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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!