Journal of Pediatric Health Care
Volume 17, Issue 3 , Pages 19a-20a, May 2003

The PNP's role in supporting infant and family well-being during the first year of life☆☆☆

Article Outline

Abstract 

J Pediatr Health Care. (2003). 17, 19A-20A.

 

Infancy is a critical period that provides an important foundation for both physical and mental health throughout life. The National Association of Pediatric Nurse Practitioners (NAPNAP) recognizes the important role of the pediatric health care provider in assisting newborns to thrive physically, developmentally, emotionally, spiritually, and intellectually within the family environment.

NAPNAP accepts the American Academy of Pediatrics' policy statements on the care of newborns, including Hospital Stay for Healthy Term Newborns (AAP, 1995) and Recommendations for Preventive Pediatric Health Care (AAP, 2000) as safe, evidence-based guidelines for the management of healthy, term newborns and infants. NAPNAP, however, believes that where the guidelines state “physician” “pediatric primary care provider” should be substituted. NAPNAP further supports strategies to support infant and family well-being and mental health during the first year of life. Infant mental health is the optimal growth and social-emotional, behavioral, and cognitive development of the infant in the context of the unfolding relationship between infant and parent (Minnesota Early Intervention Team, 1998).

Increasingly, leaders in both infant development and in public policy recognize that the “ability of our youngest children to thrive depends on the quality and continuity of their relationships with responsive, loving caregivers” (Stark, 2000, p. 1). The nurturing quality of infants' environment allow infants to become emotionally and physically healthy, prepares them for learning, and enables them to develop to their full potential. It is through nurturing caregivers that children experience parental attachment, positive parent-child relationships, and encouragement to develop to the best of their abilities. These mutual interactions provide social support for all family members (Florida State University, 2001). Implementation of a nurturing environment for all infants requires that health professionals support an infant's caregivers through health services based on the latest child development research. PNPs should assess the family's network of support and resources, developing and implementing a plan to strengthen areas of weakness before the newborn's birth whenever possible.

The foundation for readiness to learn begins with the newborn's earliest interactions with his or her caregivers. An expanding research base highlights the important role emotional health plays in preparing infants and children to learn (Landry, Smith, Miller-Loncar, & Swank, 1997; Pettit, Bates, & Dodge, 1997). It is the quality of the relationship between infant and caregiver that enables trust to develop, trust that fuels attachment to a safe and protecting caregiver, and attachment that supports infant exploration and learning (Shonkoff & Phillips, 2000). As an organization dedicated to the promotion of child health and excellence in practice by pediatric health care professionals, NAPNAP believes:

1.PNPs should offer prenatal support to families to include not only education on basic infant care, nutrition, and safety, but also infant communication through behavioral cues, sleep-wake organization, ways to assist newborns with state regulation, and strategies to promote healthy newborn development.

2.PNPs should consult with mothers on infant feeding choices, assuring understanding of sound feeding practices, including the social and learning aspects of infant feeding, and should provide support to breastfeeding mothers with referral to a lactation specialist as needed.

3.PNPs should be skillful in screening caregivers for potential child maltreatment (Murray, Baker, Lewin, 2000) and screening mothers for risk of maternal depression (Olson, et al, 2002).

4.PNPs should include careful observation of caregivers for indications of responsive caregiving of the newborn and infant during each health encounter, providing positive reinforcement, information, and supportive interventions to parents as needed.

5.PNPs should provide individualized services to each parent-child dyad that recognize and build upon their strengths, helping the parent to gain insight and understanding into the unique characteristics of each newborn and the changing infant.

6.PNPs should develop relationships of trust and respect characterized by a genuine partnership with families in fostering the health and development of the infant.

7.PNPs should incorporate a multidisciplinary family-parent-child-focused approach that recognizes the unique contributions of all family members and values and incorporates beliefs and practices of diverse cultures.

8.PNPs should be knowledgeable about the available community services that promote infant mental health and should coordinate services among agencies as needed.

9.PNPs should become skilled in the use of formal screening instruments and assessments evaluating infant development and psychological well-being.

10.PNPs should work collaboratively with early intervention services to assure that infants with special needs and their families receive ongoing health promotion services and skilled care to assure psychological well being for both parents and infants as well as developmental support for the infant.

11.Educational programs preparing PNPs should include preparation in infant mental health assessment and intervention for all students.

12.PNPs who care for infants should participate in continuing education programs that include ongoing education in the developing research surrounding infant mental health assessment and intervention.

13.PNPs should work to raise public awareness about legal and protective systems, which interface with infants and toddlers, to ensure they operate with well-informed policies and procedures that protect and optimize infant mental health needs (Minnesota Early Intervention Team, 1998).

14.PNPs should collaborate with other health care providers to raise public awareness and to develop well-informed public policies that protect and optimize infant mental health.

NAPNAP acknowledges the recent and profound progress researchers have made in understanding child development, early brain development, and infant/toddler mental health. NAPNAP supports efforts to fully integrate this knowledge into our systems of care for young children. NAPNAP encourages all PNPs to develop knowledge and skill in the assessment and support of psychological well being in infants and families, both prenatally and after birth.

Approved by the NAPNAP Executive Board: February 24, 2003 Designation: Regular

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References 

  1. American Academy of Pediatrics . Hospital Stay for Healthy Term Newborns (RE9539). Pediatrics. 1995;96(4):788–790
  2. American Academy of Pediatrics . Recommendations for preventive pediatric health care (RE9399). Pediatrics. 2000;103(3):645
  3. Florida State University Center for Prevention and Early Intervention Policy . Florida's Strategic Plan for Infant Mental Health. Retrieved 08/20/2002 from www.cpeip.fsu.edu2001, February;
  4. Landry SH, Smith KE, Miller-Loncar CL, Swank PR. Predicting cognitive-language growth curves from early maternal behaviors in children at varying degrees of biological risk. Developmental Psychology. 1997;33(6):1040–1053
  5. Minnesota Early Intervention Team . Minnesota Infant Mental Health Services Feasibility Study. Retrieved 10/04/2002 from http://education.umn.edu/CEED/publications/imhstudy/feasibility.htm/Definition1998;
  6. Murray SK, Baker AW, Lewin L. Screening families with young children for child maltreatment potential. Pediatric Nursing. 2000;26(1):47–54
  7. Olson AL, Kemper KJ, Kelleher KJ, Hammond CS, Zuckerman BS, Dietrich AJ. Primary care pediatrician's roles and perceived responsibilities in the identification and management of maternal depression. Pediatrics. 2002;110(6):1169–1176
  8. Pettit GS, Bates JE, Dodge KA. Supportive parenting, ecological context, and children's adjustment: A seven-year longitudinal study. Child Development. 1997;68(5):908–923
  9. In:  Schonkoff JP,  Phillips DA editor. From neurons to neighborhoods. Washington, D.C: National Academy Press; 2000;
  10. Stark DR. A commitment to supporting the mental health of our youngest children: Report of the Infant Mental Health Forum. October 23-24, 2000 Washington, DC: USDHHS Administration of Children and Families; 2000;

☆ Reprint requests: NAPNAP National Office, 20 Brace Rd, Suite 200, Cherry Hill, NJ 08034-2633.

☆☆ 0891-5245/2003/$30.00 + 0

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Journal of Pediatric Health Care
Volume 17, Issue 3 , Pages 19a-20a, May 2003

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