Visitation restrictions: is it right and how do we support families in the NICU during COVID-19?

Abstract

Although the COVID-19 pandemic has largely not clinically affected infants in neonatal intensive care units around the globe, it has affected how care is provided. Most hospitals, including their NICUs, have significantly reduced parental and family visitation privileges. From an ethical perspective, this restriction of parental visitation in settings where infectious risk is difficult to understand. No matter what the right thing to do is, NICUs are currently having to support families of their patients via different mechanisms. In this perspective, we discuss ways NICUs can support parents and families when they are home and when they are in the NICU as well as provide infants the support needed when family members are not able to visit.

Unintended consequences of restrictive visitation policies during the COVID-19 pandemic: implications for hospitalized children

“…The consequences may be especially deleterious in settings such as the neonatal intensive care unit (NICU) where 24-h parental presence with extended intimate contact of the newborn has both physiological and psychological benefits to the newborn and parents. 7 A recent study by Darcy Mahoney et al 8 assessed the impact of restrictions on parental presence in the NICU before and during the COVID-19 pandemic. The cross-sectional survey of global NICUs identified a variety of visitation policies among 130 NICUs worldwide that restricted parental presence during the COVID-19 pandemic.…”

“…Assuring that visitation policies are carried out in an ethically rigorous manner with transparency (e.g., clear appeals process), communication (e.g., public-facing website), and patient-centeredness (e.g., support mechanisms) is also essential. 2 , 3 , 7 , 10 This requires periodic modification of policies informed by epidemiological data, protective equipment availability, and stakeholder engagement. Specific engagement of vulnerable at-risk populations is critical in order to prevent exacerbation of health inequities.…”

Letter to the Editor on “Visitation restrictions: is it right and how do we support families in the NICU during COVID 19?”

“…Sir, We read with interest your article regarding visitation restriction in neonatal ICUs (NICUs) and the need for family support during the COVID-19 pandemic [1]. In developing countries like India, severe community transmission of COVID-19 has now led to constantly evolving issues like the need for further visitation restriction in the NICU [2].…”

The Collateral Impact of COVID-19 Emergency on Neonatal Intensive Care Units and Family-Centered Care: Challenges and Opportunities

“…In cases where the other parent is also infected, they cannot visit the infant until the test results return negative. Furthermore, in an effort to reduce the risk of SARS-CoV-2 transmission, many NICUs have reduced parental (especially paternal) and family visitation privileges (Cavicchiolo et al, 2020a ; Murray and Swanson, 2020 ) regardless of the other parent's chance of being infected. Despite parents' understanding of the need for visitation restrictions, they are seriously concerned about their ability to visit, care for, and bond with their hospitalized infants (Muniraman et al, 2020 ).…”