Parental Presence in the NICU: Keeping Families Together
The Importance of Parental Presence in the NICU
Parental presence in the NICU is not just valuable—it is essential. A parent’s involvement in their baby’s care has been shown to positively influence bonding, emotional wellbeing, and even health outcomes for both baby and parent. It is vital that NICUs recognize and support the profound impact of having parents actively present and engaged during this critical time. The Canadian Premature Babies Foundation (CPBF) strongly advocates for NICUs to view parents as their baby’s primary caregivers—equal and integral members of the care team—whose presence, voice, and touch are central to the healing process.
Parents are not visitors – they are essential caregivers to their babies in the NICU
Questions & Answers
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What is RSV?Respiratory syncytial virus, or RSV, is a virus that causes cold and flu-like illness. For most healthy adults, RSV might feel like a cold. But RSV in babies and young children can be more serious.
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How common is RSV in babies?RSV is very common in babies and children. Almost all babies and children will have had an RSV infection by the time they are 2. RSV is most common in the fall and winter months.
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How do babies get RSV?The RSV virus spreads through droplets produced by coughs and sneezes. The most common way we get sick from RSV is by touching our nose, eyes and mouth with germs on our hands. RSV can live on surfaces for many hours. Premature babies are especially at risk of RSV because they have trouble fighting infections.
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Can I prevent my baby from getting RSV?Most babies and young children will get RSV sometime during the first two years of life. It is important to protect all babies, especially premature babies, from RSV as best we can during their first winter. Here are some ways you can help prevent your baby from getting RSV: Always wash your hands with soap and water before you touch your baby. Wash your hands after you blow your nose, sneeze, or cough. Do not smoke or let others smoke around your baby or in your home. Keep your baby away from anyone who is sick. If you are sick, do not kiss your baby. Keep your baby away from crowded places such as daycare centers, shopping malls, and large family gatherings. Ask your healthcare provider if your baby should get RSV prevention medicine
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How sick can my baby get from RSV?RSV will cause a bad cold for most babies. Some babies will get very sick from RSV. Babies born very prematurely, with breathing problems, certain heart problems or other medical conditions, are at the highest risk of getting very sick. RSV can cause pneumonia and bronchiolitis, serious lung and airway complications. If this happens, most babies need to be admitted to the hospital, and some need oxygen or breathing help.
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What are the signs and symptoms of RSV in babies?Some babies with RSV will only have cold symptoms like a runny nose. Other symptoms of RSV include: Fever Cough Problems with breathing (fast breathing or working hard to breathe) Whistling or wheezing noise when breathing Trouble feeding
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What should I do if my baby gets sick with a cold?Always call your baby's healthcare provider if your baby seems sick, is not eating well, is irritable, and has a runny nose If your baby has a fever or a cough, go to the hospital If your baby looks blue, has difficulty breathing, or stops breathing, call 911
Parent/Caregivers should have:
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Uninterrupted access to mental health and psychosocial support services while their infant is admitted to the NICU.
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Unrestricted access to provide skin-to-skin contact for their infant in the NICU.
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Uninterrupted access to attend medical rounds while their infant is admitted to the NICU.
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Unrestricted access to breastfeed and to receive breastfeeding supports (including early hand expression, pumping and pumps, encouragement, and lactation support) for their infant in the NICU.
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Inclusion in co-designing/decision-making for parent-related NICU policies (e.g., infection control, response planning), including NICU parent partners and advocates.
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Unrestricted, in-person access to mental health and psychosocial support services while their infant is admitted to the NICU. Virtual care services may be preferred, based on the local context or if parent need/parent preference warrants it.
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Unrestricted access to provide hands-on care tasks for their infant in the NICU.
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Unrestricted access to provide healing touch for their infant in the NICU.
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Unrestricted, in-person access to attend medical rounds while their infant is admitted to the NICU. Virtual care services may be preferred, based on the local context or if parent need/parent preference warrants it.
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Unrestricted access to food and allocated spaces to eat/drink while their infant is admitted to the NICU.
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Uninterrupted access for two parents/caregivers to be present while their infant is admitted to the NICU.
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Unrestricted access to use communication devices (their own or hospital devices) for remote connectedness and support (with partners, family, peers, etc.) while they are in the NICU with their infant.
What’s next?
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Broad dissemination of the national recommendations
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Active advocacy from families, healthcare providers, societies and partners, and members of our teams
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Seeking to implement these recommendations as part of Canadian NICU Accreditation Criteria
Preemie chat
Our Advocacy during the COVID-19 Pandemic
Throughout the COVID-19 pandemic, Canadian families of premature babies faced restrictive NICU policies that limited their presence. During this time, CPBF participated in the Presence Study to better understand and address these challenges. Our position remains clear: #ZeroSeparation between parents and their premature infants. Parents are not visitors—they are essential members of their baby’s care team. Evidence
overwhelmingly shows that parent-infant contact benefits both the baby’s health and the parents’ well-being.
The global study and project report: “Zero separation. Together for better care! Infant and family-centred developmental care in times of COVID-19 – A global survey of parents’ experiences” was launched during a digital live event. The alarming key findings of the global survey were presented, highlighting the very personal experiences of parents worldwide in times of the COVID-19 pandemic.
Call to Action
CPBF in collaboration with the International Family Integrated Care (FICare) committee released a position statement on Parental presence in Neonatal Units during SARS-CoV-2 Pandemic in 2020. Click here to read the full
statement.
The most recently publication, March 2021, reviews the evidence on safety of maintaining family integrated care practices and the effects of restricting parental participation in neonatal care during the SARS-CoV-2 pandemic.
Click here.
We have also collaborated with the Global Alliance for Newborn Care (the global initiative of GFCNI), have launched the Zero Separation global campaign to keep preterm and sick babies close to their parents. The goal of
the campaign is to raise awareness for the benefits of zero separation of preterm and sick babies and their parents in the NICU whether they’re in a pandemic or not.
To find out more about the 'Zero separation. Together for better care!' campaign in more than 20 languages, visit: www.glance-network.org
Resources
The NICU Parent Network advocates for all NICUs to consider parents as their baby(ies)’s primary caregivers and are essential members of their baby’s care team.
Read more on their stance in their Position Paper.
Family Centered Care Task Force
The first international, multicenter, collaborative initiative solely dedicated to quality
improvement in NIICU Family-Centered Care. Supporting NICUs as they seek to begin
or strengthen Family Centered Care in their units.