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From walls to warmth: How room design shapes parent-infant closeness in the NICU

2025-05-02

When newborns require intensive care, closeness between parents and infants can be difficult to maintain—especially in traditional open bay units. Research has long suggested that skin-to-skin contact and physical presence are vital for a newborn’s development and for fostering the emotional bond with their parents. A recent Dutch cohort study explored whether switching from an open bay unit to single-family rooms could support more parent-infant closeness. Based on observations from over 800 families, the results show that architectural changes led to longer daily presence of both mothers and partners, and increased physical contact with their infants. While the transition had measurable benefits, the study also emphasizes that further improvements are needed to meet current care standards. When a newborn is admitted to a neonatal intensive care unit (NICU), the environment can either support or limit the connection between infants and their parents. In open bay units (OBUs), care is often efficient for staff but leaves little space for privacy, intimacy, or prolonged parental involvement. Emotional and physical closeness—like skin-to-skin care or holding—are essential to reduce stress, strengthen attachment, and promote healthy development in preterm or critically ill infants. To investigate how architecture influences this closeness, researchers followed families before and after a Dutch NICU transitioned from OBUs to single-family rooms (SFRs). These rooms allow parents to stay with their child throughout the day and night, offering more privacy and comfort. The study measured how often parents were present, how long they held their infants, and how much skin-to-skin contact occurred.   More time, more contact: A space that fosters bonding The results were clear: SFRs significantly increased parent-infant closeness. Mothers’ daily presence doubled, from about 3.5 hours in OBUs to 7 hours in SFRs. Partners showed a similar pattern, with their presence rising from 3 to 6 hours per day. Skin-to-skin care also improved—mothers increased from 2 to nearly 3 hours a day, and partners from under 2 to more than 2 hours. Lap holding saw smaller gains, mostly for mothers. These increases were consistent across all gestational age groups and started as early as the first day of life. The study highlights that while SFRs support stronger bonds, even with this improvement, parental presence fell short of WHO and GFCNI (former: EFCNI) recommendations. This suggests that room design alone is not enough—staff encouragement, flexible routines, and family-integrated care also matter.   Designing care that includes families For parents, these findings offer hope: the environment can support their presence and involvement, even in the stressful NICU setting. For hospitals and care teams, the study reinforces that investing in SFRs can enhance emotional and developmental outcomes. However, to fully support closeness, physical changes should be paired with cultural shifts that truly integrate parents into the care team. Encouraging closeness isn’t just about architecture—it’s about prioritizing family-centered care. This study adds to the growing evidence that where infants heal can shape how they connect.     Paper available at: Effect of Shifting From Open Bay to Single-Family Rooms on Closeness in a NICU – PubMed Full list of authors: Wielenga, J.M.; Pascual, A.; Ruhe, K.; Aarnoudse, C.; van Kaam, A.H. DOI: https://doi.org/10.1111/apa.70108

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Enhancing postpartum care: A new review on follow-up strategies for mothers and newborns

2025-03-18

The postpartum period is a critical phase for both mothers and newborns, yet follow-up care remains inconsistent across healthcare systems. While global initiatives stress the importance of postpartum support, many women and infants do not receive adequate follow-up after leaving childbirth facilities. This gap in care can lead to undetected health complications, missed opportunities for intervention, and a lack of support for new mothers. A recent scoping review by researchers from the London School of Hygiene & Tropical Medicine examines different approaches to post-childbirth follow-up and their effectiveness.   Current methods of follow-up The study reviewed 31 research papers from high-, middle-, and low-income countries, identifying four main follow-up approaches used within the first 12 months postpartum: In-person visits – Conducted at home or in healthcare facilities, allowing direct medical assessment. Telephone calls – Used for checking maternal and newborn health, particularly in resource-limited areas. Self-administered questionnaires – Distributed by post or electronically to gather data on health outcomes. Hybrid models – Combining multiple approaches for better data collection and response rates.   Key findings and challenges The review found that post-discharge follow-up is feasible and important for identifying postpartum illnesses or complications that might otherwise be missed. However, it also highlights key challenges: Limited research on long-term postpartum complications, such as mental health issues and chronic pain. Gaps in cost-effectiveness analysis, with few studies reporting financial and resource implications. Low uptake of follow-up care in some regions, particularly where healthcare infrastructure is weak.   The need for better integration The findings suggest that structured follow-up could become an essential part of maternal and newborn healthcare, helping to detect complications early and provide timely support. However, more research is needed to evaluate the cost-effectiveness and sustainability of different follow-up methods. Healthcare providers and policymakers should consider integrating follow-up into routine care to improve maternal and neonatal health outcomes. This review provides a valuable resource for those involved in maternal and newborn health research, policy, and care provision. By strengthening post-childbirth follow-up, healthcare systems can address gaps in care and support the long-term well-being of mothers and newborns.   Paper available at: Current Approaches to Following Up Women and Newborns After Discharge From Childbirth Facilities: A Scoping Review – PubMed Full list of authors: Pepper, M.; Campbell, O. M. R.; Woodd, S. DOI: https://doi.org/10.9745/ghsp-d-23-00377

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Bridging the gap: Improving neonatal transport in Sub-Saharan Africa

2025-02-11

Neonatal transport plays a crucial role in ensuring newborns receive timely and specialised medical care, yet in Sub-Saharan Africa (SSA), transport systems are often unstructured and inadequate. A recent systematic review by Okai, Fair, and Soltani examines existing neonatal transport practices in SSA and evaluates the impact of low-cost interventions on outcomes. The study highlights significant gaps, including the reliance on informal transport methods and poorly equipped ambulances, which put vulnerable neonates at risk. Importantly, despite its proven benefits, no studies reported the use of Kangaroo Mother Care (KMC) in any transport scenarios. The review underscores the urgent need for structured transport systems, better-equipped ambulances, and the integration of cost-effective, evidence-based interventions to improve survival rates. Strengthening communication between referring and receiving facilities is also essential for continuity of care. Addressing these challenges could greatly enhance neonatal health outcomes across the region.   A recent systematic review titled “Neonatal transport practices and effectiveness of the use of low-cost interventions on outcomes of transported neonates in Sub-Saharan Africa: A systematic review and narrative synthesis” by Emmanuel Okai, Frankie Fair, and Hora Soltani, published in Health Science Reports in 2024, delves into the critical issue of neonatal transport in Sub-Saharan Africa (SSA).   Study Objective The study aimed to assess existing neonatal transport practices within SSA and evaluate the effectiveness of low-cost interventions designed to improve outcomes for transported neonates. This focus is particularly pertinent given that SSA accounts for approximately 43% of global neonatal deaths, with many infants requiring transfer to specialised care facilities after birth.   Methodology Researchers conducted a comprehensive literature search across multiple databases, including CINAHL, EMBASE, MEDLINE, Web of Science, African Index Medicus, and Google Scholar, covering publications up to March 2023. The inclusion criteria encompassed peer-reviewed studies detailing neonatal transport processes and outcomes within SSA. The review included 20 studies that met the criteria, involving 11,895 neonates from 10 countries.   Key Findings Transport methods: Caregivers often transported neonates via public means, carrying them in their arms with minimal communication between referring and receiving facilities. This lack of structured transport systems poses significant risks to neonatal health during transit. Ambulance services: Studies highlighted widespread deficiencies in both human resources and essential transport equipment when ambulances were used, undermining the quality and safety of neonatal transfers. Low-cost interventions: Notably, none of the reviewed studies reported the implementation of Kangaroo Mother Care (KMC) during transport. KMC, which involves skin-to-skin contact between the mother and infant, is a proven low-cost intervention that can regulate the infant’s temperature and provide physiological stability.   Implications The findings underscore a critical need for improved planning and resource allocation for neonatal transport in SSA. The prevalent reliance on unregulated public transport and the evident gaps in ambulance services reveal systemic weaknesses that targeted interventions could address. Implementing cost-effective strategies, such as training community health workers and integrating KMC during transport, could significantly enhance neonatal outcomes. Moreover, establishing structured communication protocols between referring and receiving facilities is essential to ensure continuity of care and preparedness upon arrival.   Conclusion This review illuminates the pressing challenges in neonatal transport within Sub-Saharan Africa and advocates for the adoption of low-cost, evidence-based interventions to improve survival and health outcomes for transported neonates. By addressing these gaps, healthcare systems in the region can move closer to achieving equitable and effective neonatal care.   Paper available at: Health Science Reports   Full list of authors: Emmanuel Okai, Frankie Fair, Hora Soltani   DOI: 10.1002/hsr2.1938

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