The world through the eyes of a preterm baby / Welma Lubbe

Abstract

Coming into the world too early may result in a lot of stress for the preterm baby. However, if we understand this world better we can support these early arrivals to develop optimally and ensure that they have the best possible outcome. The intra-uterine environment is the best place for the unborn baby to be and supports optimal development during a critical developmental window. Seven sensory systems develop in a particular sequence as follow: Tactile, vestibular, gustatory, olfactory, auditory, visual and neurological systems. The neonatal intensive care unit may be the best place for the preterm baby to be and give her the best support to survive in the harsh adult world until she is mature and healthy enough, but this environment is very different from the supporting womb environment. In order to change the NICU environment to one that is closer to the comforting and supportive womb environment in which the baby is supposed to be developing, I developed the best practice guidelines (BPGs) for neurodevelopmental supportive care during my PhD. Neurodevelopmental supportive care is a care approach which aims to decrease the stress on the preterm infant by adjusting care in response to the infant’s development and communications. Eleven BPGs are presented including: environment, positioning, handling, individualized care, self-regulation, feeding, pain management, family centered care, family education, staff education and multi-disciplinary teams. I believe that initiatives such as neurodevelopmental supportive care will ensure the optimal development of premature babies and their parents during a traumatic life experience and as a result building a healthy nation.