Having a baby in the NICU is difficult for all family members, including big brothers and sisters.

When a baby is in the NICU, family routines change. Children sense that you are stressed, and young children may not understand why others must care for them when you are at the hospital. It is natural for children to feel resentful and confused.

How a child responds partly depends on their age. A toddler may be upset by being separated and unable to understand why you have to be away so much. An older child may be worried. And children may become jealous of the new baby.

Some behaviors you may notice include regressing in developments such as toilet training, excessive clinginess, irritability, sulking, whining, or difficulties at school.

Encourage your children to express their feelings. Drawing pictures and writing stories is a good way for them to do this. Explain to them what is happening with their baby brother or sister. The NICU has a child life specialist available to help you come up with a plan on how to discuss matters with your older children. Please ask your social worker if you are interested in this.

Calm your children’s worries. Reassure them that you love them. Make sure they understand they did not cause the baby to be in the NICU. Let your children know that sometimes you may be upset and may even cry because you are worried about the baby. Assure them that you love them and are not upset with them.

Below are some ideas on how to support the big brothers and sisters in your family as they adjust to having a baby in the NICU:

• Try to keep as many routines as possible (mealtimes, story time, bedtime and activities).
• Set aside special time for big brothers and sisters: reading books at bedtime, singing songs in the car, visiting the playground, going to a movie. Make time every day to spend some quality time with your children at home.
• Make a “brag book” with your children to take to school. Include photos, a preemie-sized diaper, a handprint, etc.
• Seek support of family or friends to give special time to the big brother or sister, such as having a sleepover with a friend or going shopping with grandma and grandpa.
• Take your children to visit the baby in the NICU. Encourage them to ask questions. Listen to them.
• Help your child choose a toy to give the baby in the hospital.
• Let your children draw pictures or write messages to the baby. Hang them up at the baby’s bedside.
• Surprise your child with a toy or book from the baby when the child visits. Leave special messages at the bedside from the baby, such as “I’m glad you’re my big sister!” or “My big brother is the best!”

About Team NICU 101

CHKD is home to the region’s largest and most sophisticated neonatal intensive care unit, certified by the state as a subspecialty nursery. We provide intensive care for high-risk, critically-ill neonates and care for approximately 500 babies a year.