Family-Centered Care in the NICU

June 13, 2019

During the past few decades, neonatal intensive care has shifted dramatically – from a system that primarily separated parents and their infants to one that facilitates early bonding and parental involvement. This concept of Family-Centered Care (FCC) takes various forms in different neonatal intensive care units (NICUs), but the end goal is always the same: to allow parents to become active participants in the care of their child. Here are three of the key FCC trends we’re seeing in today’s NICU.

Single-Family Rooms Improving Patient Satisfaction in the NICU

At many hospitals, the days of parents looking at their babies through the window of an open-bay NICU crowded with multiple infants are long gone. In single-family rooms, families have more space and increased privacy, while the babies benefit from lower light and noise levels and closer contact with their parents. As a result, this trend has helped several healthcare systems to improve their patient satisfaction scores.

Earlier this year, Yale New Haven Children’s Hospital opened an advanced NICU, with private rooms that each feature an isolette for the baby, a station for the nurse, and a place for parents to sit (which doubles as fold-up bed). The new ward also has couplet rooms, which allows moms and babies with less complicated conditions to recover together in the same room and improves mother-baby bonding.

This increased focus on the entire family has led to several aspects that are changing the NICU environment. In many modern NICUs, each single-family room includes refrigeration units for breast milk and formula, making it easier for parents to feed their babies with minimal staff involvement.

Comforting NICU Parents by Design

NICU parents are often overwhelmed, anxious and unsure how to cope. To help guide staff in alleviating the difficulties faced by NICU families, the term Newborn Intensive Parenting Unit (NIPU) was first introduced in 2016 and is currently a topic of discussion at neonatal medical congresses and in medical journals. The NIPU represents the shift to prioritize intensive parenting and attachment as soon as possible in the infant’s life. The emotional well-being of the parents ultimately affects the well-being of the baby.

The National Perinatal Association recommends that NICUs offer six key aspects of care to families: family-centered developmental care, peer support, mental health support, palliative and bereavement care, post-discharge support, and staff education and support.

Technology to Empower Mom and Support NICU Breastfeeding

While all newborn babies receive nutritional, immunological and physiological benefits from breast milk, the advantages to premature and/or sick babies are even more significant. However, the breastfeeding hurdles are much greater for mothers with babies in the NICU. That’s why breastfeeding programs have become a key aspect of FCC at many NICUs.

Dr. Diane Spatz, Nurse Researcher & Director of the Lactation Program at Children’s Hospital of Philadelphia (CHOP), developed a program that focuses on enabling breastfeeding for infants who are hospitalized and separated from their mothers. The 10-Step Model consists of: informed decision, establishment and maintenance of milk supply, human milk management, oral care and feeding of human milk, skin-to-skin care, non-nutritive sucking, transition to breast, measuring milk transfer, preparation for discharge and appropriate follow-up.

CHOP has been supporting NICU moms and their babies with the 10-Step Model for over a decade and many other NICUs are now doing the same.

According to Spatz, Step 3 (human milk management) necessitates that “hospitals provide adequate refrigerators and freezers in which moms can store their milk. The hospital should have in place a system to ensure that the right infant receives the right milk.”

By storing breast milk in a small fridge located in the patient room, NICUs can eliminate the risk and associated costs of cross-contamination. It’s also important to use refrigerators that guarantee temperature stability throughout the entire cabinet. Most refrigerators struggle to maintain the appropriate breast milk storage temperature range recommended by the FDA and CDC (0-4.4°C).

Phononic’s compact, solid state refrigerators meet this level of temperature stability, feature rapid recovery to constantly stay within guideline temperatures, and operate almost silently so the babies will not be disturbed.

Many NICU parents find that FCC practices give them a sense of control and bring them closer to their baby. Whether it’s through the peace and privacy of single-family rooms, much-needed emotional support, or the ability to make breastfeeding a reality for their babies, enabling parents to actively participate in their infant’s care can dramatically improve the NICU experience and outcome for the entire family.