Environmental and developmental neonatology

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Abstract
Many foetuses that are born prematurely would be expected to die since their organismic adaptations do not fit the extrauterine environment. Modern medical technology is now providing external life-support systems to enable increasing numbers of such babies to live, but we have yet to establish how best to provide for the preterm babies' psychological and biobehavioural wellbeing. A new subdiscipline, environmental and developmental neonatology, which is concerned with the study of newborn special care facilities and their impact on the medical and developmental status of sick infants, is trying to bridge this knowledge gap. It is argued that there is not a good fit between the neonatal intensive care unit (NICU) environment and the infant's behaviour organization. Evidence from psychophysiological studies of the adverse effects of handling of preterm infants, noise and light exposure and the lack of contingent infant-controlled social interaction in nurseries on the infant is reviewed. Short-term and long-term implications are discussed and suggestions for a biobehavioural individualized and developmental care approach are made.