Emotional help for parents in the NICU

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Read about the challenge that parents face when coping with emotional ups and downs in the NICU. These often overshadow practical realities.

Key points

  • Parents of babies in the NICU should seek help to cope with difficult emotions, including relationship and family stress.

Although the practical realities of having a newborn baby in the Neonatal Intensive Care Unit (NICU) can be trying, the emotional ups and downs can be even more of a challenge. It is important for parents to seek help during this time.

Ask for help

As with the practical difficulties, staff at the NICU are aware that being a parent in this situation is stressful. As a result, there will be services and specific staff to help out in these matters. If you are not offered help, ask.

Typically, fathers have more difficulty asking for help than mothers; many men feel they must take on the role of being the strong one and the pillar for everyone else. Indeed, others in the culture expect no less. Regardless, both men and women are encouraged to get help expressing and examining the emotions that come from the stress of being a parent of a baby in the NICU.

Typical emotional reactions

There is no one overriding reaction that parents have in the NICU. In fact, if there is one common emotional theme applicable to all parents, it is that emotional reactions change, often rapidly. Parents often describe it as an emotional roller coaster. One minute they are angry, the next stoic, the next depressed and guilty. This is normal. Given the circumstances, which at times can change daily as the baby’s condition improves or suffers a setback, parents should expect that they will have a wide variety of emotional reactions.

There is nothing wrong with emotional reactions to stressful situations. It is just that some emotional reactions are much more positive than others. Given the proper help, parents can learn to avoid or minimize negative emotions and behaviour, and increase positive ones.

No parent responds “perfectly” to having a newborn baby in the NICU. Cut yourself some slack, get help, and try to do the best you can. Try to understand that there will be good days and bad days, and that these may not have anything to do with how well your baby is doing at any particular moment. For example, a parent may have a bad day on a day that their baby is having a good day.

Initial reactions

Shock is probably the first emotion that parents of a premature or sick baby feel. Having a baby who was born early and needs support or was born with urgent health concerns is not usually a situation that parents have planned for. Premature babies, especially to those who have never seen one before, can look rather unlike newborn babies as seen on television.

Also, with premature births or complications there are often many unknowns, uncertainties and trauma to deal with. Will my baby be all right? Will my spouse be okay? What is going to happen next? These uncertainties are stressful and often provoke strong emotional reactions in individuals, between spouses, and between parents and the staff at the NICU.

Communication

One of the most helpful things that people can do is to communicate their emotions as fully as possible to the people around them. Keeping emotions inside is often not helpful in reducing stress and making the best out of what is admittedly a difficult situation. Of course, flying off the handle is not particularly helpful either; however, the right times and contexts can be found or made for expressions of feeling, no matter what those feelings are.

Suppressing emotional expression

Expressing emotion can be very difficult for people to do. Depending on background and culture, people can be averse to emotional expression, no matter what their circumstances. Despite this, all parents should make an effort at communicating and expressing their feelings to their partner and to staff at the NICU. Following this advice will go a long way to make the best of the situation. There are special counsellors and other staff at the NICU who can help. It is highly recommended that parents use these resources.

Some parents may have trouble expressing their emotions because they believe that their role is to be “strong,” and to be there for everyone else. This belief often leaves them holding in their worries and fears. Parents are encouraged to share their feelings with their spouses.

Parents are often reluctant to share their feelings with each other because they do not want to alarm their partner. However, research shows that even when news or expectations are not particularly positive, speaking openly and honestly about them is beneficial. It may not change the outcome but it will comfort the parents and bring them together.

Sometimes parents are reluctant to bond with their baby in the NICU. Because they fear that the baby may not live or may be severely disabled, they may not want to get close to the baby only to lose them. While in some ways this is understandable, this is not a healthy way to react and may have negative effects down the road. Often, reacting in this way leads to guilt, probably one of the most negative emotions of all. Even if the baby’s prognosis is not good, parents are encouraged to bond with the baby and make the most of the time that they do have together. As emotionally hard as bonding with a baby with a limited life may be, parents who do not do this often regret it later in life.

Guilt and blame

Some parents look to answer the question “why has this happened to my baby,” and then either blame themselves or their spouse for a premature birth or any complications the baby has. This is not a good idea for many reasons. First, except in the most extreme cases of self-abuse, this is never the case. No parent can be blamed for a premature birth or a health complication. Second, as times become trying, the best strategy is to pull together and work as a team to get through it. Blaming one another, and unjustifiably so, will likely have the opposite effect.

Forgive yourself, forgive others

Although some ways of coping are better than others, it is highly unlikely that any individual will always react in the best possible way. When communications and feelings are not absolutely perfect, parents should learn to forgive themselves and others, talk about the problems and try to do better the next time something comes up.

Last updated: October 31st 2009