European Standards of Care for Newborn Health

Abstract

Infant- and family-centred developmental care (IFCDC) is a descriptive term for a framework of newborn care that incorporates the theories and concepts of neurodevelopment, neuro-behaviour, parent-infant interaction, parental involvement, breastfeeding promotion, environmental adaptation, and change of hospital systems. It is based on the leading-edge work of Als and her colleagues in the NIDCAP Federation International (NFI) (1,2) and Brazelton (3) and on the World Association for Infant Mental Health Declaration of Infants’ Rights. (4) The core pillars of IFCDC are: sensitive care based on infant behavioural communication and cues gives the infant a voice (1,2) and is beneficial for brain growth (5), parent engagement supports parental wellbeing and infant development (6–10), and customised adaptations of the NICU environment and hospital system as a whole. (11) The strategies for implementing this approach are based on supporting the unity of infant and parents, i.e. family access and integration into all care, early bonding, shared-decision-making, and parental involvement as the primary caregivers. (12,13) The practical implementation is assured by early and continuous skin-to-skin contact between mother or father and the newborn infant, as well as by the promotion and support of breastfeeding. (14) Sensory and environmental expectations of the newborn infant are paramount, since early sensory experiences have been shown to have significant impact on neurodevelopment. The model, therefore, advocates protection from deleterious environmental stimuli in newborn intensive care units (NICU) and access to positive sensory stimulation from parents and other caregivers. (15–18) Support strategies for families play a major role, including socioeconomic, mental health, and spiritual services as well as an individual case management plan for each newborn infant. This case management plan is established in collaboration with parents. (11) Well trained and supported healthcare professionals who receive counselling and regular clinical supervision in communicating with and providing emotional support for parents is the prerequisite for proficient successful implementation of IFCDC. (8,19,20) The role of the Topic Expert Group on Infant- and family-centred developmental care focuses on defining practice standards for the implementation of newborn care that is centred around the infant and the infant’s family and their close supporters in order to support optimally the infant´s health and development.