Sitting beside your baby in the NICU while he is hooked up to machines, wires attached to his body, overwhelms new parents and stirs a flood of thoughts and emotions. The majority of babies are in the NICU because of premature birth (born prior to 37 weeks gestation), but babies can be admitted for other reasons, such as breathing problems, low birth weight, heart conditions and other complications. The tidal wave of parental emotions, though normal, can knock parents off their feet.
Loss
Like any expecting parents, NICU parents dreamed of how the end of pregnancy would be, wrote a birth plan and envisioned how the first few hours after birth would go. Mom looked forward to nursing her child, and both parents pictured bringing home a healthy newborn and starting life with the new addition to their family. When a baby is in the NICU, the experience is very different. Moms may grieve the loss of the end of the pregnancy and feel jealousy toward other mothers who carried their babies to full term and experienced a typical birth with big, healthy babies. It is frustrating to have to wait for the appropriate time to feed your baby, ask for help picking him up and worry about germs when he comes home because of his lower immunity. Feeling a sense of loss over these things is totally normal. Acknowledge your feelings and talk them through with a loved one or a professional counselor. In time, you can begin to set new dreams and goals for your family’s future.
Fear
Fear is a common, completely normal, response to having a baby in the NICU. Most parents do not have previous experience with the NICU, which creates a fear of the unknown. Parents worry their child will have long-term medical issues or that they are not capable of caring for them at home. The nurses and doctors are there to explain things and help you understand what is going on. Their goal is for you to feel comfortable caring for your child, both in the hospital setting and after you bring the baby home.
Guilt
Parents often question what they could have done differently in order to have a different outcome, a normal birth and no NICU stay. Mothers, in particular, blame themselves for the situation. Feelings of guilt and blame are common when a baby is in the NICU, but most premature babies are born early for unknown reasons. In the majority of cases, nothing could have been done to prevent premature birth. Discuss your feelings with your partner and with the medical staff in the NICU. They will help you work through your feelings and move forward as a family.
Feeling “on display”
Many NICUs have open areas with multiple cribs. Parents can feel like they get little or no privacy. Curtains can do little to keep conversations private, and nursing moms can feel like they are out in the open. Nurses and doctors are in and out, and you may feel like those medical experts are “watching” you all the time. Though the experience is uncomfortable, note that the NICU staff is watching to make sure you know how to care for your baby. They are there to help. As a NICU parent, let family and friends know that you need some time alone to unwind. They will be happy to give you the space you need.
Powerlessness
In the NICU, your baby will be surrounded by nurses and doctors who are caring for her. It’s normal to feel overwhelmed by the medical equipment. Ask the nurses to teach you how to work around the tubes and wires to change diapers, take temperatures and bathe your child. Once you begin to be a part of your child’s care, you will feel less helpless and more like a parent of a newborn.
Anger
Some parents may have feelings of anger that their child is in the NICU. It is easy to blame doctors, NICU staff or your partner for the situation. You may feel angry that someone else is taking care of your child or that you are in this situation in the first place. Anger can be expressed in different ways. One person may express anger by acting rude, demanding and being vocal, while others may retreat from the situation or into themselves, resulting in a form of silent treatment. Try to let go of anger and focus on you and your baby. Vent to a friend, write in a journal or use exercise as an outlet. Feelings of anger take a lot of energy, and you will need to save all of yours for taking care of yourself and baby.
Feeling disconnected
When your baby is in the NICU for an extended amount of time, parents may feel a disconnection from the child. This feeling can be surprising and disturbing, but it is both normal and common for NICU parents. Shortly after birth, the baby may have been whisked away for medical care. Hours pass before the baby and parents are reunited, and then it may be several more days before it is safe for parents to hold their child. Mom is often released from the hospital long before the baby is allowed to join the family at home, and during that time the main caregivers are doctors and nursing staff. No wonder so many parents feel disconnected from their child! Be honest about your feelings and share them with the NICU staff. They will encourage you to become more involved with Baby’s care and help you work through your feelings in a healthy way.
As a NICU parent, you may feel one or all of these emotions as you walk through this journey. Keep in mind that the NICU staff is there to help guide and encourage you and your family through the process. Many NICUs have social workers on staff to provide any resources you may need to make a smooth transition in bringing the baby home. In time, the baby will grow and thrive, and the NICU experience will be a thing of the past.
Common NICU Terms
- Adjusted Age: The child’s age minus the number of weeks he or she was born early. Adjusted age is calculated until approximately age 2.
- Apnea: When a baby stops breathing for 20 seconds or longer, also known as an “episode” or a “spell” and is commonly associated with low heart rate (bradycardia).
- Blood gasses: The amount of oxygen, carbon dioxide and degree of acidity in the blood.
- Bradycardia (“Brady”): An abnormally low heart rate due to a pause in breathing.
- Continuous Positive Airway Pressure (CPAP): Tubes are attached to a ventilator and oxygen is delivered through the baby's nostrils. This helps the baby breathe but does not breathe for her.
- Incubator or Isolette: An enclosed bassinet used to keep preemies warm.
- Kangaroo Care: Skin to skin contact between parent and baby.
- Nasogastric Tube (NG Tube): Flexible tube inserted through the nostril, down the esophagus and into the stomach. It is used to give food or remove air from the stomach.
- Room air: This is the air we breathe without oxygen support.
- Ventilator (or respirator): A mechanical breathing machine that delivers air to a baby's lungs. The ventilator breathes for the baby as her lungs recover.
Sarah Lyons is a mother of six children, including 7-year-old triplets who were born six weeks premature. The triplets spent 16, 19 and 41 days in the NICU before joining their family at home.
As always, please consult your health care provider with any questions or concerns.