Based on the belief that infant is a person an can communicate its needs, the developmental care theory encourage us to examine infant responses and adjust our caregiving activities.
Infants benefit from DSC included: better neurobehavioral- autonomic and motor system regulation, self-regulation and reduced need for interventions. Overall infants treated based on DSC system needed fewer days on TPN, improved weight gain and fewer days in the NICU (Gardner et al., 2011)
Expert nursing care requires understanding of infant’s needs, knowing infant behavior and anticipating outcomes. To provide continuous support and decrease stressors the nurse must advocate for the family and be able to provide individualized developmental care.
Sleep disruption was associated with hypoxemia (Gardner et al., 2011)
Developmentally Supportive Care
Supportive Care and
Respiratory Support in
Recognizes the physical, psychological and emotional
vulnerabilities of infants and their families.
Focused on minimizing potential short and long-term
complications associated with the hospital experience.
(Coughlin, Gibbins, & Hoath, 2009)
The concept combines developing infant, his family and
the environment where he exist. The goal is to provide
care environment, which supports and encourages the
developmental organization of the premature and/or
critically ill infant.
Cluster care in the NICU can improve infant’s outcomes.
By protecting his sleep we encourage natural heeling and
promote development of his brain.
Supporting the infant during painful procedures by containing him or
giving a soother can improve outcomes and his perception of pain
Changing positions will stimulate different parts of the body and brain
and will help with muscular and neural development
Teaching and involving parents in their child’s care will help them to
develop confidence, and support the partnership between the care
provider and the family
Being receptive and sensitive to infant’s cues will help the care
provider to get “to know” him and apply individualized care
(Gardner, Carter, Enzman-Hines, & Hernandez, 2011)
The core measures include: protected sleep, pain and stress assessment, and
management, daily living activities(positioning, feeding and skin care), family-centered
care and the healing environment (Coughlin et al., 2009)
Respiratory support and
Although initiating respiratory care is essential and
life saving, it conceals many risks factors and challenges.
Ventilated infant and his family become far more vulnerable
and require special treatment that include holistic and
Parent involvement in these cases is important, as
they are the ideal planers and providers of developmentally
Anticipation and careful planning is crucial to avoid
unnecessary handling and procedures.
Respiratory support and
Respiratory support can interfere with the ability of the infant
to communicate his needs
Take control over the environment from the infant and
increase his vulnerability
Jeopardize infant’s development of self and trust by
May lead to overstimulation and disruption of essential
Can prevent the family from initiating contact and delay
Effect of DSC on Infant
Developmental support important to every infant in the
NICU, however infants receiving respiratory support are the
most vulnerable and will benefit the most.
Consistency of care providers will allow the caregiver to get
familiar with behavior functioning of an infant.
Procedures like suctioning should be done only on PRN
basis, while providing physical support
Quiet environment and dim lights will enhance rest and
Effect of DSC on Infant
Receiving Respiratory Support
Uninterrupted sleep have been associated with increased
weight gain and improved state organization
Containing the infant’s limbs will reduce random
movement and help to conserve energy for growing
Research showed that infants that were treated
according to developmentally supportive care were
extubated earlier and required less oxygen therapy (Becker,
Grunwald, Moorman, & Stuhr, 1991)
Description of Learning
With increasing technology and the variety of
medical treatment options, the infant became a patient
that we treat. DSC remind us that the newborn has its
own personality, his own path and can communicate his
needs. Based on observation of behavior cues we can
“tailor” the treatment to a specific baby and his family.
The DSC model “humanized” the medical care that
we were giving, and I can’t agree more with it. I believe it
allows parents and caregivers to have a better emotional
attachment, to see a baby rather than a patient.
Promoting DSC can play a big role in shaping the future
on neonatal care.
Becker, P., Grunwald, P., Moorman, J., & Stuhr, S. (1991). Outcomes of Developmentally Supportive Nursing Care for
Very Low Birth Weight Infants. Nursing Research. Retrieved from
Coughlin, M., Gibbins, S., & Hoath, S. (2009). Core measures for developmentally supportive care in neonatal intensive
care units: theory, precedence and practice. Journal of Advanced Nursing, 65(10), 2239–48. doi:10.1111/j.1365-2648.2009.05052.x
Gardner, S. L., Carter, B. S., Enzman-Hines, M., & Hernandez, J. A. (2011). Merenstein & Gardner’s Handbook of
Neonatal Intensive Care (7th ed.). St. Louis: Mosby.
Lawhon, G. (1997). Providing developmentally supportive care in the newborn intensive care unit: an evolving challenge.
The Journal of Perinatal & Neonatal Nursing, 10(4), 48–61.