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The birth of any baby represents a sudden and intense change in the environment. Inside the womb the atmosphere is quiet with dimmed lighting, supportive positioning and consistent temperature. Premature and unwell term infants are unprepared for the harsh environment that they often face on NICU. Evidence suggests that the greater the degree of prematurity, the more negative an effect the harsh reality of the NICU environment can have on the infant. Taking this information into account, neonatal units worldwide try to minimise the risk to infants they care for by endeavouring to change and minimise the hostile environment in which they care for these vulnerable infants.

 

Light

 

Bright and harsh lighting with the neonatal unit can cause infants to become uncomfortably aroused and affect sleep-wake cycles. These infants are unable to sleep, but also unable to interact due to the harsh environment, thus hindering growth, wellbeing and social interaction.

 

Medical practitioners are aware of the detrimental effect of harsh lighting upon a premature or unwell infant’s wellbeing. Therefore, measures are taken to try to reduce the amount of inappropriate light your infant receives during his/her stay in neonatal services. Cot and incubator covers are used to absorb noise and to allow light at appropriate times, such as when your baby is awake and wanting to interact. This encourages sleep and helps to promote sleep-wake cycles throughout your baby’s stay. Thick, soft blankets are used to surround your baby, which not only provide comfort and supported positioning, but also help to absorb residual noise from outside the incubator or cot.

 

Staff are encouraged to ensure that each infant is appropriately covered at times when bright light is required, such as during an emergency, procedure or ward round. Lighting within the unit can be modified to emit night lights, spotlights are in place for each individual cot space so as not to disturb other infants with harsh fluorescent lighting and outside brightness from large windows is reduced.

 

There are inevitable limits to the amount of light reduction, especially in an intensive care environment, and it must be remembered that whilst every effort is made to reduce the amount of harsh lighting your baby receives, sometimes it is inevitable simply due to the nature of the work that takes place within the unit.

 

Parents are encouraged to interact with their baby, especially during alert and interactive states.

 

Noise

 

Excessive noise within the neonatal unit can cause distress and instability for the premature or unwell infant as well as affecting sleep-wake cycles, increasing the likelihood of hearing loss, hearing and language delays and creating increased stress for parents. Efforts are made to reduce the amount of unnecessary noise within the unit thus minimising these risks. Staff are encouraged to talk in quiet, hushed tones, and wear quiet-heeled footwear, handover takes place outside the nursery, incubators are designed to minimise noise exposure, alarms within the unit have volume control, bins have quiet closing lids, telephones and nurses stations are situated outside the nursery and cot or incubator covers, along with soft quilted blankets, are used to absorb residual noise. Day-night cycles are encouraged by trying to provide a quieter environment during the night to aid growth and wellbeing.

 

However, it must be remembered that whilst every effort is made to reduce excessive noise within the neonatal unit, sometimes, such as during an emergency, procedure or ward round, some noise cannot be avoided. Parents are encouraged to talk to their baby, as evidence suggests that the human voice, especially from a parent, is an infant’s preferred sound. You can help achieve this by reading to your baby for brief periods, talking to him/her whilst providing nappy/mouth care and talking to him/her whilst having kangaroo cuddles.

 

Warmth

 

Upon arrival within the neonatal unit, you will experience a very warm environment. This is because premature and unwell infants cannot regulate their own body temperature as effectively as well, term infants. The cramped environment and heat from equipment adds to the heat within the unit. Your baby may be nursed in an incubator, or heated cot, and will have his/her temperature closely monitored. Initially, he/she will not be dressed so that staff can assess and tailor care to your baby’s needs.

 

Parents are encouraged to have their baby out for cuddles and you shouldn’t be afraid of your baby becoming too hot or cold when out of his/her cot. Evidence suggests that kangaroo cuddles actually help an infant to regulate his/her body temperature more effectively. You will also find that your own body temperature increases or decreases according to your baby’s requirements. Parents are also encouraged to remain well hydrated during their visits to the neonatal unit.

 

 

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