Psycho-Emotional Care in a Neonatal Unit During the Covid-19 Pandemic

Abstract

A rduous times. Although the Covid-19 pandemic caused by SARS-CoV-2 has, until now, affected relatively few newborns (NB), 1 it has induced intense and disorganizing changes for neonatal care, influencing the bonding and neurosensory protection practices so hard-won over the past years. 2 With the presence of SARS-CoV-2, the current context requires distancing and reduced movement of people. Namely, it demands the reformulation of procedures and practices, leading to the need for new strategies to ensure care. Published documents suspended the visits from grandparents, siblings, and other individuals who comprised the support network, guaranteeing the exclusive access to the asymptomatic mother and/or father, after daily and safe checks at the entry to the Neonatal Intensive Care Unit (NICU). 3,4 The challenge for neonatal teams is ensuring the safety of the NB, the NB's parents, and their own, without, however, departing from the basic principles of humanized care, which have guided the neonatal care in Brazil. 2 It is essential to understand and fulfill the requirements imposed by this moment in the world to ensure the needed adaptations, aiming at protecting the trinomial NB, family, and health team. To this end, it is important to consider care, regarded herein as intensive, focusing on supporting the NB, the NB's parents, and the health team. The experiences of countries that first faced this disease have shown this concern. Wang et al. reported that, in neonatal units, the stress of parents and the staff is high, and that social workers and psychologists must assist both. 5

Misalignment of global COVID-19 breastfeeding and newborn care guidelines with World Health Organization recommendations

“…49 The absence of recommendations for psychological support for separated mothers and infants in the vast majority of guidance is alarming and cannot be justified on the basis of infection control risk. 50 Physical distance between mothers and infants and lack of breastfeeding undermine maternal caregiving capacity and place infants at increased risk of poor developmental and psychological outcomes, abuse and neglect. 5 Hynan 51 highlighted the need for perinatal psychological support in the COVID-19 pandemic, noting the very high rates of post-traumatic stress disorder in parents of infants in neonatal intensive care units where access, S2S contact, and breastfeeding were restricted.…”

“… 5 Hynan 51 highlighted the need for perinatal psychological support in the COVID-19 pandemic, noting the very high rates of post-traumatic stress disorder in parents of infants in neonatal intensive care units where access, S2S contact, and breastfeeding were restricted. Similarly, Morsch and colleagues 50 described the negative psychological impact of maternal separation on infants and emphasised the importance of emotional care for separated infants in the pandemic. The almost absolute absence of psychological support recommendations for separated mothers and infants suggests a knowledge gap regarding the importance of breastfeeding and maternal proximity for infant well-being that needs to be addressed.…”

Assistência ao recém-nascido prematuro e família no contexto da COVID-19

“…A interação e o apoio da equipe ao membro da família que permanecerá e prestará os cuidados ao RN devem ser garantidos. (28) Mantém-se a recomendação de que o menor número possível de profissionais toquem e cuidem do RN. Ademais, orienta-se a manutenção dos mesmos profissionais cuidando dos mesmos neonatos, visto que oferece referência para que o bebê reconheça a rotina de cuidados, a voz e o toque de cada profissional, propiciando segurança e confiança diante de tantas mudanças para o mesmo.…”

“…Ademais, orienta-se a manutenção dos mesmos profissionais cuidando dos mesmos neonatos, visto que oferece referência para que o bebê reconheça a rotina de cuidados, a voz e o toque de cada profissional, propiciando segurança e confiança diante de tantas mudanças para o mesmo. (28) Nos casos em que os pais estejam impossibilitados de estarem presentes ou com permanência limitada na UTIN, atenção especial deve ser dada ao princípio do compartilhamento de informações. Evidências mostram que uma das maiores necessidades das famílias que vivenciam situações de doença e hospitalização de suas crianças é receber informações dos profissionais de saúde.…”

Evaluación de las hospitalizaciones de recién nacidos en una UCI Neonatal durante una pandemia

“…O isolamento e a diminuição do fl uxo de pessoas durante a pandemia têm exigido mudanças nas rotinas, inclusive na suspensão de visitas de familiares que fazem parte da rede de apoio dos pais na UTI Neonatal. Ademais, a permanência dos pais e o livre acesso estão prejudicados (7) . A saúde da criança tem avançado, reduzindo a mortalidade infantil (em menores de 5 anos), porém, a meta do direito à vida e saúde que toda criança possui, não foi alcançada.…”