Résumé
Les enfants nés prématurément sont à risque de déficiences neurosensorielles, cognitives et comportementales. L’effet potentiellement délétère de l’environnement des services de néonatalogie et de la séparation parents–bébé sur le cerveau en développement est maintenant reconnu ainsi que la nécessité de développer des stratégies environnementales et d’implanter des programmes de soins de développement (SD) centrés sur la famille. Bien que ces aspects de la prise en charge néonatale soient largement documentés et que les unités de néonatologie se transforment, il subsiste encore un fossé entre les connaissances et les pratiques. En effet, un grand nombre d’unités de néonatologie se focalisent sur l’aspect technique de la prise en charge des nouveau-nés, et les parents sont souvent considérés comme des « visiteurs ». Cet article reprend, d’une part, le contexte scientifique justifiant une prise en charge axée sur les SD et la place des parents dans les services de néonatologie et, d’autre part, l’expérience belge où le gouvernement a décidé de promouvoir l’allaitement maternel et les SD dans les maternités et les unités néonatales. Ce projet est en cours d’évaluation et tend à indiquer que l’implication des pouvoirs publics dans ces domaines a un impact sur le changement des pratiques de soins.
Abstract
Children born prematurely are at risk of cognitive, neurosensory, behavioral and academic impairments. The potentially harmful effects of traditional neonatal settings and the separation of baby and parents have been recognized as having an impact on the developing brain. Developmental family-centered care and environmental strategies emerged in response to these findings. Developmental family-centered care programmes have proven their benefit and hospitals are changing, but there is still a big gap between knowledge and practice. In many of these units, the focus of care is very often technically directed and many parents are still considered as mere “visitors”. In this paper, the scientific arguments are addressed to justify focusing on developmental care and supporting parents in neonatal units. The second part covers the Belgian experience where the government decided to promote breastfeeding in maternity wards and to support the implementation of developmental care in neonatal units. This project is still to be evaluated, but it tends to show that governmental support has an impact on changing care practices.
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Van Herreweghe, I., Druart, D., Janssens, K. et al. Une politique de soins de santé au secours du lien parents–enfants et de la bientraitance hospitalière : l’exemple belge. Rev. med. perinat. 8, 133–140 (2016). https://doi.org/10.1007/s12611-016-0376-6
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DOI: https://doi.org/10.1007/s12611-016-0376-6