In a fantastic example of "why didn't they think of this sooner," a study organized by group of Canadian doctors has discovered that premature babies are healthier if parents get involved in their hospital care, according to The Guardian. It seems like a no-brainer, but the current standard of care calls for nurses to do basically everything for babies in the neonatal intensive care unit, or NICU, while parents mostly sit on the sidelines. In addition to benefiting babies' health, parents who participated in Family Integrated Care (FICare) during the study ended up being more comfortable with caring for their babies once they're sent home, compared to parents who followed the standard protocol. The practice also allows the hospital staff to spend more time where they're truly needed, rather than changing diapers.
In a paper introducing the study, the authors pointed to the already well-established facts that maternal presence in the NICU leads to more stable health for the babies, improved feeding, shorter length of stay, and even better behavioral outcomes. FICare could amplify those benefits, they hypothesized, by having parents spend more time at the hospital and provide more direct care to their babies, just as they would at home, or during a standard postpartum hospital stay for full-term babies. Parents in the study also participated in a parent education program, a nursing education program, and received peer support from veteran parents.
Current NICU protocols have parents participate in care plans like family centered care, kangaroo care, skin-to-skin care, operating under the premise that "only NICU professionals with special skills can provide care for the infant," the authors wrote. "Parents are relegated to a supportive role, and some have described themselves as voyeurs who are 'allowed' to visit and hold their infants." That's obviously not good for parents' confidence or parent-child bonding, and as it turns out, it's not beneficial to the babies' health, either.
FICare was inspired by a 1979 staffing shortage among NICU nurses in Estonia, which led to the implementation of a new care model in which parents provided most of the nursing care for their infants, such as bathing, feeding, dressing, diaper changes, administering oral medication, taking temperatures, and basic charting. The nurses provided guidance to the parents, and only took over for more complicated care, like administering IV fluid and medication. The study authors reported that this model not only freed up 50 percent of the nurses' time, it also resulted in a 30 percent improvement in infants' weight gain, a 30 percent reduction in infections, a 20 percent reduction in the length of NICU stays.
A paper published in the Lancet outlined the protocols for the new study. they recruited about 1,800 babies born at 33 weeks' gestation or earlier at 26 different hospitals in Canada, Australia, and New Zealand. Half of the parents carried on as usual, while parents in the FICare group had to commit to spending six to eight hours a day, five days a week, caring for their babies and attending educational sessions. Metrics for babies and parents in both groups were compared three weeks later.
Babies in the FICare group had greater weight gain than the control group, as well as "significantly higher" average daily weight gain. Parents in the FICare group also had lower stress and anxiety test scores. And when the babies were discharged from the NICU, the rate of "high-frequency exclusive breastmilk feeding," meaning six or more feedings per day, was also higher for the FICare babies than the standard care babies. The authored caution that further research is needed, as this is just one study, but there were no adverse effects, so honestly, it can't hurt to give it a shot.
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