Having parents who are actively involved in the care of their newborn and who are in close physical and emotional contact with their baby as early after birth as possible and during hospitalisation can positively impact the short- and long-term outcome of their baby. This includes for example: less need for respiratory support, increased weight gain, improved breastfeeding, shortened hospital stay, less readmission to hospital, or better neurodevelopmental outcome. Active involvement also reduces parental stress, equips parents to take better care of their baby, and has positive effects on the parent-child relationship and family life at home, after hospitalisation.
• Enabling parents to care for their hospitalised baby and strengthening them to fulfil their parental role decreases parental stress and anxiety, improves physical health, and helps to prepare them for taking care of the baby after hospitalisation at home.
• Skin-to-skin contact as early after birth and as continuously as possible has positive and protective effects, including, e.g., the regulation of cardiac and respiratory rates, the prevention of sepsis, hypothermia and hypoglycaemia, and reduced hospital readmission. It has been linked to better reflexes at term and better development at preschool age and beyond. It also supports early initiation and continuation of exclusive breastfeeding.
• Early and exclusive breastfeeding and providing mother’s own milk have a positive impact on the baby’s short- and long-term physiological and neurodevelopmental outcomes.
Promote respectful, culturally appropriate and responsive infant- and family-centred developmental care and support, including the provision of necessary space and facilities. Educate parents so that they gain self-confidence, feel comfortable in fulfilling their parental role, and can bond with their baby.
• Engage parents from the beginning with good communication, education, participation in care giving, and decision-making.
• Keep the baby and parents together (zero separation).
• Facilitate and encourage skin-to-skin contact between baby and parents.
• Provide adequate space in the hospital unit and amenities allowing parents to stay.
• Educate and support parents with breastfeeding.
• Respect the parents’ right to information and consent in all treatments and interventions, invite them to participate in medical rounds.
• Recognize parents as the ultimate caretakers for their baby; listen to their concerns, and provide psychosocial support for their own well-being.
• Ensure mothers of inpatient preterm, small, or sick babies receive routine postnatal care and management of complications, including assessment and management of anxiety, depression, or any other mental health conditions.
• Promote responsive care and early stimulation through a stimulating environment to improve essential neurosensory development for preterm babies whose senses may only be beginning to develop.
• Educate and engage non-birthing partners to understand the needs, risks, and danger signs of pregnancy, childbirth, and the postnatal period. Provide space for non-birthing partners in health facilities.
• Test innovative parent-community / parent-healthcare provider partnership models to expand access to facility-based services and post-discharge follow-up care.
• Develop and implement programmes for financial and social support of families with low social or financial status or living in underserved, marginalised areas during hospitalisation. This should also include follow-up support.
• Develop, validate, and contextualize tools that measure types of support that parents, families, and newborns receive. Give them opportunities to provide feedback and to evaluate their care experience.
• Adapt care to the needs of adolescent mothers – ensure ample time is provided during consultations so that they fully understand the care provided to their babies and what is expected of them. Where possible, hold group counselling sessions with adolescents for peer support and to promote positive behaviour. Assess support available from partners and/or families, encourage their participation, and, if support is not available, explore community options to address this. Ensure linkage to mental health services especially during inpatient care for newborns.
• Create opportunities for sharing/mentoring by other parents to allay anxiety of parents/families.
• Adopt “Water and Sanitation for Health Facility Improvement Tool (WASH FIT): A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities”. Emphasize its use in Low- and Middle-Income Countries (LMIC).
With gratitude to: Survive and Thrive: Transforming care for every small and sick newborn, WHO, 2019.