In honor of September being Neonatal Intensive Care Awareness month, I’d like to address those parents who have the Neonatal Intensive Care Unit (NICU) as part of their journey into parenthood.  

Becoming a parent is incredible, in every sense of the word.  As in, the actual dictionary definition: “difficult or impossible to believe."  It requires an intense amount of planning in and of itself, whether that be in a practical way (putting together a nursery, having a baby shower, buying baby supplies) or an emotional way (What will this baby look like?  How will I support this baby?  How will I adjust to the transition of becoming a parent?).

When a person transitions to parenthood with a baby in the NICU, however, a whole new layer is added.  Sometimes parents know from early on in the pregnancy that their baby will spend some time in the NICU.  Often, however, this is something that happens as the result of an emergency - maybe baby was born too early to survive on their own outside of the NICU, or maybe there is a significant health problem that requires the specialized care of the NICU.  Many times parents had just gotten used to the idea of being pregnant, and then are quite suddenly required to adjust to the confusing and, at times, scary world of the NICU.

Either way, transitioning into parenthood with a baby in the NICU can be an intensely emotional time, whether that stay equals a week or months.  Parents may be feeling a range of emotions; both positive (such as gratitude that they have the care needed to keep their child healthy) and/or negative.  

The negative can be overwhelming, to say the least.  Many parents feel a deep sense of grief.  They had envisioned bringing their newborn home in a much different way - maybe a day or two after birth, snuggled into a cute onesie and matching hat, sleeping in the bassinet/in their bed or in the crib they built.  Instead their little one is in an incubator, often attached to tubes and maybe a ventilator, artificial lights and beeping machines blaring in the background. Sometimes, the baby is so frail they can’t be held at first.  Parents are exhausted, as they are supposed to be as new parents, but in a different way.   They’re usually in a sleep room next-door to, but not with, the baby, awakening throughout the night with anxious thoughts, with the hum of hospital noises, or with the need to pump because their baby is too weak to latch.    Or they’re staying outside of the hospital, sometimes far away, and making the trek in as much as possible, just to spend a few precious minutes with their child.  Parents may only have limited time away from work that they hoped would be spent in the comfort of their home, but instead is spent in the hospital. That grief of losing what was “supposed to be” can be consuming.  Parents may even have a difficult time connecting or bonding with their newborn because of this grief.

Then there’s the anxiety and depression.  For many of these parents, every day is full of the ups and downs of assessing their baby’s health.  Some days will be positive and hopeful, while other days may be downright terrifying.  Many times becoming a parent in the NICU involves making difficult decisions about care and interventions for their little one. Each day can bring a new set of worries and hurdles.  

No matter the journey to the NICU, it’s important to recognize that all of these emotions and more are valid and completely understandable.  Although we’re so lucky to live in an era when NICU services (and the amazing staff that goes with those services, which is a whole other blog-post) are available, that doesn’t make the transition easy.  Self-care is incredibly important when you have a baby in the NICU.  

These are some key ways to take care of your needs during this transition:

  • Ask for help – whether that be from family, staff, friends, coworkers or your partner.  Have folks cook meals or bring you food, take care of siblings, arrange for transportation, be a shoulder to cry on.  This could also mean connecting with a therapist in the community who can understand the specific stressors of having a child in the NICU, such as those at Porch Light Counseling.
  • Keep to a routine as much as possible- having a baby in the NICU can put a serious dent in any routine you had established with a work-life balance.  Having a schedule you can try to stick with can be helpful in managing some of that anxiety.  This includes doing things OUTSIDE of the NICU that feel “normal” and healthy for you, like exercising, or spending time with friends/family, so that you can “recharge” and return to your baby a little renewed.
  • Allow yourself to feel all of the ups and downs you may be feeling - vent, cry, scream if you need to.  All emotions are acceptable emotions.  That includes laughing - often parents feel guilty if they have any fun or laugh when their baby is in the NICU.  But finding joy even in the worst moments is an important part of surviving.  And remember that you and your partner may be experiencing different emotions, and that’s ok.
  • Get to know the NICU staff as much as possible.  Nurses in the NICU are your best friend!  They are incredibly knowledgeable, and a special breed of warm-hearted beings.  Use them!  One of the positives of having a baby in the NICU is you have a team of people ready to show you the best ways to care for your newborn.  Another great group of support in the NICU are other parents- no one knows better than them how you’re feeling.
  • Be on the lookout for signs and symptoms of postpartum depression or anxiety.  Having a baby in the NICU does increase the risk of developing these illnesses, so if you notice that you’re feeling down more often than not, worrying so much that it affects your functioning, or otherwise feeling that your mood is unstable, ask for help.  Often the NICU staff or hospital social worker will be able to point you in the right direction of someone who specializes in treating these issues.
  • Set up supports for when you bring your baby home.  “Graduating” from the NICU to home can be both exciting and frightening at the same time.  Suddenly, the full-time experienced medical staff you got accustomed to are no longer available on-demand.  Recognize that this transition may be difficult, and have family and friends help out as much as wanted or needed (that means sending them away, too, if it feels like too much).  Here’s a great resource on how to talk to friends and family about your needs when coming home from the NICU.
  • And finally- remember to breathe and take it one day at a time!