Parents shorten hospital stay for sick children

Parents of children undergoing treatment at the various hospitals across the country often experience hostility from medical personnel on claims that they interfered with clinical management of their little ones.

They are often excluded from their children’s treatment journey and only watch from the side-line.

A new study however challenges this exclusion approach and urges hospitals to incorporate parents in the management of their sick children so as to hasten their recovery process.

The research published in the Lancet Child and Adolescent Health journal found that actively involving parents in the care of their newborns – from feeding, giving oral medicine, taking their temperature, to participating in ward rounds – improves the wellbeing of premature babies in intensive care units (ICU).

Compared to neonates (babies less than a month old) given standard or normal care, the research revealed that premature infants who benefitted from an integrated family care programme had improved weight gain and better breast feeding rates which usually expedites recovery processes.

Their parents also suffered from less stress and anxiety levels which enabled them to have an improved connection or bond with their sick babies. This is important for boosting children’s immunity and keeping them calm since infants can easily pick negative ‘vibes’ from parents and end up being more sick.

Dr Karel O’Brien, lead author of the study noted that all these positive effects — weight gain, breast-feeding and reduced parental stress — are also associated with positive brain development outcomes in children.

“This suggests that integrating parents into the care of infants at this early stage could potentially have longer-term benefits.”

The international research trial was conducted in different hospitals in Canada, Australia and New Zealand. It involved close to 2,000 children who had been born prematurely (at 33 weeks or earlier) and were thus admitted at ICUs in selected health facilities.

The hospitals that offered integrated family care services provided families with free parking, a rest place and sleeping room intended for their use only.

They also had comfortable reclining chairs situated next to their sick child as well as access to nurses that offered them adequate training in offering the required health services to their babies.

The parents committed to spending at least six hours daily, five days a week, at their ill babies bedside.

They delivered tasks such as bathing, feeding, and dressing. They also changed diapers, checked body temperatures and gave oral medication to their kids.

In addition, they were encouraged to take part in clinical decisions, attend ward rounds as well as chart their infants’ growth and progress.

However, parents were also informed of tasks they could not perform, such as adjusting oxygen levels.

“Parents are too often perceived as visitors to the ICU. But our findings challenge this approach and show that helping them assume the role of primary caregivers to their sick infants as soon as possible has benefits for both of them,” said Dr O’Brien, who is also a neonatologist from the Paediatrics department at Sinai Health System in Toronto, Canada.

According to Dr John Wachira, paediatrician at Gertrude’s Children’s Hospital, involving parents in the care of their sick children is a best practise that should be encouraged in all hospitals. “So far, only a few hospitals in Kenya have adopted this new approach. But we would like it to be widespread so as to increase survival rates of sick children.”

The Kenya Demographic and Health Survey (2014) indicates that the country has a high infant mortality rate of approximately 39 deaths per 1,000 live births. This shows that about one in every 26 Kenyan children die before celebrating their first birthday.

Dr Wachira said that new initiatives such as parental involvement in the management of sick children can play a key role in reducing the deaths.

He noted that kids, especially the much younger ones, have a special bond with their parents and are thus likely to respond well to their care as opposed to services offered by clinicians who they will view as strangers.

“For instance, babies are used to their mothers feeding them. So they are more likely to co-operate and not create a fuss if they are receiving oral medicine through them.”

“They may reject the touch of strangers in hospital settings but will not have an issue with their temperatures being taken by their parents.”

In addition, Dr Wachira said that when parents are trained on how to offer certain health services to their children while in hospital, they are well prepared to do them after being discharged from hospital.

“This helps with drug adherence and effective management of certain conditions such as proper administration of ORS (Oral rehydration therapy) to prevent dehydration caused by diarrhoea as well as appropriate use of inhalers in children with asthma.”

He added: “The parents will also feel better knowing that they are doing something to contribute to the wellbeing of their sick children instead of watching helplessly from the side lines and dying of fear and uncertainty.”