Developmental, neuroprotective, trauma-informed care

Definition

Developmental care is an individualized approach of care that promotes the maximal potential of development for premature or sick infants admitted in neonatal care units. This philosophy of care is based on the infant’s behavior (cues) interpretation, specific intervention to maximize their adaptation to the extra-uterine environment as well as the involvement of parents in the care of their infants as early and completely as possible. This type of care promotes and maximizes the neurosensory integration essential to neurodevelopment, but also decreases toxic stress with a trauma-informed approach, and even prevents in some cases, long-term neurodevelopmental complications. It is thus, neuroprotective and trauma-informed.

Why is it so important?

When infants arae born prematurely, they possesses fetal competencies.  When they are hospitalized in the neonatal unit, there is a massive contrast between their previous intra-uterine life and the new extra-uterine one they are now facing.   Their senses, still immature, will be bombarded by inappropriate stimulations and experiences that they would  not have known in his mother's womb.   Moreover, they don't have the capacity nor the maturity to defend himself against these outside aggressions.  As for the term sick baby, they don't have the capacity of a healthy term newborn to communicate their needs, as their medical condition often prevents it.

However, as small or sick as they are, these infants can communicate with us through their body language, called behavioral cues.  As health care professionals and as parents, we must learn to decode this language and protect these infants by creating an environment appropriate to their development.  Precisely, developmental care helps us to understand their language, to respond to their needs accordingly and to interact with these infants, as they must continue their development in the neonatal unit, using their individual strengths and vulnerabilities.

This philosophy has many goals aiming to recreate optimal conditions for the development of these infants, but also to create a stronger attachment between them and their parents. Widely documented evidence-based of this approach are as important for the infants’ short, mid and long term outcomes but also for their parents, health care professionals and even the health care system, through the decrease of hospitalization costs.