Babies born too early often have a challenging beginning, especially regarding how their brains grow. The special hospital units that care for these babies, called neonatal intensive care units (NICUs), which are highly specialized areas for critical newborn care, are essential for survival but can sometimes create stressful environments that affect brain development. Understanding how important sights, sounds, and touches are for brain growth, experts looked for a better way to support healthy development right from the start.
Lisa Sampson, Maureen Luther, Dr. Asaph Rolnitsky, and Dr. Eugene Ng, a team of newborn care experts from Sunnybrook Health Sciences Centre and the University of Toronto created a new guide called the Sensory Development Care Map. Featured in the medical journal Children, this colorful, easy-to-read guide helps parents and hospital caregivers understand how to help develop a baby’s senses based on how early the baby was born.
Caregivers can use the map to know the best times to gently introduce sounds, lights, or touch and when to avoid too much stimulation. Families using it say they better understand how to support their baby’s development. Available both as posters with a QR code with the link to the map in hospital rooms and as a digital version online, the tool is always easy to find and use.
Before this guide, the hospital had already implemented a program to successfully reduce serious brain injury from bleeding in premature babies. However, the team realized that keeping the brain safe wasn’t enough. “Positive sensory input has been shown to have beneficial effects for preterm infants and the emotional bond with their caregivers,” explained Dr. Ng. Their team began promoting gentle, loving interactions called “Nurturing Encounters,” a term used for comforting moments like skin-to-skin cuddling and calm, reassuring touch.
Surveys and observations of parents and staff at the Sunnybrook NICU revealed that parents often receive mixed messages about how to promote their babies’ senses, leading to confusion in this highly stressful environment. Nurses also shared that while they knew how to keep babies safe, some didn’t feel confident teaching parents how to help their baby’s brain grow through sensory activities. Clearly, there is a need for more consistent and clear advice in this area.
Following a step-by-step quality improvement method known as Plan-Do-Study-Act cycles, which is a way to test and improve new ideas, the team designed the Sensory Development Care Map using color bars to show when different sensory actions should start or be avoided. The map was designed after reviewing many studies and took into account common practices in their hospital. Based on feedback, the team added large posters, smaller handouts, and scannable codes that link to the map online. “The Sensory Development Care Map allows the families to set appropriate goals of care for their infant for a particular age at birth,” said Dr. Ng.
Since the map was introduced, families and caregivers have been spending more time in nurturing activities each month. This rise shows how the map supports and encourages positive actions. Parents have shared encouraging feedback, though some said they would appreciate clearer color explanations and being introduced to the map earlier during their hospital experience.
Clearly, the Sensory Development Care Map is more than just a guide. It represents a shift in how hospitals help support babies’ brain development. Parents are now seen as important partners in care, supported by tools that help them feel confident and involved. By learning together and sharing responsibilities, families and caregivers are creating better outcomes for the smallest and most vulnerable patients.
Although the long-term results of using the map are still being studied, early signs are encouraging. In an environment filled with machines and medical routines, this gentle and thoughtful tool is helping to cradle the brain, to protect and nurture young minds during the most critical time of their growth.
Journal Reference
Sampson L., Luther M., Rolnitsky A., Ng E. “Enhancing Neurodevelopmental Outcomes in Preterm Infants Through the Sensory Development Care Map.” Children, 2025; 12(2):192. DOI: https://doi.org/10.3390/children12020192
About the Authors
Dr. Eugene Ng is a newborn intensive care specialist based at Sunnybrook Health Sciences Centre, affiliated with the University of Toronto in Canada. He completed his tenure as medical director of the tertiary neonatal intensive care unit (NICU) at Sunnybrook from 2013-23. He is an associate professor of paediatrics at the University of Toronto, and an associate scientist at the Sunnybrook Research Institute. His research interests include neonatal respiratory physiology, nutrition for preterm infants, systematic reviews, standardization and quality improvement. He has provided medical leadership to the interprofessional quality improvement team at the Sunnybrook NICU to develop expertise in care of the micropremature infants, in collaboration with the international Vermont Oxford Network, leading to significant improvement in outcome of this vulnerable group of patients. He is the co-chair of the Brain Health Group for the Evidence based Practice to Improve Quality (EPIQ) initiative of the Canadian Neonatal Network, focusing on best practices in neuroprotection and neuropromotion for preterm infants. Beyond his academic achievements, Dr. Ng is providing leadership in defining pediatric care in Canada as a member of the board of directors at the Canadian Paediatric Society, and a member of the governing board at the Canadian Neonatal Network. He is recognized for mentoring the next generation of neonatologists as an educator in one of the largest neonatal-perinatal medicine training programs in Canada.
Dr. Asaph Rolnitsky is the Chief of Newborn and Developmental Paediatrics and the medical director of the neonatal intensive care unit (NICU) at Sunnybrook Health Sciences Centre in Toronto, Canada. He graduated from paediatrics in Schneider Children’s hospital and the neonatal-perinatal medicine subspecialty program at the University of Toronto, later the VA Quality Scholars fellowship in Quality Improvement (QI). He received his Master’s degree in healthcare quality from Queen’s university in Kingston, Ontario, and is currently enrolled in a PhD program in health services research. Dr. Rolnitsky is involved in numerous QI interventions targeting better outcomes of micropremature infants and research studies in health services costs of NICU care. He teaches quality improvement sciences at the University of Toronto, Queen’s University, Vermont Oxford Network, and others. He is also the education director of Sunnybrook NICU and involved in multicultural competence education to trainees. He has received several awards for his clinical, leadership, and education excellence.
Maureen Luther received her Bachelor of Science in Physiotherapy and her Masters of Arts in Special Education from the University of Toronto. In addition, she has completed extensive training and certifications in several infant motor and feeding assessment tools. She has taught nationally and internationally on topics regarding prematurity, developmentally supportive care within the NIUC, feeding and long-term neurodevelopmental outcome for preterm infants. While Maureen is currently partially retired from Sunnybook Health Sciences Centre where she worked in the NICU and the Neonatal Follow-up Clinic from 1989 to 2020, she continues to participate in educational and research projects involving preterm infants.
Lisa Sampson is a Registered Nurse in the neonatal intensive care unit at Sunnybrook Health Sciences Centre in Toronto with 24 years of experience. Over the past six years, she has been the quality improvement (QI) team leader and QI coordinator for Sunnybrook, in collaboration with the international Vermont Oxford Network, and has led several QI projects focusing on the optimal care of our smallest, most vulnerable patients. Lisa is also a co-chair of the stabilization and support during transition (START) taskforce for the Canadian Neonatal Network.
