Interacting with Your Premature Baby in the NICU

Talking or singing quietly to your baby can help him or her be calm.

Premature babies and term babies that need special care are cared for in the NICU (neonatal intensive care unit). NICU staff can take care of your baby’s medical needs. Your presence is just as important. Only you can give your baby a parent’s love and care. You may find the NICU scary and confusing at first. But despite the wires, tubes, and machines, you can still begin to form a lifelong bond with your baby. That feeling of warmth and connection is good for both of you. Mothers and fathers often have many of the same feelings about having a sick baby, but they may show those feelings differently—and that's OK. Be patient with each other.

Who can come to the NICU?

As a parent, we welcome you to be with your baby at any time - 24 hours a day, 7 days a week.  You are our most important partner in your baby’s care.  You may want other family members and friends to meet your baby too. Parents can write a list of family care partners and visitors that they approve to see their baby in the NICU.  Speak to your baby’s nurse about specific guidance for family care partners and visitors.  Siblings must be over age 2 years to visit the NICU.  Please bring sibling immunization records for the nurse to review.  For the health of your baby and other babies in the NICU, please make sure that your family and any visitors are healthy and well before coming to the NICU. 

Holding and touching your baby

Very early preemies have skin that is thin and fragile.  Also, their brain is not fully developed.  So they may not be able to cope well with being touched. But as your baby grows and develops, touch can be pleasant for you and your baby. Depending on your baby’s gestational age, NICU staff may suggest:

• Containment: This means putting your hands and arms on either side of your baby while the baby lies in bed. Preemies like this because it’s much like what they experienced in the womb.
• Light touch: Stroking your baby may be too much stimulation. A steady touch is best.
• Kangaroo care: As soon as your baby is ready, skin-to-skin contact is an important step for mothers and fathers. This is your chance to hold and cuddle your baby. Adjust your shirt so you can hold your baby against your bare skin. Cover your baby with the shirt or a blanket to stay warm. Kangaroo care can be relaxing for you and your baby. It may also help your baby recover better or more quickly from some of the medical problems preemies have. Plan on doing it for at least 1 hour to best support your baby’s comfort.
• Non-nutritive (comfort) breastfeeding: Babies with feeding tubes in the mouth, sometimes develop “oral aversion.” Holding your baby and having your baby suckle, even without getting any milk, can help your baby overcome oral aversion. It will also help your baby develop the ability to feed at the breast and will help you make more milk.
• Your presence at the bedside: Your baby knows your voice and scent so being at the bedside is important. Your voice can help your baby be calm so he or she can grow and get better. Once your baby is feeling better, your nurse will show you how you can place your hands on your infant to help your baby feel secure. As your baby feels better, the nurse will let you know when you can help with your baby's care.

Creating a soothing environment

Preemies can be very sensitive to touch, sound, bright light, and other forms of stimulation. To keep your baby as comfortable as possible:

• Let your baby sleep when he or she needs to.
• Keep noise and bright lights to a minimum.
• Try not to hit things on the incubator, talk in a loud voice, or slam doors.

If your baby is in an isolette, there may be a cover over it to protect your baby from the light.  Once the baby is 32 weeks old the nurse will begin removing the cover to help your baby transition to getting used to light/daylight.

Other ways you can be involved

• Personalize your baby’s environment. But first, check with a nurse about what is and isn’t allowed and what’s safe for your baby.
• When your baby is awake, talk or sing in a quiet voice.
• Participate in your baby’s care as advised by your baby’s nurse. This may include diapering, breast or bottle feeding, or taking your baby’s temperature. If your baby is very sick, NICU staff may need to take on more of these tasks, but there is always something you can do.
• Work with NICU staff to develop a plan of care for your baby.
• Share your sense of how your baby is doing with NICU staff. As you get to know your baby, you may notice subtle changes that nobody else does.
• Make sure to take care of yourself, too. If you are feeling sick, it's important that you tell the NICU staff and avoid visiting if they feel your baby could catch a cold or other infections from you. As difficult as this is, it's important that your baby stay as healthy as possible. Ask the NICU staff or your healthcare provider about other ways to protect your baby, such as making sure you have had the Tdap vaccine and a seasonal flu shot.