Journal of Perinatology https://doi.org/10.1038/s41372-019-0514-7 PERSPECTIVE The Growth and Development Unit. A proposed approach for enhancing infant neurodevelopment and family-centered care in the Neonatal Intensive Care Unit Carmina Erdei 1,2 ● Terrie E. Inder 1,2 ● Pamela Dodrill 1,2 ● Lianne J. Woodward 1,2,3 Received: 22 March 2019 / Revised: 12 July 2019 / Accepted: 15 August 2019 © Springer Nature America, Inc. 2019 Abstract There is growing evidence that the neurosensory and social environment of the Neonatal Intensive Care Unit (NICU) has lasting effects on the neurodevelopment of the high-risk hospitalized infant. Thus, many NICUs are transitioning from traditional, medical healing approaches to enhanced family-centered developmental care approaches with the aim of improving infant outcomes and parental mental health. This commentary describes a transdisciplinary neurodevelopmental program based on key principles and recommendations from current and evolving evidence-based care practice guidelines. This clinical initiative, known as the Growth and Development Unit (GDU), was developed within the context of a 66-bed level III NICU. The process of program inception, key elements of program development, as well as program strengths and challenges are discussed. It is increasingly recognized that the long-term outcomes of fragile infants depend not only on the provision of cutting- edge medical care, but also on the optimization of these infants’ early neurosensory experiences and social envir- onment. This is especially important for preterm babies who are born more than 12 weeks before their due-date and often spend many months in the Neonatal Intensive Care Unit (NICU) during a critical period of rapid brain growth and development [1]. As early brain development appears highly sensitive to experiential learning and social–emotional connection [2], the implementation of evidence-based neuroprotective interventions in the NICU are an important part of the infant and family care strategy. Based on this evolving knowledge, enhanced models of family-centered developmental care are being established in the NICU [3, 4], with families becoming integral partners in the care of their infants. Furthermore, NICUs are transi- tioning from a traditional, medical healing-based model to a Neonatal Intensive Parenting Unit (NIPU) model, which seeks to optimize infant outcomes, parent–infant attach- ment, and parent mental health [5]. The purpose of this commentary is to describe an application of such a model following the key principles and expert recommen- dations from current and evolving evidence-based practice guidelines. Within this framework, our team has developed a spe- cialized, neurodevelopmentally-focused program embedded within a 66-bed level III NICU, known as the Growth and Development Unit (GDU). The GDU was conceptualized by a transdisciplinary group of clinicians and parents, with a mission to provide comprehensive, individualized, developmentally supportive health care services for infants and families who transition beyond the acute critical illness phase. A full spectrum of services and neurodeve- lopmental support are offered to GDU infants and families, including highly specialized medical and nursing care, feeding therapy, nutrition guidance, lactation counseling, developmental therapy, care coordination, and family mental health and wellness support, in keeping with the key principles of family-centered developmental care for ICU settings [3, 4, 6]. The GDU was designed to serve a subset of convalescent NICU infants recognized to be at highest neurodevelop- mental risk based on current research [1]. These included (a) preterm infants born before 32 weeks gestational age, * Carmina Erdei cerdei@bwh.harvard.edu 1 Brigham and Women’s Hospital, Boston, MA, USA 2 Harvard Medical School, Boston, MA, USA 3 School of Health Sciences, University of Canterbury, Christchurch, New Zealand 1234567890();,: 1234567890();,: