The Speech and Language Pathologist and the Caregiver in the NICU
Sara Panizzolo, Giulia Nicolosi
The current clinical-care models hope for a progressive transformation of care pathways in favour of a family-centred approach, where the family caregiver takes on a crucial role in the management of the fragile person. Even in the field of neonatology, progress in the scientific, technological and pharmacological fields calls for the need to outline paths characterized by a greater humanization of care. In accordance with the definition of health, understood as a state of physical and mental well-being (WHO 1948), it is essential to recognize the new needs of the fragile newborn, not only in terms of physical improvement, but also of mental well-being, which, at an early age, arises mainly from the emotional closeness of the parent. The parent becomes an element of care, like medical and pharmacological therapies, and takes on the role of primary caregiver for enabling care that is more responsive to the characteristics of their child and is aimed at adequate neurodevelopmental development. The importance of the parental figure is clearly underlined in the current European Care Standards for Newborn Health (EFCNI, 2018) and in the Organizational Standards for Perinatal Care (SIN, 2021). Within the multidisciplinary team of the NICU, the speech and language pathologist collaborates in the treatment of newborns who show signs of dysphagia and, in parallel with the specific professional intervention, carries out information and education activities for the parent (preferably the mother), which represent essential elements for the construction of a therapeutic alliance, aimed at collaboration to support the newborn during the transition from enteral nutrition to reaching oral feeding, considered one of the criteria for discharge from the NICU (AAP2011). In the context of nutritional care, the caregiver, through the support of the speech and language pathologist, acquires skills, while still in hospital, which allow effective and autonomous nutritional management even after discharge.
Keywords
Neonatal dysphagia, Prematurity, Speech therapy rehabilitation, Caregiver, Family centred care.
