54 - Barriers and Enablers of Parental Visitation in the Neonatal Intensive Care Unit

Poster Number: 54
Publication Number: 54.563

Background: Early social connections and bonding within the infant-parent dyad are biological imperatives to healthy brain development. However, daily life demands paired with medical complexities in high -risk infants admitted to the neonatal intensive care unit (NICU) results in shorter and less frequent parental visits.

Objective: We investigated medical and socio-demographic barriers to parental visitation (PV) to the NICU and studied the effects of PV on expressed breast milk (EBM) provision and maternal mental health screenings.

Design/Methods: This descriptive study was conducted at Children's Memorial Hermann Hospital (CMMH) and the University of Texas – Houston Fetal Center (FC) from June-August 2023. Mother-infant dyads qualified if: (1) infant was prenatally diagnosed with a congenital anomaly, (2) mother received prenatal care at FC, and (3) mother delivered at CMHH. Primary outcome variables were mean time to first PV and first parental skin-to-skin contact (STS).

Results: Mean time to first PV and first STS were 7.6 hours (h) and 8.3 days (d), respectively. African-American and Hispanic parents averaged 3.5h and 12.5h (p=0.05) to first PV, respectively. English-speaking parents performed STS nearly three times sooner than Spanish-speaking parents (6.2 v. 17.5 d, p=0.044). Mean time to first STS in parents with private versus public insurance was 5.6d and 15.3d, respectively (p=0.045). Parents of infants receiving EBM at postnatal day (PD) 14 averaged 6.7h to first PV compared to 18.5h in infants not receiving EBM at PD 14 (p=0.016). Postnatal Edinburgh screenings in FC found ~40% of mothers included were prescribed medication for depression or anxiety, and nearly 33% were referred to perinatal psychiatry. Of mothers prescribed medication, mean time to first PV was 11.7h, compared to 5.2h in mothers not prescribed medication.

Conclusion(s): Hispanic race increased time to first PV, while Spanish-speaking and public insurance variables increased time to first STS. Infants receiving EBM had sooner and more frequent PV than those not receiving EBM. Time to first PV in mothers prescribed medication was 2.25x longer than mothers not prescribed medication. This delay highlights the vital need for attention to mental health support of infants and families in NICU. Future direction includes a larger, powered study to replicate pilot findings that may inform parental resilience programs. Correlation with infant neurodevelopmental outcomes throughout NICU stay and post-discharge is warranted.