1. McGrath, Jacqueline M. PhD, RN, FNAP, FAAN

Article Content

The focus of this Advances in Neonatal Care supplement is family-centered developmental care. We have worked to provide you with articles that we believe will provide some evidence to guide your practice in care of the high-risk newborn and family. Epigentics is not just the latest buzzword. The science about how the genetic materials in each cell of the body is molded by the environment and the experiences encountered is growing. However, our understanding about what this means to neonatal developmentally supportive caregiving is only in its infancy. Much research is needed in this area and is mostly limited at this point by our ability to measure and link environmental changes to changes in the genetic makeup such that we could ultimately influence the genetic materials both positively and negatively. This is definitely an area where research will be exploding over the next several years, so stay tuned as we learn together what this means to the care we provide in the neonatal intensive care unit (NICU). This supplement also includes 2 very different research studies. Smith and colleagues explore the use of a new technique for providing relaxation to preterm infants in the NICU. The M Technique has been used in many different populations but only recently has begun to be used in the NICU. Finding different ways to best support high-risk infants provides us with alternative therapies to potentially increase relaxation and decrease the stressors of being preterm in the NICU. This study is a feasibility study examining the safety of this technique. Smith and her colleagues will soon be examining the benefits of this therapy in a randomized control trial, so be sure to watch for their next publication in this area. Dr Elser and her colleagues explore the use of infrared spectroscopy as a means to examine the effects of positioning on cerebral oxygenation. This is a new technology that has the potential to help us better understand how different therapies may affect cerebral oxygenation and ultimately long-term neurodevelopment. This technology is gaining acceptance in the NICU, but we need more research to guide our understanding about how best to use the technology to provide care that is neuroprotective in the short term and supportive of neurodevelopment in the long term. Lastly, Torowicz and colleagues provide us with insight about implementation of developmentally supportive care into cardiac care for high-risk infants and families. Infants who are cared for in the cardiac intensive care unit may not always receive care that is in sync with their developmental stage. The focus of care is often related to their cardiac defect and may not have a holistic developmental focus. Yet, these infants are at high risk for developmental delays. This team of nurses found that using the evidence from the lessons learned in the NICU can be very helpful in providing guidance for implementation of developmentally supportive interventions in the cardiac intensive care unit. Using research to guide practice in the NICU and other areas where high-risk infants are cared for is becoming increasingly evident. As bedside caregivers, we need to stay abreast of the evidence and ask the hard questions! Does this evidence make sense in my setting? Is the evidence appropriate for my patient population? And lastly, is the evidence strong enough to change my practice? The best practitioners never stop asking these questions. We hope that this supplement encourages you to stretch your curiosity and keep asking the hard questions!!