Bonding with Your NICU Baby

Much ado is given to “bonding with babies,” especially birth bonding. Parents are encouraged to bond to their babies at birth, if not before. For many parents, bonding comes easily and naturally. For others, it is a harder process. For preemie parents, it can seem like climbing Mount Everest – impossible and exhausting.

Preemies are not miniature full term babies, and the earlier a baby is born, the harder it might be to bond with them. Parents of full term babies are encouraged to hold their children skin-to-skin immediately after birth, breastfeed on demand, baby wear, and respond to their baby’s cry. But how do you bond with a baby who was whisked away for life-saving care immediately after birth, is too fragile to be touched, and cannot breastfeed? Here are ten ideas that can help you bond with your NICU baby.

Laura bonds with her 35 week preemie.

1. Pump your milk: Providing breastmilk for your child is the one thing you can do for your baby that no one else can. Even if you are unable to provide all of her meals, a little milk can do wonders for a tiny, immature gut.

2. Bond with his caregivers: Natalie, the mother of a 25 week baby, said, “Although you can’t do a lot with a 25 weeker, it’s nice to know how your baby is used to being handled by the nurses and doctors. This way, when you DO take over care, you can maintain consistency for your baby and help him/her to feel safe. In addition, knowing what was going on – in detail – helped me feel like I was getting to know (my daughter’s) personality even though I couldn’t interact with her the way normal mothers can. Like how much she liked to try to extubate herself, and how much she hated those wipe-down baths.”

3. Talk to your baby: If you feel silly talking to a baby, read a book. It doesn’t have to be a children’s book – any one will do! If you can’t go to the hospital as often as you want, record your voice talking and singing to your baby. The staff can play it when you aren’t there.

4. Hold your baby: Hold your baby as much as is possible, but know that the earlier a baby is born, the more likely they are to be unable to tolerate touch. Touch can be painful or upsetting to the baby, and they show this by dropping their heart rate and oxygen levels. It’s very hard, but those are your baby’s cues that, right now, he wants to be left alone. Just as you would respect a term baby’s cues to be left alone to sleep, you need to respect your preemie’s cues.

5. Decorate his room: Bring in pictures from home – your older children, your pets, the grandparents. Bring in special stuffed animals and colorful blankets to cover the incubator. Make this “new home” as homey as possible.

6. Leave your scent: You, your partner and even baby’s siblings can sleep with some soft cloth items and leave them for your baby. “Tag” blankets, animal blankets, large burp cloths and receiving blankets work especially well. I would often pump with a burp cloth under my breasts so any milk that dripped would catch on the cloth. When the time came to wash the cloth, I would hold it close to smell my baby as I pumped. His scent would facilitate a letdown.

7. Dress your baby: As soon as the staff gives you permission, bring in her clothes. Don’t worry if they don’t fit perfectly.

8. Take pictures: Put together a little “brag book” for yourself. You have as much right as any parent to show off your new one!

9. Celebrate your baby: Many faiths have an initiation for infants, such as a baptism or dedication. If you wish, have your child baptized or receive a blessing. If you don’t feel like you can celebrate his birth, celebrate another first, like the first bath or the first time he comes off the vent. A celebration can be anything from a special dinner for the parents to a small toast with juice or a simple high-five with the staff.

10. Don’t force yourself: For most parents, bonding will happen. Sometimes it happens in the hospital; for others, it happens at home, away from the stress and daily grind of the NICU. It’s misleading, I think, to imply that bonding is always a strong, intense, “bolt of lightning” moment. That happens to some but for many other parents, it is a slow, gradual process.

I was a very lucky and atypical NICU mother. Puddin’Pie was born at 35 weeks and was able to breathe at birth. I was able to hold him for a short amount of time before he had to go to the nursery for monitoring and, later, a Level III NICU. Although we had that short time together, something most NICU moms do not have, I still had trouble considering him “mine.” I loved him deeply but I felt like I had work to bond with him, something that came easily with my other children. At times, I wondered if it would ever happen.

Today, he is 22 months old and very much bonded with his family. Although we were unable to bond in the typical way, it happened and he is the happy, well adjusted toddler I hoped for, in spite of his rough beginning.

_______________________________

Laura is the mother to a herd of four young children, wife to her Engineer Husband and owner of a pesky dog. Her 35 week preemie is so well bonded to her husband, they sometimes feel he is super-glued to Daddy’s leg.

About The Author: Laura

Walden Mommy: Life Behind the Red Front Door My NPN Posts

Laura is the mother to a herd of four small children, wife to her Engineer Husband, and owner of a pesky dog. She blogs about her life in the Midwest at Walden Mommy: Life Behind the Red Front Door.

25 Responses to Bonding with Your NICU Baby

  1. Anna  

    My twins were born at 32 weeks, and I can’t stress the importance of Kangaroo Care enough! :)

    One twin was able to latch on at start nursing a wee bit three days after she was born. It was a stunning moment to me having read that preemies “could not” nurse before then.

    Also, we left a small recorder that the nurses put in their incubators at night when we weren’t there. It was my husband, their big sister and myself singing a few songs and reading books.

  2. Christina

    Beautiful piece, and such great advice!! Many moms end up in the NICU unexpectedly and have no idea what to do from there.

  3. Jenny

    I have a boy who was born at 29 weeks. I managed to pump breastmilk from the very beginning and the first 24h he got donated breastmilk. So he never had to get formula. We (me and my husband) took turns sitting with A by the incubator, with our hands inside, laying still on him. And then of course kangaroo care as soon as we could take him out of the incubator for some time. I gave him food with his mouth by my breast so that he could feel the nipple when he ate. I ended up breastfeeding him exclusively for 6 months and part time for 15 months. Now he is a very happy little guy, 23 months old. =)

  4. Dionna  

    Tom and I were lucky enough to be able to room in with Kieran when he was in the NICU – that gave us a wonderful opportunity to bond! I pumped out of necessity (bad latch, lazy nurser), but I would have definitely pumped if he wouldn’t have been able to nurse at all. It made me feel useful!
    These are awesome tips, Laura – thank you for sharing!

  5. Laura

    Thank you Ladies! :)
    @Anna- wow, she nursed at 32 weeks! What a rockstar! Puddin’Pie had trouble nursing at 35 weeks. We used a nipple shield and had to pump and supplement until he reached his due date.
    @Dionna- the NICU my son was in did not, at the time, have a space for parents to room in INSIDE the NICU. Now they have a “breastfeeding room” where mothers of the “Feeders and growers” can sleep and bf on-demand with their baby. I was so pleased when I heard that!

  6. Karen  

    I worked on an NICU for 12 years and agree totally with what you have said.

    Kangaroo care was nearly my cure all for big and small and most of the time I was happy to get even ventilated babies out (depending on what lines they had in and whether they had had any procedures recently) Some nurses are not as comfortable doing so but it is worth asking it is good for you (and Dads)and the baby. You need to choose a time when the unit is quiet (late evening early morning are often good times) and you can sit comfortably for at least 45mins. With the really preterm babies they sometimes object to being moved initially but often settle in under 10mins and show how happy and relaxed they are by how steady their heart rate becomes, needing less oxygen and how their toes warm. One tip to help the very little ones cope is not to over stimulate them while having a cuddle, ask for the lights to be dimmed, keep noise to a minimum and try not to rock, stroke, pat…. it can be very hard initially to resist because it seems to normal but many find it too much until they have matured a little.

    If you can’t hold them then ask about just touching them, your touch is very different from the nurse or doctor yours is not doing something it is just a pleasant caress which smells far better because it is you. Again it’s worth remembering that like when cuddling them too much stimulation can be too much so try not to stroke etc initially just place your hands on them. A crying or distressed baby can often be soothed by placing one hand on the top of the head and another restricting the movement of feet/legs and gently holding that position. They are used to being confined when in your tummy and feel secure when they can feel that gentle restriction and know where the edge of their world is.

    When you go to your baby always great them and say goodbye the same way then they get to know it’s you although they will recognise your voice they could hear it inside. Always tell them what you are going to do touch hand, change nappy… before you start then they won’t get a shock when you start (Nurses and dr’s should do this too). If you cannot be there all the time try making a tape which staff can play to them when you are not there, saw the most amazing reactions from babies when parents did this.

    Ask what tasks you can do you will be shocked how quickly you can help with changing nappies, feeding…. BUT if this makes you feel really stressed say so do not feel you must do things you are not comfortable with.

    Having a Kangaroo cuddle will help your milk supply, expressing where you can see your baby or with a picture can help too, having something they have worn, or a blanket they have laid on to sniff can also help.

    Keep a memory box, if you are a diary writer or blog writer that can help too this was one a couple of parents who’s lovely daughter I looked after for a short while did http://www.abigailns.co.uk/Hospital/index.htm

    All Mums and Dads cope in different ways, many find it very hard and worry about becoming attached to a baby they feel may die. Please talk about things that worry you no matter how trivial you think they are, ask questions as often as you need to, get staff to draw diagrams or write things down if you think it will help. If someone does something that upsets you if you cannot talk to them find the nurse in charge or the nurse looking after you baby and talk to them about it, the person in question probably dose not even know they have done it. When you are home give us a ring ring before you go to bed, in the night when you get up to pump, when you wake in the morning before your partner goes to bed…. when ever you need to, we do understand, if we are busy at the moment you ring we will get someone to pass on a message.

  7. Laura

    Thank you, Karen, for your wonderful response!

  8. SunRa  

    My youngest daughter was not preterm, but she ended up in the NICU for five days after birth anyway. It was really distressing and I tried my best to be there with her as much as possible. I was under extreme duress at the time (details of which i will not go into) and found it difficult to focus on anything, including her. I also had two other children at home who needed my care as well. I wish I had had more support at the time to be able to spend more quality time with my new little one who was stuck to an IV for five days, unable to go home with me. I often think that some of the issues I see displayed in her personality now are a direct result of those very traumatic and lonely five days.

    • Laura

      I understand. My preemie is my third and when I was with him, I wanted to be home with my others. Home with them, I wanted to be in the hospital. I also did not have alot of help, something I resent. That made it much harder.
      Many hugs to you and your sweet little girl.

  9. livi  

    4 and a half years later I STILL remember with tear in my eyes. After our second home birth of my now 4 and a half year old son and having difficulty to breathe on his own due to a staff infection and fever, we decided to transport him to Children’s Hospital in Los Angeles. 7 days of red tape, needles, and BS tubes to feed him simply because breastfeeding for the first couple of weeks or more WAS NOT ALLOWED in the NICU/ICU environment!… My wife and I FOUGHT 3 LONG DAYS and NIGHTS just to start to enjoy a basic right for a few minutes while monitored and constantly observed by a nurse. I can’t forget her suffering as a mother and mine as a father knowing that our first daughter did not have to endure that experience. “Imagine if this was our first and we haven’t had the experience and the knowledge we had?”. NO BABY UNDER ANY circumstance should be deprived of bonding and breastfeeding with mama!… No BODY even the head of the Neonatal Department at Children’s Hospital could STOP YOU.. the sad part: we were actually the first couple to have done so. Our beautiful son was supposed to stay in the NICU por 3 or more weeks without any objective reason after he was in fact cleared from tests and ready to be discharged 6 days later doctors were still making up NEW excuses on each and every visit. Let me say this clear as much as there are beautiful doctors out there, the system wants YOUR money, “your insurance may not cover this, MAY not cover that, if you don’t do this if you don’t do that… LISTEN: BS… I am OUT of this sterile environment, my baby does not need it, bye, bye” literally, we stood up pack and start leaving. You had to see how fast they prepared all that paperwork. Just in case you still wondering: yes we made the right decision.

    • Laura

      I often thought that I was glad my preemie is my third. I knew I could breastfed and I had wonderful resources at my fingertips. I knew how parent, change diapers, all those little thing. Knowing those made life so much easier.
      That breastfeeding information is insane. I understand it with preemie or those with breathing issues but not in some other cases. Many, many drs out there are wonderful and supportive of breastfeeding and attachment parenting. Sadly, it is the few that are not that can really make your life miserable.

  10. Lauren  

    Wow, thank you for this great list of ideas for bonding in the NICU. I will definitely be passing it on to anyone I know who might need it.

    I haven’t had a NICU experience yet, and I can only imagine how stressful it must be. Just having been in the hospital to give birth, I know how it can be hard for some people (me, for instance) to remember in that situation that they’re the parent, not just a patient, and that they have a say in their baby’s care. And I’m sure with a preemie, most parents are so nervous about affecting the baby’s health negatively by questioning the staff or taking initiatives that aren’t suggested by the hospital (like kangaroo care in a hospital where it’s not common). I have no solutions there; I just feel for you NICU parents! I think this practical list will give some concrete ideas for ways to interact in a satisfying manner. Thanks!

  11. Janet  

    Our 27 weeker is now 28 months old. We were in the NICU 291 days (a really long time, even for a 27 weeker).

    Kangaroo care is so so so important – we started at a week old, even though he was intubated (would have been sooner, but he was on an oscillator vent and couldn’t be moved). There are some hospitals in Europe now that do not have isolettes – every baby is held 24/7 by parents and close relatvies.

    We wore my son once he had his tracheostomy, even with a ventilator – we had an argument with the docs about why parents *need* a stroller, because we hadn’t planned on buying one.

    On clothes – there are specialty shops that make clothes for even micro preemies; our nurses said that had we asked, they would have let us put a shirt on my son to take a picture even when he wasn’t supposed to be dressed.

    Breastfeeding was out of the question with his early respiratory status, but I wish NICUs were more open to donor milk – sometimes pumping is not enough. Many NICUs have a lactation consultant on staff, and if you’re planning on breastfeeding, make this person your new best friend :)

    Also, if you’re going to be there a while, ask to put together a primary nursing team – this way you get the same nurses over and over. Having the same people caring for your child day after day helps you and your child, because they become familiar with what’s “normal” for your baby.

  12. Ruth

    LOVE this article!!!! Full of beautiful advice and I wish I had of read this before delivering our son at 25 weeks! We spent 4 very long months in NICU – but he is now a beautiful 9 month old little boy. His sister is 20 months old, so very hard as the other mums have mentioned when this is not your first. Also hard for those mums who have had their first as a preemie, a different experience altogether. I very much feel that life only began for us as a family the minute I took my son out of NICU. I loved him so much, but I didn’t know him. And there is nothing wrong with that! I can’t be separated from my babies now, and they know their mum and always want to be with me. But it takes time with a preemie, and that can be a real shock. We assume we bond right away. The love is there, but the bonding comes in its own time. It DOES come though!!

    Karen – what a wonderful response! Couldn’t agree more with your suggestions, thank you for taking the time out to reply for other preemie mums (my son especially was easily overstimulated and needed a lot of physical reassurance).

    Thank you for this wonderful article xx

    • Laura

      Thank you for you experience and comment, Ruth! I was up at “my” NICU for Thanksgiving and we spoke about bonding with other parents. Many parents found preemies “hard to get along with” because they tend to be fussy/high needs. Thankfully, bonding does come, as you said and it is worth it!

  13. Angela

    I just had my son Monday 12/20/2010- he is a 27 weeker. I have my momments in which I really feel like I am being cheated from the whole bonding experience and start crying. I really want to hold my son but know that I will have to wait till he is more stable. Since Monday- he had to have surgery on his bowels and when I went to see him on Wednesday he was hooked up to so many machnies that I broke down in the nicu. It is very hard for me to see him like this. I am afraid to touch him because I feel like he is going to break. I am unsure when he will start feeding but have started to pump to establish my milk supply.

    • Dionna  

      I am so sorry Angela, I’ll be thinking of you and your little one.

    • Laura

      Angela,
      First of all CONGRATULATIONS on the birth of your son! I am sure you have the cutest baby in the whole hospital! :)
      I am sending you BIG HUGS. (((hugs))) It is okay to cry and mourn and be sad about the whole experience. It really is. It doesn’t mean you are a bad mother or less of a mother- it means you are a mother in a really, really tough situation. Please be sure to talk to the hospital social worker or your doctor if you feel like your feelings are going beyond the “typical” PP or stressful experience feelings. There may be a support group at the hospital or through a PP resource center. Taking care of yourself is important too.
      Please ask the nurses if you have any questions about the machinces or medicines your son is on. They will be happy to answer any questions you have.
      My blog has a page devoted to pumping tips. Please feel free to check it out and use them.
      I will be thinking of you and your new little family this holiday season. Please keep us updated on you and your little guy.

  14. Michelle Barton

    Angela,
    You are in my family’s prayers. I had a little one a few weeks early also and she ened up in the nicu. It was very scary to try and hold her with all the tubes and cords, but I did and now she is very attached to me. She is going on 3 this February. Even when you can’t him. Put your hands on the crib and tell him how much you love him. He will feel it and know his mommy is there. Something some hospitals will let you do is sleep with a small cloth and then put it in the crib with him so he can smell you and bond to that smell. May god be with you through this rough time.

    Michelle

  15. Karen  

    (((Angela))) Bonding often starts from the moment we realise you are pregnant, the fact you feel so upset shows that you are already strongly bonded to your little boy, although I’m sure your arms ache to hold him. NICU is scary and I say that as someone who worked in one. They are noisy and bright and after this acute time is over he will really need you to show him what a gentle place this really is so don’t worry that right now it is too scary.

    Well done for starting on expressing it is not easy but it will be so important for him as he begins to have food. Make sure you have a picture of him and ask if you can take home a sheet she has been lying on or place something in the cot for a while next to him which you can take home and sniff, bonding with the pump can be hard smelling and seeing him can sometimes kick start the hormones you need. You will not get much to start with if you get enough for a dribble in the bottle then you are doing really well but it will come especially as you are able to get some skin to skin contact in the next few weeks.

    Talk to him, he will have heard your voice when inside you it will be reassuring to him. What you say does not matter your voice your tone are what are important. Make a tape ask staff to play it if he is awake while you are not there children’s stories are a good start and end with the same words so he gets to know what to expect. Classical music has also been shown to be beneficial to the little ones.

    Talk to the staff about how you feel they may be able to put you in contact with a support group I know most UK hospitals have one not sure about the US but they probably do, most parents find talking knowing your feelings and worries are normal and felt in some way by most parents can be reassuring. xx

  16. Amanda

    Angela my heart breaks for you and I know exactly how your feeling. My third child was born at 26 weeks seven years ago. She was only given a ten percent chance of living because her lungs were so BAD. She was not able to tolerate the regular vent and went on two other osicilating vents. She had bilateral chest tubes and I could just go on and on. She wasn’t able to get any feedings (my breast milk) until she was almost 4 weeks old. Just too unstable. I thought she would never come home and had the same hopeless and helpless feelings you are now experencing.

  17. Amanda

    Didn’t get to finish. After 78 days she was able to come home on oxygen. We didn’t get to hold her or touch her the first five weeks of life. Just too critical. In my experience I had a hard time bonding and till this day still do. I am not suggesting you won’t be able to bond but it was hard for me. I think the biggest problem for me is that she was so sick and I was afraid to let myself get close. It was my personal coping mechanism. You can bond don’t try to make the same mistake I did. Let your heart get close and take it minute by minute. Take lots of pictures and keep a daily journal.

  18. Mama Mo

    Angela, you are a brave and strong mama. That being said, please do allow yourself the emotions that are coursing through you. It’s ok to be sad, or angry, or bewildered. Be gentle with yourself. You have had a very rough start to motherhood, but you most definitely are a mama… just look at your concern for your darling little one!

    My twins were born six weeks early, and the hardest part for me was taking time to heal from my (unwanted) c-section. People kept telling me to take it easy and sleep and allow myself to heal, but I felt like I wasn’t allowed to, as long as my boys were still in the hospital.

    You are allowed to take care of yourself even as you care for your baby.

    You are your family will be in my prayers. I hope you connect with others moms who are/have been in a similar position. There is a blog run by three mamas called The Good Letdown. Christa, one of those mamas, had a preemie not too long ago, and the blog chronicles her story. You can find it at http://www.thegoodletdown.blogspot.com.

    Be well, mama, and let us know how your journey is progressing.

  19. Michal

    Thank you for your post. My little guy is a week old today and was born at 34 weeks. Just got word they took the cpap off this morning and is getting a bit of oxygen through his nose. He still hasn’t started feeding. After every visit he feels more and more like mine, but while I was at the hospital recovering from the c-section it was such a weird feeling knowing I just gave birth to this baby but not feel bonded to him. I thought leaving him at the hospital was going to be a horrible horrible thing, and it really wasn’t as hard as I thought it was going to be…I think part of it was because I hadn’t been given the chance to hold him until after coming home. I’ve struggled with thoughts that my daily visits aren’t enough and I should be there 24/7, I have to stop thoughts of me thinking I have abandoned him. It has been hard, but I thank God for the strength he has given us. What felt like the hardest thing in the world while I was hospitalized for a week before he was born has turned out to be manageable and we are just going day by day. I am such a strong advocate for attachment parenting and was able to successfully breastfeed, stay-at-home, and love on my first that I have wondered how do you create that same bond with a baby that has to be away from you during the first weeks of his life. Thank you for your ideas!

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