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Better design leads to better bonding

21 October 2013

Lyndsey Boardman

Researchers publish findings of intensive study into neonatal care  

The design of spaces within neonatal intensive care units can have an impact on how newborn babies feed and how they bond with their parents according to research published by a University of Central Lancashire (UCLan) academic and her Swedish colleague.

Dr Renée Flacking, a UCLan Senior Research Fellow and Senior Lecturer at Dalarna University in Sweden and Dr Fiona Dykes, Professor of Maternal and Infant Health at UCLan, have collaborated on an 11 month project in which Dr Flacking observed and interviewed a total of 52 mothers, 19 fathers and 102 staff from two neonatal intensive care units (NICU) in the North West of England and two comparable units in Sweden.


The results, in a new article in BioMed Central’s open access journal BMC Pregnancy and Childbirth, have implications for the future design of neonatal intensive care units and the facilities available to parents.


The main focus was on interactions related to feeding, and the researchers identified four main categories that were important to parents for a quality feeding experience; the level of ownership of the space; the feeling of being ‘at-home’; the experience of ‘the door or a shield’ against people entering, and for regulating socialising and; the ‘window of opportunity’. These categories were used to analyse the experience within four typical NICU spaces where parents could spend time with their babies.

There has been a growing interest in the ways in which the design of spaces within hospitals influences health and relationships. The article published in BMC Pregnancy and Childbirth explores, in-depth, the impact that different spatial designs in neonatal intensive care units (NICUs) have on how well newborn babies feed and the parents’ experience of their hospital stay.

The findings show that when the spaces available to parents in NICUs are designed so that the parents’ emotional and physical needs are met they facilitate better feeding experiences and time spent together. Parents prefer to feel less like a visitor, having a sense of ownership over a space that has some degree of privacy, allowing them to relax and engage with their child.

Dr Renée Flacking and Professor Fiona Dykes conclude that the spatial configuration of the NICUs influence the developing parent-baby relationship.

“If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences."

Dr Renée Flacking said: “If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent’s experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.

“Every aspect of the design such as layout, furniture, colours on the walls, signals something to parents; and we behave in accordance to those signals. If the environment indicates that parents are visitors then they will become only visitors and not the primary caregivers, which they are.”

Professor Fiona Dykes commented: “Our findings show that having a space that parents can call their own, with a feeling of ‘at-homeness’ to it will help to facilitate a sense of connectedness between parents and their baby. We might not be able to completely redesign a NICU but small changes can make positive differences for parents.”

The collaborative research is the result of a successful postdoctoral grant awarded to Dr Renée Flacking in 2009 by Uppsala University, Sweden, to develop her research in the internationally renowned Maternal and Infant Nutrition and Nurture Unit (MAINN in the School of Health, at UCLan. In September 2012 Renee was appointed as a part-time Senior Research Fellow in MAINN at UCLan.

A full copy of the report can be downloaded via the BioMed Central website: