Neurodevelopmental Disabilities Fellow Oregon Health & Science University Portland, Oregon, United States
Background: Both parent and baby benefit from holding while admitted to a neonatal intensive care unit (NICU). Skin-to-skin care (SSC) involves placing an undressed neonate onto parent’s chest, and increases the dyad’s oxytocin levels and decreases cortisol levels and parental anxiety levels. SSC and regular parental holding improves infant neurobehaviors and developmental outcomes. Less holding occurs with more medical complexity. Holding tends to increase through a NICU stay, but is often not offered for neonates with clinical instability, critical tubes and lines, or use of oscillatory ventilation. Select conditions or treatments may impact holding practices, such as those receiving therapeutic hypothermia (TH) for HIE requiring temperature probes, umbilical catheters, and EEG, or those with congenital heart disease with early surgical intervention requiring intubation, sternotomy, and chest tubes. There is limited data on parental holding practices and no guidelines based on medical condition. The American Academy of Pediatrics (AAP) recently updated standards of care in the NICU to include family centered care (FCC), though there is little definition of what practices this should entail. Objective: We aim to explore current parental holding practices during various medical interventions used in NICUs across the United States. Design/Methods: This is an exploratory study, approved and overseen by our Institutional Review Board. A NICU provider survey was created examining holding practices during various medical interventions, including EEG, intubation, high-frequency ventilation, chest tubes, types of lines, sternotomy, and TH. We inquired about formal holding policies and who determines if a child is appropriate for holding. The survey will be distributed through AAP’s listserv for Section on Neonatal-Perinatal Medicine. Survey will be distributed and active collection November 2023-January 2024. Data will be presented using descriptive statistics, and analyzed for trends based on acuity, location, size of the unit, and holding practices in regards to medical intervention.
