Developmentally supportive care to promote well-being in the neonatal setting

Developmental care in the neonatal unit is an area concerned with promoting the well-being of the neonate by implementing developmentally supportive measures and promoting an environment that minimises stress (Williams et al, 2018). Developmental care promotes positive neonatal neurodevelopment and behavioural outcomes involving many important components (Altimier and Phillips, 2013). This includes positive touch, providing appropriate sound levels and lighting, careful positioning and handling, promotion of sleep, minimising stress and pain, optimising nutrition and managing skin integrity, all emphasising the need to treat the neonate according to their behavioural and physiological cues. Parents should be involved with all aspects of the neonate’s care; we must look at the neonate and family as a whole and promote individualised, inclusive and culturally appropriate family integrated care. Preterm neonates who receive consistent individualised developmentally supportive care from birth demonstrate fewer behavioural stress cues and improved neurodevelopmental outcomes (O’Brien et al, 2018; Séassau et al, 2023). This chapter addresses the important elements of developmental care; namely, an overview of the concept (Figure 9.1), seven key components (Table 9.1), principles of good positioning (Table 9.2), recognising and minimising stress (Table 9.3), environmental care (Figures 9.2 and 9.3), pain management (Figures 9.4 and 9.5) and skin-to-skin care (Figures 9.6 to 9.8).