abstract: Late preterm infants (LPIs), born between 34 and 37 weeks gestation, are at risk for a myriad of health conditions related to neuro-muscular and physiologic immaturity. However, relative stability allow many of these infants to avoid care in specialty nurseries and discharge home with their mothers after birth. Due to underlying immaturity, feeding difficulty is the most common issue LPIs experience, resulting in early breastfeeding cessation, increased risk for secondary diagnoses, and hospital readmission. The purpose of this study was to assess early breastfeeding behavior of LPIs, including testing inter-rater reliability of an assessment tool and the feeding patterns of infants over time. An extensive review of breastfeeding assessment tools resulted in the selection of the Premature Infant Breastfeeding Behavior Scale (PIBBS) based on its reliability and validity in the preterm infant population. A convenience sample of LPI dyads was recruited and used to conduct inter-rater reliability testing of PIBBS. A longitudinal one-group non-experimental study was used for observational follow-up. A strong statistical agreement of PIBBS scores occurred between mothers and a healthcare professional (Cohen’s kappa values of items ranged from .776 to 1.000, p = <.001). Participants continued using the PIBBS tool after hospital discharge until their infants expected due dates (40 weeks adjusted age). T-test analyses were conducted to examine changes in scores over time indicating increase in item scores (p = .003 - .193). PIBBS appears to be a valid and reliable tool to assess breastfeeding among LPI dyads. Incorporation of PIBBS into a comprehensive plan of care could better support and protect breastfeeding among the LPI population. / Dissertation/Thesis / Doctoral Dissertation Nursing and Healthcare Innovation 2018

Kinder, welche nach 34 (+0) bis 36 (+6) Gestationswochen geboren werden, bezeichnet man als späte Frühgeborene. Genau wie Kinder eines jüngeren Gestationsalters sind diese von einer höheren postnatalen Morbidität und Mortalität betroffen als reif geborene Kinder. Diese Studie betrachtet die pulmonale Funktionsleistung dieser Kinder weit über die Neonatalperiode hinaus. Ehemals späte Frühgeborene wurden im Alter von 6 Jahren untersucht. Eine gleichaltrige Kontrollgruppe, bestehend aus ehemals reifen Neugeborenen, diente dem Vergleich. Vor allem Parameter der Spirometrie sowie Peak-Flow- und Atemwegswiderstandsmessungen ermöglichten dabei die Objektivierung der pulmonalen Funktion. Statistisch signifikante Unterschiede ließen sich in der mittleren FVC (forcierte Vitalkapazität) sowie dem FEV1 (forciertes exspiratorisches Volumen in einer Sekunde) feststellen, wobei Kinder der Indexgruppe jeweils im Mittel nur geringere Werte erreichten als Kinder der Kontrollgruppe. Der mittlere Atemwegswiderstand unterschied sich in Index-und Kontrollgruppe ebenso signifikant, wobei bei ehemals späten Frühgeborenen der Atemwegswiderstand im Mittel höher war als bei ehemals reifen Neugeborenen.

Objective: To describe the breastfeeding characteristics of late-preterm infants (LPIs) in a kangaroo mother care unit (KMC). Materials and methods: In a 20-bed KMC unit, the breastfeeding of 73 purposively-selected LPIs’ (mean gestational age: 34.8 weeks) was observed once-off, using the Preterm Infant Breastfeeding Behavior Scale. Participants’ mean age was 9.5 days, mean number of days in the unit was 3.1 days, and mean number of days breastfeeding was 7.5 days on observation. Results: Only 13.7% of participants were directly breastfeeding without supplementary tube-feeding/cupfeeding and 86.3% received supplementary cup-feeding of expressed breast milk. Most participants did not exhibit obvious rooting (83.5%) and although most latched-on (97.3%), those who did, latched shallowly (93%). The mean longest sucking burst was 18.8 (SD: 10.5) and approximately half the participants swallowed repeatedly (53.4%). The mean breastfeeding session duration was 17.8 minutes but most participants breastfed less than 10 minutes (76.7%). No statistically significant associations were found between chronological age and breastfeeding characteristics. A general trend towards more mature behaviors in participants breastfeeding for more days was present for many breastfeeding characteristics. More infants exhibited the most mature behavior for each breastfeeding characteristic when the environment was quiet, rather than noisy and disturbing, except for depth of latching (quiet: 0%, disturbance: 15.2%). Conclusion: LPIs in this sample presented with subtle, moderate breastfeeding difficulties, highlighting their need for breastfeeding support. Further research is required to examine the effect of KMC on breastfeeding in LPIs. / Dissertation (MA)- University of Pretoria, 2017. / Speech-Language Pathology and Audiology / MA / Unrestricted

The experience of becoming a mother is a personal and social experience influenced by individual characteristics, friends and family, and the infant. The journey to become a mother encompasses concepts of maternal competence and responsiveness. The purpose of this study was to examine maternal competence and responsiveness to the infant in mothers of late preterm infants compared to mothers of full term infants. The conceptual model for this work was based on the work of Reva Rubin describing maternal identity and role development. Maternal competence and responsiveness are components of maternal role and are influenced by social support, maternal self-esteem, well-being, stress and mood. In addition, infant temperament and perception of infant vulnerability influence development of maternal competence and responsiveness. A non-experimental repeated measures design was used to compare maternal competence and responsiveness in two groups of postpartum mothers. One group consisted of mothers of late preterm infants 34-36, 6/7 weeks gestation. The second group consisted of mothers of term infants, >/=37 weeks gestation. Both primiparas and multiparas were included in the study. Data was collected in the initial postpartum period prior to discharge from the hospital and again at six-weeks postpartum. No statistically significant differences in development of maternal competence or responsiveness between mothers of LPIs and term infants were identified. This study adds to our knowledge concerning outcomes of mothers of late preterm infants and development of competence and responsiveness.

Preterm birth continues to be an important public health concern globally. Born only 3 to 6 weeks premature, findings increasingly demonstrate that the late preterm population (34-36 weeks gestational age) is not exempt from long-term risk, as the last few weeks of gestation are important for both physical and cognitive development. This study examined whether late preterm birth was associated with poorer health, development and educational outcomes in the early childhood period, after controlling for a range of medical and social factors. / February 2016

Kinder, welche nach 34 (+0) bis 36 (+6) Gestationswochen geboren werden, bezeichnet man als späte Frühgeborene. Genau wie Kinder eines jüngeren Gestationsalters sind diese von einer höheren postnatalen Morbidität und Mortalität betroffen als reif geborene Kinder. Diese Studie betrachtet die pulmonale Funktionsleistung dieser Kinder weit über die Neonatalperiode hinaus. Ehemals späte Frühgeborene wurden im Alter von 6 Jahren untersucht. Eine gleichaltrige Kontrollgruppe, bestehend aus ehemals reifen Neugeborenen, diente dem Vergleich. Vor allem Parameter der Spirometrie sowie Peak-Flow- und Atemwegswiderstandsmessungen ermöglichten dabei die Objektivierung der pulmonalen Funktion. Statistisch signifikante Unterschiede ließen sich in der mittleren FVC (forcierte Vitalkapazität) sowie dem FEV1 (forciertes exspiratorisches Volumen in einer Sekunde) feststellen, wobei Kinder der Indexgruppe jeweils im Mittel nur geringere Werte erreichten als Kinder der Kontrollgruppe. Der mittlere Atemwegswiderstand unterschied sich in Index-und Kontrollgruppe ebenso signifikant, wobei bei ehemals späten Frühgeborenen der Atemwegswiderstand im Mittel höher war als bei ehemals reifen Neugeborenen.

Globalt födds varje år 15 miljoner barn prematurt före gestationsvecka 37+0.Barn som födds mellan gestationsvecka 34+0 – 36+6 benämns som sent prematurt födda. Sent prematurt födda barn kan bedömas både som låg vårdkrävande och högvårdkrävande. De kan både vårdas på en neonatalavdelning eller på ett barnbördshus. Mödrar är inte alltid förberedda att ta hand om sitt sent prematurt födda barn eftersom det sker ett avbrott i mödrarnas omställningsprocess från graviditet till moderskap. Amningen har många fördelar för de ammande mödrarna och barnen. Amningsprocessen kan skilja sig vid amning av sent prematurt födda barn i jämförelse med fullgångna barn. Syftet med denna litteraturöversikt är att beskriva mödrars upplevelse vid amning av sent prematurt födda barn under barnets första levnadsår. Metoden som tillämpades var en icke systematisk litteraturöversikt. Databassökningen i databaserna PubMed och Cinahl genererade i 14 artiklar som besvarade arbetets syfte. Även en manuell sökning utfördes, vilket genererade i en artikel. Totalt inkluderades 15 vetenskapliga artiklar av kvalitativt, kvalitativt ansats samt mixed metod. Med hjälp av en kvalitetsbedömningsmall har artiklarnas kvalitet granskats och därefter har en integrerad dataanalys använts för att besvara arbetes syfte. Resultatet presenterar tre huvudkategorier och åtta underkategorier. Resultatet visade att mödrar till sent prematurt födda barn upplevde en önskan och längtan om att få amma sitt barn, de förstod bröstmjölkens betydelse för det prematurt födda barnets utveckling. Amningen upplevdes som en känslomässig period som ingav känsla av glädje, harmoni och avslappning. Men amningen orsakade även känslor av stress, utmattning och ångest främst på grund av utmaningarna som tillkom vid amningen. Fysiska utmaningar både hos barnet och mödrarna var återkommande. Behov av stöd, undervisning och uppmuntran från anhöriga och sjukvårdspersonalen var betydelsefullt för mödrarna och amningsutfallet. Slutsatsen i studien indikerar att mödrar till sent prematurt födda barn upplever amningen som utmanande men betydelsefull. Under amningen upplevs starka känslor. Mödrars anknytning till barnet och barnets bindning till mödrarna stärktes genom amningen. Behov av stöd och undervisning under amningsperioden identifierades som kan underlätta amningsutmaningar och främja fortsatt amning. Arbetet belyser vikten av undervisning och stöd från sjukvårdspersonal, bland annat barnmorskor, som arbetar nära denna patientgrupp. / Globally every year 15 million infants are born prematurely before gestational week 37 + 0. Infants born between gestational week 34 + 0 to 36 + 6 are referred to as late preterm infants. Late preterm infants can be assessed both as low care- requiring or high care-requiring. They may require neonatal care or care in a maternity unit. Mothers are not always prepared to care for their infant due to early interruption in mother´s transition process from pregnancy to motherhood. Breastfeeding has many benefits for both the breastfeeding mother and the infant. The breastfeeding process may differ when breastfeeding late preterm infants compared to full-term infants.  This study aims to describe mothers' experience of breastfeeding late preterm infants during the infants first year of live.  The method applied was non-systematic literature review was. The databases PubMed and Cinahl generated 14 articles. A manual literature search was conducted, which generated one more article. A total of 15 scientific articles of quantitative, qualitative approach and mixed method were included. Using a quality assessment templet of the articles and an intergrade analysis, the quality and results of the articles have been analyzed. The result presents three main categories and eight subcategories. The results of this study showed that mothers of late preterm infants experienced a desire and longing to breastfeed their infants because the mothers were aware of the importance of breast milk for their late preterm infant for the infants’ development. Breastfeeding was considered as an emotional period which was experienced as joyful, gave harmony and a feeling of relaxation but also feelings of stress, exhaustion and anxiety was experienced mainly due to the challenges that emerged during breastfeeding the late preterm infant. Physical challenges for both the infant and the breastfeeding mother were recurring. The need for support, education and encouragement from relatives and healthcare staff was significant for the mothers and the outcome of breastfeeding.   The conclusion of this study showed that mothers of late preterm infants experienced breastfeeding as challenging but significant. Strong emotions were recurring during breastfeeding. Mothers’ attachment to their infants were strengthened through breastfeeding. The need for support and education during the breastfeeding period was identified to facilitate breastfeeding challenges and promote continued breastfeeding. It is essential for healthcare professionals, as midwives, to have an understanding of breastfeeding experience of mother of late preterm in order to offer adequate care and support.

Die Kaiserschnittrate erhöhte sich in den letzten Jahrzehnten in zahlreichen geburtshilflichen Kliniken. Diese Entwicklung ist problematisch, weil damit eine erhöhte pulmonale Morbidität der Neugeborenen verbunden sein kann. Die vor­ liegende Arbeit untersucht die Anpassung von späten Frühgeborenen (34,0–36,6 SSW) und 2 Gruppen von reifen Neugeborenen (37,0–37,6 und 40,6–40,6 SSW) in einem Level 1 Zentrum in Abhängigkeit vom Geburtsmodus. Eingeschlos­ sen wurden primär gesunde Kinder, die im Verlauf eines Jahres geboren wurden. Ausge­ schlossen wurden Kinder mit nachgewiesener angeborener Anomalie und Kinder mit einer schweren Anpassungsstörung (Apgar 5‘<6). Die Kaiserschnittrate lag bei 22% und war am höch­ sten bei späten Frühgeborenen (39%) im Ver­ gleich zu Kindern der 37. (30 %) und der 40. SSW (11%). Die Rate der Kinder, die mit CPAP behan­ delt werden mussten fiel von 88 % in der 34. SSW auf 17% in der 37. und 8% in der 40. SSW. Kinder nach Kaiserschnitt mussten im Vergleich zur spontan geborenen Kindern signifikant häufiger mit CPAP therapiert werden (50 vs. 12%). Dieser Unterschied war für späte Frühgeborene deutlich (82 vs. 36 %) und lag niedriger bei in der 37. (33 vs. 9 %) und 40. (26 vs. 6 %) SSW geborenen Kindern. Der deutlichste Unterschied fiel bei in der 36. SSW geborenen Kindern auf (66 vs. 9%). Die Ergebnisse der Analyse dokumentieren, dass ein Kaiserschnitt bei primär gesunden Kindern zu einer schlechteren respiratorischen Anpassung führt. Dies gilt besonders, jedoch nicht nur, für späte Frühgeborene und dort besonders für Kinder, die in der 36. SSW geboren werden. Die weltweit wachsende Rate von Kaiserschnittent­ bindungen sollte immer wieder kritisch hinter­ fragt werden. Eine Kaiserschnittentbindung ohne klare Indikation führt zu einer erhöhten Rate an respiratorischen Anpassungsstörungen, zur neo­ natologischen Aufnahme der Kinder und damit verbunden zu einer Störung der Mutter­Kind­Bindung, sowie zu einer unnötigen finanziellen Belastung des Gesundheitssystems. Es ist zu wünschen, dass die Daten der Studie benutzt werden, um in der Diskussion zwischen Eltern, Geburtshelfern und Neo­ natologen immer den besten Geburtsweg für das Kind zu finden. / The rates of delivery by Cesarean section (CS) have been trending upwards in recent decades, perhaps leading to higher rates of dysfunction in respiratory adaptation in newborns. We present epidemiological data for pulmonary adaptation by mode of delivery for healthy late preterm and term infants born at a regional tertiary care center. The overall CS rate was 22 % with the lar­ gest proportion of these in late preterms (39%). This drops to 30% in infants born after 37 weeks gestation and to 11% for those born after 40 weeks. Infants needing respiratory support de­ creased significantly as gestational age increased: 88% at 34 weeks, 67% at 35 weeks, 28% at 36 weeks, 17% at 37 weeks and 8% at 40 weeks. The risk of respiratory morbidity following CS as compared to vaginal delivery (VD) was substan­ tially higher. 50% of infants born by CS needed respiratory support compared to only 12% fol­ lowing VD. 82% of all late preterm infants born by CS developed respiratory morbidity compared to 36 % following VD. Comparable data for infants born after 37 and 40 weeks gestation were 33% compared to 9 % and 26 % compared to 6 % respec­ tively. Late preterm infants born after 36 weeks gestation showed the most marked difference by mode of birth with 66 % needing respiratory sup­ port following CS as compared to only 9 % follow­ ing VD. Our data could be useful in counselling parents about risk associated with delivery by Cesarean section. A critical view should be taken of increasing CS rates worldwide because of a clear correlation in increased morbidity in infants, especially late preterm infants.

Made available in DSpace on 2016-03-22T17:27:16Z (GMT). No. of bitstreams: 1 luciana correa.pdf: 746120 bytes, checksum: 09a2aa7fea7c4deef3b1adf8c970878b (MD5) Previous issue date: 2013-12-16 / Objective: Assess the characteristics of late pre term newborns admitted in a neonatal intensive care unit. Methods: Descriptive, cross-sectional, retrospective study with all the patients in the neonatal intensive care unit of a university hospital in a mid-size city, between January 2011 and December 2012. Perinatal and neonatal variables were avalued throughout hospitalization. Results: The study population consisted of 330 patients. Newborns under 33 weeks of gestational age accounted for 50% of hospitalizations, late preterm infants, for 27,3% and full-term newborns, for 20%. The majority of the population had adequate weight for gestational age, with a rate of 67.8% among late preterm. Over seventy percent of the general population and those born cesarean; whose primary indication was fetal distress. The main cause of hospitalization for all groups was infant respiratory distress syndrome, accounting for 70% of admissions of late preterm. Sepsis reached 66.7% of this group requiring several therapeutic measures during hospitalization. The mortality rate of late preterm infants was 5.6%, the lowest among groups of gestational age. Conclusion: The need for emergency neonatal care and increased occupancy rate in intensive care units show us the importance of this premature group and warns us that are not functionally "near term" and that their particularities physiological and metabolic put them on a different level to be disregarded at the time of his birth / Objetivo: Determinar a prevalência e as características dos recém-nascidos prematuros tardios admitidos em uma unidade de tratamento intensivo neonatal. Métodos: Estudo descritivo, transversal, retrospectivo com todos os pacientes internados na unidade de tratamento intensivo neonatal de um hospital universitário, entre Janeiro de 2011 e Dezembro 2012. Variáveis perinatais e neonatais foram avaliadas durante todo período de internação. Resultados: A população do estudo foi constituída de 330 pacientes. Recém-nascidos com idade gestacional menor ou igual a 33 semanas foram responsáveis por 53,3% das internações, prematuros tardios por 27,3% e nascidos a termo por 20%. A maioria da população tinha peso adequado para a idade gestacional, com uma taxa de 67,8% entre os pré-termos tardios. Mais de setenta por cento destes e da população geral nasceram de cesareana; cuja principal indicação foi sofrimento fetal agudo. A principal causa de internação para todos os grupos foi síndrome do desconforto respiratório, responsável por 70% das admissões dos prematuros tardios. Sepse atingiu 66,7% deste grupo que necessitou de várias medidas terapêuticas durante a internação. A taxa de mortalidade dos pré-termos tardios foi de 5,6%, a mais baixa dentre os grupos de idade gestacional. Conclusão: A necessidade de atendimento emergencial neonatal e a crescente taxa de ocupação de leitos de intensivismo nos demonstra a importância deste grupo de prematuros e nos alerta que funcionalmente não são quase a termo 60 e que suas particularidades fisiometabólicas os colocam num patamar diferenciado que devem ser respeitados no momento do seu nascimento

Nas últimas semanas gestacionais ocorrem importantes alterações na atividade cerebral, tornando-se relevante monitorar o desenvolvimento neurológico de recém-nascidos pré-termos tardios (RNPT-T). Além disso, com os avanços nas unidades de terapia intensiva neonatais (UTIN) os profissionais de reabilitação, fisioterapeutas (FT), terapeutas ocupacionais (TO) e fonoaudiólogos (FG), são considerados integrantes fundamentais na equipe multidisciplinar. Objetivo: (1) avaliar o estado neurocomportamental de recém-nascidos (RNs) de 36 a 36 semanas e 6 dias de idade gestacional (IG) e de 37 a 37 semanas e 6 dias de IG; (2) examinar o papel atual dos profissionais de reabilitação (FT, TO e FG) nas UTINs canadenses e comparar com os dados de um survey de 15 anos atrás. Método: (1) Trata-se de um estudo de corte transversal. A amostra foi definida por conveniência e constitui-se de 20 RNs, sendo 8 RNPT-Ts e 12 recém-nascidos a termo (RNT), de ambos os sexos, internados no Alojamento Conjunto do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, São Paulo, Brasil. Foi realizada uma avaliação do desenvolvimento neurocomportamental através da Neurobehavioral Assessment Preterm Infant (NAPI), em que os bebês foram avaliados em uma sequência invariável nos sete domínios da escala: sinal do cachecol, desenvolvimento motor/vigor, ângulo poplíteo, alerta e orientação, irritabilidade, qualidade do choro e percentual adormecido. Foi realizada uma análise descritiva dos dados. O teste de Mann-Whitney foi utilizado para a comparação dos escores entre os RNPT-T e RNT e comparação entre o gênero e o teste-t de Student para duas amostras independentes foi utilizado para a comparação do grupo de RNPT-T com três estudos nacionais envolvendo o NAPI. (2) Trata-se de um survey do tipo entrevista, via telefone no qual foi conduzido em todas as UTINs canadenses que integram a Canadian Neonatal Network. Um total de 42 questionários foi completado proveniente de 31 instituições de saúde canadenses. Foram realizadas uma análise descritiva das variáveis e a comparação dos dados com o survey realizado há 15 anos.O teste Exato de Fisher foi utilizado para investigar a relação entre a disponibilidade do profissional de reabilitação e o tipo de intervenção por ele conduzida. Em ambos os estudos foi adotado o valor de p 0,05. Resultados: (1) Não houve diferença significativa entre os escores do NAPI comparados entre os grupos RNPT-T e RNT. Houve diferença significativa entre o grupo de RNPT-T com os outros três estudos, em todos os domínios da escala NAPI. (2) Pelo menos um profissional de reabilitação oferece serviço em hospitais pediátrico, adulto e geral. Os profissionais participam de grupos para promover a educação do processo do cuidado, principalmente para os membros da equipe multidisciplinar das unidades e para os pais e familiares dos RNs. Além disso, estão envolvidos com discussão de caso, processo de tomada de decisão, planejamento da alta hospitalar e referenciam RNs para outros serviços. Em relação às intervenções, splinting e amamentação, foram identificadas como sendo atividades realizadas mais por TO, sendo que fisioterapia respiratória e exercícios que englobam amplitude de movimento são realizados mais por FT. Conclusão: (1) Não há diferenças entre o grupo RNPT-T e RNT em relação ao desenvolvimento neurocomportamental na amostra estudada. Os RNPT-Ts demonstram-se mais acordados e ativos durante a avaliação, entretanto, com baixo estado de alerta e orientação, sugerindo que atenção em fatores ambientais e ações no cuidado do RNPT-T na unidade de alojamento conjunto devem ser investigadas. (2) Ao longo da última década, as mudanças no papel dos profissionais de reabilitação evidenciaram maior participação com a equipe multidisciplinar, colaboração nas discussões e planejamento das atividades nas unidades, educação continuada e maior tempo despendido no cuidado com os RNs nas UTINs. / Neonatal neurobehavioral examinations describe newborns behavioral repertoire and observable responses to environmental stimulus and in the neonatal intensive care unit (NICU), rehabilitation specialists are considered an integral part of the multidisciplinary team. New approaches to rehabilitation practice have evolved to promote child health and developmental outcomes. Aim: This study aimed (1) to evaluate the neurobehavioral of healthy late preterm (LP) and full-term infants (FTI) using Neonatal Neurobehavioral Assessment Preterm Infant (NAPI). (2) To describe the current roles in the NICU of the occupational therapist (OT), physical therapist (PT) and speech language pathologist (SLP) in Canadian NICU and compared to these roles documented 15 years ago. Method: (1) In this cross-sectional study, 20 babies were assessed. Eight infants born with 36 weeks gestational age (GA) and 6 days late preterm group (LPG) 12 infants born with 37 weeks GA and 6 days the full-term infants (FTI) in a tertiary health care institution of São Paulo state, Brazil were assessed 24 hour after birth, using NAPI. The infants were assessed in seven clusters of NAPI: scarf sign, motor development and vigor, popliteal angle, alertness and orientation, irritability, cry quality and percent asleep ratings. A descriptive analysis was conducted and Mann-Whitney test was used for comparison between groups and Students t test for two independent sample was conducted for comparison with three Brazilian studies. (2) In total, 42 questionnaires were completed from rehabilitation departments in 31 Canadian health care institutions. A descriptive analysis was conducted and The Fisher Exact Test was conducted to investigate the relationship between availability of rehabilitation specialist and type of intervention. In both studies the p value was 0,05. Results: (1) There was no statistical difference between LPG and FTI groups. The infants of LPG group were more awake during the NAPI exam, although with lower alertness and orientation score. (2) Results demonstrate that all have some rehabilitation coverage and they provide service in pediatric, general and adult hospitals. All therapists provide education to staff and to families. Typically therapists are involved with case discussion, decision-making, referrals to other services and discharge planning. Splinting and feeding were most often carried out by OT whereas chest physiotherapy and range of motion (ROM) were predominantly accomplished by PT. Conclusion: (1) The comparison between LPG and FTI showed no statistical difference. New strategies in terms of care must be stimulated in the unit of data collect to promote best practice in late preterm infants. (2) Changes to the role of rehabilitation specialists over the last decade were perceived as participation with the NICU team, education and training, collaboration and discussion and modifications/interventions.