Pregnancy Complications
Infant- and Family-Centered Developmental Care
Neonatal Eye Health
Hygiene
Rare Diseases
Families of preterm and sick newborns often face stressful and traumatic experiences during stays in neonatal intensive care units (NICUs). Family Integrated Care (FICare) is an approach designed to empower parents as primary caregivers, fostering stronger parent–professional partnerships and improving outcomes for infants and families. This systematic review looked at how healthcare professionals (HCPs) perceive the barriers and facilitators of FICare. Drawing on 37 qualitative and mixed-method studies including 1,243 neonatal staff members worldwide, the review found that while staff value FICare, challenges remain in implementing it consistently. Findings highlight the importance of education, resources, and supportive environments to make FICare a sustainable part of neonatal care.
Family Integrated Care recognizes parents as essential partners in their newborn’s care. This approach can reduce complications, shorten hospital stays, and improve breastfeeding and parental well-being. However, the review showed that many neonatal staff face emotional, cultural, and structural challenges when integrating parents into care. Balancing professional responsibilities with parental involvement can feel difficult for staff, and the physical environment of NICUs is not always designed to support this model.
The review included studies from several countries and gathered the experiences of nurses, doctors, and other neonatal staff. It explored how healthcare teams viewed their roles and responsibilities in enabling parents to take an active role in care. The findings reveal that staff perspectives greatly influence how FICare is practiced, and that both belief in its value and support from leadership are crucial for success.
One key theme was the tension between professional identity and shared caregiving. Staff reported that supporting families emotionally, not only clinically, could feel overwhelming. Some worried that involving parents too much might devalue their professional expertise, while others found joy and job satisfaction in helping parents connect with their infants. Education and experience were seen as important in shifting mindsets towards embracing parents as primary caregivers.
Additional results showed that staff sometimes had conflicting views about practices like skin-to-skin care, with some considering it beneficial while others feared it would disrupt rest. Differences in personal beliefs led to inconsistent practices across units. This highlighted the need for clearer guidance and shared understanding within teams.
Another major theme was the role of conditions and consistency. Staff emphasized that FICare depends on resources such as space for parents, adequate staffing, and ongoing training. Without these, even motivated staff struggled to make FICare work. Clear policies and leadership support were seen as vital to overcome inconsistent practices and ensure that all families benefit equally from this approach.
The practical implications are significant: hospitals that want to embed FICare need to invest in both physical environments and education programs. Training healthcare professionals in the philosophy and benefits of FICare helps build belief in the model, which in turn shapes practice. Strong leadership and consistent policies are key to creating a culture where parents are welcomed as active partners.
In conclusion, this review shows that FICare holds great promise for improving outcomes for preterm and sick newborns and their families. Yet, to succeed, it must be supported at every level – from individual beliefs to hospital policies and resources. For parents, knowing that healthcare professionals are working to overcome these challenges offers hope for more compassionate, family-centred neonatal care in the future.
Paper available at: Facilitators and barriers to the practice of neonatal family integrated care from the perspective of healthcare professionals: a systematic review | ADC Fetal & Neonatal Edition
Full list of authors: Leake, N.; Edney, S.; Embleton, N.; Berrington, J.; Rankin, J.
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