Peer-reviewed article

Effectiveness Trial of Family Nurture Intervention as a Standard of Care in the NICU: Enhanced Brain Activity in Preterm Infants

Christiana Farkouh‐Karoleski, Michael M. Myers, Philip G. Grieve, Joseph R. Isler, Robert J. Ludwig et al. · 1 Jul 2025

Summary

Written by AI, not yet AICS's view · claude-haiku-4-5-20251001

This study tested whether Family Nurture Care (FNC), a structured program of calming sessions combining skin-to-skin contact, vocal soothing, and eye contact between mothers and preterm infants in hospital neonatal units, could improve brain development. Preterm infants receiving FNC showed significantly higher brain activity measured by EEG, particularly in the left frontal region at 35 weeks of age, with effect sizes exceeding 0.60. The intervention was implemented as standard care across the entire neonatal unit and was found to be practical to deliver.

Key points

Infants receiving FNC showed significantly higher EEG power at 35 weeks in the left frontal polar region
Effect sizes for brain activity at lower frequencies (4-15 Hz) ranged from 26% to 44%
FNC consisted of approximately 3 calming sessions per week facilitated by nurture specialists
The intervention combined emotional expression, clothed or skin-to-skin holding, vocal soothing, and eye contact
FNC was successfully implemented as standard care across the entire NICU unit

Limitations

This single-center study used a phased design without randomization, so differences between phases may reflect factors other than the intervention itself, such as temporal trends or selection bias. The study measured only early brain activity via EEG and did not assess longer-term developmental or health outcomes.

Abstract

OBJECTIVE: This study sought to evaluate the effectiveness of Family Nurture Intervention (FNI) in the NICU on enhancing early brain activity of preterm infants. This unit-wide implementation of FNI is referred to as Family Nurture Care (FNC). METHODS: This was a single-center prospective phased effectiveness study conducted in two sequential phases in the NICU (NCT03267043). In Phase I, all mother-infant dyads received the baseline standard care (SC), and in Phase II, all mother-infant dyads received SC supplemented with FNC starting at NICU admission. Preterm infants (25-34 weeks gestational age) and their mothers were eligible for participation. Preterm infants (25-34 weeks gestational age) were sequentially assigned to receive standard care (SC, Phase I) or FNC (Phase II) during their NICU stay. The primary outcome was EEG power assessed at two ages, ∼35 weeks (SC, n = 34; FNC, n = 28) and near to term (SC, n = 28; FNC, n = 27). FNC consisted of repeated calming sessions (∼3 times/week) facilitated by nurture specialists during which mothers engaged in emotional expression during clothed or skin-to-skin holding, vocal soothing, and eye contact. EEGs were collected from 128 leads. EEG power was computed using fast Fourier transforms. RESULTS: Infants receiving FNC were found to have significantly higher brain activity (EEG power) at 35 weeks in the left frontal polar region. The effects at lower frequencies 4-15 Hz ranged from 26% to 44% with effect sizes exceeding 0.60. CONCLUSIONS: FNI is practicable as standard of care in the NICU and leads to enhanced brain activity early in life. SIGNIFICANCE: FNC is designed to facilitate the emotional connection and coregulation between mothers and infants in the NICU, resulting in profound effects on early brain development.

Findings the Hub has extracted

Each claim below is labelled by its type of design and links back to this report.

SurvivalDevelopment

Problem

Preterm infants in neonatal intensive care units experience separation from mothers and reduced sensory contact, potentially affecting early brain development

Intervention: Family Nurture Care (FNC): structured calming sessions approximately 3 times per week where mothers engage in emotional expression, skin-to-skin or clothed holding, vocal soothing, and eye contact with their preterm infants, facilitated by nurture specialists
Population: Preterm infants born at 25-34 weeks gestational age and their mothers in a single-center NICU (Phase I SC: n=34 at 35 weeks, n=28 at term; Phase II FNC: n=28 at 35 weeks, n=27 at term)

Key finding

Infants receiving FNC had significantly higher EEG power at 35 weeks in the left frontal polar region compared to standard care