Behavioral Epigenetics of Family-Centered Care in the Neonatal Intensive Care Unit

To the Editor In an Editorial published in JAMA Pediatrics, Marlow¹ highlighted a critical ethical dilemma for neonatal intensive care units (NICUs). The progress in neonatal sciences has led to higher survival rates for very preterm (VPT) infants. Nonetheless, the NICU is not a surrogate of the maternal womb. Physical and painful stimulations as well as socioemotional adversities are common sources of distress for both infants and parents. To adequately care for VPT infants, NICUs have progressively moved toward the active parents’ engagement, embracing family-centered interventions. Caregiver engagement is increasingly warranted as an ethical and effective practice² to promote an aware assumption of parental roles. Nonetheless, evidence for effective family-centered and developmental care interventions is inconsistent and affected by variability in local practices.¹ To this extent, we propose considering advances in developmental psychobiology (ie, behavioral epigenetics³) to establish a promising pathway to keep up with smart and ethical care for VPT infants.