Infants born preterm are at high risk of developing speech, language and communication difficulties. We recognise the supportive framework of Family Integrated Care within the neonatal setting which is essential in enabling parents to bond with their infant through strategies such as skin to skin care, responding to infant cues and developing confidence with everyday care. Early bonding strategies are important skills for allowing parents and carers to develop their own unique communication style with their infant that can then be built on to establish a positive and interactive communication environment. We feel that much of the literature in neonatal care does not adequately address the development of good communication from a linguistic perspective; given that preterm infants are at risk of developing speech, language and communication difficulties we are undertaking research that addresses this ’gap’.
Project aim:
To investigate nurses’ and parents’ understanding of factors that enhance or hinder communication and early interaction between preterm infants and their parents after experiencing care on a neonatal unit.
Rationale:
For parents, learning to interact with their infant on a neonatal unit presents an unexpected complication with time being needed to develop confidence and coping mechanisms within a challenging healthcare setting. Becoming attached to an infant through involvement in care can support physical and emotional closeness for both the infant and parents/carers; this provides important skills for developing parent-infant interaction and communication. Specifically, vocal stimuli from parents/carers can improve preterm infant stability and enable better feeding development. Promoting early communication strategies to enhance parental/carer sensitivity to an infant through eye contact, initiating talking and responding using natural gestures and facial expressions can all increase attachment and bonding as well as support improved parent well-being and the interpretation of early infant communication signals.
The need to explore infant interaction in the early stages of development is an urgent necessity which has been made worse by the increase in mask wearing as part of protective personal equipment (PPE) use. This and reduced parent visiting during the pandemic highlighted that communication and interaction is essential for infant development, but is poorly understood. Healthcare practitioners, for example nurses and speech and language therapists, are in a unique position to provide support for parents to enable the development of confident and competent communication skills during limited visiting times.
Background:
There are few studies that have investigated early communication between preterm infants and their carers within a neonatal unit, and whether these are effective. Research that has examined areas such as early feeding (tube and oral) and skin to skin care, often allude to the importance of communication when discussing outcomes. Such approaches are important but much of this work fails to address the necessary skills to facilitate the development of early communication.
Preterm birth is a risk factor for a range of difficulties including an increased risk of developing communication and language problems. The ongoing use of face masks has impacted on bonding, developing confident infant care skills and learning to be a supportive and responsive communicator. In addition, the skills necessary to enable positive communication for both preterm infants and their carers, are poorly understood by neonatal practitioners; this therefore limits the quality of interaction that parents can be encouraged to participate in. Very few studies have described core elements of early communication with preterm infants even though there is a critical need to do so.
