DISORGANIZED INFANT BEHAVIOR
Disintegrated physiological and neurobehavioral responses of infant
to the environment
• Attention–interaction system—abnormal response to sensory stimuli
(e.g., difﬁculty soothing, inability to sustain alert status)
• Motor-system—altered primitive reﬂexes; ﬁnger splaying; jittery,
uncoordinated movement; increased or decreased tone; startles,
tremors, or twitches
• Physiological—arrhythmias, bradycardia, or tachycardia; desatura-
tion; feeding intolerances; skin color changes
• Regulatory problems—inability to inhibit startle; irritability
• State-organizational system—active or quiet awake; diffuse sleep
• Caregiver—Cue knowledge
• Postnatal—feeding intolerance;
deﬁcit; cue misreading; environ-
mental stimulation contribution
invasive procedures; malnutri-
tion; motor and/or oral prob-
• Environmental—physical envi-
lems; pain; prematurity
sensory deprivation, inappro-
priateness, or overstimulation
• Prenatal—congenital or genetic
disorders; teratogenic exposure
• Individual—gestational or
postconceptual age; illness;
immature neurological system
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Physical regulation
The parents will
• Learn to identify and understand infant’s behavioral cues.
• Identify their own emotional responses to infant’s behavior.
• Identify means to help infant overcome behavioral disturbance.
• Identify ways to improve their ability to cope with infant’s
• Express positive feelings about their ability to care for infant.
• Identify resources for help with infant.
The infant will
• Begin to show appropriate signs of maturation.
SUGGESTED NOC OUTCOMES
Knowledge: Infant Care; Mobility; Neonate; Neurological Status;
Preterm Infant Organization; Sleep Thermoregulation
INTERVENTIONS AND RATIONALES
Determine: Monitor infant’s responses to ensure effectiveness of pre-
Inform: Explain to parents that infant maturation is a developmental
process. Their participation is crucial to help them understand the
importance of nurturing the infant.
Explain to parents that their actions can help modify some of
infant’s behavior; however, make it clear that infant maturation isn’t
completely within their control. This explanation may help decrease
the parents’ feelings of incompetence.
Explain to parents that infant gives behavioral cues that indicate
needs. Discuss appropriate ways to respond to behavioral cues—for
example, providing stimulation that doesn’t overwhelm the infant;
stopping stimulation when the infant gives behavioral cues (such as
yawning, looking away, or becoming agitated); and ﬁnding methods
to calm the infant if she becomes agitated (such as swaddling, gentle
rocking, and quiet vocalizations). Monitoring responses aids in gaug-
ing effectiveness of meeting needs.
Help parents identify and cope with their responses to infant’s
behavioral disturbance to help them recognize and adjust their
response patterns. When the infant doesn’t respond positively, the
parents may feel inadequate or become frustrated. They need to
understand that these reactions are normal.
Attend: Explore with parents ways to cope with stress imposed by
infant’s behavior to help them develop better coping skills.
Praise parents when they demonstrate appropriate methods of
interacting with the infant to provide positive reinforcement.
Manage: Provide parents with information on sources of support
and special infant services to promote coping with infant’s long-term
SUGGESTED NIC INTERVENTIONS
Environmental Management; Neurologic Monitoring; Newborn
Care; Parent Education: Infant; Positioning; Sleep Enhancement
Beal, J. A. (2005, November–December). Evidence for best practices in the
neonatal period. The American Journal of Maternal Child Nursing, 30(6),