The Effect and Implication of Developmental Supportive Care Practices in Preterm Babies


Authors : Rakhi Chandel; Ratna Tadi

Volume/Issue : Volume 8 - 2023, Issue 3 - March

Google Scholar : https://bit.ly/3TmGbDi

Scribd : https://bit.ly/3KydNeR

DOI : https://doi.org/10.5281/zenodo.7797210

With the growth in the field of Neonatology there is a noticeable decline in both neonatal and infant mortality rate; however, morbidity rate due to neurodevelopmental impairment has not shown any change for the babies who are born preterm. Before the delivery the preterm baby is in the safe environment i.e. inside the mother’s womb but immediately after birth the preterm infant has to undergo through a lot of stressful environment in the Neonatal Intensive Care Unit (NICU). These stressful sensory experiences can be harmful for the brain development of infant. This stressful environment may include events such aspainful medical procedures, excessive light, excessive noise, disturbed sleep, and most importantly separation from mother. As per the previously done researches, in the developing foetal brain the positive sensory input are replaced by negative sensory inputs which in turn can permanently alter the normal brain development among the preterm babies. For the optimal development of preterm newborn’s brain and neurobehavior, an evidenced based intervention- ‘Developmental Supportive Care (DSC) practice’ can be effective. It stimulates normal motor functions, sensory neurological development, supports stability of autonomic nervous system and promotes organization of behaviour states of preterm babies and also reduces the stress of NICU environment. This paper aimed to provide a systematic review of literature on ‘Effects and implications of developmental supportive care (DSC) for preterm babies in NICU’. Method- an electronic search was conducted using the keywords: “Developmental supportive care, preterm baby, NIDCAP, family centred care, neurobehavioral capacity neuroprotection environment and Swaddling”. Studies conducted from 2000 - 2020 were fetched from five different research databases (PubMed, Cochrane, CINHAL, Scopus, and Google Scholar). The study search was executed from January to December 2020. A sum of 74 articles were identified which were fulfilling the inclusion criteria, out of which 24 studies (quantitative and qualitative) were involved in this systematic review. During the first stage of review, two researchers singly appraised the titles and abstracts which were followed by second stage of the full text review. Data were individually extracted.  Result All the reviews incorporated in this review article have shown positive results and supporting the developmental supportive care for the preterms babies and their families and none of the review have found any negative impact on the preterm babies. For their outcome measures most of the conducted studies have assessed short term outcome measures at discharge. The considerable areas where positive results are identified include- feeding behaviour, growth, reduced hospital stay, improved neurobehavioral, neuro-physiological, and neuro-structural functioning.  Conclusion For improving the brain and neurodevelopment among preterm babies in NICU, Developmental supportive care is an effective evidenced based intervention. In spite the fact that DSC is very effective, its implication is limited in NICU. Healthcare workers including nurses and doctors plays a major role for its implication in NICU setting.

Keywords : Developmental Supportive Care, Preterm Baby, NIDCAP, Family Centred Care, Neurobehavioral Capacity and Neuroprotection Environment, Individualized Developmental Supportive Care, Nurse’s Perception

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