Single family rooms that enable parents to stay with premature babies slash serious infections

Single family rooms that enable parents to stay with their premature babies in hospital slash serious infections by more than a third, according to new research.

A study of around 5,500 infants found the facility reduced cases of sepsis, or blood poisoning, by 37 per cent.

The babies were also 31 per cent more likely to be exclusively breastfed after they were discharged.

Study leader Dr Sophie van der Schoor, of OLVG (Onze Lieve Vrouwe Gasthuis) teaching hospital in Amsterdam, said: “Our findings support future development of single family rooms in neonatal units to reduce sepsis and improve breastfeeding rates during hospital stay.”

In the UK most neonatal units are an open ward where parents can’t be with their babies 24 hours a day.

The study published in The Lancet Child & Adolescent Health supports the growing trend towards building more single family rooms for them

However it also suggested they have little effect on long-term neuro-development for extremely premature babies born before 28 weeks gestation.

Dr Sophie van der Schoor said: “But to establish whether single rooms have an impact on long-term neuro-development we also need well-designed studies to examine the vast majority of pre-term infants who are born after 32 weeks gestation, in whom no follow-up studies have been done.”

Her team pooled data on clinical outcomes of infants across the world cared for in single family rooms compared with open bay units between 2004 and 2018.

It included data on premature babies who were were assessed for their cognitive, motor and language development using a standardised test at 18 to 24 months.

Sepsis affects up to a quarter of premature babies while establishing breastfeeding in hospital is also a major challenge.

Both have implications for mental development.

Prematurity is the main complication of pregnancy – affecting more than 14.9 million babies worldwide every year.

Delivery at any gestation other than full term can impair brain development – increasing the risk of poor neurocognitive outcomes.

Pre-term babies often spend their first months after birth in neonatal intensive care units and are usually cared for communally in open bay units.

Nurses provide routine care and parents are welcome in most units at any time.

But there are concerns excessive stimulation from noise and lights, separation from parents and infections may jeopardise neuro-development – and survival.

This has led contributed to a rise in hospitals building private rooms instead of open bay units.

Centres across the United States and Europe are increasingly adopting this approach.

Four years ago Barnet Hospital offered the first neonatal single-room design of this type in the UK.

The Starlight unit now has 10 rooms which offer this kind of care. Previously premature babies were cared for in a traditional, open ward.

The rooms – known as individualised care rooms – allow a newborn baby to receive care and treatment in a private, family-centred setting.

The rooms can support a newborn baby’s brain development by limiting extraneous light and noise.

The rooms have space for parents to stay with their newborns 24-hours a day, allowing them to play a central role in the care of their child.

Each room is staffed according to the baby’s needs providing 24/7 support to parents.

But the potential benefits and harms the hospital environment has on the health, particularly neurodevelopment, of premature babies is hotly debated.

Research so far has produced conflicting results.

Dr van der Schoor’s is the biggest study of its kind to date.

There were no differences in length of hospital stay from birth to discharge home.

Rates of growth, chronic lung disease, rare cases of blindness rare cause of blindness, brain bleeding or mortality.

Dr van der Schoor said: “Although our study is based on all available data in the public domain, we did not find clear evidence of benefit of single family rooms on neuro-development.

“However, in all studies, outcomes were only assessed up to two years old, and some children who experience cognitive difficulties at school are classified as having normal neuro-developmental function at two years of age.

“Even for cases of severe cognitive deficit at later ages in childhood the accuracy of early detection is low.

“As neuro-cognitive deficits often take a long time to develop, more and longer follow-up studies are needed.”

Dr Jayanta Banerjee, a paediatrician at Queen Charlotte’s and Chelsea Hospital, who was not involved in the study, said the benefits shown “should be considered by healthcare policy makers and stakeholders assessing future development of single family rooms in neonatal units.”

However, he said: “But single family rooms also have some inherent disadvantages.

“The parents might feel more isolated from other parents and health-care professionals when caring for their infants in single family rooms, which might have deleterious effects on their stress and anxiety.

“The staffing in a neonatal unit would require rearrangement to cater for single family room care.

“Finally, provision of single family rooms would require major restructuring in most neonatal units, which would have a substantial economic effect on health-care costs and resources.

“Therefore, when building new neonatal units or redeveloping existing units, single family rooms should be seriously considered.”


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