Developmental care (DC) is a system used to care for preterm newborn infants which endeavours to enhance the development of the baby through a type of intervention which benefits both the infant and its family as it takes both as a single unit.

DC is based on a philosophy which covers the concepts of dynamic interaction between the newborn infant, the family and the environment, and is applied to the neonatal period. Intervention includes improvement to the environment with respect to light, noise, etc, as well as to the microclimate in which the child develops (position, handling, discomfort, etc.). Furthermore, the family is involved to facilitate its role as the main care provider of the child.

For many years now DC has been automatically implemented in many European countries. In our country, a great effort has been made towards its incorporation over the last few years.

Some of the care techniques involved are simple measures, such as: controlling noise pollution, placing coverlets for incubators, making staff aware and decreasing the intensity of alarms, controlling light intensity with adjustable spotlights, establishing quiet hours to allow infants to rest, instigating a protocol of minimum handling, taking measures to maximise comfort and pain control, using baby units or bars to ensure position and flexion, using sucrose as a painkiller during any handling which may inflict pain, making a scale for pain assessment, allowing parents and other family members to care for their children thereby improving their development, and promoting breast-feeding.

Parental contact

All newborns, whether preterm or not, are born with the urgent need to find their mother as she represents the safest environment.

The World Health Organisation, (WHO), recommends not separating the newborn from its mother as this may be harmful to the physical, emotional and mental health of both the infant and its mother. Being close to its mother enhances psychomotor development, improves stimulation and increases the infant’s sense of security. Skin-to-skin contact between the baby and its mother directly after birth regulates the infant’s heart beat, temperature, blood sugar and immune system.

Increased mother-infant interaction enhances the mother’s sense of security and self-confidence. Separating the two causes a feeling of insecurity in the newborn and subsequently cause stress.

Kangaroo mother care

Today, kangaroo mother care is one of the most valuable tools we have to increase the positive stimulants received by the preterm newborn infant in order to improve its development. It enhances the bonding between parents and children, their mutual understanding and increases parental confidence and competence. Its easy application combined with the absence of any negative effects has boosted its application in all Spanish units.  Although in some cases there is no alternative to separating the newborn from its mother, the ideal situation is when the baby is placed on its mother’s chest immediately after birth and is observed and identified without separating mother and infant.

The implementation of this type of care leads to important changes in work routines. The child and its needs become the centre of attention and the therapy itself is of secondary importance.

Therefore, DC involves a change in the professional’s attitude towards patients. The incorporation of DC may be difficult but, just as other forms of intervention have been implemented through consensus, progress is being made with respect to DC awareness and application. The efficiency of said care in improving sleep patterns and reducing stress for the newborn proves the higher level of stability in the infant’s constants and both long-term and short-term benefits are observed.