The studies reported on in this thesis addressed the development of suckingpatterns in preterm newborns. Preterm infants often have problems learningto suckle at the breast or to drink from a bottle. It is unclear whether this isdue to their preterm birth or whether it is the consequence of neurologicaldamage. From the literature, as well as from daily practice, we know thatthere is much variation in the time and in the way children start suckingnormally. Factors such as birth weight and gestational age may indeed berisk factors but they do not explain the differences in development. A smallspot-check proved that most hospitals in the Netherlands start infants onoral feeding by 34 weeks’ post-menstrual age (pma). By and large the policyis aimed at getting the infant to rely on oral feeding entirely as soon aspossible. The underlying rationale is to reduce the stay in hospital, and theidea that prolonged tube-feeding delays or even hampers the development ofsucking.
This thesis focuses on topics such as preterm birth, variation in gross motor development, factors that influence (premature) infant gross motor development, and parental beliefs and practices. By gaining insight into these topics, this thesis aims to contribute to clinical decision-making of paediatric physiotherapists together with parents, and with that shape early intervention.
BACKGROUND AND AIMSParents of preterm born infants experience challenges when transitioninghome, including the struggle to feel confident in their capacity to parent.Attuned information provision is a prerequisite for self-efficacy and empowerment and has been linked to positive parenting outcomes. The internet is an important source to obtain information regarding topics like prematurity, development and specific health problems. However, parents experience problems to find and understand appropriate health information with respect to their preterm born infant. Especially parents with low health literacy skills. Therefore our aim is to develop an inclusive digital information platform for and in cocreation with parents of premature infants and paediatric physical therapists (eTOP).METHODSTo generate ideas and content for eToP module, we first conducted interviewswith parents (n=10) and performed three online co-creation sessions with parents (n=14) and paediatric physical therapists (N=8). The data were analyzed through an inductive thematic approach. The analyses resulted in several main topics. With respect to these topics, experts were consulted and asked to generate text-based information content. The information content was then reviewed by the research team and included in the first prototype of the eTOP module.RESULTS11 themes were identified to be important, including general health issues,motor development, regulation, feeding, sleeping, prematurity, generaldevelopment, long term outcomes, parenthood, going back to work andprofessionals.CONCLUSIONSBased on the topics we developed the first version of the eTOP module. Inthe next two months we will develop and test a second version which willbe presented at the EAPS congress.
