NICU NOTES

It’s hard to know what to do when your baby is in the NICU. There was a plan, then the plan changed – and for some the NICU can be a scary and intimidating place. It often comes with the rollercoaster of emotions and it’s not uncommon for new fathers to feel a bit helpless and alone. If there is one thing to remember – you are not alone in this. Here’s some notes to help out.

High Level Notes

• The Neonatal Intensive Care Unit (NICU) is a quiet, lower light, calm space for babies to heal and grow. 
• Neo means new, and natal means birth.
• The first US NICU opened in October 1960 at Yale New Haven Hospital in Connecticut.
• About 15% of babies born visit the NICU – and in most cases this is unexpected.
• Most babies admitted to the NICU are preterm (born before 37 weeks of pregnancy), have low birth weight (less than 5.5 pounds), or have a health condition that needs special care.
• NICU care has transformed a lot. For instance, it’s pretty quiet in a NICU – that’s because many studies found that when NICU sound thresholds are set at 50 decibels max, the quality sleep and down time are improved which have a positive impact on the recovery and regeneration in patients at the care unit. These practices are relatively new, and have only taken wider acceptance since 2013! Lots of work is still being done in this area.
• Daily activities for babies in the NICU include dressing and undressing, diaper change, sponging, massage/touch, skin care, sleeping, feeding, and getting time with caregivers.
• Click HERE [short article] for more on NICU overview, reasons for admission, and breakdown of care staff.

The NICU experience is the definition of quickly adapting to a new situation. There is a cycle of surprise and connection that plays out early in NICUs all across the world. Many dads report feelings of anger and hostility, being torn between baby and partner. Most parents are usually not ready to deal with this event. That said, NICU parents often come out stronger than when they went in. Here’s some notes on getting through it.

Things you can do to help your baby thrive.

In General

• Take a slow breath. If you feel overwhelmed, slow it down. Add the “Psychological Sigh” to your tool belt, courtesy of Stanford University and the lab of Dr. Andrew Huberman. [YouTube, 4min 47sec].
• Ask for help. It may not always seem like it, but NICU doctors and nurses want to help you to be as involved as possible in your baby’s care. While many things have changed in the NICU over the last several years, cultural and societal conventions often prevent nursing staff from providing optimal support to NICU fathers. ¯\_(ツ)_/¯ so don’t hesitate to ask, as they sometimes forget to include us. 
• Trust your gut. If something is bothering you, or doesn’t feel right – speak up. It’s a learning curve – don’t be passive in getting the information you need. 
• Ask about resources available. Many hospitals have resources available to parents of babies in the NICU, from support groups, to breast pumps to NicView cameras (to see your baby when you are not there). For other support info, click this local google search “NICU support group near me”.
• Watch this short video on What to Expect with a NICU experience from Cincinnati Children’s [YouTube, 4min 37sec]

Specifically for Dad

• Take care of yourself. Get as much rest as you can, eat as healthy as you can, and take some time for yourself every day, even if it’s just a quick walk around the block. These things help keep your stress tolerance high which helps you stay strong for your baby.
• Mindset of “One day at a time”. This may seem like a shallow platitude, but for many dads, it proves valuable over and over again. Try not to focus on how long your baby will be in the NICU or what the future holds. Instead, focus on what you can do today to make your baby’s stay a little bit better. Some NICU’s work to make this fun – helping parents see their baby work through milestone after milestone (day by day) on the path towards “graduating from the NICU”.

Research Informed Activities for NICU Dads

Sense of touch and hearing are the most well developed senses in preterm babies. It comes at no surprise that most of the research on positive outcomes is associated with using these senses to calm and connect.
Try these:

Caregiver Touch

Touch has a powerful effect on babies’ brains and bodies. It improves response to pain, strengthens heart rate, reduces crying, promotes more sleep, helps with weight gain. It’s become so important that some NICU’s have implemented “cuddler programs” to give human touch to babies in the absence of parents or family members who are unable to visit regularly. Kangaroo care (skin to skin) is the mostly widely taught way to bring positive touch, but positive physical touch has many forms.

Try the “Hand Hug” (aka Facilitated Tucking)

This is a gentle yet firm non-moving/stationary holding. Since most NICU’s work to protect sleep – this is a great activity for when baby is awake or needs some support in managing pain.

Click HERE for an excellent hand hug guide written by a NICU therapist.

Sound Therapy

From voice (spoken, song, recorded) to music (calm music sung softly or played on an instrument or prerecorded) – sound therapy is a powerful way to support kids in the NICU. It’s been shown in numerous studies to reduce crying, improve vital signs, feeding, and sleep. When in doubt, talk/sing/hum it out. Try combing sound with touch.

Click HERE for a short guide to Music Therapy in the NICU.

Caveat: while the sound of a mothers voice (recorded or live) and soft music have many reported benefits – there is still a lack of scientific evidence on the long-term effects of these early interventions, as well as a serious of lack of research on fathers. That said – it is unlikely there is any harm in these approaches. (assuming sound dB levels are kept low).

As you participate in the above, and anyone can do them, be sure to note infant responsiveness and changes in the interactions over time! Touch and sound are the start of building a relation with your baby – and reading their states is part of forming early two way communication with baby.

There will be times when you feel like you’re at the end of your rope – that’s a human thing. Be patient, slow down, look for the positives, lean on others for support. For many dads I’ve spoken with, despite the ambiguity and daunting feelings – it’s also a time when you’ll learn more about yourself and your strength as a father than you ever thought possible. You can endure and you will. 

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