Developmental Care: Creating a Stress-Free NICU Environment - Premature baby is cared for in the NICU

Developmental Care: Creating a Stress-Free NICU Environment

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Intensive care units for premature babies are stressful environments – for the parents of the small patients, the doctors, the nursing staff and for the babies themselves. Noise, bright light, medical examinations and early physical separation from mothers make life stressful for premature babies. Stress is exhausting and robs the baby of energy that should be used for neural development and growth. So it becomes crucially important to introduce a pro-developmental care NICU environment and reduce stress factors to the absolute minimum.

Nurse places hands on baby’s head and hand in the NICU

What is pro-developmental care?

External stimuli strongly influence the development of the brain and emotional maturation of premature babies. A holistic pro-developmental care concept should enable babies in the NICU to complete their interrupted intrauterine development with as little harm as possible by minimising external stress while promoting physiological stimuli. Specifically, it includes the following aspects:

  • Reducing noise levels (high frequencies in particular) 
  • Adjusting lighting conditions to assist the developing sleep-wake rhythm
  • Avoiding, or at least reducing, pain
  • Tailoring every aspect of care to the infant's physiological and emotional needs
  • Involving parents in the entire daily routine
  • Taking the emotional needs of parents into account
Nurse considers appropriate setttings for device in the NICU

Why is pro-developmental care important?

One major problem is that the brain is still not fully developed when a baby is born early. Normally this development happens in the last trimester of pregnancy – but in many premature babies, brain structure and therefore behaviour have to develop to maturity under the influence of external stimuli in the NICU. Often, the consequences of disturbances in this early phase of life do not become apparent until later. One reason for this is that the frontal lobe, which is responsible for the ability to learn and concentrate, matures later. Studies have shown that motor impairments can also result from the disruption of normal intrauterine brain development. Pro-developmental care reduces stress, helping to promote neural and physiological development and to reduce long-term issues.


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Parents with their premature baby in the NICU

Extending the care concept: family-centred care

Family-centred care (FCC) is an approach in which the parents are not "in the way" but, instead, important and equal partners when it comes to creating the best possible conditions for the baby. This extension of the pro-developmental care concept focuses on the parents of premature babies, with two goals. First, the parents should be encouraged in their role as the baby's primary caregivers. They should be helped with and integrated into the care process, because “parental tasks” such as changing nappies and bathing the baby are not as easy as with healthy, full-term infants. And second, the family should be given the best possible emotional and psychological support so that they can better cope with the stressful, daunting and often traumatic situation.

Caregiver’s hand rests on baby’s head in the NICU

Little patients. Big success stories

Alongside advancements in research and technology, the concept of pro-developmental care has gained traction around the world, leading to an increase in the survival rates and long-term success of premature babies. Take a look at some success stories of premature babies who are now flourishing children and amazing young adults.

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