miércoles, 24 de septiembre de 2014

Newborn ICUs With Private Family Rooms Benefit Preemies: Study: MedlinePlus

Newborn ICUs With Private Family Rooms Benefit Preemies: Study: MedlinePlus

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From the National Institutes of HealthNational Institutes of Health

Newborn ICUs With Private Family Rooms Benefit Preemies: Study

More close contact with mothers may explain greater weight gains, fewer procedures, less stress
Monday, September 22, 2014
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MONDAY, Sept. 22, 2014 (HealthDay News) -- Tiny preemies may fare better when newborn intensive care units (NICU) set up private rooms for parents to spend time with their infants, a new study finds.
Researchers at one children's hospital found that preemies gained weight faster, were more alert and were less distressed when their NICU switched from the traditional "open-bay" layout to private rooms for families.
The findings, published online Sept. 22 in the journal Pediatrics, add to evidence that private rooms are better for tiny newborns' health and development than the long-used open floor plan -- or what some researchers have described as a "baby barn."
The traditional NICU can be crowded, loud and generally stressful, explained lead researcher Barry Lester, who directs the Center for the Study of Children at Risk at Women & Infants Hospital of Rhode Island.
"With the single-family room NICU, you walk in and it's quiet. It's actually relaxing," Lester said.
More important, research has shown, that environment benefits newborns. Lester said his team's findings confirm that, and point to some reasons why -- including the bigger role for moms in caring for their babies.
"We see that mothers' involvement is really making a difference," Lester said. With the private rooms, his team found, mothers bathe their babies and breast-feed more often, and have more "skin to skin" contact with their newborn -- which research has shown to have a soothing effect on infants' nervous system.
And even with other factors considered, the study found that mothers' involvement still seemed to have a direct effect on their newborns' progress: On average, their babies required fewer medical procedures, were more alert and showed fewer signs of pain or distress.
One expert noted that any improvement in outcome matters.
"The benefits aren't dramatic. The babies aren't going home a week earlier," said Dr. David Mendez, a neonatologist at Miami Children's Hospital.
But, Mendez added, small steps in improving preemies' progress are important. "They're important from the hospitals' perspective, too," he said. Redesigning NICUs is expensive, Mendez noted, so hospitals will look to studies like this for evidence that the investment does benefit infants.
The findings are based on over 400 preterm newborns placed in the Women & Infants NICU in Rhode Island between 2008 and 2012. During that time, the unit was transformed from a traditional open-bay layout to one with private rooms. Lester's team took advantage of that "natural experiment" to compare newborns' outcomes before and after the change.
Overall, they found, newborns did better afterward. When the researchers looked for some explanations for the benefit, two factors stood out, Lester said: moms' involvement in feeding, bathing and changing diapers; and a type of care known as developmental support.
That means extra care for some of the early difficulties preemies can have; if they're having trouble feeding, for example, an occupational therapist can step in to help.
After the NICU switched to private rooms, 65 percent of infants received developmental support, versus 46 percent before. Lester said the added space, quiet and calm made it easier for staff to closely observe each newborn and give extra care when needed.
Mendez said the trend now is for NICUs to move to private rooms, and these findings give added support for that.
"It seems intuitive that it's better to be in a private room with your baby," Mendez said. "But we also need studies that show tangible benefits."
Now, he added, researchers should follow preemies over the long term, to see if those early benefits in the NICU lead to better health and development later on.
Another question is whether the findings at the Rhode Island NICU would translate to other hospitals. The families there were relatively well-educated and middle-class -- and Lester said that for low-income parents, it can be more challenging to take time from work and be with their babies in the NICU.
"It's not that they don't want to be there. They do," he said. "But it's hard."
And this study, Lester noted, shows that it's not just the layout of the NICU that matters. It's families' involvement.
"That's important," Lester said. "Parents do make a difference. They don't have to feel like they're just bystanders, crossing their fingers and hoping for the best."
SOURCES: Barry Lester, Ph.D., director, Brown Center for the Study of Children at Risk, Women & Infants Hospital of Rhode Island, Providence; David Mendez, M.D., neonatologist, Miami Children's Hospital; October 2014 Pediatrics
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