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Andrew B. Kairalla MD, Editor

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Highlights from the Southeastern Association of Neonatologists Meeting at Marco Island, May 15-18, 2003

Developmental Care in NICU
Presented by Robert Cicco MD, Western Pennsylvania Hospital, Pittsburgh PA.

Data to support Developmental Care in NICU:

Cochrane Review (2001)

• Better short-term growth
• Decreased respiratory support
• Decreased length of stay.

Meta-analysis by Jacobs et al (2002)

• Less mechanical ventilation
• Less supplemental oxygen
• Better development at 6-9 mos
• Better growth
• Lower hospital costs

The Bottom Line:

• Many proven short-term benefits to developmental care in NICU
• The long-term benefits are unknown
• There are no known adverse effects.

Lighting Recommendations:

• Constantly protect preterm infant eyes from direct bright light to prevent hyperpolarization of photoreceptors.
• Cycle light to provide periods of near-darkness (4-5 foot candles) at night and higher levels of indirect light (20-30 foot candles) during the day.
• Remove covers from incubators during the day.
• Staff requires areas of increased lighting, especially at night, to perform essential tasks and maintain competency and job satisfaction.

Standards for Sound:

Limits for background and transient sounds in NICU:

• Hourly Leq (average) – 50 dB
• Hourly L10 (<10% of time) – 55 dB
• Lmax (maximum sound) – 70 dB

Infant Handling in NICU:

• Cluster Care ("touch times")
• Containment (positioning devices)
• Allow sleep time
• Recognize feeding cues (prior to discharge, infants should be placed on ad lib demand feeding – no maximum, no minimum, no tube, no pushing).

Additional Comments: 

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