Parenting in NICU

[thabit]

Dear all..

Involvements of parents in the care of their baby is of utmost importance for both parents and babies...

In our NICU , Gaza, Palestine. We are startimg to recognize that issue and thinking of the most feasible ways of doing this, because in our country wer have some barriers: social, cultural, religious ...so we are thinking of best and possible solutions to implement concept of parenting locally where we are..and i'll be very thankfull if any one can provide me with literature of parenting..

Thanks for all

[Stefan Johansson]

I am not updated on literature on parents in the NICU, but we have parents around all the time and have very good experiences from this nursing strategy. We encourage parents (mother AND father) to participate in the care as much as they can and to spend hours/day sitting skin-to-skin, also with really small infants on CPAP (not on MV/HFV, although I know of Swedish units with even more "liberal" skin-skin-strategies) .

I personally think our approach facilitates bonding, improves breast feeding rates, and have a positive impact on both parents and babies. Good luck with your work!

[Guest cherylduffy151@hotmail.com]

Although I have worked in two NICUs in Boston MA most of my experience over the last 27 years has been in a Level II Special Care Nursery. It has always been an interest of mine to facilitate the parent/infant bond by empowering the parents to feel as though they have some control and input over the care of their baby. Whether in the acute phase of their stay or the "grower feeder" stage as we call it, parents have the opportunity to participate in hands on care as much as possible. Both areas promote skin to skin contact as much as possible.

Of interest it has been my experience that the NICU nurse is far more comfortable letting parents hold infants on traditional vents and CPAP, initiating that first contact, while the level II nurses are less apt to do so. However, the NICU seems to have less time to spend with the teaching needs of the parents once they are at the level II stages where this is an area that the Special Care Nurse excels. Both levels have many supports for their families including social workers, family support meetings and scheduled team meetings so that families are able to ask questions of the doctors, nurses and various therapists all in one meeting. We have parent teaching sheets and informational handouts that outline the goals we have as caretakers to teach the parents prior to discharge. We review safety issues, medications, developmental issues and feeding goals. We have a family support group which tries to meet monthly to get parents talking to each other to verbalize their feelings about having a baby in the hospital. This can be run by a nurse, doctor and/or social worker. We provide CPR instruction and offer a visiting nurse and early intervention for developmental care after discharge.

We have many families from other countries with other customs and traditions which we try to recognize and incorporate into the care of the baby. This can be difficult if that belief conflicts with the standard of practice and regulations set by the Department of Public Health in our state. It can be a challenge. Most of the conflict arises from a lack of control over the situation felt by the parents. Often times the parent will choose one thing to be unwilling to compromise. Open communication and empathy of the parent's feelings can help to smooth things over but sometimes no matter what you say or do the parent feels their parenting skills/rights are challenged. Giving them control over other issues can sometimes help smooth things out.

I hope this has been of some help to you in your NICU.

Good Luck!

[gayle omansky]

Hi Thabit,

You can get many articles on parenting in the NICU from the Academy of Neonatal Nursing & their journal Neonatal Network (one of the sponsors here).

For a short answer though I agree that holding as soon as possible is key for parents. Most would be in favor of skin-to-skin holding. I am wondering if privacy is a concern for your unit. If you can facilitate skin-to-skin on your unit I think you will have happier parents. I agree with both above that encouraging to participate as much as possible helps them to feel that this is their babe, not the unit's babe.

I should have a recent article on family-friendly units at work. You can contact me at gayleomansky@hotmail.com if you would like it.

[Guest sameera_reddy]

We very strongly beleive in the concept that only sensory input that newborn is familiar and comfortable is Mother's touch. We encourage mothers to touch newborn preterm babies after disinfecting their hands. We beleive in not using gloves by the mother. As soon as the baby is hemodynamically stable we encoureage mothers to handle neonates even while on ventilators after adequately educating them. We also live in a very conservative country. Kangaroo mother care by mother is encourages(skin to skin contact) We also have dedicated fathers time for Kangaroo father care. We beleive father is vey essential also to support and strengthen the mother emotionally-Sameera

[gayle omansky]

Hi Thabit,

I came across an archived issue of eneonatal review which is put out by Johns Hopkins that I thought you would be interested in. They have an issue or article devoted to family centered care in the Nov. 2008 issue. The link:

www.hopkinscme.net/ofp/eneonatalreview/newsletters.html

Take care, Gayle

[gayle omansky]

OK, something is going wrong with my link address. I have tried editing it with no luck. Anyways, it is eneonatal review sponsored by Hopkins.

G.

[Stefan Johansson]

OK, something is going wrong with my link address. I have tried editing it with no luck. Anyways, it is eneonatal review sponsored by Hopkins.

G.

Here's the link:

http://www.hopkinscme.net/ofp/eneonatalreview/Newsletters/1108.html

[NICU RN 7]

One thing we do for our culturally modest families is to provide curtains which surround the bedside, and hospital gowns for parents which open in the front. There are also kangaroo shirts a parent can wear which provide full coverage, but allow for the infant to be placed skin to skin within them. Staff are sensitive to the needs of the individual families, and don't insist that any family member provide skin to skin care if they are uncomfortable.

We do, however, allow skin to skin care for any infant stable enough to transfer from the bed to the parent and back. This includes infants with lines, and intubated infants who are not on HFOV.