453 - Delivery Room Cuddles for Preterm Infants in United Kingdom Neonatal Units: A National Survey of Adoption and Implementation.

Publication Number: 453.4456

Mary Eileen Foster, University Hospital Birmingham, Birmingham, England, United Kingdom; Harsha Gowda, University Hospitals Birmingham, Birmingham, England, United Kingdom; Paul Clarke, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, England, United Kingdom; Nancy Sakaya Stephen Raj, n/a, Birmingham, England, United Kingdom

Background: We are in an era where family-centered care is recognized as foundational to optimal health outcomes, particularly for preterm infants. Early involvement of parents through Delivery Room Cuddles (DRC) provides critical emotional, social, and developmental support, creating a partnership between families and healthcare providers from birth. DRC enables preterm infants to experience physiological and psychological benefits, such as better thermal stability, improved maternal confidence, and reduced maternal stress. Although not all extremely preterm infants can engage in direct skin-to-skin contact immediately, the opportunity for a calm, supervised cuddle remains invaluable, allowing parents to hold, touch, and bond with their newborns before NICU admission.

Objective: This study sought to evaluate the prevalence, consistency, and barriers to DRC practices across United Kingdom neonatal units, with the objective of identifying opportunities to standardize and support this essential family-centered practice.

Design/Methods: A structured survey was administered to all 131 UK level 2 and 3 neonatal units between January and March 2024. The survey assessed DRC frequency, presence of formal guidelines, inclusion of fathers or birthing partners when mothers were unavailable, and barriers to implementation, including staff attitudes and equipment limitations. Sampling and data analyses addressed potential biases to ensure reliable results.

Results: Responses from all 131 units revealed that 45.8% routinely practice DRC, 50.4% offer it occasionally, and 3.8% do not practice it. Additionally, 61.8% of units operate without formal DRC guidelines, underscoring the need for standardized protocols. Key barriers include equipment limitations, concerns over infant stability, and inconsistent staff training. While not all preterm infants can participate in direct skin-to-skin contact, the benefits of a controlled cuddle are widely acknowledged. DRC provides parents an irreplaceable opportunity to engage with their newborns, fostering an early bond through touch and visual interaction, which is especially valued by families facing bereavement.

Conclusion(s): DRC is a feasible, safe, and essential practice that should become the norm in neonatal care for preterm infants. National guidelines and focused training could enable more consistent implementation, helping every family experience the "birthday cuddle" as a critical first bonding moment. Such practices can deliver lasting emotional and developmental benefits for both infants and parents, establishing a strong foundation in family-centered neonatal care.

Table 1
Table showing survey results of Delivery Room Cuddles (DRC) practice in United Kingdom

Parental feedback on Delivery Room Cuddles
What delivery room cuddles mean to parents

Chart 1
Pie chart showing barrier to delivery room cuddles implementation