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Developmental Care Standards for Infants in Intensive Care

Two adults, wearing surgical masks, cradle two newborn babies, each swaddled in hospital blankets. Thin medical tubes are attached to the babies. The backdrop is a light green curtain.

In 2015, the Consensus Committee of the Standards, Competencies, and Best Practices for Infant and Family-Centered Developmental Care in the Intensive Care Unit was formed with a group of interprofessional experts in order to produce a broad set of evidence-based recommendations for developmentally supportive care.

The Introduction provides a detailed background to the work of the committee and how these recommendations are intended to be used. Systems thinking should be the first area to examine after the Introduction as it provides evidence-based recommendation for change management and a checklist to start your unit’s self-evaluation. The committee believes this approach will ease the adoption of topical evidence-based best practices. Each topic section has its own recommendations, and these also complement other sections.

Using These Guidelines to Improve Care

The committee members performed a careful review and rated the evidence (1 through 7) according to the Hierarchy of Evidence for Intervention Studies by Melnyk and Fineout-Overholt in Evidence-Based Practice in Nursing and Healthcare. The evidence ratings were accumulated to provide a ranking of the strength of the recommendation based on the body of evidence, the ranking was adapted from the adapted from the Oxford Centre for Evidence-based Medicine (A through D). The committee also identified gaps in the literature in each area. This web document is the full report of the committee and an executive summary is in press, in the Journal of Perinatology. The work of the Committee was supported by an educational grant from Pampers Professional.

Consequently, based on the mounting evidence of the neuroprotective aspects of infant family centered developmental care (IFCDC) and the importance of supporting infant mental health (IMH), it is critical that the baby’s behavioral communication and the nurturing relationship of the parent(s)/family be central to managing and delivering care. Practices that support the message and interaction of the baby and parents can no longer be viewed as “additional” or “optional”, but should be integrated as an essential part of medical management, and caregiving for babies and their families.

If you have feedback, please contact Carol Jaeger, DNP, RN, NNP-BC at caroljaeger75@gmail.com.

Infant and Family Developmental Care (IFCDC) Standards, Competencies, and Best Practices for Infants in the Intensive Care Unit

Proposal of New or Revised Standards

Effective developmental care in intensive care settings requires an approach that prioritizes both the infant's needs and the active involvement of their family. These guidelines address key aspects like positioning, sleep, pain management, and nutrition to support holistic care.

Infant and Family-Centered Developmental Care (IFCDC) infographic detailing standards and recommendations for infants in intensive care. Key areas include systems thinking, individualized positioning and touch, sleep and arousal interventions, skin-to-skin contact, pain and stress management, and feeding and nutrition. The infographic emphasizes the importance of integrating parents as partners in care and supporting the infant's unique needs.
Download PDF for Infant and Family Developmental Care (IFCDC) Standards, Competencies, and Best Practices for Infants in the Intensive Care Unit

Systems Thinking in Complex Adaptive Systems

  • Are the baby and family central to the mission, values, environment, practice & care delivery of IFCDC in the unit?
  • Are the parents of each baby fully integrated into the team and treated as essential partners in decision-making and care of the infant?
  • What are the strategies and measurements used to improve and sustain IFCDC in the unit?

Positioning and Touch for the Newborn

  • Are the positioning plans therapeutic and individualized, given the care needs and development of the baby?
  • Are the positioning and touch guidelines continually reviewed by the team, including the parents, and adapted to meet the changing comfort needs of the baby?

Sleep and Arousal Interventions for the Newborn

  • Can the team confidently describe the “voice” or behavioral communication of the baby?
  • Are the baby's unique patterns of rest, sleep, and activity documented by the team and protected in the plan of care?

Skin-to-Skin Contact with Family Members

  • Is the practice of skin-to-skin contact supported and adjusted to the comfort needs of each baby, parent, & family member?
  • Are the parents & family members supported to interact with the baby to calm, soothe, & connect?

Reducing and Managing Pain and Stress in Newborns and Families

  • Are parents supported to be present and interactive during stressful procedures to provide non-pharmacologic comfort measures for the baby?
  • Are there sufficient specialty professionals to support the wellbeing of the team, including parents, families, and staff? Examples include mental health, social, cultural, & spiritual specialists.

Management of Feeding, Eating, and Nutrition Delivery

  • Are the desires of the mother central to the feeding plan? Is this consistently reflected in documentation with input of the mother?
  • Does the feeding management plan demonstrate a feeding & nutrition continuum from in-hospital care through the transition to home & home care?

Standards and recommendations from Consensus Panel on Infant and Family-Centered Developmental Care, 2022

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Developmental Care Standards Downloads

Access essential documents and guidelines related to the standards for developmental care in intensive care settings:

IFCDC Recommendations

Explore detailed recommendations and best practices from the Infant and Family-Centered Developmental Care (IFCDC):