'Being in a womb' or 'playing musical chairs': the impact of place and space on infant feeding in NICUs.
BACKGROUND
Becoming a parent of a preterm baby requiring neonatal care constitutes an extraordinary life situation in which parenting begins and evolves in a medical and unfamiliar setting. Although there is increasing emphasis within maternity and neonatal care on the influence of place and space upon the experiences of staff and service users, there is a lack of research on how space and place influence relationships and care in the neonatal environment. The aim of this study was to explore, in-depth, the impact of place and space on parents' experiences and practices related to feeding their preterm babies in Neonatal Intensive Care Units (NICUs) in Sweden and England.


METHODS
An ethnographic approach was utilised in two NICUs in Sweden and two comparable units in England, UK. Over an eleven month period, a total of 52 mothers, 19 fathers and 102 staff were observed and interviewed. A grounded theory approach was utilised throughout data collection and analysis.


RESULTS
The core category of 'the room as a conveyance for an attuned feeding' was underpinned by four categories: the level of 'ownership' of space and place; the feeling of 'at-homeness'; the experience of 'the door or a shield' against people entering, for privacy, for enabling a focus within, and for regulating socialising and the; 'window of opportunity'. Findings showed that the construction and design of space and place was strongly influential on the developing parent-infant relationship and for experiencing a sense of connectedness and a shared awareness with the baby during feeding, an attuned feeding.


CONCLUSIONS
If our proposed model is valid, it is vital that these findings are considered when developing or reconfiguring NICUs so that account is taken of the influences of spatiality upon parent's experiences. Even without redesign there are measures that may be taken to make a positive difference for parents and their preterm babies.
Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, Lancashire, UK. rfl@du.se.
Renée
R
Flacking
Fiona
F
Dykes
D000328:Adult; D001942:Breast Feeding; D004739:England; D005220:Fathers / Q000523:psychology; D005260:Female; D006272:Health Facility Environment; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D007374:Interior Design and Furnishings; D008297:Male; D008875:Middle Aged; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology*; D017060:Patient Satisfaction; D018907:Privacy; D036301:Qualitative Research; D012386:Rooming-in Care; D013548:Sweden; D055815:Young Adult