Stronger communication between neonatal intensive care unit (NICU) staff and families, especially in situations such as fetal and neonatal alloimmune thrombocytopenia (FNAIT) in which where parents face fear and uncertainty, can ease stress, improve trust and help parents feel more involved in their child’s care, according to a review and assessment published recently in Acta Paediatrica.
“Improving everyday communication between parents and the medical team in the NICU promotes the health of the infant, the mental health of the parents and shared decision-making,” the authors wrote. “The present study highlighted three points for NICU caregivers to improve on: mastering basic communication skills, having tools for strengthening communication, and learning communication skills.”
This analysis of 37 articles found that parents reported feeling more satisfied and less anxious when clinicians prepared thoughtfully for meetings, used their baby’s name, and offered clear and empathetic explanations. In contrast, poor communication sometimes caused parents to withdraw from staff and even hampered bonding with their newborn. These results may be especially important for conditions such as FNAIT, where early medical interventions and close cooperation between parents and caregivers are vital.
This review described three main areas for improvement: basic skills, tools to strengthen communication, and ways for staff to learn and practice. Basic skills include introducing the care team, providing accurate information, and paying attention to parents’ emotional cues. Families valued staff continuity, which helped them build trust, though scheduling challenges sometimes made that difficult.
Read more about the care team for FNAIT
Tools that supported communication ranged from acronym checklists and written educational materials to newer approaches such as FaceTime, Skype, or NICU webcams. Written tools worked best when they used short, clear sentences, illustrations, and parent feedback in their design. For families dealing with complex conditions such as FNAIT, such tools may help them understand treatment plans and follow-up needs after discharge.
Language barriers were another concern, with only 41% of NICUs in a U.S. survey reporting consistent access to interpreters. Parents who spoke Spanish were four times more likely than English-speaking parents to misunderstand their infant’s diagnosis. This gap could increase risks if parents misinterpret lab results, imaging, or discharge instructions.
Learning opportunities for staff included workshops and simulation exercises where residents and physicians practiced giving bad news, managing conflict, and comforting distressed families. Participants rated these trainings highly, and self-assessments showed improved confidence months later. For families facing life-altering conditions such as FNAIT, clinicians with refined communication skills may be better equipped to answer questions, address fears, and guide parents through the difficult days in the NICU.
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