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We had a discussion regarding our "protocol" for teddy bears, i.e. where we accept teddy bears and similar toys which parents/friends/relatives give to children in the nicu.

Currently we allow such toys in the beds of stable infants (typically infants fully fed enterally), and on the side board beside incubators.

However, we thought we might re-evaluate this policy, since we really do not know to what extent those toys might be colonized with bacteria.

Do you have a Teddy Bear Policy? :)

We are currently changing our policy regarding stuffed toys in the beds. Due to concerns regarding infection only toys that can be wiped down will be allowed. The other issue with toys in beds is the concern of parents modeling our behavior. It is not recommended to have toys in the bed due to the SIDS risks.

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I browsed PubMed and found the following references.

Teddy bears in NICU beds seems like a bad idea!

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Bacterial colonization of toys in neonatal intensive care cots. Pediatrics 2000

Conclusion: With time, all the toys in NICU cots became colonized with bacteria. Many were potentially pathogenic. Toys may be reservoirs for potential infantile nosocomial sepsis. infant, newborn, toys, infection, neonatal intensive care.

http://www.ncbi.nlm.nih.gov/sites/entrez/10920174

Evidence-based practice: examining the risk of toys in the microenvironment of infants in the neonatal intensive care unit. Adv Neonatal Care 2004

Pre- and postintervention infection rates were compared. NI rates decreased from 4.6 to 1.99 per 1,000 patient days over a 6-month evaluation period. Although this decrease was not statistically significant, it was the lowest rate recorded in 5 years.

http://www.ncbi.nlm.nih.gov/pubmed/15368211

comment_1192

I work in a 60 bed level 3 NICU. We do not allow anything that cannot be wiped of with antimicrobial wipes or (bucket) sanitizer solution. We have also not allowed anything heavy (statues/figurines) that may fall into a crib or onto an isolette. We do allow prayer cloths, but will put them into a bag and tape them to a bed/isolette. Hope this helps.

Sondra RN

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