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

Tandberg, Bente Silnes; Frøslie, Kathrine Frey; Markestad, Trond; Flacking, Renée; Grundt, Hege; Møen, Atle

doi:10.1111/apa.14746

Cited by 15 publications

(20 citation statements)

References 26 publications

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“…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 .…”

Section: Discussionmentioning

confidence: 99%

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

2019

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Aim To describe parental facilities for staying in neonatal units, visiting policies and access to emotional support during hospitalisation. Methods A cross‐sectional design was used in which a survey was presented to all neonatal units in Sweden; 34 out of 38 units participated (89%). Results The findings showed that in 50% of the units, parents could stay 24/7 for the infant's entire hospital stay. In 32% of the units, siblings could stay the night with their parents. Units had policies on restrictions for visits by siblings (80%), grandparents (59%), friends and relatives (71%). All units offered counselling to parents, and some units offered peer‐to‐peer groups (24%), diaries (35%), relaxation techniques (6%) or Internet parental forums (6%). All units enabled parents to be at home with their infant and to visit the unit for check‐ups (35%) or to have staff visits at home (65%). Conclusion Facilities for parents to stay with their infant during hospitalisation and to have significant others visit are good, but there is room for improvement. During the transitional phase to being at home, parents are facilitated in being at home before the infant is discharged and are supported by the unit, which must be considered beneficial for parents.

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Section: Discussionmentioning

confidence: 99%

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

2019

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“…We have previously reported effects of SFR design on parental presence, infant growth trajectories, morbidity, medical procedures and nutrition [24]. In the present study, we report parents’ emotional reactions to continuous presence, using questionnaires to screen for the risk of depression, anxiety, stress and attachment, and we provide a more in-depth description of parental presence.…”

Section: Methodsmentioning

confidence: 97%

Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit

et al. 2019

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BackgroundStudies of parents’ psychological well-being in single-family rooms in neonatal intensive care units have shown conflicting results.AimsTo compare emotional distress in the form of depression, anxiety, stress and attachment scores among parents of very preterm infants cared for in a single-family rooms unit vs an open bay unit.Study designProspective survey design.SubjectParents (132) of 77 infants born at 28 0/7–32 0/7 weeks of gestation in the two units.Outcome measuresDuration of parental presence was recorded. Scores for depression (The Edinburgh Postnatal Depression Scale), anxiety (The State–Trait–Anxiety Inventory, Short Form Y), stress (The Parent Stressor Scale: neonatal intensive care unit questionnaire and The Parenting Stress Index—short form) and attachment (Maternal Postnatal Attachment Scale) measured 14 days after delivery, at discharge, expected term date and four months post-term.ResultsParents were present 21 hours/day in the single-family room unit vs 7 hours/day in the Open bay unit. Ninety-three percent of the fathers in the single-family rooms unit were present more than 12 hours per day during the first week. Mothers in the single-family rooms had a significantly lower depression score -1.9 (95% CI: -3.6, -0.1) points from birth to four months corrected age compared to mothers in the Open bay unit, and 14% vs 52% scored above a cut-off point considered being at high risk for depression (p<0.005). Both mothers and fathers in the single-family rooms reported significantly lower stress levels during hospitalization. There were no differences between the groups for anxiety, stress or attachment scores after discharge.ConclusionThe lower depression scores by the mothers and lower parental stress scores during hospitalization for both parents supports that single-family rooms care contribute to parents’ psychological wellbeing.

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“…From the eligible cohort (120 infants), 77 infants (SFR n = 35, OB n = 42) and their 66 mothers (SFR n = 30, OB n = 36) were enrolled in the study (Figure 1). The power calculation was based on the main outcome in the main study (Tandberg, Frøslie et al, 2019.…”

Section: Samplementioning

confidence: 99%

“…In contrast, a single family room (SFR) NICU design facilitates continuous parental presence, reduces stressful stimuli, facilitates privacy, and allows undisturbed parent-infant closeness with longer periods of skin-to skin care (SSC;Dunn et al, 2016). We have previously reported large differences in duration of parental presence and SSC between OB and SFR NICU care (Tandberg, Frøslie et al, 2019), with concurrent reduction in depression scores among SFR mothers and reduced stress in both parents . SSC facilitates milk production and direct breastfeeding, and is associated with improved breastfeeding rates among preterm infants (Sharma et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants

et al. 2020

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Background Hospitalization in neonatal intensive care units with a single-family room design enables continuous maternal presence, but less is known regarding the association with milk production and breastfeeding. Research aim To compare maternal milk production, breastfeeding self-efficacy, the extent to which infants received mother’s milk, and rate of direct breastfeeding in a single-family room to an open bay neonatal intensive care unit. Methods A longitudinal, prospective observational study comparing 77 infants born at 28– 32° weeks gestational age and their 66 mothers ( n = 35 infants of n = 30 mothers in single family room and n = 42 infants of n = 36 mothers in open bay). Comparisons were made on milk volume produced, the extent to which infants were fed mother’s milk, and rate of direct breastfeeding from birth to 4 months’ corrected infant age. Breastfeeding self-efficacy was compared across mothers who directly breastfed at discharge ( n = 45). Results First expression (6 hr vs. 30 hr, p < .001) and first attempt at breastfeeding (48 hr vs. 109 hr, p < .001) occurred significantly earlier, infants were fed a greater amount of mother’s milk ( p < .04), and significantly more infants having single-family room care were exclusively directly breastfed from discharge until 4 months’ corrected age; OR 6.8 (95% CI [2.4, 19.1]). Volumes of milk produced and breastfeeding self-efficacy did not differ significantly between participants in either units. Conclusion To increase the extent to which infants are fed mother’s own milk and are exclusively directly breastfed, the design of neonatal intensive care units should facilitate continuous maternal presence and privacy for the mother–infant dyad.

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

Cited by 15 publications

References 26 publications

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

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

Parent psychological wellbeing in a single-family room versus an open bay neonatal intensive care unit

Associations Between Single-Family Room Care and Breastfeeding Rates in Preterm Infants

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