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Bonding in the NICU

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Cara Dumaplin

RN, BSN, Certified Pediatric Sleep Consultant

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parent's hand touching premature baby in the NICU

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The Neonatal Intensive Care Unit (NICU) is a place where miracles take place. But no one expects to be there. Many wonder about bonding in the NICU.

While the NICU is not the place where you imagine your baby’s first days, 10-15% of babies spend time in NICU care. That time can feel confusing and scary as new parents try to navigate a medical situation while trying to bond with their new baby. When I worked in the NICU myself, I saw this struggle firsthand.

I would love to offer you some encouragement and practical tips from a neonatal nurse. I’ve also asked Chelsea on the Taking Cara Babies team to add some of her best insight and tips as a Child Life Specialist and parent of a baby who spent time in the NICU.

Here are our top suggestions for bonding in the NICU:anchor

(If you have any questions about what is most appropriate for your baby, please consult with your baby’s medical team.)

1. Visit when you can.anchor

Your presence alone can have a long-term positive impact on your baby’s development and give you confidence as a parent too. Spending time with your baby is such an important part of bonding in the NICU.

However, you may find yourself wanting to be at the hospital every waking moment or feeling guilty for every second you’re away. Please do not let yourself take on this burden. Do not feel guilty for going home to sleep and shower. Do not feel guilty for being present with your other kids outside of the hospital. Do not feel guilty for taking care of home or personal responsibilities. This is a VITAL part of taking care of your baby. Remember, your baby needs a healthy and present parent when you do visit AND when that sweet baby is ready to come home.

2. Take time to learn your baby’s cues.anchor

Did you know that even the tiniest babies give signs as to how they are feeling in a given moment? When you are visiting, you can learn your baby’s cues which will help you know if he or she is overstimulated, calm, ready to interact, hungry, or tired. Your baby’s team can help you learn about some of the subtle cues of a premature infant. 

3. Get involved in your baby’s care.anchor

While you are visiting, there are many ways you can be an active part of your little one’s day.

Your medical team will be more than happy to show you ways to provide care for your baby and teach you how to meet your baby’s needs. Take advantage of this time to learn from experts who care for tiny babies every day. Many parents who have been in the NICU feel this time is invaluable as they receive one-on-one instruction from healthcare professionals. This is truly a priceless gift for new parents! 

Helping with things like diaper changes, feedings, holdings, and basic care can empower parents to feel more involved and truly does have a monumental impact on a baby’s development.

The Taking Cara Babies Will I Ever Sleep Again? newborn class is a perfect next step to help you learn more about your baby and equip you with tools that you can use as your baby prepares to come home with you. The lessons from the class will build on what you’ve learned in the NICU and give you so much confidence moving forward. Taking Cara Babies uses adjusted age for babies born prior to 37 weeks (age from due date rather than birth date) for expectations to make sure that we’re caring for your baby in a developmentally appropriate way.

4. Meet your baby where he or she is developmentally.anchor

For some babies in the NICU, this world is full of stimulation that tiny bodies just aren’t ready for. Talk to your healthcare team about your baby’s development and medical stability so that you can understand the best ways to interact with him or her. If your baby isn’t ready for the noise of this world, simply being quietly present may be the best way to love your baby.

If your baby is ready to be held, practice skin-to-skin care. Shirts like the NuRoo are great for helping to feel covered and still practice skin to skin. If your baby isn’t ready for skin-to-skin, but is able to be touched, simply place your hands gently, but firmly on your baby’s body. Avoid tickling or rubbing as this can feel overstimulating. Remember, touch can be a huge part of your baby’s growth and development. Your baby’s team can help you know what is most beneficial.

Talking, singing, or even reading books can be a way to bond with your baby when your little one is developmentally and medically ready for this. Research shows that, for NICU babies, more exposure to a parent’s voice is associated with higher cognitive and language scores as they get older. For late-term premature infants (those born at or after 35 weeks), some research shows that playing a recording of a parent’s voice can help babies sleep better in the NICU. This is a great option for families who might not be able to be present as much as they would like. Talk with your medical team to see if this is an option for your baby.

5. Remember that you ARE the best parent for this baby.anchor

In the NICU, there are so many healthcare professionals who help care for your little one. It may seem that these professionals know everything about your baby and your baby’s needs. It may feel as though there is so much to learn. Perhaps you are completely overwhelmed. Perhaps the nurse can calm your baby more effectively than you can at this point. Maybe you still fumble around when changing that tiny diaper. Please remember, these are new strategies for you, and your baby’s medical team is full of experts who get to practice these techniques every day. The expertise of your nurses and doctors does not make YOU less vital to your baby.

New mama, new daddy: YOU are still the best parent for this baby. Your love for your sweet little one is unsurpassed. YOU are meant to be this baby’s parent.

 6. Leave reminders behind while you are away.anchor

One way to support your baby in the NICU when you have to be physically away from him or her, is to have something with your scent on it placed in the baby’s isolette/bassinet. Smell is one of the strongest senses for your little one in these early days. The easiest way to do this is to sleep with an object (clothing article, swaddle blanket, etc.) and have it placed under or near the baby as appropriate and approved by the medical team. Another option is a comfort item like this panda bear designed for use in the NICU.

You can also decorate the baby’s area.  Many families find that making a sign with your baby’s name, decorating with family pictures, or adding other personal touches can feel like you are giving your baby a piece of home while you are away.

7. Take mementos of your baby with you when you leave.anchor

Keeping reminders of your new baby close can help foster that bond with a new baby for parents as well as older siblings. You may not be able to take your baby home yet, but you can put a picture on the fridge or on your phone, watch a video of visits, or take a piece of the baby’s clothing home with you. For moms who are nursing/plan to nurse, have these reminders close by when pumping. It can actually assist with letdown.

8. Document this important part of your baby’s story.anchor

Some families find that documenting their baby’s experience in the NICU by journaling or scrapbooking (either digitally or in physical form) can be helpful.

In this moment, taking photos and journaling experiences may feel very tender or even painful. I encourage you to document what you can and when you feel able. In moments when you’re not feeling up to it, ask someone else to help you do this by taking pictures or writing memories. This is an important part of your story as parents as well as an important part of your baby’s story, and you will be so thankful to have these memories documented in the future.

9. Give yourself so much grace.anchor

If you feel overwhelmed and insecure, you’re not alone or failing at this. If you’re feeling sad or confused, that’s okay. These are all such normal responses. You have a new baby!!! For moms, your own body is recovering from a major event. As a new parent, there are so many new emotions and concerns, and having a baby in the NICU adds new challenges you may not have even considered before your baby was born.

During Chelsea's career as a Child Life Specialist, she spent time supporting families bonding with their babies in the hospital. She had all of the education and theory in supporting families in the NICU, and yet, when her own baby was in the NICU, even she felt overwhelmed. She felt disconnected from her baby; it was different from what she had dreamed of for so long. Even so, Chelsea and her husband were able to bond with their sweet baby, and both Chelsea and I have seen countless other parents bond beautifully as well.

So, in moments of doubt, please remember: There is no better mama or daddy on this planet for that baby than you! You got this!

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