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 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. RESULTS: The mean hours/week of parent visitation was 21.33±20.88 (median= 13.90; interquartile range 10.10–23.60). Infants were held an average of 2.29±1.47 days/week (median= 2.00; interquartile range 1.20–3.10). Over the admission, 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). INTERPRETATION: Infants of caregivers who were visited and held more often in the NICU had differences in early neurobehavior by term equivalent, which supports increased early parenting in the NICU.