Zero Separation

Zero separation: Keeping preterm and sick babies close to their parents

Across Australia families have experienced the anguish and heartache of being separated from their loved ones amid the COVID-19 pandemic and lock down restrictions.

Sadly, this painful experience is a common reality in hospitals around the world where parents of sick or premature newborns are forced to say goodbye to their precious babies each night. In Australia, parents usually have 24/7 access to their baby in the Neonatal Intensive Care Unit or Special Care Nursery. During COVID-19 some units introduced a limit of only one parent at a time.

“It took me ages to get my head around what was going on, it was so hard seeing her hooked up to the monitors. It was heartbreaking leaving her at the hospital every day, and because of COVID-19, for the first couple of weeks the hospital only allowed one parent at a time to visit.” – Miracle Mum, Brenna

Miracle Babies Foundation in collaboration with the Global Alliance for Newborn Care (the global initiative of EFCNI), have launched the Zero Separation global campaign to keep preterm and sick babies close to their parents. The goal of the campaign is to raise awareness for the benefits of zero separation of preterm and sick babies and their parents in the NICU or SCN whether they’re in a pandemic or not.

Miracle Babies CEO and CoFounder Kylie Pussell knows how difficult it can be for families in this position.
“By limiting the access parents would usually have, this can cause unnecessary stress and trauma to the parents which can increase isolation and loneliness.  We support and encourage all hospitals to allow family centred care and full access to their baby whilst in hospital, before, during and after the pandemic. The experience of having a premature or sick baby is already traumatic with a range of emotions from guilt, fear, uncertainty and more. The family should be together wherever possible, for the long term health and outcome of the baby, the parents and the whole family unit."

“About 9-10 days after her birth at 33 weeks gestation, I finally got to go home which was bittersweet. I’ll tell you this was by far the hardest journey. Every single time I left that hospital without my daughter it got harder and harder. I remember not being able to leave unless her eyes were closed and she was asleep. I would nurse her to sleep every night, giving her a kiss on the forehead and waiting for her to close her eyes. I hoped it would be easier leaving if she was asleep, but it never was.

There is nothing normal or easy about having a baby in the NICU. I know people may think or say things like ‘at least you get to go home and sleep” or “You have someone caring for your baby, you don’t need to do anything” but you are up all hours of the night wondering if your baby is ok, or if your phone rings at any point, will it be the hospital calling to say something is wrong. The endless amount of sleep I got just wondering what she was doing and if that phone was going to ring was indescribable.” Miracle Mum, Nikki

Chairwoman of EFCNI and founder of GLANCE, Silke Mader echoes these concerns saying it appears many of the separation restrictions were introduced with no evidence and in conflict with World Health Organization (WHO) recommendations.
“Since the global spread of Coronavirus, and the introduction of measures against COVID-19, we saw many parents struggling with the very restricted or even prohibited access to the neonatal intensive care units due to the pandemic.”

The WHO states “Mother and infant should be enabled to remain together while rooming-in throughout the day and night and practice skin-to-skin contact, including kangaroo mother care, especially immediately after birth and during establishment of breastfeeding, whether they or their infants have suspected or confirmed COVID-19 virus infection”.

Dr Robert Guaran, Board Director Miracle Babies Foundation says Australian neonatal units have liberal visiting policies. However, sometimes there are limitations consequent to the need for physical distancing and this was exacerbated by COVID-19.
“Liberal visiting is not enough. We have two further challenges: Keeping mothers with their babies in Intensive Care rather than just providing care ‘closer to home’, and stopping the unnecessary separation of mothers and babies with short term, non-life threatening problems such as jaundice or low sugar levels. The solutions to these challenges reside at Federal and State Levels and need to be addressed by changing systems and funding models for maternal and newborn care.”

There is no question that hospital staff in many places are reaching their limits and the well-being and safety of patients and staff must always come first. However, the long-term impact of these separation policies on the newborns’ health outcomes can be tremendous. The Zero Separation campaign wants to encourage an approach that allows for family centred care when and wherever possible, even in times of a pandemic.

To find out more about the 'Zero separation. Together for better care!' campaign in more than 20 languages, visit: www.glance-network.org

References:
[World Health Organization, Maintaining essential health services: operational guidance for the COVID-19 context, 1 June 2020, https://www.who.int/publications/i/item/WHO-2019-nCoV-essential_health_services-2020.2   (24.06.2020).

World Health Organization, Clinical management of COVID-19: interim guidance, 13 Jan 2023, https://www.who.int/publications/i/item/clinical-management-of-covid-19 (25.06.2020).

Guttmacher Institute, Estimates of the Potential Impact of the COVID-19 Pandemic on Sexual and Reproductive Health in Low- and Middle-Income Countries, Vol.46, 2020, p 73-76, https://www.guttmacher.org/journals/ipsrh/2020/04/estimates-potential-impact-covid-19-pandemic-sexual-and-reproductive-health (25.06.2020).