The Importance of Activities of Daily Living in the NICU: Nurturing Growth and Development
"Every moment of care in the NICU—feeding, holding, bathing—nurtures growth, connection, and healing." - Mary Coughlin
Today I want to dive deep into one of the core measures of Trauma-Informed Developmental Care (TIDC)—activities of daily living in the Neonatal Intensive Care Unit (NICU). This measure includes essential aspects like posture and play, mealtimes and nourishment, and skin care and bathing. These activities are foundational to nurturing growth and development for babies in the NICU, providing comfort to families, and supporting the clinicians who care for them.
Posture and Play
Posture and play are critical components of a baby’s development in the NICU. Proper posture supports physiological stability, growth, and motor development.
1. Optimizing Posture: Aligned posture for babies supports crucial physiological needs. These needs includes providing support for head and neck orientation to support breathing and eating, oftentimes using posture supportive aids to prevent unnatural development in the pelvic girdle, spinal curvature and limb alignment. These aids and postural alignment strategies not only protect optimal musculoskeletal development but ensure comfort as well.
2. Developmental Play: Engaging in gentle, developmentally appropriate play is vital for sensory and motor development. Simple activities like holding a baby’s hand, providing visual and auditory experiences, and encouraging serve-and-return movements encourage brain growth and development.
3. Tummy Time: Supervised tummy time, when appropriate, helps strengthen a baby’s neck and shoulder muscles and promotes motor skill development. It’s a foundational activity that sets the stage for future physical milestones.
Mealtimes and Nourishment
Mealtimes are not just about feeding; they are opportunities for bonding, social and sensory experiences, and ensuring proper nutrition for growth and development.
1. Breastfeeding and Bottle Feeding: Supporting breastfeeding is a priority, as it provides optimal nutrition and enhances bonding. Bottle feeding should be handled with the same care, ensuring that meal times are calm and nurturing experiences.
2. Hunger Cues: Recognizing and responding to a baby’s hunger and fullness cues is essential. This responsive feeding approach supports healthy eating patterns and reduces stress for both babies and caregivers.
3. Nutritional Support: Providing the right balance of nutrients is critical for growth. This may involve fortified breast milk, specialized formulas, and ensuring that dietary plans meet each baby’s unique needs.
4. Parent Presence and Partnership: Empowering parents to be actively involved in meal times fosters bonding and helps parents validate their role identity. Educating parents on evidence-based meal time practices and infant cues empowers them to create nourishing and nurturing mealtime experiences with their baby.
Skin Care and Bathing
Skin care and bathing are not just routine tasks; they are moments of comfort, bonding, and developmental support.
1. Gentle Skin Care: Premature and sick babies have delicate skin that requires gentle, specialized care. Using mild, non-irritating products and ensuring proper hydration protects their skin and promotes healing.
2. Bathing Rituals: Bathing is a time for sensory exploration and bonding. It should be a calm, soothing experience, with warm water and gentle touch. Bathing routines are parenting opportunities that facilitate bonding and attachment; the foundations for safe, stable nurturing relationships with their baby.
3. Massage: Incorporating gentle infant massage into skin care routines can promote relaxation, improve circulation, and support development. It’s a wonderful way for parents to connect with their baby.
4. Infection Prevention: Proper skin care practices are essential for preventing infections. This includes regular cleaning, monitoring for signs of irritation or infection, and using barrier creams as needed.
Why Activities of Daily Living Matter
Activities of daily living in the NICU are not just about completing tasks; they are about creating meaningful, nurturing experiences that support the overall well-being of babies, families, and clinicians. Here’s why they are so important:
1. Developmental Support: These activities are foundational for a baby’s physical, neurological, and socio-emotional development. Proper posture, play, nutrition, and skin care promote growth and help babies reach their physical and emotional developmental milestones.
2. Emotional Bonding: Mealtimes, play, and skin care provide opportunities for parents to bond with their baby. These interactions are crucial for the emotional well-being of both babies and families.
3. Comfort and Healing: Gentle, responsive care during these activities reduces stress and discomfort for babies. This supports their healing and enhances their overall experience in the NICU.
4. Empowering Families: Involving families in daily care activities empowers them, builds their confidence, and helps them feel more connected to their baby’s care journey.
5. Clinician Satisfaction: For clinicians, seeing the positive impact of these activities on babies and families enhances job satisfaction and reinforces the importance of their work.
Creating a Nurturing Environment
Let’s commit to making compassionate, trauma-informed activities of daily living a central part of clinical practice in the NICU. By focusing on posture and play, mealtimes and nourishment, and skin care and bathing, we can create a nurturing environment that supports the growth, development, and well-being of our precious patients and their loving families.
With heartfelt dedication,
Mary Coughlin
I’d love to hear your thoughts and experiences about the importance of activities of daily living in the NICU. Together, we can continue to enhance clinical practice and make a profound difference in the lives of babies and families in the NICU.
