles were defined as 11 hours of light, followed by 11
hours of darkness. The near darkness was interrupted with some
transitional lighting that occurred with each change in nursing
shifts. All babies were weighed and measured daily, and vital
signs were recorded regularly.
The result:Those infants who received the cycled light from
birth, as well as those exposed beginning at 32 weeks, gained
more weight and were considered heartier than the babies who remained
in near darkness until just before going home.
There was no difference among the three groups, however, in
ventilator use or length of hospital stay.
For Hendricks-Munoz, the study results are valuable. They dovetail
with her research, which found that "not only exposure to
light, but also touch and sound, can make a tremendous difference
in how well a premature infant thrives."
Using "Kangaroo Care," premature infants often go
home up to 20 days sooner than those who receive traditional care,
she says.
What To Do: To learn more about circadian rhythms, visit
the Red
River Sleep Center. For more information on caring for premature
infants, see The
American Academy of Family Physicians. To find out more about
"Kangaroo Care," visit The
University of Manitoba.
Reference
Source 101
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