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Visiting policies in neonatal intensive care units: staff and parents' views
  1. M REID
  1. Unit of Epidemiology
  2. Burlo Garofolo Children's Hospital
  3. Trieste, Italy
  4. Neonatal Intensive Care Unit
  5. Udine, Italy
  6. Department of Pediatrics
  7. University of Padova, Italy
  8. Neonatal Intensive Care Unit
  9. University of Modena, Italy
  10. Neonatal Intensive Care Unit
  11. Lecco, Italy
  12. Department of Public Health
  13. University of Glasgow, Scotland

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Editor—Findings from a study carried out in Italy as part of an international project on parental visiting1 may provide additional information in response to the points raised by Dr Harvey in his thoughtful commentary to our recent paper.2 Three third level neonatal intensive care units (NICUs) with an open (that is 24 hours a day) policy towards parental visiting were compared with two units restricting visiting to specified hours (“restricted” policy). Sixty doctors, 106 nurses, and parents of 80 consecutively admitted very low birthweight babies were interviewed.

The staff views are strikingly consistent with their unit policy (table1), with doctors and nurses in units that restrict parental visiting being less convinced about its value, and more fearful of interference with everyday routines.

Table 1

Staff and parental views on NICU visiting policies

Most mothers would like to be able to visit more; however, only in the two restricted policy units are hospital regulations felt to be the major limiting factor.

The over threefold higher proportion of babies fed with maternal milk at four weeks in the open policy NICUs cannot be accounted for by a number of potential confounding variables, either related to the baby or to the mother.3

Patterns of counselling appear not so much linked with unit policies, as with parental role. A total of 42% of fathers received the first communication about their baby's conditionwithin one hour from delivery, and 10% later than 24 hours. The corresponding figures for mothers are 21% and 25% respectively, with no difference between inborn and outborn babies. Over 90% of fathers were directly informed by a doctor, whereas 41% of mothers were informed by their partner. In accompanying comments, many women expressed discomfort, and asked for earlier, first hand communication from the doctor in charge of their baby.

Almost a decade divides this study from the EURONIC survey,1 but the high proportion of NICUs still restricting parental visiting in some countries shows that these findings are still relevant. As Dr Harvey rightly points out, education of staff and parents is needed to stimulate change.