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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Questions & Answers

Parent-infant contact is essential for the health, development, and emotional well-being of both the baby and the parent. Here’s why your presence in the NICU matters:

Skin-to-skin contact (kangaroo care)
- Helps regulate your baby’s body temperature
- Supports healthy brain development
- Reduces sensitivity to pain
- Improves sleep quality
- Increases breastmilk production
- Strengthens parent-infant bonding
- Decreases parental stress
- Stimulates important processes in the parent’s brain and endocrine
- system
- Encourages nurturing and responsive parenting behavior

Parent and baby staying together
- Promotes physiological stability
- Enhances feeding skills
- Supports secure attachment
- Lowers pain responses
- Reduces the risk of hospital-acquired (nosocomial) infections

Talking and interacting with your baby
- Exposes your baby to more spoken language
- Supports better behavioral, cognitive, and language development later in life

For fathers in particular
- Eye contact, touch, holding, and caregiving help build a strong bond
- Involvement supports the development of their identity as a father
- Lack of access can negatively impact paternal mental health

Your presence is not only comforting—it's a powerful and necessary part of your baby’s care team.

We believe that parents are not visitors — they are vital members of their baby’s care team. Decades of research, including Canadian-led studies, clearly show that parent-infant contact in the NICU improves health outcomes for both babies and their families. Yet, despite this evidence, parental presence is still not standard practice in NICUs across Canada.

CPBF continues to advocate for equitable, family-integrated care nationwide. In 2021, during the COVID-19 pandemic, we partnered with Dr. Marsha Campbell-Yeo to conduct the Presence Study, which documented the barriers families faced during a time of restricted access and made clear recommendations for change.

The Presence Study produced 12 evidence-based recommendations to support the integration of parents as essential caregivers in NICUs. However, Canada still lacks a national standard for parental presence and participation in neonatal care. CPBF is committed to changing this.

Our goal is to:

Support the national adoption of the 12 recommendations from the Presence Study.

Push for policy change in hospitals across Canada to formally recognize parents as part of the NICU team.

Reduce care inequities so that all families, regardless of location, can be fully involved in their baby’s care.

We will not stop until every NICU in Canada recognizes what research has already proven: When parents are present, babies thrive.

Parent/Caregivers should have:

Uninterrupted access to mental health and psychosocial support services while their infant is admitted to the NICU.
Unrestricted access to provide skin-to-skin contact for their infant in the NICU.
Uninterrupted access to attend medical rounds while their infant is admitted to the NICU.
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.
Inclusion in co-designing/decision-making for parent-related NICU policies (e.g., infection control, response planning), including NICU parent partners and advocates.
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.
Unrestricted access to provide hands-on care tasks for their infant in the NICU.
Unrestricted access to provide healing touch for their infant in the NICU.
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.
Unrestricted access to food and allocated spaces to eat/drink while their infant is admitted to the NICU.
Uninterrupted access for two parents/caregivers to be present while their infant is admitted to the NICU.
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.

Parental Presence Recommendations

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What’s next?

Broad dissemination of the national recommendations
Active advocacy from families, healthcare providers, societies and partners, and members of our teams
Seeking to implement these recommendations as part of Canadian NICU Accreditation Criteria

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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.

Read the report

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.