Open Access Journal Indian Journal of Medical Research and Pharmaceutical Sciences February 2015; 2(2) ISSN: 2349–5340 © Indian Journal of Medical Research and Pharmaceutical Sciences http://www.ijmprs.com/ [17] DEVELOPMEMTALLY SUPPORTIVE CARE IN NEONATAL INTENSIVE CARE UNIT (NICU):-A REVIEW Prasenjit Halder * , Debabrata Bera , Arindam Banerjee *College of Medicine and Sagore Dutta Hospital(Department of Pediatrics medicine), Kolkata, India. Apollo Gleneagles Hospital (Department of Cardiology), Kolkata, Indian Email: prasenjit0024@gmail.com Abstract Keywords: Development, neonate, supportive care, NIDCAP. Although new advancement in health care technology in perinatal medicine the survival of preterm infants and extremely low birth weight neonates has increased. However, the increased survival rate in this group of neonates has not been matched by are reduction in disability rate. Research suggests that the cognitive disabilities, poor academic achievements, and disordered behavioral regulation seen in preterm due to early disruption of their intrauterine life and sudden exposure to entirely unfamiliar NICU environment .So, these newborn needs more developmentally oriented supportive care while they are still in intensive care. Developmentally supportive care is aimed at decreasing the the stress levels in these babies by individualized care which also involves family. Growth and developmental outcomes has been shown enhanced by this approach. This article presents a brief review of current literature as well as the scope of such practices in NICU setting. Introduction Preterm birth has an incidence varying from 5-12%.Advance in neonatal and perinatal technologies has resulted in improved survival especially amongst the extremely low birth weight neonates. However, the increased survival in this group of neonates has not been matched by are reduction in disability rate which has been reported to range from 15-25 %( 1, 2). Research suggests that the cognitive disabilities, poor academic achievements, and disordered behavioral regulation seen in preterm, are the result of early disruption of their intrauterine life and sudden exposure to entirely unfamiliar NICU environment. The fetus requires secure environments for their neurodevelopment- the maternal uterine environment, their parents and their family and community’s social groups. Preterm infants are akin to a fetus developing in the extra uterine environment. Thus, a preterm delivery removes the infant from these secure environments which contribute to malwiring of the neural network and consequent adverse neurodevelopmental consequences. Fetuses experience continuous sensory and kinesthetic stimuli from the amniotic fluid which aids in motor system development. The exposure to maternal diurnal rhythms helps in differentiations sates of consciousness and provides inputs to prepare the primary senses of hearing, smell, taste and sight. The NICU environment fails to provide these vital neurodevelopmental stimuli for the extra-uterine preterm fetus (3) .Besides the separation from parents and family in NICU environment results in later developmental difficulties. Therefore, there is a need to change our neonatal care practices in NICU to support the neurodevelopmental processes in extra uterine environment. Theoretical basis of developmental care Newborn should be viewed as intrinsically social beings who attempt to achieve self-regulation through their interaction with their care giving environment and their consequent feedback. Als et al (4) distinguished categories of behavior in preterm infants: 1.Self-regulatory: Behaviors of approach and groping and seeking stimulations. These behaviors are favorable for infants and need to be encouraged. 2. Stress related: Behavior of withdrawal and avoidance. This result from overwhelming stimulation which the infant cannot integrate and are nonfavorable. Based on these observations Als (5) put forth the synactive theory of development. Synactive theory of development :- The synactive theory of development provides a framework for understanding premature infants’ neurobehavior. The fetus from conception onward is thought to be organized in five distinct