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NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors

  • Mental Health (WF Njoroge and TD Benton, Section Editors)
  • Published:
Current Treatment Options in Pediatrics Aims and scope Submit manuscript

Abstract

Purpose of review

Parents of infants admitted to the neonatal intensive care unit (NICU) experience psychological distress, loss of the parenting role, and disruptions to parent-infant bonding. The inclusion of evidence-based practices to address these challenges in the NICU has largely been based upon short-term improvements in parent and infant functioning. However, less is known regarding the extent to which family-based interventions may also be associated with longer-term parenting behaviors and children’s neurobehavioral outcomes.

Recent findings

Comprehensive family-based NICU interventions demonstrate consistent links with later parental mental well-being, sensitive parenting behaviors, and children’s cognitive and socioemotional development. Dyadic co-regulation activities implemented inconsistently and/or in isolation to other components of NICU interventions show mixed associations with outcomes, highlighting the need for multifaceted wrap-around care. Further research is needed to delineate associations between NICU interventions and children’s neurological and language development, with follow-up beyond very early childhood in larger samples.

Summary

Long-term associations may reflect the stability of early parental responses to NICU interventions and the extent to which parents continue to implement mental health and sensitive parenting techniques in the home. However, the transition of parental psychiatric care from hospital to community-based services upon NICU discharge remains a pertinent need for high-risk families. Remaining issues also concern the extent to which NICU interventions incorporate sociodemographic differences across families, and whether interventions are generalizable or feasible across hospitals. Despite variation across interventions and NICUs, supporting, educating, and partnering with parents are crucial to strengthen longer-term family functioning and alter the developmental trajectories of high-risk infants.

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Funding

Dr. Rogers is funded by the National Institutes of Health NICHD (K23 MH105179 and KL2 TR000450) and The Doris Duke Charitable Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA

    Rachel E. Lean PhD

  2. Department of Pediatrics and Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA

    Cynthia E. Rogers MD

  3. Department of Obstetrics and Gynecology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8219, St. Louis, MO, 63110, USA

    Rachel A. Paul MPH

  4. Department of Psychological Sciences, University of Missouri-St. Louis, 1 University Blvd., St. Louis, MO, 63118, USA

    Emily D. Gerstein PhD

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Rachel E. Lean declares that she has no conflict of interest. Cynthia E. Rogers declares that she has no conflict of interest. Rachel A. Paul declares that she has no conflict of interest. Emily D. Gerstein declares that she has no conflict of interest.

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Lean, R.E., Rogers, C.E., Paul, R.A. et al. NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors. Curr Treat Options Peds 4, 49–69 (2018). https://doi.org/10.1007/s40746-018-0112-5

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