'Now she has become my daughter': parents' early experiences of skin-to-skin contact with extremely preterm infants

Abstract

Background: Based on the Family-Centred Care philosophy, skin-to-skin contact is a key activity in neonatal care, and use of this practice is increasing also with extremely preterm infants. Little is known about parents' immediate experiences of and readiness for skin-to-skin contact, while their fragile infant may still not be 'on safe ground'. Knowledge about parents' experiences might reduce doubt and reluctance among healthcare professionals to use skin-to-skin contact with extremely preterm infants and thus increase its dissemination in practice.

Aims and objectives: To explore parents' immediate experiences of skin-to-skin contact with extremely preterm infants <28-week postmenstrual age.

Methodological design: A qualitative study using thematic analysis.

Research methods: Thirteen semi-structured interviews conducted in 2008 with 16 parents after skin-to-skin contact with their extremely preterm infants analysed using inductive thematic analysis.

Findings: Parents' experiences were related to the process before, during and after skin-to-skin contact and moved from ambivalence to appreciating skin-to-skin contact as beneficial for both parents and infant. The process comprised three stages: (i) overcoming ambivalence through professional support and personal experience; (ii) proximity creating parental feelings and an inner need to provide care; (iii) feeling useful as a parent and realising the importance of skin-to-skin contact. Having repeatedly gone through stages 2 and 3, parents developed an overall confidence in the value of bonding, independent of the infant's survival.

Conclusions: Parents progressed from ambivalence to a feeling of fundamental mutual needs for skin-to-skin contact. Parents found the bonding facilitated by skin-to-skin contact to be valuable, regardless of the infant's survival.

Keywords: ambivalence; bonding; extremely preterm infant; family-centred care; health care professionals; neonatal intensive care unit; parents’ experience; proximity; skin-to-skin contact.