Principle 1

Baby lying in cot with mask on

Social, developmental and emotional needs


Every baby should be treated as an individual and with dignity, respecting their social, developmental and emotional needs, as well as their medical and surgical needs.

This principle looks at how a neonatal unit enables parents to have regular private time with their baby(ies) and how care provision is designed to minimise the stress of the NICU environment (e.g. by reducing exposure to bright lights and loud noises.)

Here are a selection of examples:

Cot side Communication Sheet

Barnsley Hospital, Barnsley

The neonatal unit at Barnsley hospital have created communication sheets for each cot so that parents and neonatal staff communicate important information about the baby's care, helping parents to feel more involved in the medical procedures their baby undergoes.

Barnsley Communication Sheet

Developmental care guidelines and competency framework

Conquest Hospital Neonatal Unit, East Sussex

Conquest hospital have established developmental care guidelines on their unit, which covers areas such as positive touch, clustering cares and controlling the environment. They have also introduced an accompanying staff competency framework to ensure that these guidelines are understood and being delivered in practice.

Interacting More with Your Baby

Queen's Hospital (Burton on Trent)

Following an audit within their unit, Queen's Hospital in Burton on Trent found that some parents did not feel encouraged to read, sing and talk to their babies. With evidence to support the positive impact this has for both baby and parents, the unit decided to take action. Now, within each nursery a small basket containing song sheets, books and the Bliss Milestone Cards is present, along with an explanation in their 'Know Your Baby Folder'. They have now found parents use these simple resources to read, sing and talk to their baby's more often.

Bliss Best Practice 1

Headphones during ward rounds (standard 1.1b)

Imperial College Healthcare NHS Trust, London

St Mary's, Queen Charlotte's and Chelsea hospitals are using headphones during ward rounds to ensure that parents can stay with their baby, even when another baby is being discussed, to achieve unrestricted access for parents.

Here are their guidelines.

Comfort: hugs heal (Standard 1.2A and 1.3A)

Queen Charlotte's and Chelsea Hospital, London

In order to promote skin to skin, the neonatal unit at Queen Charlotte’s and Chelsea Hospital have introduced a message board for parents and family members to write comments about their skin to skin experiences. One message reads “Enjoy every minute with your amazing baby. Have lovely cuddles”. This board enables parents to reflect on the importance and value of regular skin to skin experiences and really highlights the unit’s culture of fostering parental involvement and engagement with their baby every step of the way.

Recording responses to care (standard 1.2d)

Frimley Park Hospital, Surrey

Frimley Park have introduced a developmental care section on their observation charts which focuses on observing a baby's cues, responding appropriately to them and observing the outcome of the care response.

Sound (standard 1.6)

Queen Alexandra Hospital, Portsmouth

The neonatal unit at Queen Alexandra Hospital have put up signs around the unit to remind those on the unit to keep noise to a minimum. Basic care protocol and policies can help to minimise premature babies’ exposure to painful stimuli.

Environmental guidelines

Liverpool Women's Hospital, Liverpool

Liverpool Women’s Hospital have created an environmental guideline which provides guidance on how to reduce harmful stimuli, promote sleep and stability and ultimately, create an optimal environment for neuro development.

Touch (standard 1.3)

Royal Berkshire, Reading

At Reading, they have introduced a nurture of cuddles poster to promote positive touch.

Gustatory and olfactory guideline (taste and smell, standard 1.7), guideline for recommended noise level (sounds, standard 1.6)

Frimley Park Hospital,Surrey

Frimley Park Neonatal Unit have developed a set of guidelines linked to developmental care. The purpose of which being to provide healthcare professionals with clear guidance on unit expectations/recommendations to ensure consistent, high quality service delivery. Here are some of the unit’s guidelines: