The 11-Domain Neuroprotective Care Framework
A Continuum of Care from Birth Through Discharge
The Neuroprotective Care Program™ organizes neuroprotective care across 11 interconnected domains spanning physiologic stability, daily care experiences, infant and family development, and transition home.
The 11 Domains
The framework follows the infant and family across three connected phases of neuroprotective care.
FOUNDATION—PHYSIOLOGIC STABILITY
Domains 1–3 establish physiologic stability during the infant’s earliest and most vulnerable period of care.
1. Birth & Golden Hour
2. Respiratory Support
3. Thermoregulation
DAILY EXPERIENCE —
DEVELOPMENTALLY PROTECTIVE CARE
Domains 4–8 support the infant’s daily experience through positioning, pain and stress management, sleep protection, skin integrity, and environmental support.
4. Positioning & Containment
5. Pain & Stress Management
6. Sleep Protection
7. Skin Integrity
8. Environmental Support
CONNECTION & CONTINUITY —
INFANT + FAMILY DEVELOPMENT
Domains 9–11 extend neuroprotective care through family partnership, feeding and neurodevelopment, and the transition home.
Family Partnership
10. Feeding & Neurodevelopment
11. Discharge & Transition
CROSS-CUTTING PRINCIPLES
These four principles guide care across all 11 domains of the Neuroprotective Care Program™.
INDIVIDUALIZE
Recognize each infant and family as unique. Tailor care to developmental age, medical status, and family context.
PROTECT STABILITY
Support physiologic and behavioral stability in all domains of care.
RESPOND TO CUES
Observe and interpret infant cues. Adapt care to support regulation, engagement, and comfort.
ALLOW RECOVERY
Build in time and support for recovery after stress, procedures, handling, and feeding.
FROM FRAMEWORK TO PRACTICE
Neuroprotective care is not a separate task. It is a way of approaching every interaction with the infant and family.
Across the 11 domains, clinicians consider physiologic stability, developmental needs, infant cues, family partnership, and opportunities for recovery—integrating neuroprotection into routine bedside care.
Every touch is brain care.
A CONTINUUM OF NEUROPROTECTIVE CARE
The framework is designed to connect individual practices rather than treat them as isolated interventions. From the first moments after birth through discharge and transition home, each interaction becomes an opportunity to support physiologic stability, development, connection, and recovery.
Protecting the developing brain is not one intervention—it is the continuity of care across every moment.
EXPLORE THE RESOURCES
Continue into the evidence, teaching language, clinical guidance, and practical resources that support implementation of neuroprotective care across the NICU journey.