The risk of infection is reduced when the incubator is not placed in a collective room. A still too rare practice.
Approximately 60,000 premature babies are born in French maternity hospitals each year. Supported in departments of neonatology, they are mostly separated from mothers to be placed in incubators. A painful distance from parents and harmful to the newborn. This is why more and more hospitals are trying to open their doors to these families by creating single rooms. The child can be treated in an environment that is both safer and more conducive to breastfeeding, as demonstrated by a study published Monday, January 7 by the British medical journal The Lancet Child and Adolescent Health.
The researchers examined thirteen studies in specialized services, involving 4,800 babies born before the term. They observe that the risk of contracting an infection is lower in these individual rooms than in the nursing spaces where the incubators are together. The stakes are crucial in premature infants, whose immune systems are not yet able to fight bacteria. About a quarter of children born before 28 weeks of gestation (6 and a half months) develop an infection, the consequences of which can be severe during hospitalization. "The transition from one room to the other is supposed to encourage assistants to comply more closely with hygiene instructions," says Professor Jacques Sizun, head of the department of neonatology at the Morvan Hospital (Brest).
The skin-to-skin experience
Another advantage pointed out by researchers: children in single rooms are 30% likely to be breastfed by their mothers when they leave the hospital. But exclusive breastfeeding has a strong protective effect against severe digestive disorders, reduces the average length of stay of children born before the term and promotes brain development.
"The simple rooms offer a precious intimacy, but also a better chance for the mother to rest and recover after an often traumatic birth", says Charlotte Bouvard, founder of the association SOS Préma, who is struggling to impose the continuous presence of parents in all neonatal departments. The mother of a baby born before the hour, still remembers breast-feeding on a folding chair in hell, stuck between two incubators, not far from the corridor where visitors were traveling. "These uncomfortable situations still exist today," he says.
In the collective rooms, where the incubators are aligned next to each other, machine noise, unintentional activation of alarms and bright lighting increase stress. "The installation of the connection between the mother and the baby is softer in a single room where they will be able to try skin for skin for a long time (practice of keeping the baby naked against his skin, Ed) and take time to get to know us, "adds dr. Élodie Zana-Taieb, pediatrician in the department of reanimation and neonatal medicine in Port-Royal, Paris.
While neonatal services have given more space to parents over the past 30 years, there is still a way to go. In 2011, only 11% of the units open to parents 24 hours a day offered them the opportunity to sleep, wash and eat locally. This latest data comes from the Epipage 2 survey, which tracks the evolution of children born before the deadline.
"We know that the number of single rooms increases steadily with the progress of hospital work", says Professor Pierre-Henri Jarreau, at Cochin Port-Royal Hospital, whose service has banned the collective rooms after a 2012. The French Society of Neonatology now recommends this organization, which must be accompanied by a greater presence and involvement of parents.
But the management of prematurity remains in practice dramatically irregular in the territory, in the eyes of Charlotte Bouvard: "Architecture is not enough, and some hospitals are lagging behind these new practices, she complains. they do not have the same chance of being treated and developed based on where they are hospitalized. "
Additional paternity leave: a long-awaited decree
There is only one decree left for fathers of hospitalized infants to take advantage of additional paternity leave. The measure was adopted unanimously by the National Assembly last October, as part of the social security bill. The duration of this leave remains to be fixed, which should not exceed one month.
"This is an essential social and medical measure," says Charlotte Bouvard, founder of the SOS Préma association, which supports the extension of paternity leave. The continued presence of both parents during the entire hospitalization of a premature baby reduces the duration of the stay (on average 5.3 days) and improves the motor, cognitive, emotional and sensorial development of the child ".
Scientific studies show that a continuous presence of parents promotes the construction of family ties and helps to prevent stress and depression of mothers, which are more frequent in case of premature birth. The cost of the measure is estimated at 33 million euros. Its entry into force is expected by thousands of families, according to the association. The ball is in the field of the Ministry of Health.