Analysis

Innovations to help families bond with their babies in neonatal intensive care

Initiatives to create bonding experiences between parents and preterm babies in neonatal intensive care are reducing stress.

Initiatives to create bonding experiences between parents and preterm babies in neonatal intensive care are reducing stress.

The UK figure for babies born prematurely (before 37 weeks), is about 60,000 per year, based on an estimate of 59,300 preterm births in 2010 (Blencowe et al 2012). The estimate comes from the World Health Organization (WHO). In England alone, births at 22 to 26 weeks increased from 40% to 53% between 1995 and 2006, with babies experiencing long-term complications including brain damage, eye disease and respiratory conditions (Costeloe et al 2012).

15 million

The number of babies born before 37 weeks worldwide

Preterm babies spend their first weeks in neonatal intensive care units (NICU) and mothers and babies are often separated. This separation can often

...

Initiatives to create bonding experiences between parents and preterm babies in neonatal intensive care are reducing stress.

Bonding
Bonding between mother and baby can be stressful if the baby is born prematurely. Picture: iStock

The UK figure for babies born prematurely (before 37 weeks), is about 60,000 per year, based on an estimate of 59,300 preterm births in 2010 (Blencowe et al 2012). The estimate comes from the World Health Organization (WHO). In England alone, births at 22 to 26 weeks increased from 40% to 53% between 1995 and 2006, with babies experiencing long-term complications including brain damage, eye disease and respiratory conditions (Costeloe et al 2012).

15 million

The number of babies born before 37 weeks worldwide

Preterm babies spend their first weeks in neonatal intensive care units (NICU) and mothers and babies are often separated. This separation can often cause significant stress to families.

Developmental care

At the Royal Devon and Exeter NHS Foundation Trust, sister in the neonatal unit Clare Cornish speaks of the dangers of lack of attachment between mother and baby and the impact this has on their mental health in the future.

‘When a baby is born into the neonatal unit they are physically separated from mum because they are in intensive care. We don’t like separating mums and babies, so we work to break down the barriers of that separation.

‘Everything that we do for our developmental care is around improving the bonding relationship and long-term attachment of baby and mum. If we don’t get it right now it can have long-term implications.’

On arrival at the NHS trust’s NICU each family is given a comfort bag containing shampoo, conditioner and lip balm. ‘There is usually a token for the baby while they are here – teddies or muslins, or a blanket – a little keepsake for the baby,’ Ms Cornish explains. The bags are supplied by the charity Snug, a parent-peer support group set up by a family with a pre-term baby being cared for by the trust about eight years ago.

1 million

The number of deaths in 2015 from pre-term birth complications worldwide

The comfort bag also includes a booklet, designed by SNUG, guiding parents through the special care journey.

‘It’s about introducing these small projects and care packages that help mum and baby along their way,’ she adds.

Case study

At the NICU at Maxine Dunitz children’s health center at Cedars-Sinai Medical Center in Los Angeles, California, support days are held to help siblings learn how to relate to their new brothers and sisters.

Siblings play with a doll made out of socks and uncooked rice.

Sibling Day
Wadeh Constance uses a doll to show son Luka how to put a beanie on his baby sister Maya at a sibling support day at the Cedars-Sinai Medical Center, US.
Credit: Cedars-Sinai. Pictured with consent

The sibling is encouraged to dress the doll in a onesie and hat and shown how to wrap a baby in a blanket and to practise holding ‘baby’.

Assistant nurse manager at the NICU, Bevin Merideth, explains: ‘From a nursing perspective, this project is a wonderfully innovative way to engage siblings. 

‘The dolls can make the environment and the baby a little less scary.’

 

Research has focused on the impact on brain development of being born prematurely. Some studies have noted that preterm babies are more likely to be introverted or neurotic, as well as more conscientious and agreeable.

Personality defects

In 2015 research conducted at the University of Warwick on babies born before 32 weeks – or with a low birth weight of under 1.5kg – found they were more likely to develop introverted personalities, to be anxious and to have autistic spectrum features such as poor communication skills (Eryigit-Madzwamuse et al 2014).

When the study was published, lead researcher Professor Dieter Wolke, from the university’s department of psychology, urged that parents of premature babies should be provided with techniques to foster their children’s social skills to help compensate for their ‘socially withdrawn personality characteristics’.

6th

The US ranking in a table showing the highest number of premature births globally

(Source WHO 2016)

Although the problems preterm babies present are complex, many of the solutions being trialled are simple and involve simulating as much normal family contact as possible within the constraints of the NICU.

Solutions

This may mean that technology is used so that parents get regular updates on their babies’ progress at times when it is impossible for them to be at the unit, or that a sibling learns how to relate to the new baby by playing with a doll. Or the solution could be as simple as a pair of home-sewn fabric hearts given to mum and baby so that they become familiar with each other’s smell.

An example of a technological solution is in Glasgow where secure video communication is used between nurses and parents at the Royal Hospital for Children to help reduce parents’ stress.


Fabric hearts used at Sheffield Teaching Hospital’s NICU

At the hospital the HUGG (Helping Us Grow Group) was set up with the aim ‘to empower parents to be primary caregivers for their baby during their stay in the neonatal unit’.

The group identified that parents’ stress increased when it was not possible for parents to be by their baby’s cots. A secure video messaging platform was set up so nurses can record video messages to send to parents to be accessed at any time.

Case study

A charity aims to foster parent-baby bonding by giving home sewn fabric hearts to parents and babies.

Each of the 900 babies treated at Jessop Wing NICU at Sheffield Teaching Hospital each year receives a feeding pack including the two fabric hearts. Sheffield Hospitals Charity provides the materials for the hearts, which are made by volunteers.

The mother wears a heart next to her skin and the other is placed next to the baby, then the hearts are swapped regularly.

A hospital spokesperson says that anecdotal evidence indicates that the fabric hearts help relax distressed babies making them more likely to sleep well.

‘The baby gets to know the mother’s smell and the parents get to know their baby’s smell, which helps create a bond difficult to achieve when skin to skin contact isn’t available,’ she said.


Further information

The Glasgow project

References

Want to read more?

Subscribe for unlimited access

Enjoy 1 month's access for £1 and get:

  • Full access to nursingchildrenandyoungpeople.com
  • Bi-monthly digital edition
  • RCNi Portfolio and interactive CPD quizzes
  • RCNi Learning with 200+ evidence-based modules
  • 10 articles a month from any other RCNi journal

This article is not available as part of an institutional subscription. Why is this?

Jobs