Parental presence restrictions due to COVID-19: Examining impact and priorities for neonatal care (The PRESENCE Study)

No parent wants to be separated from their baby during a time of crisis. This is especially true for parents of sick preterm infants requiring care in a neonatal intensive care unit (NICU). Yet, given the severe parental presence restrictions due to the COVID-19 pandemic response, this is the reality for many Canadian families. Many partners must leave the hospital following attendance at the birth and for some parents who must leave to care for other children at home, they are unable to return. For parents able to stay their infant, most cannot be present together. Families lack access to their usual social support systems, partners have little engagement, and usual in-person support, education, and discharge teaching have been disrupted, all associated with higher parental mental health concerns. Many infants have reduced access to life saving breastmilk, parental touch, and learning through facial interactions, with significant implications for later development. Despite the serious consequences for vulnerable infants and their families, inconsistency exists in the degree of restriction nationally, resulting in wide variation within provinces and cities. The lack of standardized approach heightens distrust in health care provision. There is an urgent need to examine the impact of parental presence restrictions on family mental and physical wellbeing, infant outcomes, and healthcare provider experiences to identify priority areas for practice change to reduce unintended harm and inequities, as well as to inform the priority needs of families and stakeholders in the post COVID-19 period to determine a consistent evidenced based national approach. Our diverse team, including families, neonatal care providers, researchers and decision makers, are uniquely positioned to act now. We will leverage existing work and longstanding successful networks to ensure diverse engagement, rapid deployment, and broad impactful and timely uptake of our findings to improve care.