Parents' presence and parent–infant closeness in 11 neonatal intensive care units in six European countries vary between and within the countries

Abstract

AimLittle is known about the amount of physical parent–infant closeness in neonatal intensive care units (NICUs), and this study explored that issue in six European countries.MethodsThe parents of 328 preterm infants were recruited in 11 NICUs in Finland, Estonia, Sweden, Norway, Italy and Spain. They filled in daily diaries about how much time they spent in the NICU, in skin‐to‐skin contact (SSC) and holding their babies in the first two weeks of their hospitalisation.ResultsThe parents' NICU presence varied from a median of 3.3 (minimum 0.7–maximum 6.7) to 22.3 (18.7–24.0) hours per day (p < 0.001), SSC varied from 0.3 (0–1.4) to 6.6 (2.2–19.5) hours per day (p < 0.001) and holding varied from 0 (0–1.5) to 3.2 (0–7.4) hours per day (p < 0.001). Longer SSC was associated with singleton babies and more highly educated mothers. Holding the baby for longer was associated with gestational age. The most important factor supporting parent–infant closeness was the opportunity to stay overnight in the NICU. Having other children and the distance from home to the hospital had no impact on parent–infant closeness.ConclusionParents spent more time in NICUs if they could stay overnight, underlining the importance that these facilities play in establishing parent–infant closeness.

Single‐family room design in the neonatal intensive care unit did not improve growth

“…There is evidence of improved clinical stability during hospitalisation and of better short‐ and long‐term outcome if SSC and family‐centred care are practiced on a daily basis . Both our and other studies concluded that SFR care facilitate early and prolonged parental presence and involvement, and Lester et al. suggested that these factors, together with developmental support, were the main mediators of the positive effects of SFR care.…”

“…Involvement of parents , and family‐centred care with parents as primary caregivers, has been associated with faster attainment of full enteral feeds and weight gain . As opposed to open‐bay (OB) units, single‐family room (SFR) units protect the infant and parents from environmental stress and offer more privacy, which may facilitate long‐term parent–infant closeness and skin‐to‐skin contact (SSC) . SFR design has been associated with more hours of maternal presence improved weight gain , earlier feeding , reduced risk of infection and earlier discharge and improved neurobehavioral and pulmonary outcomes .…”

Facilities for presence and provision of support to parents and significant others in neonatal units

“…Our findings show that a majority of Swedish neonatal units provide opportunities for infant‐parent closeness, that is letting the parents stay with their infant day and night. Having the opportunity to stay overnight and/or having a single‐family room is not only positive for parental presence but also for the initiation and duration of skin‐to‐skin contact . A single‐family room is also a space where parents are more likely to feel emotionally close, attuned to their infant's needs and emotionally supported by staff .…”

Exposure to human voices has beneficial effects on preterm infants in the neonatal intensive care unit

“…Thus, interventions probably have different relevance for, and different effects on, preterm infants’ development at different ages. Moreover, the physiological and behavioural responses of preterm infants, through which the effects of exposure to human voices are mainly assessed, also mature with increasing GA. What could be effective for, and tolerated by, an extremely preterm infant of below 28 weeks of GA or postmenstrual age, may be very different to what is effective for an infant at 34 weeks . Despite this, we found that this issue was not mentioned in the majority of the studies we reviewed, most of which started the enrolment at 32 weeks of GA.…”