The purpose of this study was to recognized the sleep activity patterns of the normal infants in Korea. The subject were 41 normal infants who were below 8 weeks old and were born in Taegu city and Kyungbuk province. The measuring instrument the sleep activity was NCASA translated by the Korean-parent-child Health Academic Association. The data that were collected from April, 18 1999 to January 1, 2000 were analysed by the SPSS 7.5 program. The results of the study was summarized as follow; 1) The mean amount of total sleeping hours per day was decreased from $16.27{\pm}1.96$ hr at the 1st week, to $15.19{\pm}2.39$ hr at the 2nd week, to $13.66{\pm}2.40$ hr at the 3 week but increased to $16.55{\pm}5.77$ hr at the 4-8 week after birth. 2) The mean frequency of feeding was increased to $9.43{\pm}2.79$ times at the 3rd week but decreased to $7.55{\pm}1.23$ times at the 4-8th week after birth. 3) The regularity of day time sleep was decreased from 50.00% to 19.79% and that of night time sleep was increased from 51.79% to 72.92%. 4) The regularity of feeding was increased from 30.42% at the 1st week to 50.07% at the 2nd week but decreased 26.34% at the 4-8th week after birth. 5) The longest period of day time sleep was decreased to $2.39{\pm}0.42$ hr at the 3rd week but increased $2.47{\pm}0.69$ hr at the 4-8th week after birth. The longest period of night time sleep was decreased to $2.58{\pm}0.67$ hr at the 2nd week but increased to $3.00{\pm}1.32$ at the 3rd week and $4.30{\pm}1.16$ hr at the 4-8th week after birth. 6) At the 1st week, the 2nd week, the 3rd week after birth, the frequency of day time feeding was positively correlated with the frequency of night time feeding($R_{1week}=0.948^{**}$, $R_{2week}=0.927^{**}$, $R_{3week}=0.779^{**})$. At the 4-8th week after birth, the frequency of night time feeding was negatively correlated with the amount of night time sleep ($R_{4week-8week}=0.875^{*}$). On the basis of above findings, the following is suggested; It is need a longitudinal and transcultural study which are designed for children's sleep and feeding.

The purpose of this research is to investigate Sleep/Activity pattern of normal neonate in Kangwon area. The subjects of this research were 23 normal neonate who visited pediatric clinic of kangneung general hospital from Jun 15, 1999 to August 10, 2000. The instrument of this research was the NCASA. The results of this research were as follows: 1. The mean time of daytime sleep was 8.21 hours. The mean time of nighttime sleep was 5.70 hours. The mean time of total daily sleep was 13.92 hours. The mean time of longest sleep period was 5.02 hours. The mean time of regularity of sleep were daytime 46.59%, nighttime 74.43%, total daily sleep 55.88%. The mean frequency of nighttime wakening was 2.03 times. 2. The each mean time of activity were daytime 7.72 hours, nighttime 2.28 hours, daily total activity 9.99 hours. The mean time of the longest activity period was 6.16 hours. The mean times of feeding frequency were daytime feeding 4.53, nighttime feeding 1.92, total daily feeding 6.45. The mean of regularity of feeding frequency was 65.71%.

The purpose of this study is to identify the sleep/activity patterns of neonates and to provide a baseline data in developing an effective maternal-child nursing intervention strategies. The subjects of this study were 57 normal newborn babies from birth to 4 weeks of age, who visited the Postpartum Care Center and two General Hospitals and One Local clinic in Taejon. The data were collected from October 28th, 1999 to April 28th, 2000. The instrument used in this study was NCASA developed by Barnard and validated by the Academic Society of Parent-Child Health. The data were analyzed with the SPSS PC+ 7.5 for window program using means, standard deviation, one-way ANOVA. The results of this study were as follows: 1. The mean amount of daytime sleep was 7.45 hours, nighttime sleep was 4.27 hours, and the total daily sleep was 11.72 hours. The mean amount of longest sleep period was 4.32 hours. The mean regularity of daytime sleep was 35.55%, the nighttime sleep was 44.82%, and the total daily sleep was 39.02%. The mean frequency of nighttime awakenings was 2.44 times. 2. The mean amount of daytime awake periods was 8.54 hours, the nighttime awake periods was 3.72 hours, and the daily total awake periods was 12.27 hours. The mean amount of the longest awake period was 3.98 hours. 3. The mean frequency of daytime feeding was 5.18 times, the nighttime feeding was 2.50 times, and the total daily feeding was 7.49. The mean of regularity of total daily feeding was 61.34%. 4. According to an analysis of sleep patterns based on newborn's age, there were some statistically significant differences noted in the following factors ; amount of nighttime sleep (F=7.65, p=.002), longest sleep period(F=5.84, P=.006). 5. According to an analysis of activity patterns based on newborn's age, there were some statistically significant differences noted in the following factors ; amount of nighttime activity (F=7.64, P=.002), longest activity period (F=4.34, P=.020), frequency of nighttime feeding(F=3.89, p=.029), frequency of total daily feeding(F=3.76, P=.033), and regularity of daily feeding(F=4.66, P=.016). In conclusion, the newborn baby slept more during the daytime than nighttime and more active during the daytime. And there were some irregular sleep/activity pattern noted during 1 to 2 weeks of newborn baby. The results of this study will contribute to maternal-child health nursing practice and nursing research, and provide an information to parents about what to expect their newborn baby.

The sleep is the most important problem for new parents. However, there were very rare the study about sleep of normal neonates and early infants in Korea. So we attempted pilot survey study of neonates' sleep pattern. The purpose of this study was to investigate the sleep pattern of normal neonates in Seoul and Kyungki area and to provide for basis for nursing intervention for parents of them. The subjects of this study were 37 normal full-term neonates of 2~3weeks of age who were visited by researcher or assistant at postpartum care unit, health care clinic, outpatient clinic located in Seoul and Kyungki area from April 20, 1999 to March 15, 2000. This study was descriptive survey study under the convenient sampling method. The instrument of this study was the NCASA translated by Korean Parent Child Health Academic Association. The collected data were coded as 1/4hour unit, and analyzed by MS Office Excel program. The result of this study were as followed: 1. The mean amount of total sleep was 15.1hours. The mean amount of daytime sleep was 9.5hours. The mean amount of nighttime sleep was 5.7 hours. The mean amount of longest sleep was 2.9hours. The mean amount of shortest sleep was 0.6hour. 2. The mean amount of total activity was 8.9hours. The mean amount of daytime activity was 6.5 hours. The mean amount of nighttime activity was 2.3hours. The frequency of feeding was 10.4 times a day. The frequency of daytime feeding was 7.3 times. The frequency of nighttime feeding was 3.1 times. It is suggested that various subjects and more data according to age, and comparative study among different cultures are needed for further study in the future.

Pregnancy is a task of creation in which a women mobilizes her self and the resources available to her in the generation of a new person. Through the pregnancy, a mother has formed the new human relationship with a fetus. Maternal-fetal relationship is considered one of mechanism making the relationship of mother and child. It is important to well-being of mother and fetus, too. The earliest interaction between a mother and her child is during prenatal period. Maternal-fetal dyad is unique and perceived interactions with the fetus make the pregnancy real for the mother. Maternal behavior is "instinctive" and is formed in early childhood by copy of the mother. But, Rubin argues that this behavior is an open intellectual system rather than a prepackaged bundle of traits. There is openness to new learning and a high value placed on knowing which occurs with silent organization in thought. Thus, nurses and other health professionals provide prenatal care that optimally is part of the environment in which the maternal-fetal dyad develops. Thus it is appropriate for nurses to increases their understanding of the dyad and to explore ways to enhance its development. This study focusses on the interaction ability and response of fetus, and the maternal-fetal interaction. The research of fetal responses that involve physiological changes and motor movement have been shown to coccur to both external sensory stimuli and to maternal emotional states. The fetus does also have sensory capacity to be aware of some maternal behaviors, and the motor ability to respond in a way the mother can notice. Thus, very rudimentary interactions appear to be possible. Maternal awareness of fetal activity was supported by several studies. More interesting to the present study are description of maternal-fetal interaction and the finding that there appear to be levels of sensitivity to the fetus involved in maternal-fetal interactions. First, recognition comes that the fetus is separate from the maternal self. Next, the fetus engages in. Lastly, the parent may describe active interaction with the fetus, believing that mother and fetus are communicating on a meaningful level. Several interventions, developed to promote more active interaction between mother and fetus, have been reviewed. In general, the parents were taught to stimulate the fetus and to notice the fetus' responses. This type of intervention might increase the mother's sensitivity to her unborn baby, and she may have a head start toward learning how to res pond sensitivity to the newborn infant. Research In the area of maternal-fetal interaction is scarce. Sensitive behavior is construed as an appropriate and timely response to a signal of need from another person, but no such signal of need can be claimed regarding the fetus. The highest level of maternal-fetal interaction, therefore, might be based more on maternal representations of the imagined fetus than on factual evidence of fetal participation.

This study was described as midwife's role and obstacle of midwife's role expansion. Midwife as primary medical personal who practices for a mother and infant health care and promotion of mother infant interaction. As the trend of increasing natural childbirth, midwifery has to provide childbearing care those who want delivery in a midwifery center. This study conducted to survey for 44 midwives who work at the midwifery center. The results of the study as fellows. 1. Most of the midwives role was care of pregnancy, delivery, postpartum women and babies. Another role was conducted educational classes childbirth, breast feeding, contraception and sexual education. 2. Some midwives role perform breech, vaccum delivery, episiotomy and suture, pitocin induction and augmentation, ultrasonogram, giving medication, anesthesia, collecting specimen from Pap smear and vaginal discharge. Midwife perform these roles without medical law support. 3. Most of the obstacles of the midwife role was the medical law limitation. Midwives want revise medical law to perform simple treatment for childbearing women and babies. 4. Half of the midwives refer cases to medical doctor in case of complication of women and newborns. 5. Current frequency of home birth rate is slightly higher than before and me cases like to have delivery under water. Finally, midwife and midwifery have to prepare to meet childbearing woman, baby and family's need. For activation and expansion of midwife's role, every midwife has to be aware of medical law accurately and they must know what practice they can do and what practice they can not do.

The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

Due to the promotion based on the recent research evidences that support benefits of breastfeeding, the proportion of breastfeeding mothers have steadily been increasing in the industrialized countries(60-90%). The purpose of the present review was to evaluate the recent findings on the nutritional values of breast milk and immunological benefits of breastfeeding in order to promote the breastfeeding practice in Korea. Research findings supported the concept that the breast milk has a lasting effect on the development of digestive and immune systems. Most of the works assessed whether breastfeeding enhanced protection against infection as well as decreased risk for certain allergic disorders.