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Application of the M Technique in Hospitalized Very Preterm Infants: A Feasibility Study

Smith, Joan R. PhD(c), RN, NNP-BC; Raney, Mary MSN, NNP-BC; Conner, Sandy BS, PT; Coffelt, Patricia MOT, OTR/L; McGrath, Jacqueline PhD, RN; Brotto, Marco PhD, RN; Inder, Terrie MD

doi: 10.1097/ANC.0b013e31826743ea
Developmental Care

PURPOSE: To explore the application of a novel relaxation method (the M Technique) in hospitalized very preterm infants in a level IIIC neonatal intensive care unit.

DESIGN: A feasibility, observational intervention study.

SUBJECTS: Ten very preterm infants were enrolled to receive the treatment intervention. Eligible infants born less than 30 weeks' gestation received the intervention at 30 weeks' postmenstrual age.

METHODS: Based on infant readiness, each infant received the M Technique for 5 minutes. Physiologic parameters (heart rate, respiratory rate, and oxygen saturations), behavioral variables (stress and relaxation cues), and infant behavioral state were measured 5 minutes before, during, and up to 10 minutes after the intervention, continuously.

RESULTS: Descriptive analysis revealed that baseline physiologic, behavioral state, and behavioral cue parameters changed during and after the application of the M Technique. A decrease in heart rate and respiratory rate occurred during the M Technique (P = .006, P > .001 respectively) and a decrease in heart rate occurred at the end of the M Technique session (P = .02). In addition, an increase in SaO2 occurred during and at 5 minutes following the M Technique session (P = .04, P = .02, respectively). State scores decreased from baseline (mean = 5.1; range, 3–9) to after the intervention (mean = 2.0, range 1–4). As the intervention was delivered, more positive than negative behavioral cues were observed throughout, at the end, and after the M Technique session.

CONCLUSION: In this feasibility study, the M Technique can be delivered without adverse effects to very preterm infants who are 30 weeks' postmenstrual age. Additional research is needed with a larger, randomized design to determine short- and long-term effects specifically related to neurologic outcomes.

Division of Nursing and Newborn Intensive Care (Mss Smith and Raney) and Division of Therapy Services (Mss Conner and Coffelt), St Louis Children's Hospital, Missouri; Nursing Research, Connecticut Children's Medical Center, Hartford, and School of Nursing, University of Connecticut, Storrs (Dr McGrath); School of Nursing and Medicine, University of Missouri Kansas City (Dr Brotto); and Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri (Dr Inder).

Correspondence: Joan R. Smith, Phd(c), RN, NNP-BC, Division of Nursing and Newborn Intensive Care, St Louis Children's Hospital, St Louis, MO 63110 (

The authors thank the St Louis Children's Hospital Foundation; Ryan Colvin, Washington University School of Medicine Division of Biostatistics; and Jane Buckle.

The authors declare no conflict of interest.

© 2012 National Association of Neonatal Nurses