Dear NICU Mom and Dad,

Lyndsee Baldwin, Registered NICU Nurse

I’ve always enjoyed being in the presence of babies. Their newborn smell and sweet innocence instantly instill happiness inside my soul. One of the primary jobs I held throughout nursing school was babysitting. In my fourth semester of nursing school, I took a maternal health class and completed the maternal health clinicals. On one clinical day, the instructor took us through the NICU. A ten- or fifteen-minute visit was all it took to tell me I belonged there. I was in awe of the nurses, the equipment required to keep these babies alive, and the resilience of those tiny babies, and I knew the NICU was where I wanted and needed to be.

In my last semester of nursing school, I had to complete a preceptorship, and the NICU was my first choice. The NICU offered me one of two available preceptor positions. I spent two nights a week in the NICU, learning from a trained nurse, snuggling babies whose
parents couldn’t be there at night, and experiencing the miracle that is the NICU. Upon graduation, the NICU I precepted in offered me a full-time position, and my dream of becoming a NICU nurse became a reality.

One of the most rewarding aspects of being a NICU nurse (besides caring for the babies) is engaging with families and providing parents with the tools necessary to deliver the best care for their little ones once discharged. The NICU can be overwhelming with all the equipment, wires, and sounds. Mix unfamiliar territory with the stress of having a sick newborn, and new parents are left feeling terrified.

I am passionate about providing education and calming words to parents going through something that should be happy and exciting. When I worked at the Duke Intensive Care Nursery, we could sign up as a recurring nurse on a baby’s team or a primary caretaker. I am partial to this concept because some babies are in the NICU for months, and this continuity of care allowed me to bond with the baby and the family. Nothing is more fulfilling than meeting a family on the first day of their baby’s admission, seeing how discouraged and scared they are, and watching their confidence grow! I’m very blessed to be able to help moms and dads connect with their babies in an atypical environment.

The NICU can be intimidating, and it’s challenging for parents to focus on anything other than what they can see. Vital signs and numbers keep changing on the monitor, everything is beeping, there are so many wires and tubes, and you’re scared to touch your baby because they are so tiny, and you don’t want to hurt them. You didn’t picture your first moments with your newborn to be in an ICU setting.

Maybe you’re thinking, how am I supposed to bond with my baby like this? It’s understandable and easy to forget, amid all the chaos, that you can still connect and create an attachment with your baby. Here are some memorable ways to bond with your NICU baby from a NICU nurse.

• 1. Simply touching your baby.  At first, physical contact with your baby might seem scary. You don’t want to hurt them or mess up wires or tubes. When introducing a mom or dad to their baby in the NICU for the first time, I always orient them to the space and explain what they see. I strongly advocate for physical touch, so I invite the parents to put their hands on their baby. I
  like to demonstrate how to provide containment holds or hand hugs. A premature baby has heightened sensory receptors, so specific movements such as stroking or tapping the baby’s skin can be interpreted as painful by the baby. Hand hugs are the perfect contact form because they provide that sensory connection, making the baby feel safe as if it were back in the mother’s
  womb.
  2. Holding your baby. Holding is one of the most significant ways to bond with your baby. Skin-to-skin, or kangaroo care, benefits the bonding experience and the baby’s overall health. Parents can still hold NICU babies with wires and tubes and partake in kangaroo care. I’ve cared for many babies who can’t seem to get comfortable or have an elevated heart rate or respiratory rate, and as soon as they are put skin-to-skin with mom or dad, they stabilize. Nurses and other healthcare providers will always go out of their way to make sure a parent has the chance to hold their baby!
• 3. Interact with your baby! You can interact with your baby in countless ways, get to know their personality (they may be tiny, but they have giant personalities!), and begin to understand their cues while in the NICU. Urging families to participate in care times is essential. Take advantage of this time to learn from experts who care for tiny babies daily. Become involved by changing your baby’s diaper, changing their outfit, breastfeeding if possible, feeding them if they take a bottle, talking, reading, singing, and participating in bath time (my favorite!). Your nurse will support and encourage you every step of the way. Before you know it, you’ll be comfortable enough to do everything independently, even get a blood pressure and temperature! Getting to know your baby helps create that special bond, but if you know their normal behavior and cues, you will also gain the confidence to know when something isn’t quite right with your baby. I know it isn’t the same as taking care of your baby in their beautifully themed nursery, but these personalized interactions will make the NICU feel less like a hospital and a little more like home.
• 4. Advocate for your baby and ask questions. Your baby can’t advocate for themselves, and nobody knows your baby better than you do. Tell your nurse if your baby’s behavior isn’t normal. Get involved with your baby’s care team, including the nurses, respiratory therapists, occupational and physical therapists, residents, and physicians. Parents are an integral part of
  the care team! Talking with your providers will keep you in the loop regarding long-term and short-term plans and goals. I like to encourage families to do their research as well. It’s okay to advocate for your baby’s plan of care and make suggestions, and if you come across some information you want to know more about, don’t hesitate to bring it up to your providers.
• 5. Document this part of your baby’s story. The woes of the NICU are hard on an infant, and they will go through many challenging situations. It’s common for parents to keep a journal at their baby’s bedside and write daily entries and encourage nurses to write notes. Journaling can be a therapeutic technique that creates a lifelong keepsake. Take pictures of your baby every day so you can see how your baby grows and develops. Many NICUs create photo albums for their NICU babies. With the parent’s consent, nurses will take weekly pictures of the babies and put them in a little scrapbook for the parents. Dress your baby up for holidays, decorate their bed space, take videos of you and your baby when you can, and have your nurse get weekly
  footprints for you to add to your scrapbook. This journey is your baby’s story, but it’s also your story.
• 6. Don’t put yourself on the back burner. Remember to take care of yourself, too. It’s easier said than done, right? I list this as a tip because your baby can pick up on your stress and other negative emotions you may be feeling. To do right by your baby, you first need to do right by yourself. Self-care is especially pertinent for those parents who spend much time at their baby’s bedside. I’m not saying you should forego spending time with your baby, but sometimes, too much time in an ICU setting can be very draining. Take some time for yourself every day, even if that’s only twenty minutes. Create a clear headspace to be there 100% for your baby.
  7. For the working mom and dad. This topic needs more attention, so I wanted to add this little blurb for working parents. Your baby has been born at 25 weeks, and you’ve exhausted all your maternity and paternity leave. You’ve been spending most of your day in the NICU, and now reality sets in, and you and your partner need to return to work. Many parents struggle with this enormous guilt, feeling like they aren’t spending enough time with their baby. I’m here to tell you that your feelings aren’t abnormal. Your baby knows your scent; they won’t feel neglected, and you won’t lose that connection with your baby. Being a parent with a baby in the NICU is challenging. You and your baby will experience ups and downs. You will have setbacks, but you’ll also conquer huge milestones. The feeling of being overwhelmed and discouraged comes with the territory. Give yourself grace. I implore NICU parents to find the support of people who understand what they’re going through. There are many Facebook support groups for NICU parents, and it’s easy to bond with other parents who have a baby in the same NICU as you. Be present in every moment, both physically and mentally and emotionally. Don’t doubt yourself. There is no better mama or daddy for that baby than you. Every moment, good and bad, is precious, and you’ll want to remember it because these memories will serve as a testament to what your family has overcome. Your love for your sweet little one is unmatched. Remember that you’ve got this!