• Korean Parent-Child Health Journal
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• v.2
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• pp.83-110
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• 1999

The purpose of this study was to identify the sleep/activity patterns of neonates and to provide a baseline data for the development effective mother-infant relationship. Subjects of this study were 36 newborns aged 1-21 days and stayed in Postpartum Care Center in Taejon during the period of October 28th, 1999 to February 10th, 2000. The data were collected using NCASA developed by Barnard et al. and were analyzed with SPSS 7.5 for window program. The results of this study were as follows: 1. An average day sleep of neonates was 8.0 hours, night sleep was 3.6 hours, and total sleep was 11.6 hours. A longest period of day sleep was 3.8 hours and a longest period of night sleep was 3.4 hours. The regularity of day sleep was 22.1%, night sleep was 23.3%, and total was 22.1%. 2. The frequency of daytime feeding was 6.9, nighttime fee ding was 3.4, resulting in total of 10.3. The regularity of feeding was 37.4%, and the frequency of night awakening was 2.4. 3. Associations among variables related to neonate's sleep/activity records were as follows : - The regularity of total sleep was positively correlated with the frequencies of day sleep(r=.57, P=.00), night sleep (r=.40, P=.01), and total sleep(r=.65, P=.00). - The frequency of total feeding was negatively correlated with the frequencies of day sleep(r=-.29, P=.04), night sleep(r=-.39, P=.02), and total sleep(r=-.42, P=.00), as well as longest day sleep(r=-.50, P=.00). - The regularity of feeding was negatively correlated with the frequency of night sleep(r=-.35, P=.02), longest period of day sleep(r=-.32, P=.04), and longest period of night sleep(r=-.30. P=.04), whereas positively correlated with frequencies of daytime feeding (r=.29, P=.02) and nighttime feeding (r=.32, P=.05). - The frequency of night awakening was negatively correlated with amount of night sleep(r=-.39, P=.02) and frequency of daytime feeding(r=-.42, P=.01) while positively correlated with frequencies of nighttime feeding(r=.68, P=.00) and total feeding(r=.50, P=.00). 4. Although there was no statistical significant difference between sleep pattern and infant's age, following tendency was noted: - As baby gets older, total amount of sleep and longest period of day sleep decreased while longest period of night sleep increased. - As baby gets older, the regularity of day sleep decreased while the regularity of night sleep and total sleep slightly increased. - The frequencies of daytime and total feedings increased while the frequency of nighttime feeding decreased. In conclusion, the author found that the neonates of this study showed less amount of sleep, more night awakening, and more night time feedings than NCAST sample. There was a certain sleep/activity pattern existed: If babies were fed more frequently, daytime or nighttime sleeping hours became shorter, and if babies had longer daytime sleep, frequent nighttime awakenings were noted. This pattern illustrated the significant influence of feeding and sleep periods on each other. Awakening in the night is natural and normal patterns in the newborn period. The result of this study will provide information to parents about what to expect their infants.

• Korean Parent-Child Health Journal
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• v.3 no.2
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• pp.49-66
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• 2000

Pregnancy is a task of creation in which a women mobilizes her self and the resources available to her in the generation of a new person. Through the pregnancy, a mother has formed the new human relationship with a fetus. Maternal-fetal relationship is considered one of mechanism making the relationship of mother and child. It is important to well-being of mother and fetus, too. The earliest interaction between a mother and her child is during prenatal period. Maternal-fetal dyad is unique and perceived interactions with the fetus make the pregnancy real for the mother. Maternal behavior is "instinctive" and is formed in early childhood by copy of the mother. But, Rubin argues that this behavior is an open intellectual system rather than a prepackaged bundle of traits. There is openness to new learning and a high value placed on knowing which occurs with silent organization in thought. Thus, nurses and other health professionals provide prenatal care that optimally is part of the environment in which the maternal-fetal dyad develops. Thus it is appropriate for nurses to increases their understanding of the dyad and to explore ways to enhance its development. This study focusses on the interaction ability and response of fetus, and the maternal-fetal interaction. The research of fetal responses that involve physiological changes and motor movement have been shown to coccur to both external sensory stimuli and to maternal emotional states. The fetus does also have sensory capacity to be aware of some maternal behaviors, and the motor ability to respond in a way the mother can notice. Thus, very rudimentary interactions appear to be possible. Maternal awareness of fetal activity was supported by several studies. More interesting to the present study are description of maternal-fetal interaction and the finding that there appear to be levels of sensitivity to the fetus involved in maternal-fetal interactions. First, recognition comes that the fetus is separate from the maternal self. Next, the fetus engages in. Lastly, the parent may describe active interaction with the fetus, believing that mother and fetus are communicating on a meaningful level. Several interventions, developed to promote more active interaction between mother and fetus, have been reviewed. In general, the parents were taught to stimulate the fetus and to notice the fetus' responses. This type of intervention might increase the mother's sensitivity to her unborn baby, and she may have a head start toward learning how to res pond sensitivity to the newborn infant. Research In the area of maternal-fetal interaction is scarce. Sensitive behavior is construed as an appropriate and timely response to a signal of need from another person, but no such signal of need can be claimed regarding the fetus. The highest level of maternal-fetal interaction, therefore, might be based more on maternal representations of the imagined fetus than on factual evidence of fetal participation.

• Journal of Chest Surgery
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• v.42 no.4
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• pp.434-440
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• 2009

Background: Surgical closure of a patent ductus arteriosus (PDA) can be considered when conservative medical treatment is ineffective or contraindicated. Low weight and earlier gestational age neonates who are treated with conservative medical therapy generally showed a higher failure rate. The morbidity of surgical PDA closure in such extremely low birth weight (ELBW) neonates is also high. Here we present the early results of a new technique for approaching the PDA through a dorsal minithoracotomy. Material and Method: From March 2006 to November 2008, 24 premature neonates underwent surgical PDA closure. The procedures were performed in the newborn intensive care unit via a 2 cm long dorsal minithoracotomy with the baby in the prone position with the left hemithorax elevated 30$^{\circ}$. Bimanual cotton swab blunt dissection completed the extrapleural accesstothe PDA and then two clips were applied. Tube thoracostomy was avoided if there was no meaningful pleural laceration. Result: The infants mean gestational age was 26.5$\pm$2.1 weeks (range: 23 to 30 weeks) and the average age at operation was 11$\pm$11 days. The mean body weight at operation was 933$\pm$271 grams (range: 570 to 1,700 grams). Eight patients expired, but there was no procedure-related death. Postoperative echocardiography revealed two cases of residual shunt but none of these shunts were detected on the follow up echocardiogram that was performed on the post operative 5 and 59 days. Conclusion: We concluded that the technique described here is an effective procedure in view of the satisfactory operative exposure and the low rate of complications.