In different countries neurodevelopmental care in the NICUs definitions are different. What do you think about this?
Do you think only skin to skin care is enough? or other things are also important.
I consider several things to be part of developmental care...skin-to-skin, clustered care, proper positioning and containment, light and noise modifications, cue-based care and feeding, and family focused care.
if skin to skin is not feasible, we can do infant massage. in addition to individualized care that includes cue based approach to promote neurological growth and development and to decrease stress. In addition to family centered care that supports and encourages breastfeeding and lactation as early as possible.
positioning, sensory activities like hand to mouth, sensory exploration of the face, tactile kinesthetic stimulation, visiual and auditory stimulation, flexor tone development activities, oromotor stimulation.
I consider several things to be part of developmental care: Family centred care, skin-to-skin, to decrease stress, positioning, preservation of the newborn sleep, to decrease light and noise, visual, tactile and auditory stimulation provided by parents and parents´s participation in the NICU.
The thresholds for positive versus negative exposures need to be defined. Too much can likely have adverse affects on health while too little can likley affect the optimization of outcome as well. Better defining when (PMA, in the midst of medical complications) and how much (dosing) of vestibular, tactile, kinesthetic, sound and language can enable the best neurodevelopmental care in the NICU.
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