Supporting the parent-infant relationship: using the NBO in the neonatal intensive care unit

Gibbs, D.P. (2015). Supporting the Parent-Infant Relationship: Using the Neonatal Behavioural Observation in the Neonatal Intensive Care Unit. Journal of the Association of Paediatric Chartered Physiotherapists, 6, 1, 26-34.

Abstract

The birth of a preterm infant requiring admission to a neonatal intensive care unit (NICU) represents a major crisis for parents, in which they may struggle to establish meaningful and positive parent-infant interaction. The fragility of the infant and the level of care they require can serve to inhibit parent engagement with their infant. The incidence of parent stress in the NICU and its association with psychological distress can also impact on the development of a sensitive parent-infant relationship. Over a twenty-year period, the proposal and adoption of family-centred care principles has aimed to provide supportive care for both preterm infants and their families and enhance opportunities to build the parent-infant relationship. However, barriers still exist which will impact on the sustainability of family-centred care principles within the neonatal setting. Building on the strengths of the Neonatal Behavioural Assessment Scale, the Newborn Behavioural Observations (NBO) system was developed as an infant-centred and family-focused relationship-building tool. The NBO is designed to help sensitise parents to their infant’s competencies and capabilities, with a view to helping them read their infant’s signals, understand their behaviour, and promote positive interactions between parent and infant. This paper aims to highlight the impact of a NICU admission on parenting and explore how the NBO may be implemented by therapists to promote positive parent infant interaction. It will also present a case study on the use of the NBO in the neonatal unit for high risk infants and their families as a process for supporting parents with anticipatory guidance as they increase their confidence in caring for their infant and prepare for discharge from neonatal unit to home.