RNSystematic ReviewNeonatal network : NN2026

Enjoyment in Preterm Infants: Exploring Clinical and Research Perspectives in the Neonatal Intensive Care Unit.

Kristy Fuller, Barbara O'Rourke, Thao Griffith

PMID 42062099

WHAT IT FOUND

Enjoyment in preterm infants is rarely described and has no agreed direct measure.

Nurses can look for calm alertness, steady heart rate and breathing, and engagement, and use skin-to-skin, scent, and care paced to cues to support connection.

Key findings

01Enjoyment is rarely used to describe preterm infants, and related terms include pleasurable experiences, positive attachment, participation, engagement, attending behaviors, comfort, and stability.

02The review proposes indicators across autonomic, motor, state, and attention/interactive subsystems, including physiologic stability, sustained muscle tone, midline position, organized calm behavior, quiet alertness, smooth state transitions, focused attention, engagement, and calmness.

03Strategies that may foster enjoyment include caregiver-infant connection, maternal closeness, maternal voice, skin-to-skin contact, nurturing touch, sucking at the breast or pacifier, the scent and taste of mother's milk, swaddling, coordinated suck-swallow-breath, and appropriate nipple flow rate.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The search was limited to English-language publications from 1999 to 2025. The authors acknowledge that their keyword list may not be all-inclusive. No full-text article explicitly discussed enjoyment in preterm infants, so the construct was inferred from related terms such as comfort and stability. There is no validated instrument specifically measuring enjoyment in preterm infants. The case examples are reflective tools, not real patients or clinical events. The review focused exclusively on preterm infants in the NICU.

The easy way to misread this

Do not treat the suggested care strategies or case examples as evidence that they cause enjoyment or better infant outcomes. The paper proposes a framework and says no validated instrument specifically measures enjoyment in preterm infants.

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