For infants born at 33 weeks' gestation or earlier, Family Integrated Care (FICare) in neonatal intensive care units (NICUs) is associated with improved infant and parent outcomes, according to a study published online in The Lancet Child & Adolescent Health.
In this multicentre, cluster-randomised controlled trial, we stratified 26 tertiary NICUs from Canada, Australia, and New Zealand by country and size, and assigned them, using a computer-generated random allocation sequence, to provide FICare or standard NICU care. Eligible infants were born at 33 weeks' gestation or earlier, and had no or low-level respiratory support; parents gave written informed consent for enrolment.
To be eligible, parents in the FICare group had to commit to be present for at least 6 h a day, attend educational sessions, and actively care for their infant. The primary outcome, analysed at the individual level, was infant weight gain at day 21 after enrolment.
Secondary outcomes were weight gain velocity, high frequency breastfeeding (≥6 times a day) at hospital discharge, parental stress and anxiety at enrolment and day 21, NICU mortality and major neonatal morbidities, safety, and resource use (including duration of oxygen therapy and hospital stay).
The researchers found that weight gain was greater in the FICare group than in the standard care group at day 21 (mean change in Z scores, 1.58 versus 1.45; P < 0.0001). In infants receiving FICare, average daily weight gain was significantly higher than that seen in those receiving standard care (mean daily weight gain, 26.7 versus 24.8 g; P < 0.0001).
For infants in the FICare group, the high-frequency exclusive breastmilk feeding rate at discharge was higher than that seen in those in the standard care group (70 versus 63% ; P = 0.016). Parents in the FICare group had lower mean stress and anxiety scores at day 21.
"FICare improved infant weight gain, decreased parent stress and anxiety, and increased high-frequency exclusive breastmilk feeding at discharge, which together suggest that FICare is an important advancement in neonatal care," the authors of the study write. "Further research is required to examine if these results translate into better long-term outcomes for families."