Fam ily Centered care in a Swedish NI CU Uwe Ewald, Uppsala, Sweden

“Today it is rout ine that parents are

together with their child in the hospital”

But is this t rue in the NI CU?

Separat ion of newborn infants today

• Majority of infants are healthy at bir th – albeit some are immature/preterm – Only in need of

• Cleanliness, warmth, breastfeeding/milk

• And ”love” » Essential care of the newborn, WHO2012

• But 10-15 % are referred to a NI CU – Prolonged hospitalization – Rooming-in and/or single family room uncommon – Visiting allowed, but restrictions common

But who is at r isk to be separated?

• Be close to m y child • Part icipate and have influence • Feel safe • Qualified staff in a well-organized unit • Have a good and open com m unicat ion with

the staff

Hallström 1998, Wigert 2008

Whishes from parents in hospital

Closeness vs separat ion

• Mother infant interact ion - offspring variat ion in phenotype – epigenet ics

– Meaney 2005

• Bet ter sleep – brain developm ent – Morrissey 2004

• At tachm ent – relieve pain/ st ress – Axelin 2009

• Physical contact enhance developm ent – Treyvaud 2009

• Parent ing intervent ion – bet ter cognit ive outcom e

– Nordhov 2010

• Parental presence – m ore vocalizat ion – Caskey 2011

Separat ion vs closeness

• Maternal depression de Alencar 2009

• I ncom petence of parental role Muller-Nix 2004

• Bonding requires close physical contact Klaus & Kennel 1976

• More guilt / sham e Flacking 2007

• Less breast feeding Flacking 2011

Parent chest = the new care space

Prom ot ing factors for im plem ent ing FFC Thernst rom Blom quist Y, Acta Paediat r 2012

- Early start

- Space - place, pr ivacy, environm ent

- Staff at t itude and care culture - Support (parental leave, social network)

The staff - new roles as guide,

coach and educater

Infant: 25 w, 2 days

5 days

Coaching of a m ot ivated pupil

Take part or part icipate?

Blood sam pling

Examinations

Phototherapy

Feeding

… and of course breast feeding

Vent ilat ion, m onitor ing, feeding, keeping

warm ...

Som ething to do…

Reading, handicraft , radio, dvd, m p3, internet…

Mobilit y in a ” top”

Sleeping

Siblings are im portant too..

…. and granny

Early discharge

Support from home-visiting team from the unit

Thank you!