Closeness and separation in neonatal intensive care

• Published in: Acta Paediatrica 2012-10, Vol.101 (10), p.1032-1037
• Main Authors: Flacking, Renée, Lehtonen, Liisa, Thomson, Gill, Axelin, Anna, Ahlqvist, Sari, Moran, Victoria Hall, Ewald, Uwe, Dykes, Fiona
• Format: Article
• Language: English
• Subjects: Babies; Biological and medical sciences; Brain - growth & development; Brain Chemistry; Diseases of mother, fetus and pregnancy; Family; General aspects; Gynecology. Andrology. Obstetrics; Health and Welfare; Health Facility Environment; Humans; Hydrocortisone - analysis; Hydrocortisone - physiology; Hälsa och välfärd; Infant behaviour; Infant, Newborn; Infant, Premature - psychology; Intensive care; Intensive Care Units, Neonatal - organization & administration; Intensive Care Units, Neonatal - standards; Intensive Care, Neonatal - methods; Intensive Care, Neonatal - psychology; Intensive Care, Neonatal - standards; Kangaroo-Mother Care Method; Medical sciences; Neonatal; Neonatal care; Object Attachment; Parent-Child Relations; Parents; Parents - psychology; Power (Psychology); Pregnancy. Fetus. Placenta; Preterm birth; Review; Touch
• ISSN: 0803-5253; 1651-2227; 1651-2227
• DOI: 10.1111/j.1651-2227.2012.02787.x

In this paper, we highlight the need for acknowledging the importance and impact of both physical and emotional closeness between the preterm infant and parent in the neonatal intensive care unit. Physical closeness refers to being spatially close and emotional closeness to parental feelings of being emotionally connected to the infant (experiencing feelings of love, warmth and affection). Through consideration of the literature in this area, we outline some of the reasons why physical closeness and emotional closeness are crucial to the physical, emotional and social well‐being of both the infant and the parent. These include positive effects on infant brain development, parent psychological well‐being and on the parent–infant relationship. The influence of the neonatal unit environment and culture on physical and emotional closeness is also discussed. Conclusions:  Culturally sensitive care practices, procedures and the physical environment need to be considered to facilitate parent–infant closeness, such as through early and prolonged skin‐to‐skin contact, family‐centred care, increased visiting hours, family rooms and optimization of the space on the units. Further research is required to explore factors that facilitate both physical and emotional closeness to ensure that parent–infant closeness is a priority within neonatal care.