Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

A pivotal moment in the evolution of neonatal care

Journal of Perinatology volume 43, pages 538–539 (2023)Cite this article

Subjects

Abstract

While extraordinary advances have been made in the medical care of critically ill newborns, understanding the need of even the smallest of these infants for early, extensive, intimate human contact and facilitating the family’s role in the care of their baby has been much slower and inconsistent. There is abundant evidence for the essential role of nurturing parent–infant connections (bonding/attachment) for development of optimal physical, cognitive, and emotional health of all babies. It is time to leave behind the tradition of sensory deprivation and social isolation common in the care of high-risk infants. A paradigm shift is needed in neonatal care to acknowledge the critical importance of infant and family-centered developmental care and to remove any remaining constraints on a family’s ability to become full partners in the nurture of their NICU newborn.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

Data availability

This paper does not contain any previously unreported data.

References

  1. Fathi O, Nelin LD, Shepherd EG, Reber KM. Development of a small baby unit to improve outcomes for the extremely preterm infant. J Perinatol. 2022;42:157–64.

    Article  PubMed  Google Scholar 

  2. Banerji AI, Hopper A, Kadri M, Harding B, Phillips R. Creating a small baby program: a single center’s experience. J Perinatol. 2022;42:277–80.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Harlow HF, Dodsworth RO, Harlow MK. Total social isolation in monkeys. Proc Natl Acad Sci USA. 1965;54:90–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Kramer KP, Minot K, Butler C, Haynes K, Mason A, Nguyen L, et al. Reduction of severe intraventricular hemorrhage in preterm infants: a quality improvement project. Pediatrics. 2022;149:e2021050652 https://doi.org/10.1542/peds.2021-050652

    Article  PubMed  Google Scholar 

  5. Klaus M, Kennell JH. Maternal-infant bonding: the impact of early separation or loss on family development. CV Mosby Co.: St. Louis, 1976.

  6. Karlsson V, Heinemann AB, Sjors G, Nykvist KH, Agren J. Early skin-to-skin care in extremely preterm infants: thermal balance and care environment. J Pediatr. 2012;161:422–6.

    Article  PubMed  Google Scholar 

  7. Lee J, Parikka V, Lehtonen L, Soukka H. Parent-infant skin-to-skin contact reduces the electrical activity of the diaphragm and stabilizes respiratory function in preterm infants. Pediatr Res. 2021; e-pub ahead of print Jun 4;1–5. https://doi.org/10.1038/s41390-021-01607-2.

  8. White RD. Mother’s arms—the past and future locus of neonatal care? Clin Perinatol. 2004;31:383–7.

    Article  PubMed  Google Scholar 

  9. Toivonen M, Lehtonen L, Loyttyniemi E, Ahlqvist-Bjorkroth S, Axelin A. Close collaboration with parents intervention improves family-centered care in different neonatal unit contexts: a pre-post study. Pediatr Res. 2020;88:421–8. https://doi.org/10.1038/s41390-020-0934-2. Epub

    Article  PubMed  PubMed Central  Google Scholar 

  10. O’Brien K, Robson K, Bracht M, Cruz M, Lui K, Alvaro R, et al. Effectiveness of Family Integrated Care in neonatal intensive care units on infant and parent outcomes: a multicentre, multinational, cluster-randomised controlled trial. Lancet Child Adolesc Health. 2018;4:245–54.

    Article  Google Scholar 

  11. Welch MG, Myers MM. Advances in family-based interventions in the neonatal ICU. Curr Opin Pediatr. 2016;28:163–9.

    Article  PubMed  Google Scholar 

  12. Pineda R, Smith J, Roussin J, Wallendorf M, Kellner P, Colditz G. Randomized clinical trial investigating the effect of consistent, developmentally-appropriate, and evidence-based multisensory exposures in the NICU. J Perinatol. 2021;41:2449–62.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Beacon Children’s Hospital, South Bend, IN, USA

    Robert D. White

  2. Turku University Hospital, Turku, Finland

    Liisa Lehtonen

  3. Texas Children’s Hospital, Houston, TX, USA

    Kristina M. Reber

  4. Loma Linda University Children’s Hospital, Loma Linda, CA, USA

    Raylene Phillips

Authors
  1. Robert D. White
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Liisa Lehtonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kristina M. Reber
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Raylene Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RDW, LL, KMR, and RP participated equally in the preparation of this manuscript.

Corresponding author

Correspondence to Robert D. White.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

White, R.D., Lehtonen, L., Reber, K.M. et al. A pivotal moment in the evolution of neonatal care. J Perinatol 43, 538–539 (2023). https://doi.org/10.1038/s41372-022-01436-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-022-01436-z

This article is cited by

Search

Advanced search

Quick links