Redirecting Care: Compassionate Management of the Sick or Preterm Neonate at the End of Life

Abstract

The primary moral commitment of medical care has traditionally been based on a belief in the intrinsic value and significance of human life and a desire to protect the most vulnerable from harm. In this respect, the care of newborn infants who are at the border of viability is no different. Despite the intrinsic value of the life of every newborn, all agree that there is no moral duty of doctors to provide every possible treatment where the prognosis is hopeless. Instead, every action and treatment should be orientated towards the best interests of the individual child and towards the minimisation of serious harm. Decisions about the withholding or withdrawal of life-supportive treatment should be made collaboratively between professionals and parents, with discussion starting prior to delivery wherever possible. The goals of neonatal palliative care are to prevent or minimise pain and distressing symptoms and to maximise the opportunity for private, loving interaction between the dying baby and his or her parents and the wider family. Physical contact, gentle stroking, cuddles and tender loving care are of central importance for the dying baby. At the same time, we must provide psychological support for parents and family as they go through the profound and painful life experience of accompanying their baby to death. To enable a baby to die well, pain-free and in the arms of loving parents and carers is not a failure but a triumph of neonatal care.

Social Touch: Its Mirror-like Responses and Implications in Neurological and Psychiatric Diseases

“…Future investigations in these areas are needed. Nonetheless, a growing body of evidence supports the notion that physical contact, gentle stroking, cuddles, and tender loving care are of central importance for a dying baby [121]. Given the importance of maternal contact during early life, several hospitals have launched volunteer cuddling programs for all infants admitted into the neonatal intensive care unit.…”

Faktor yang Mempengaruhi Efikasi Diri Ibu Menyusui Neonatus Sakit: Penelitian Observasional

“…Neonatus sakit membutuhkan perawatan yang lebih intensif dalam kaitannya dengan pelayanan yang holistik. Dukungan nutrisi, pemberian Air Susu Ibu (ASI) merupakan salah satu faktor terpenting dalam perawatan neonatus sakit (Wyatt & Hain, 2022). Akan tetapi, banyaknya masalah ibu menyusui yang dapat terjadi di ruang perawatan neonatus, misalnya stres melihat kondisi di ruangan neonatal intensive care unit (NICU), pemisahan dari bayi mereka, kelelahan dan kecemasan, kurangnya privasi, ASI yang dihasilkan tidak banyak, dan pengetahuan yang kurang mengenai pentingnya ASI (Bernaix et al, 2006;Davanzo et al, 2013;Niela-Vilén et al, 2014).…”