Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit

Abstract

Despite the recent improvements in perinatal medical care leading to an increase in survival rates, adverse neurodevelopmental outcomes occur more frequently in preterm and/or high-risk infants. Medical risk factors for neurodevelopmental delays like male gender or intrauterine growth restriction and family sociocultural characteristics have been identified. Significant data have provided evidence of the detrimental impact of overhelming environmental sensory inputs, such as pain and stress, on the developing human brain and strategies aimed at preventing this impact. These strategies, such as free parental access or sleep protection, could be considered 'principles of care'. Implementation of these principles do not require additional research due to the body of evidence. We review the scientific evidence for these principles here.

Promoting attachment between parents and neonates despite the COVID‐19 pandemic

“…All these actions are part of infant and family‐centred developmental care. Parents of very preterm infants face a high risk of stress and depression, 29 and these feelings may be enhanced during the pandemic. Mothers who have tested positive may also feel more guilty.…”

Parents experiences of feeding their extremely preterm children during the first 2‐3 years – A qualitative study

“…It is well known that parental stress can have both a short‐term and a long‐term impact on a child's feeding development . Swedish NICUs implement several strategies to reduce parental stress during infants’ NICU stay, such as free parental access 24/7 and skin‐to‐skin care . Use of an approach in which the infant is in control and feeding is infant driven has been shown to result in a significant reduction in the time to reach full feeds by mouth, as well as earlier discharge, especially in infants born before 28 weeks of gestation …”

Is the privacy of information protected in a neonatal intensive care unit?

“…This is strongly supported by staff and caregivers 3 but, if the rounds took part in the common area of the NICU, an additional effort to preserve intimacy has to be done. The promotion of low voice in the conversations between parents and staff or between the staff members is a useful tool, not only to protect infants' natural sleep and neurodevelopment 4 , but also their intimacy.…”