Effects of developmental care on behavioral organization in very-low-birth-weight infants.

The purpose of this study was to determine whether modifying care to reduce stressors in the neonatal intensive care unit and support infant development affected physiological, motor, and behavioral state organization. Twenty-one infants weighing less than 1501 g were studied prior to a nursing staff-training program (control) and 24 infants were studied posttraining (study). Nurses were taught to lower environmental stress, reduce procedural stress, and facilitate motor and sleep-wake organization. Oxygen saturation, motor activity, posture, and sleep-wake states were measured biweekly during routine care. Study infants showed higher oxygen saturation levels, fewer disorganized and jerky movements, more flexor movements, more flexed posture, and more alert-wakefulness than controls. Results suggest that this approach to care may have potential to improve behavioral organization during the preterm period.