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When you’re expecting a baby, you dream about the first moments you get to spend with your newborn. You imagine counting 10 tiny fingers and 10 teeny toes, stroking their hair and feeling their soft baby breath on your skin. You think about cradling them in your arms, memorizing their face and savoring their presence.
But what you don’t dream about is your baby being born preterm or with a serious health problem and then getting whisked off to a neonatal intensive care unit (NICU) to receive life-saving care. And that experience, as distant as it may seem, isn’t that rare.
In the United States, about 1 in 10 births is preterm. Around the world, that number amounts to 15 million preterm babies born each year.
“The NICU is a place of profoundly delicate baby care, and it’s also the place of interrupted parenthood,” explains Dr. Davia Loren, a neonatologist at the NICU at University of Washington Medical Center. “It’s a very emotional space — we know that, we recognize that and we’re compassionate, careful and gentle for that.”
So while a NICU isn’t what you envision for your baby, you can learn what to expect and how to handle the experience if you find yourself at one.
What to expect in a NICU
The NICU environment can be an intimidating one at first, especially if you’re already feeling overwhelmed. But having a small idea of what you’ll encounter can help.
Depending on the specific hospital, your NICU may be set up like an open nursery with all the babies in one room or as a collection of private spaces for each baby and family.
And while the NICU is a place of healing and care, it’s still a highly specialized medical space. Don’t expect things to be whisper quiet. Buzzing, beeping and the occasional alarm from vital sign monitors are the norm. The NICU team also checks in multiple times a day with babies and their families to do examinations, take tests, change diapers and chat about baby’s progress.
NICU equipment — enclosed incubators called isolettes, ventilators, oxygen masks and phototherapy lights — may seem big and scary in comparison to your tiny newborn, but remember that it’s all there to aid your baby. Don’t be afraid to ask the NICU staff what the equipment is and what it’s used for.
You should also be prepared to follow some specific rules regarding how and when you can see your baby. Older siblings or family members may not be able to visit, especially if they show any signs of a cold or other contagious illness. And when you’re with your newborn, you might be required to follow specific hand-washing methods and potentially wear a mask.
All these restrictions can be frustrating, especially because it’s your baby, but try to remember that these procedures are in place to protect your child.
Seek out support
To help you cope with your NICU situation, Loren says it’s vital to enlist the help of family and friends.
They can shore up your life outside of the NICU — preparing meals, assisting with pet care, picking up kids from school and taking care of household duties — so you can focus on tending to your newborn.
“Gathering your village, your emotional support, is so important,” Loren explains. “Suddenly you’re in a place where your sense of control is gone. This kind of experience can spin you into a rabbit hole, especially if you have issues with control and anxiety.”
To help birth parents cope with this feeling of powerlessness, the NICU at UW Medical Center offers mental health resources, social workers and postpartum depression screenings. But, Loren notes, it’s also important for you to pay attention to how others in your family, from your partner to baby’s siblings, are faring on an emotional level.
“We have weekly conversations as a team and we’re all talking about how families are coping,” she says. “If we have a concern, we raise the issue.”
Connecting with other parents who have babies in the NICU can offer comfort, too. It can be therapeutic to share stories, talk through your worries and, if anything, lean on each other during what is undoubtedly a scary experience.
Ask if bonding opportunities are possible
While the realities of having a baby in the NICU may not mesh with what you first imagined for your newborn, you might still be able to experience some of those moments you dreamed about. Don’t be afraid to ask if common bonding practices like skin-to-skin time or breastfeeding are possible.
“Our babies may have life support equipment attached to them, but those are things we can work with,” Loren says. “They’re not barriers — they’re just inconveniences.”
The way she sees it, NICU staff members are hyperaware that you’re mourning the loss of normalcy for yourself and your child. So when it’s medically possible, they do whatever they can to let you feel normal again, even if it’s something as simple as holding your own child.
“We’ve had babies whose parents are in the intensive care unit, and we’ve brought the baby out of the NICU to do skin-to-skin time,” Loren says. “We’ll move things around in the room, we’ll set up heating lamps and we’ll prop people up in various ways. We’ll do everything we can to get a baby into a parent’s arms.”
The same goes for breastfeeding. Although some babies in the NICU may be too small or young to breastfeed, Loren notes that you can still pump breastmilk and practice nippling, where your baby suckles at the breast.
Eventually, when your baby is developmentally ready, a team of feeding therapists and lactation specialists can help you and your baby transition to actual breastfeeding.
But if it’s just not possible for you to hold or breastfeed your baby yet, there are other ways you can foster your connection. Talk to your baby about their family and the world outside, read to them or sing them lullabies.
Participate to build up confidence
It’s normal, especially if you’re a new parent, to feel uncertain and tentative about caring for a newborn. And that feeling is only amplified when your baby is in the NICU.
“We understand that when a baby enters a NICU, we steal away from parents everything that is a parenting experience,” Loren explains. “We’re holding them, we’re changing their diapers and we’re doing everything that you typically do as a parent.”
While it’s the responsibility of the nurses, doctors and NICU staff to tend to your baby around the clock, keep in mind that your presence matters. Don’t be afraid to ask how you can participate in some of the seemingly simple tasks.
You can offer to take your baby’s temperature, change their diapers and even help with feedings. It’s never considered an intrusion by NICU teams, Loren says.
“We try very hard early on to offer those experiences to a parent so they get a sense that their voice matters,” she notes. “These small things that engage in the care of their babies, they’re ways of expressing a connection and love for the baby.”
Bring home to the NICU
With your baby in the NICU instead of at home, it can feel like your family life is on pause. And while that’s true to some extent, try to put a positive spin on it by bringing a touch of home to the hospital.
“Whatever you can do in the NICU, do in the NICU,” Loren says. “The more you operate from the paradigm of simulating the home environment in the NICU, the happier you’ll be when you go home.”
If your hospital allows it, personalize your child’s isolette or room with decorations. Bring in family photos or tape up letters spelling out your baby’s name.
It’s also a great opportunity to discover more about your child. Pay attention to what soothes your baby, what times of day they are most awake and whether they prefer certain voices, sounds or movements.
“Viewing the journey in the NICU as just part of your larger journey, when you’re able to move on and raise your beautiful child, is going to help you get ready to go home and make that transition as smooth as possible,” Loren says.
Take care of yourself
While your baby’s needs may absorb all of your attention, it’s essential to listen to your needs, too.
“Nothing brings your feet to the ground faster than having a baby,” Loren says. “But you can no more control a NICU journey than a baby who never saw a NICU.”
Be sure to take breaks from the hospital to rest, eat, spend time with family and participate in favorite activities like reading a book or walking the dog. It may feel frivolous or trivial, but these moments help you de-stress so you can be more present when your newborn needs you.
If you’re having a difficult time coping with everything, though, don’t be afraid to seek out assistance from a therapist or mental health expert. It’s completely normal to feel grief from the loss of normalcy, Loren says, and talking to others about it can only help.
“This is a brief moment in your life,” she says. “We know it’s a powerful one and an incredibly impactful one, but it is brief. I find that parents who relax into the experience and learn from and listen to what happens here are the ones who emerge from this stronger and more resilient than before.”
