Inspired by the March of Dimes report Toward Improving the Outcomes of Pregnancy, several organizations formulated developmental care and hospital design guidelines.  In 1993 an open, multi-disciplinary conference on NICU design and care led to the creation of a multi-disciplinary committee of neonatologist, nurses, researchers, architects, and regulators. They convened to review current evidence on the physical environment of the NICU and this led to the First Recommended Standards of Newborn Intensive Care Unit Design.  The Consensus Committee has continued to meet and update the recommended standards and this is the 9th edition. 

The multi-disciplinary conference continued and became the Gravens Conference on the Environment of Care of the High-Risk Newborn. Out of this meeting, there was a call to develop a multi-disciplinary consensus on developmentally supportive care practices, in addition to the physical design recommendations.  

The Consensus Committee was assembled with nursing, neonatology, physical and occupational therapy, psychology, social work, speech-language, and parent support professionals. 


Developmental Care Standards for Infants in Intensive Care

Positioning and Touch

“Imagine…holding your daughter’s hand, and its entire width fits across the tip of your finger.”*  

Standard 1, Positioning and Touch:  Babies in intensive care settings shall be positioned to support musculoskeletal, physiological, and behavioral stability.


Support Sleep and Arousal

Imagine…one day being able to rock my twin sons to sleep without tubes and equipment.”*

Standard 1, Sleep and Arousal:  Intensive care units (ICUs) shall promote developmentally appropriate sleep and arousal states and sleep wake cycles. 


Skin-to-Skin Contact

"Imagine....feeling frightened at the thought of holding your baby.... then turning the fear into confidence when your nurse guides you to do skin-to-skin care with your baby. I loved this time with my daughter; she always seemed so peaceful sleeping on me.”*

Standard 1, Skin-to-Skin Contact:  Parents shall be encouraged and supported in early, frequent, and prolonged skin-to-skin contact (SSC) with their babies.  


Call for Photos!

Call for Photos!

Over the years, many families have presented their story at the annual Gravens Conference. As a result, their thoughts, observations, and feelings have impacted the NICU collaborative team to make change to improve care, include parents and families in care and decision-making, and bring families to the table as advisors and teachers.

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