Healthful Environments for Hospitalized Infants

Purpose: Medical and technological advances dominate the design of infant incubators because of their essential role in the survival of critically ill neonates. Yet other important design considerations, such as caregiver interaction, discomfort at bedside, and harmful materials, often are overlooked. The purpose of this paper is to consider the effects of existing incubator designs and to suggest criteria for the next generation of infant incubators. Background: Incubators of the mid-1940s established an industry standard that exists to this day: portholes in an infant chamber positioned over a mechanical system, resting on top of storage cabinets or drawers. This design is unresponsive to many of the infants' needs and significantly influences parent/infant interaction. The physical effects and social barriers that the incubator presents to the health and well-being of infants are compounded by the use of unhealthful substances and materials such as formaldehyde. Collectively, these conditions call for an incubator that not only ameliorates physical and social obstacles, but also uses benign materials. Conclusions: Simple alterations to existing incubator design, such as introducing color and pattern, providing arm rests, and freeing space beneath the infant chamber to accommodate seated caregivers, would encourage more prolonged periods of contact with the infant occupants, thereby improving their behavioral organization and recovery. Replacing harmful materials with alternatives such as formaldehyde-free substrates in the cabinetry also will improve the developmental outcomes of the infant occupants. These types of recommended changes embrace the intent of the incubator to provide a controlled, secure environment while acknowledging that incubators are not merely medical equipment, but the living spaces of their infant occupants.