Early visual development: implications for the neonatal intensive care unit and care.

Much of the early development of the human visual system occurs while the preterm infant is in the neonatal intensive care unit (NICU). Critical events and processes happen between 20 and 40 weeks' gestational age, before the onset of vision at term birth. Knowledge of the development of the visual system and the timing of the processes involved is essential to adapting NICU care to support all neurosensory development including visual development.

Implementing potentially better practices to support the neurodevelopment of infants in the NICU.

Objective: The purpose of the Vermont Oxford Neonatal Quality Improvement Collaborative 2005 was to explore improvements related to the physical environment of the newborn intensive care unit (NICU) in order to optimize the neurodevelopmental outcome of newborns.

Study Design: Five centers were involved in a focus group examining NICU environmental design and its impact on the neurodevelopmental outcome of the neonate. Using an evidence-based approach, the group identified 16 potentially better care practices.

The development of potentially better practices to support the neurodevelopment of infants in the NICU.

Objective: To review the existing evidence used to identify potentially better care practices that support newborn brain development.

Study Design: Literature review.

Result: Sixteen potentially better practices are identified and grouped into two operational clinical bundles based upon timing for recommended implementation.

Sleep and brain development.

Historically, researchers studying the field of sleep have been divided into two main groups. The first group of sleep studies was based on behaviors and behavioral sleep. The second group of researchers based their studies on electroencephalogram EEG patterns and changes.

Early neurosensory visual development of the fetus and newborn.

Neurosensory development of the visual system has its origins long before birth. The genetic processes of basic structure formation are followed by endogenous retinal ganglion cell activation in the form of spontaneous synchronous waves of stimulation. These waves of stimulation are required to establish the topographic relationship among retina, lateral geniculate nucleus, and visual cortex.