Clinical Review ABC of preterm birth

Supporting parents in the neonatal unit

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7478.1336 (Published 02 December 2004) Cite this as: BMJ 2004;329:1336
  1. Peter W Fowlie,
  2. Hazel McHaffie

    Introduction

    Parents find it very stressful when their baby is admitted to the neonatal unit for any reason. Different sources of stress have been identified, and certain occasions (such as discharge from hospital or bereavement) are particularly difficult. These experiences impact on families in positive and negative ways, and people adopt a range of coping mechanisms. Staff should adopt a holistic approach to care that acknowledges the uniqueness of each family and supports them appropriately.

    Sources of stress

    During pregnancy, most women and their partners do not give serious consideration to the possibility of preterm delivery or illness in their newborn baby. In most cases admission of an infant to the neonatal unit is unexpected and is stressful for the parents.


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    Seeing their baby receive intensive care can be terrifying for parents

    If a problem is diagnosed antenatally, parents can be forewarned. For most admissions to the neonatal unit, however, there is little or no time to prepare the family. Parents are unfamiliar with the potentially complex problems their infant is facing and they are unsure of the future. Incomprehension and uncertainty are major sources of stress. In addition, maternal health is often compromised at this time.

    View this table:

    Sources of stress experienced by parents

    A degree of separation exists between the mother and baby when the infant is admitted to the neonatal unit, and this may extend over many months. Although in some places a visit to the neonatal unit is a routine part of antenatal care, the neonatal unit is an alien environment to most parents. Units are often noisy, bright, and hot. They can be overcrowded and parts of every unit will be “high tech.” Parents rarely know the neonatal unit staff before their baby is admitted, and the language and behaviours they encounter can contribute to an overwhelming feeling of isolation. The …

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