Abstract:
Background: Healthy parent-infant interaction is crucial for the growth and development of the infant. Specifically, parental holding has substantial health benefits for both the infant and parent.
Purpose: Exploration of practices for parental holding related to common care, equipment, and procedures in neonatal intensive care units (NICUs).
Methods: A survey was developed and distributed through the American Academy of Pediatrics (AAP) Section on Neonatal Perinatal Medicine (SoNPM) to physicians and advanced practice providers. Data were analyzed using descriptive statistics and thematic analysis.
Results: Peripherally inserted central catheters and conventional ventilators had the highest reports of allowing parental holding (86% and 41% reporting “always,” respectively) and no reports of “never.” Parental holding was infrequently permitted during therapeutic hypothermia, with chest tubes in place and receiving high-frequency ventilation (43%, 25%, and 20% reporting “never,” respectively). In the free-text responses, a variety of factors were identified as barriers to parental holding, including equipment limitations, infant clinical instability, and unit culture and staffing.
Implications for practice and research: Despite the known benefits of parental holding, wide variability in NICU holding practices exists. Importantly, no medical intervention in this study was unanimously associated with restricting parental holding, suggesting that safe and feasible approaches to holding exist across clinical contexts. This highlights the critical need to document and disseminate these practices to inform and advance standards of care. The development of national standardized holding guidelines is a viable pathway forward to eliminate variability in individual perceived safety barriers and provide a pathway to improving family-centered care in the NICU.
Reference:Garavatti E, Calder T, Scottoline B, Ondusko DS. Parental Holding Practices in the Neonatal Intensive Care Units in the US: A Survey of Physicians and Advanced Practice Providers. Adv Neonatal Care. 2025 Dec 9. doi: 10.1097/ANC.0000000000001328. Epub ahead of print. PMID: 41364535.