This tip sheet explains leave and pay rights for parents and other close family members who need extended time off work to care for children with serious health conditions, including preterm infants in the neonatal intensive care unit (NICU). These rights are available regardless of immigration status. It includes information on qualifications, ways to obtain legal advice, FAQs, and sample timelines to help providers guide parents and families.
Human milk use in the NICU can improve outcomes for VLBW infants by reducing rates of NEC, chronic lung disease, retinopathy of prematurity, late-onset sepsis, and neurodevelopment impairment. CPQCC member, Natividad Hospital, discusses how they have improved human milk use in their NICU in the video below.
These potentially better tips and change ideas reflect current best practices in the literature as well as practices gathered from CPQCC NICUs with high rates of human milk use at discharge. It is important to note that human milk use is not equal for all races and ethnicities. Because of this, some of the suggestions below refer specifically to increasing human milk use among infants of color who may otherwise be less likely to receive it.
Infants of limited English proficient (LEP) families in the NICU are at risk for poor outcomes and potential medical errors due to language and cultural barriers. Clinician interpretation techniques may fail to consider LEP family cultures and expectations, which have led to disproportionate readmission rates, less time performing skin-to-skin, decreased breastmilk use rates, and patient dissatisfaction.
Randomized clinical trials have also shown other benefits of DCC including improved cardiovascular stability, cerebral oxygenation, and lower risks for both severe IVH and late-onset sepsis. Delayed Cord Clamping of up to 1 minute for preterm infants has been recommended by the WHO, NRP, and ACOG.
The Health Equity Tip Sheet includes ten suggestions on how NICUs can improve family-centered care for diverse families. Rather than being seen as a definitive list of "must-dos," these suggestions are intended to generate conversation within and among NICUs on how to recognize and address disparate care. Tips are grouped into six categories: acculturation of the unit; staff communication; counseling; organizational resources; family leadership; and education.
