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Overview

Infant- and family-centred developmental care (IFCDC) is a generic term for a framework of neonatal 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 founded on the leading-edge work of Brazelton and Als (1, 2, 3) and World Association for Infant Mental Health Declaration of Infants’ Rights. (4) The core pillars of IFCDC are: sensitive care based on infant behavioural communication gives the infant a voice and is beneficial for brain growth, parent engagement supports parental wellbeing and infant development, and customised adaptations of hospital organisations. (5–7)

There are several strategies on how to implement IFCDC. They are primarily based on non-separation, i.e. family access, early bonding, shared-decision-making, and parental involvement as the primary caregivers. (8,9) The practical implementation is ensured 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. (10) A special focus of IFCDC is put on sensory expectations of the newborn infant, since early sensory experiences can impact neurodevelopment. Thus, infants should be protected from deleterious environmental stimuli happening in neonatal intensive care units, and access to positive sensory stimulations from their parents and other caregivers should be granted. (11–14) 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. (6) Adequate IFCDC trained healthcare professionals who receive counselling and regular clinical supervision in communicating with and providing emotional support for parents is the prerequisite for proficient IFCDC. (15,16)

The Topic Expert Group on Infant- and family-centred developmental care develops standards for the implementation of neonatal care that is centred around the infant and the infant’s family to optimally support infant´s health and development.

Sources

  1. Brazelton, T.B., & Nugent, K.J. (1995). Clinics in Developmental Medicine. Neonatal Behavioral Assessment Scale (No.137, 3rd edition). London: Mac Keith Press
  2. Als H. A synactive model of neonatal behavioral organization. Phys Occup Ther Pediatr 1986;6:3-55.
  3. Als H. Program Guide- Newborn Individualized Developmental Care and Assessment Program (NIDCAP): An education and training program för health care professionals. 2015. www.nidcap.org
  4. WAIMH. Declaration of Infants’ Rights. 2016. https://perspectives.waimh.org/2016/06/15/waimh-position-paper-on-the-rights-of-infants/
  5. Westrup B. Family-Centered Developmentally Supportive Care. NeoReviews. 2014 Aug 1;15(8):e325–35.
  6. Westrup B. Family-centered developmentally supportive care: the Swedish example. Arch Pediatr Organe Off Soc Francaise Pediatr. 2015 Oct;22(10):1086–91.
  7. Roué J-M, Kuhn P, Lopez Maestro M, Maastrup RA, Mitanchez D, Westrup B, et al. Eight principles for patient-centred and family-centred care for newborns in the neonatal intensive care unit. Arch Dis Child Fetal Neonatal Ed. 2017 Jul;102(4):F364–8.
  8. Mörelius E, Örtenstrand A, Theodorsson E, Frostell A. A randomised trial of continuous skin-to-skin contact after preterm birth and the effects on salivary cortisol, parental stress, depression, and breastfeeding. Early Hum Dev. 2015 Jan;91(1):63–70.
  9. Welch MG, Myers MM, Grieve PG, Isler JR, Fifer WP, Sahni R, et al. Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: a randomized controlled trial in the NICU. Clin Neurophysiol Off J Int Fed Clin Neurophysiol. 2014 Apr;125(4):675–84.
  10. Conde-Agudelo A, Belizán JM, Diaz-Rossello J. Kangaroo mother care to reduce morbidity and mortality in low birthweight infants. Cochrane Database Syst Rev. 2011 Mar 16;(3):CD002771.
  11. Caskey M, Stephens B, Tucker R, Vohr B. Importance of parent talk on the development of preterm infant vocalizations. Pediatrics. 2011 Nov;128(5):910–6.
  12. Filippa M, Panza C, Ferrari F, Frassoldati R, Kuhn P, Balduzzi S, et al. Systematic review of maternal voice interventions demonstrates increased stability in preterm infants. Acta Paediatr Oslo Nor 1992. 2017 Aug;106(8):1220–9.
  13. Frie J, Bartocci M, Lagercrantz H, Kuhn P. Cortical Responses to Alien Odors in Newborns: An fNIRS Study. Cereb Cortex N Y N 1991. 2017 Aug 1;1–12.
  14. Kuhn P, Zores C, Pebayle T, Hoeft A, Langlet C, Escande B, et al. Infants born very preterm react to variations of the acoustic environment in their incubator from a minimum signal-to-noise ratio threshold of 5 to 10 dBA. Pediatr Res. 2012 Apr;71(4 Pt 1):386–92.
  15. Hall SL, Phillips R, Hynan MT. Transforming NICU Care to Provide Comprehensive Family Support. Newborn Infant Nurs Rev. 2016 Jun;16(2):69–73.
  16. Hyrkäs K, Appelqvist-Schmidlechner K, Haataja R. Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care. J Adv Nurs. 2006 Aug;55(4):521–35.

Standard

© Christian Klant Photography

Case management and transition to home

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Clinical consultation and supervision for healthcare professionals on supporting families

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© Asociatia Unu si Unu, Romania

Education and training for infant- and family-centred developmental care (IFCDC)

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© Christian Klant Photography

Family access

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Family support services

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Management of the acoustic environment

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Parental involvement

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Support for parental-infant bonding

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Supportive sensory environment

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Very early and continuous skin-to-skin contact

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