Promotie N.J. (Naomi) Meesters

Below is a brief summary of the dissertation: 

Neonatal Intensive Care Unit (NICU) treatment following preterm birth inevitably induces acute and prolonged pain and stress. This exposure importantly impacts the infant’s development. This thesis includes three parts, each addressing an essential aspect to pursue comfort in infants admitted to the NICU. First, we focused on the assessment of pain, an important first step in pain management. We showed that the extent to which existing pain measurement instruments are able to detect both a change in pain intensity following a pain reducing intervention or the level of pain and comfort in extremely preterm infants is limited. Also, we evaluated the reliability and validity of the COMFORTneo to determine prolonged pain in infants. In the second part we describe the effect of pain treatment including sucrose to reduce acute pain and pharmacological treatement in infants with the very painful gastrointestinal disease necrotizing enterocolitis. In the last part of this thesis we described the development of an instrument to determine the level of stress exposure, the NeO-stress score. Next, we applied this instrument in very preterm infants admitted to one of our Dutch NICUs to analyze their exposure to stress. Lastly, we focused on the impact of the restricted visitation restrictions during COVID-19 lockdown on parental stress. This thesis highlights that prioritizing neonatal comfort, reducing unnecessary stressors, effective treatment including promoting positive stimuli, and providing adequate follow-up and support aligned with the specific needs of the infants and their parents are essential for optimal outcomes in pursuing comfort during NICU admission.