Many hospitals in the world still do not recognise the importance and benefits of family-centred care. This hinders parents to engage in potentially life-saving care procedures, like kangaroo mother care or breastfeeding.
In a scientific study, Mendizabal-Espinosa and Warren identified obstacles regarding the implementation of family-centred care in neonatal intensive care units (NICU) of two publicly funded hospitals in Mexico. Data was gathered during a 10-month time period, by observing 29 parents (21 mothers and 8 fathers), their newborns, and 34 healthcare professionals (neonatologists, neonatal nurses, social workers, psychologists, a dietician and a manager). In addition, also interviews about how parents could be a part of their babies’ care were conducted with the parents and healthcare professionals. Follow-up interviews and observations took place with 18 of the families.
During the observations in the NICUs, interactions between parents, newborns and healthcare professionals during different care procedures were studied. This included mapping the participants’ movements in the NICU. From these observations, the researchers tried to find patterns and differences between parents and healthcare staff.
Results show that in one of the hospitals parents were only allowed to visit their baby for half an hour in the morning and afternoon. At another hospital, only one of the parents was allowed to see the newborn for one hour in the afternoon. This significantly lowered the possibility for parents to provide kangaroo mother care and on top of this, the extraction of breastmilk was more encouraged than breastfeeding itself.
Furthermore, the healthcare professionals felt judged by parents and stated that parents demand how their baby should be treated and that parents would not understand simple medical information. The staff therefore did not want to be watched by parents while taking care of the babies.
In addition, the professionals were convinced that parents carry germs into the NICU and therefore they did not want them to be close to the newborns. In contrast to this, many parents feared that doctors and nurses could cause infections, as they observed inconsistent sanitary practices from the personnel. The observations by the researchers showed that the parents’ concerns were correct and that healthcare professionals did indeed not always follow the hygiene guidelines appropriately, but parents followed them more carefully. Observations showed that even a priest was allowed into the NICU of one of the hospitals without having to follow any sanitary measures to prevent infection.
Overall, the healthcare professionals are aware of the benefits of kangaroo mother care and breastfeeding for newborns, and the Mexican government recommends family-centred care. Nevertheless, professionals are convinced that they are protecting the infants when they exclude parents, as they are considered as a risk factor for infections. This belief is preventing the parents’ involvement in newborn care and thus potentially life-saving care procedures.
This study shows, however, that parents do not pose a risk to the infants’ health and that healthcare professionals need to be further trained on the potentially life-saving benefits regarding the parents’ engagement in the care of their babies.
Paper available to view at: Wiley Online Library
Full list of authors: Rosa Maria Mendizabal‐Espinosa, Inga Warren