Joy Voyles Browne, PhD
Adjunct faculty, Infant & Early Childhood Development
April 16, 2020
During this tenuous time of needing to provide protection for both hospital staff and the larger community, many policies in hospitals have included restricting visitors from being with their hospitalized loved ones. Policies include restrictions for “visiting” babies in intensive care. Many ICUs are preventing all family members from being with their babies, some have changed their policies to allow one parent to be with their baby. Regardless of current policies and protections, it is imperative that we change our thinking about how babies and mothers need to be together right from the start.
A shift of our thinking about parents as essential to the outcomes of their babies’ health and development reflects a large body of literature about the essential aspects of the mother’s regulation (both physiologically and emotionally) through her presence. Additionally, the benefits to the mother’s health and emotional stability and the adverse effects of separation during this sensitive period are well documented. Mothers and newborns need to be building a foundation for long term regulation, relationships and mental health. As a result, we no longer see the baby as separate from the mother, and in fact, we now realize that the focus of our work is with the dyad. We are moving to “zero separation” policies of mothers and babies in many hospitals from the delivery room to the recovery room to the intensive care room.
Following the line of thinking that the “patient” is the mother/infant dyad (considered as one co-regulatory unit), and based on the mother’s need for support during the stressful hospitalization of her baby, it is imperative that the mother never be restricted from being with her baby. When thinking further about the dyad’s need for support, an important consideration is for there to be allowance for an additional family member (typically the father, but often another significant person identified by the mother) to be permitted to be with them in intensive care.
This approach does not negate the need for scrupulous screening of the baby, the mother, the family member and the staff. Instead, it emphasizes protective measures and careful monitoring of anyone who engages with the baby. As many mothers and fathers are currently self-isolated, it may be an opportunity to change policies so that mothers in particular are afforded appropriate space and other supports to be able to be with their baby consistently and intimately into the future.
There is an urgency to ensuring that babies and mothers are kept together in order to avoid downstream effects on the mother’s and baby’s health and development. It is imperative that what is scientifically known about the importance of the physiologic and psychological benefits be taken seriously and that policies, procedures and environments are adapted appropriately and with as much haste as is possible.