Influence of holding practice on preterm infant development.

purposeThe purpose of this randomized, controlled trial was to determine if nurse-supported kangaroo holding of healthy preterm infants in the first 8 weeks of the infant's life facilitates early behavioral organization and development.

methodsWe randomized 87 infants born between 32 and 35 weeks gestation and their mothers to one of three holding groups: kangaroo (skin-to-skin between mother's breasts), blanket (held in mother's arms), or control (no holding restrictions). Nurse-supported groups (kangaroo and blanket) received 8 weekly visits from a registered nurse who encouraged holding and provided education about infant development. The control group received brief social visits. Mothers recorded time held in a daily diary. The Assessment of Preterm Infant Behavior was administered when infants were 40 to 44 weeks postconceptional age.

resultsTotal holding time averaged 4 to 5 hr/day and did not differ among groups. Mothers held kangaroo style an average of 59 min/day in the kangaroo group, and 5 and 9 min/day in the blanket and control groups, respectively (p < .001). Infants in the kangaroo and blanket groups had more optimal scores than the control group in Robust Crying (p = .015) indicating that they could arouse to vigorous crying and calm. Scores, except for Attention and State Regulation, were at least as high as those of full-term infants. CLINICAL IMPLICATIONS: When kangaroo holding is compared to blanket holding, both methods may provide equal early behavioral organization and developmental benefit to the infant.