Aims and objectivesTo explore the experiences of mothers of extremely premature babies during their Neonatal Intensive Care Unit stay and transition home.BackgroundMothers of extremely preterm infants (28 weeks’ gestation or less) experience a continuum of regular and repeated stressful and traumatic events, during the perinatal period, during the Neonatal Intensive Care Unit stay, and during transition home.MethodAn interpretive description method guided this study. Ten mothers of extremely premature infants who had been at home for less than six months were recruited via a Facebook invitation to participate in semi‐structured telephone interviews exploring their experiences in the Neonatal Intensive Care Unit and the transition home. The data were examined using a six‐phase thematic analysis approach. The COREQ checklist has been used.ResultsTwo main themes emerged: (a) things got a bit dire; and (b) feeling a failure as a mother. Participants had a heightened risk of developing a mental disorder from exposure to multiple risk factors prior to and during birth, as well as during the postnatal period in the Neonatal Intensive Care Unit and their infant's transition to home. Mothers highlighted the minimal support for their mental health from healthcare professionals, despite their regular and repeated experience of traumatic events.ConclusionThe mothers were at high risk of developing post‐traumatic stress symptoms and/or other mental health issues. Of note, study participants relived the trauma of witnessing their infant in the Neonatal Intensive Care Unit, demonstrated hypervigilance behaviour and identified lack of relevant support needed when their infant was at home.Relevance to Clinical PracticeThis study highlights the need for nurses to include a focus on the mothers’ psychosocial needs. Supporting maternal mental health both improves maternal well‐being and enables mothers to be emotionally available and responsive to their extremely preterm infant.
COVID-19 has changed the way that newborn babies are cared for within the neonatal setting due to the introduction of social distancing and wearing of face masks to limit the spread of the infection. Potential implications exist related to the normal development of bonding and connections with others. This paper discusses the importance of face to face interactions for early attachment between babies and parents within the context of relevant underpinning developmental theory. Mask wearing can also potentially impact relational communication, requiring us to change our current ways of working. Decreasing face to face interactions and relational communication, along with key recommendations for both parents and health professionals are further highlighted to mitigate the potential negative effects of masks on long-term development related to human connection and attachment.
Parental experience of being discharged home with a premature baby can be emotionally challenging and necessitates a range of support mechanisms to help them to cope with this period of transition. Health professionals can direct parents to appropriate counselling services, resources and peer support groups. Tailored education is needed for community-based health professionals, such as health visitors, to equip them to support parents practically and emotionally during the transition home and beyond. In addition, health professionals can learn much from parents about what is needed to support them.
Taking a premature baby home after an often-protracted period on the neonatal unit can be stressful for parents and they are often confronted with an unexpected reality. The transition to motherhood and parenthood has occurred in the neonatal unit, under the watchful eye of neonatal nurses. When the baby goes home, parents are expected to take on the full-time caregiving role of a baby who may require around the clock care with medications, home oxygen, feeding issues and monitoring. The level of preparation for the transition home of the premature baby can impact on how the family survives and thrives. It is not surprising that parents may find this challenging because the growth and development trajectory of extremely premature babies can be markedly different from a term infant requiring tailored support to meet. This article is an integrative review of the literature focusing on parents' experience of transitioning home from a neonatal unit with a premature baby. Six themes were identified, and an analysis is presented: namely, transition, unique needs of premature babies, discharge preparation and readiness, discharge learning content, maternal mental health and the role of the neonatal nurse in transition.
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