Coping With Stress in the NICU

By Gina Rossetti, LCSW-C

September is NICU Awareness Month! So with that in mind, I wanted to offer you a few ways to support yourself and others if you ever find yourself or someone you love parenting in the NICU.

My introduction into parenting involved an unexpected and multiple months long stay in the NICU. It was an emotional and eye opening experience in which I had to learn to parent while my baby was hospitalized and while collaborating with a multidisciplinary team of medical professionals. That time was full of hope filled highs (goodbye breathing support!) and exhausting lows (another delayed discharge date). Through that experience, I realized the limited support that exists for NICU families, and it changed my clinical practice forever. 

The NICU stands for Neonatal Intensive Care Unit. It's important to know that families with a baby or babies in the NICU often experience birth trauma. Although this can be related to the birth itself, the trauma can also be associated with conception, pregnancy, and/or postpartum events. We often think of the physical trauma associated with perinatal experiences, but it's important to remember that trauma can also be emotional and psychological. 

Having a baby in the NICU and experiencing birth trauma are both risk factors for postpartum mood disorders. Unfortunately, this makes families with a baby in the NICU at significant risk for anxiety, depression, and post traumatic stress. 

About 10-15% of babies go to the NICU. While babies are in the NICU for many different reasons, the most common are preterm birth, low birth weight, and health concerns that require specialized medical care. This means that parents are typically dealing with many professionals on a daily basis. While these medical professionals are often supportive and trying to be helpful, parents often feel overwhelmed and overstimulated. This makes it especially difficult to develop a parental identity and advocate for themselves and their child. 

A few things to remember:

Although not all families with babies in the NICU experience trauma, the situation is often stressful and parents typically have strong and complex feelings. 

Each parent is likely to deal with the stress and/or trauma differently and may have very different feelings and capacities to cope. 

Grief, guilt, anger, helplessness, sadness, fear, overwhelm, and hope are common feelings in the NICU. It can feel like a rollercoaster for families. 

Ways to help:

Parents often feel like they've lost their peer group because having a baby in the NICU is so different from the typical birth experience. Given this, connecting with other NICU families can be very helpful. This can be done through support groups offered at the hospital or a local therapist. I have one that I offer a few times a year (please reach out if you need support!). 

It is important for parents to take care of themselves and feel supported so that they can care for their baby. Parents should be encouraged to ask for help and/or accept help. This might look like bringing them dinner or sending a gift card for coffee. It could also be listening to them and validating their feelings. It's also so important to encourage parents to take breaks. This may mean taking a walk and leaving the unit at the hospital or taking some time at home to rest and recharge. 

Finding their parental identity and noticing ways they can parent in the NICU is very important. This may look like connecting with their baby through touch or talking to them, advocating for them at the hospital, and reading or singing to them. 

Both birthing parents and non birthing parents need support. It's important to remember that the non birthing parent is also part of the baby's care team and should be considered. Checking in on fathers and other non birth parents is so important. 

Finally, parents and families do not have to do this alone. You can reach out to your support system, staff at the hospital, specialized NICU focused professionals (I recommend Clara at The Baby Barista for lactation services), and mental health therapists for extra support. 

“Cool, Calm and Connected”

The Need for Connection in Parenting

By: Debra Boblooch, LCPC, LCPAT

As a mother of three young children, it can be challenging to meet all their needs all the time. Someone inevitably must wait their turn, their chance to chime in on the topic of conversation, or simply connect-whether that be physical (a hug, hand holding) or just spending time with me. As I have navigated what seems like constant growth and development of these young minds as a mom, I remember discussing with my pediatrician the challenges I was facing in terms of outbursts, meltdowns and what appeared to be dysregulation. She said something to me that has stuck throughout the years, particularly during pivotal adjustment and transition times which was… “try your best to find 15 minutes of daily connection time”.

As a therapist who focuses on treating children and adolescents, I emphasize a connection-based approach throughout my sessions and use it to educate parents, caregivers and families as a modality to aid in behavior change and tackling the root of the issues. Connected parenting combines limit setting and boundary creating along with gentleness, close attachment, love and connection. The ability to strengthen a parent-child relationship through connection will result in a child to feel heard, feel seen, validated, and ultimately heal big emotions that they are experiencing. Learning a more mindful approach to parenting to make “connections before corrections” can improve the child’s ability to regulate feelings and externalize them safely and efficiently.

When a child is experiencing big emotions, their brains are activated typically resulting in a “fight/ flight” response. At this moment they are unable to access the ability to comprehend when a parent or caregiver is attempting (with good intention) to reason with them or explain the consequences of their actions. Instead, try connecting with the child by welcoming their feelings, listening and empathizing. This creates safety. Once the child feels safe, they will begin to feel more relaxed, cooperative and ultimately closer to you. Slowing down and listening not only shows the child that you are showing up for them by being fully present, but it also will allow for you to see things from their perspective. By mindfully choosing to connect over reacting or attempting to rationalize with the child in the heat of the moment will help you to see the reasons for the behavior and aid in regulation of your own emotions.

Remaining “cool, calm and connected” can be really challenging when anger is present among a child. But by staying patient and calm in the face of their anger is key if you want the more vulnerable feelings to surface (sadness, fear). Ask yourself, do you have to resolve the problem right then? No. Just listen and acknowledge feelings. Remind yourself that connection starts by listening and embracing or offering a hug can go a long way too. I continue to strive to find 15 minutes daily to connect with each of my littles, whether that be bedtime chats, bathtime play, or holding hands while walking around the house. My intention to connect more initially sprung from a desire to seek guidance on how to handle toddler meltdowns and dysregulated behaviors but quickly shifted into a daily habit aiding me in becoming a more present and regulated mother.