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Family integrated care: what’s all the fuss about?
  1. Amy Young,
  2. Liz McKechnie,
  3. Catherine M Harrison
  1. Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  1. Correspondence to Dr Catherine M Harrison, Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, LS1 3EX, UK; catherine.harrison10{at}nhs.net

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Introduction

The WHO estimates that 15 million babies are born preterm every year. The Epicure studies, published in 1995 and 2006, showed an increase in survival for extremely preterm babies from 40% to 53% over the decade, but no difference in rates of morbidities despite technological advances over this time.1

The impact of having a premature baby on the family is also considerable, with parents incurring significant financial and emotional costs, as they endure long hospital admissions with parent–infant separation.

Prematurity is an independent risk factor for increased maternal anxiety, which can be reduced by increasing parental involvement in delivery of care.2 3 Despite this knowledge, the Picker Report, published in 2014 with 6000 parental responses from 88 neonatal units, noted that over a third of parents felt they were not involved in discussions about their baby’s management, and 60% felt unable to do as much skin-to-skin as they would like.4

With this in mind, should we change our approach to caring for our preterm population, by allowing parents to deliver part of their care?

What is family integrated care?

The concept of families providing nursing care for their loved ones is not new. This model has been used in low-resource settings for decades, primarily due to the lack of trained staff.

Levin was the first to describe the approach in a neonatal setting in Tallinn, Estonia.5 Termed the ‘Humane Neonatal Care Initiative’, it upholds that mothers’ and infants’ well-being is inextricably linked, citing the importance of maintaining the integrity of the ‘biological and psychological umbilicus’ to ensure optimum development for both. Here, after a baby is born, mothers move into the hospital and the parents provide all care until discharge.

Since then, the concept has assumed various, subtly different guises, including Family …

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