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Running head: EFFECT OF 40% DEXTROSE GEL ON ADMISSION RATE INTO NICU
Effect of 40% Dextrose on admission rate of Infants into the NICU
Problem Statement By admitting infants diagnosed with neonatal hypoglycemia (low blood glucose levels in infants) into the Kennestone Neonatal Intensive Care Unit (NICU), infants are not in close proximity of their mothers. In addition to interrupting breast feeding, this disturbance in the mother-infant bonding creates separation anxiety for the infants leading them to being anxious-resistant or avoidant (insecure attachment patterns where infants are extremely distressed or unaffected by the separation respectively) in the strange situation, which is “a laboratory paradigm for studying infant-parent attachment” (Fraley, 2010). Obtaining an insecure attachment pattern, instead of a secure attachment pattern (infants who seek for parental attention), impacts “multiple domains, such as emotional processing and executive functions” (Escobar et al., 2013, pg. 1). In addition, insecure attachments correlate with “reduced attention to angry faces, which can reflect a failure to notice threatening stimuli” (Escobar et al., 2013). Avoidance of disturbances between the mother-infant bond aids in
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Attachment patterns trigger differential neural signature of emotional processing in adolescents. PLoS ONE 8(8), 1-10. Retrieved from https://doi.org/10.1371/journal.pone.0070247
Fraley, R. C. (2010). A brief overview of adult attachment theory and research. Retrieved August 17, 2017, from https://internal.psychology.illinois.edu/~rcfraley/attachment.htm
Hegarty, Harding, Gamble, Crowther, Edlin, Alsweiler (2016). Prophylactic oral dextrose gel for newborn babies at risk of neonatal hypoglycemia: A randomized controlled dose-finding trial (the Pre-hPOD Study). PLoS Med 13(10), 1-10. Retrieved from
The importance of a healthy attachment in early childhood development can lead to a better adult development and skills for daily life. A secure and healthy attachment to the caregiver in infancy to adolescence showcases the importance of building strong relationships and coping skills during periods of stress and anxiety. The research that has been found, goes into detail about the different types of attachments that infants and children can develop as well as what negative and positive aspects come along with the attachments.
According to modern attachment theory, a “good enough” mother needs to be psychobiologically attuned with her infant in order to co-regulate the shifts in the Central Nervous System (CNS) and Automatic Nervous System (ANS) that the infant will experience (J. Schore & A. Schore, 2012). The mother’s ability to co-regulate the infant through the mother-infant affect synchrony, meaning the process of attunement, misattunement, and re-attunement will ultimately determine the child’s attachment style and if the child will be resilient as well as if the child will be able to self-regulate (J. Schore & A. Schore, 2012). A mother does not need to be perfectly attuned with her infant’s needs because moments of misattument that consist of mild to moderate stress followed be re-attunement are necessary in order to help foster the child’s resiliency (Mulligan, 2014a). However, during a moment of misattunement, the mother needs to re-attune with the infant in an appropriate amount of time in order to ensure that the child becomes
Infant attachment is the first relationship a child experiences and is crucial to the child’s survival (BOOK). A mother’s response to her child will yield either a secure bond or insecurity with the infant. Parents who respond “more sensitively and responsively to the child’s distress” establish a secure bond faster than “parents of insecure children”. (Attachment and Emotion, page 475) The quality of the attachment has “profound implications for the child’s feelings of security and capacity to form trusting relationships” (Book). Simply stated, a positive early attachment will likely yield positive physical, socio-emotional, and cognitive development for the child. (BOOK)
In the first third of our course we studied the intense, complex relationship a mother has with her offspring. In order to fully understand this bond, three concepts must be understood: the emotional nature, the adaptive strategy, as well as the relationship's pros and cons. However, for the purpose of this paper, I will be focusing on the mother-infant relationship as an adaptive strategy primates developed, with emphasis on attachment theory.
It also involves social context and behavior. At around 12 months the Attachment relationships are by insecure-avoidant and insecure-resistant types. Disorganized attachment is where the parent seems to be disconnected and dissociated with the infant. Parenting style and behavior tend to interfere with the children’s formation of attachment. Parental intrusiveness is a no contingent, verbal directives or physical behaviors in parents that constrain the children’s activities and behavior. In this study parents believed that discipline and control and child temperament had no significant correlation now were they correlated with attachment disorganization. Child gender did significantly show a higher disorganization for boys than girls negative intrusive parenting at age 6 months, parental belief in discipline and control at age 6 months, and child difficult temperament at age 6 months. Overall, Negative intrusive parenting did have an impact on attachment disorganization and children temperament. Negative intrusive parenting style can lead to provoke fear in young children which then reflects to the children being disorganized attachment as early as 6 months. Parenting style has a large effect on the child’s attachment and temperament as they grow older. Parenting strong belief in discipline and control could lead to a long term consolidate and stabilize negative
Attachment theory was originally proposed by Bowlby (1969) as an explanation of interpersonal relationships, with particular focus in his work on the parent-child relationships which are formed in early childhood. He noted that this was an evolutionary need within us as humans to form close attachments to improve our rate of survival (Bowlby, 1969). He later also theorized that these attachment styles would persist throughout life into adulthood (Bowlby, 1988). Further work on attachment theory by Bartholomew & Horowitz (1991) expanded on attachment styles and looked at the continuation of attachment style into adulthood. Using interviews with participants and the participants close friends they found evidence for four types of adult attachment styles: Secure, Preoccupied, Dismissing and Fearful (Bartholomew & Horowitz 1991). Further support for adult attachments styles is from Mikulincer & Shaver (2004) showing that attachments styles persist from childhood into adulthood demonstrating bowlby 's later hypothesis
Brennan, Kelly A., Clark, Catherine L., & Shaver, Phillip, R. (1998). Self-report measurement of adult attachment: An integrated overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (46-76). New York, NY: Guilford Press.
Fraley (2002) completed a meta analysis of studies concerning attachment in order to investigate the level of attachment pattern’s continuity throughout life. The study indicated that there was a certain stability of the attachment pattern, and that the stability is independent of time. Even though it is theorized that a secure pattern will be likely to stay unchanged, it is still indicated that experiences such as bad relationships will be able to change the attachment pattern (Fraley,
Attachment types, or styles, develop in the early relational environment of a child, and reflect the affective or cognitive representations of strategies for regulating distress (Mikulincer & Shaver, 2007).
The AAI classifies adult attachment in three main classifications: Secure-Autonomous (F), Insecure Dismissing (Ds), and Insecure-Preoccupied (E) (IJzendoorn & Bakermans, 2010). In this case, Ms. Johnson was classified in the Insecure-Preoccupied (E) attachment category; however, further assessment is needed. Adults in this category often highlight the negative impact of her attachment experiences, but still demonstrate constant preoccupation with her relationships (IJzendoorn & Bakermans, 2010). In addition, adults with high attachment anxiety have fear of rejection, abandonment, and obsessive needs for emotional dependence. For example, Ms. Johnson reported that she experienced several long-term abusive relationships. Individuals scoring high
“ (The Strange Situation). Based on the results of the Strange Situation, Ainsworth and her colleague identified three types of attachment styles, a secure attachment which composed a majority of the children in the experiment, insecure avoidant and ambivalent/resistant. For a child who has secure attachment can be “able to freely explore when the mother is around, interacts with the stranger when the mother is present but not when she is absent, shows distress when the mother leaves and is happy to see the mother return” (Mary Ainsworth). For a child that exhibits that inhibits “Anxious-Resistant Insecure Attachment is anxious to explore and is wary of the stranger even when the mother is present, is extremely distressed when the mother leaves, but is ambivalent when the mother returns. He will stay close to the mother upon her return, but will show resentment by resisting the mother's attention and pushing her away.” and for the child who inhibits “an Anxious-Avoidant Insecure Attachment will avoid or ignore the mother and show little emotion when his mother leaves and upon her
Humans are complicated and so are our relationships. Attachment theory is a psychological modal used to guide clinical interventions to understand the long-term effects of interpersonal human relationships. However, this theory is not about relationships in general but is about human relations and the support seeking behavior in response to emotional trauma or threats (Vrtička & Vuilleumier,
Advances in technology and research methodology, have illuminated our understanding of brain development, across multiple scientific fields. What follows is a brief review of several important new understandings in contemporary attachment theory. These new understandings have been elucidated by research findings in multiple fields including epigenetics, right brain development, and the regulating versus dysregulating effects of early attachment. Finally, a number of important implications for clinical work are exemplified, by a brief discussion of the therapeutic alliance. We begin with a cursory description of early attachment theory, and several of its important positions.
The concept of infant-mother attachment is as important to the child as the birth itself. The effect this relationship has on a child shall affect that child for its entire life. A secure attachment to the mother or a primary caregiver is imperative for a child’s development. Ainsworth’s study shows that a mother is responsive to her infant’s behavioral cues which will develop into a strong infant-mother attachment. This will result in a child who can easily, without stress, be separated from his mother and without any anxiety. Of course the study shows a child with a weak infant-mother relationship will lead to mistrust, anxiety, and will never really be that close with the mother. Without the
Infants are very helpless and extraordinarily dependent. Their earliest behaviors are goal driven for gaining a caregiver to focus and engage reciprocity in their behavior (Sroufe, 2011). The infants task is to gain their survival needs and regulate fear and stress by creating contingent responses so that the world may be predictable and comprehensible (Sroufe, 2011). Regulating emotions can only occur in relationship with the parents; an infant is ill equipped to reduce arousal on their own (Seigel, date, Sroufe, 2011, cite.) The infants work is most effective when circumstances and contingent responses are anticipated and more challenging when they encounter unpredictability and transitions (Hughes, 2014).