Parent Contact.

Developmental care should incorporate the parents into the team effort. There are many benefits to parent-infant contact. For the baby benefits range from physical to developmental to psychological. For the parent it can promote the sense of being a parent and increase their comfort level in handling their fragile offspring. Much of the research reviewed has focused on mother-baby pairs, however, fathers also need to be considered as having the same potential affect on neonatal outcomes. In some cases the father may be the primary caregiver. Both parents are care-team members, advocates and can help provide continuity of care.

Research has shown that maternal-infant interaction plays a role in the neonate's brain development and developing sense of self.(1) Maternal interaction can regulate many behavioral and physical factors in the infant including activity level, sucking activity, O2 need and sleeping cycles; as well as hormonal, cardiovascular, immune and neuroendocrine responses.(1) The disruption of normal maternal-infant interaction can have an affect on a neonates ability to be organized. Education by demonstration and other means has shown to improve the quality maternal-infant interactions.(2) The quality of maternal-infant interactions has shown to be associated with decreased neonatal risk and improved cognition after the NICU stay. (3) NICU parents suffer extreme stress and are at high-risk for problems bonding with their infant. NICU nurses can promote high quality parent-infant interactions and provide opportunities for bonding thereby improving outcomes for infants as well as increasing the parents' satisfaction.

NICU nurses can promote parent contact throughout the NICU stay by encouraging handswaddling and appropriate vocal contact; providing opportunities for kangaroo care and holding; and by teaching parents routine hands-on care as well as about the physical and developmental needs of their baby. Early hands-on care by parents can increase the parents sense of being a parent, and promote continuity of care. NICUs can promote continuity of care through primary nursing and same-patient assignments, however, unit dynamics such as staffing and skill level needs can make this hard to maintain. Parent-caregivers will be present not only through-out the NICU stay but carry on continuity of care after the NICU stay as well. Over time, they are likely to know their babies better than any staff members will. Their NICU-educated input into caregiving decisions should be welcomed. As part of the caregiving team they should feel welcome in the NICU at all times. There should be very few times when parents are asked to wait or leave, such as when a sterile procedure is needed or a code is happening nearby. Some parents may need to be encouraged to step away only in order to take care of their own needs.