1. Equipping Parents for Success
Few families are prepared for a NICU stay. Until the moment they find
out their baby will be admitted, most families have never even heard of a
Neonatal Intensive Care Unit. The role of NICU staff is to help parents
navigate this frightening, unfamiliar territory. Whether a family’s NICU
stay is long or brief, their needs are the same. Parents need to learn to
care for their babies, form a bond and acquire the skills they need to be
competent and confident caregivers.
MEET PARENTS WHERE THEY ARE While they are
expecting, parents build hopes and dreams for their child. A preterm birth
or NICU stay puts those dreams in jeopardy. Parents have to confront the
possibility of long-term developmental consequences and special
healthcare needs. While we know that NICU babies may face greater
risks than most for developmental delays and ongoing health issues, we
also know those risks can be mitigated when a child has strong, effective
advocates at home. The parents’ ability to readily adjust to and address new challenges is a key indicator of positive
developmental outcomes for their baby. The challenge is to help families make this adjustment. We do this by
recognizing:
 They may be in shock – Parents are experiencing real somatic and physiological responses to traumatic events.
They need to be treated gently as they adapt to their new reality.
 Mothers are patients, too – The same factors that contributed to the baby’s early or complicated birth may also be
affecting the mother. Many times mothers will have undergone a c-section or surgery and need time to recover.
 They are afraid –They are wondering if their baby will survive, and if they do they ask themselves, “Will they be okay? Will
they have a disability? Will we be able to provide the care they need?”
 They are experiencing feelings of loss and grief – Their pregnancy did not go as planned, and they have not given
their baby the birth they had hoped for. This is a real loss, and it is appropriate to recognize and acknowledge it.
START EARLY With support from the NICU staff, families can prepare to meet their baby’s challenges. It is
important that NICU parent support and education start on the first day of a NICU stay. This is possible when we:
 Believe in parents’ abilities – Start with the assumptions that every parent loves their baby, every parent is resilient
and every parent is competent.
 Offer opportunities to assist in their baby’s care – As soon as their baby is stable, invite them to touch, hold, feed,
bathe and diaper their baby.
 Give them the tools they need – Families need to learn a lot of new information in a very brief amount of time. Staff
can help by familiarizing parents with the language, rules, routines and equipment of NICU care.
 Remove barriers – Identify factors that may interfere with a parent’s ability to fully participate in their baby’s care.
The barriers can be financial, cultural, relational or linguistic. Enlist your hospital’s resources and social workers to help.

2. ASSESS THE FAMILY’S STRENGTHS Each parent brings unique strengths and abilities to the
bedside. They are ready to learn and eager to help. Parents have a strong need for a therapeutic relationship with
NICU staff and to be positively perceived. They want to succeed. We can help them do this when we:
 Understand how they learn – Uncovering their unique learning style will help you know how to teach them and how
you should deliver new information. Provide written materials and resources, but discuss them together to make
sure the parents can understand them.
 Identify their personal competencies – The support parents receive during a NICU stay can influence their parenting
throughout their child’s lifetime. Celebrate their strengths together and reinforce productive skills and behaviors.
 Observe and ask questions – The best way to provide relevant support to families is to ask what they need. Find out
what their concerns are and address them directly. This will help you understand what is important to them, help
them meet those needs and increase the likelihood that the baby will continue to get the care they need.
 Be flexible and adaptable – Every family is different. Be ready to adapt your care to meet their needs. Help them
identify who will be participating in the baby’s care and how to give them the information they need.
BRIDGE THE GAPS Once we have assessed a family’s strengths and identified the supports they need, we
can fully prepare for transitioning their care from the NICU to home. We must:
 Build a bridge between what a parent knows and what they will need to know – Offer additional training, support
and education to meet their anticipated needs.
 Teach skills with transition in mind – Talk about how what they are doing in the NICU will look as they transition
between the NICU setting and home. Identify potential problems and model solutions.
 Practice facilitated care and interactions – Look for ways to actively mentor the baby’s caregivers. Give parents
opportunities to practice new skills through guided participation.
 Teach them how to understand their baby – Equip and empower them to read their baby’s cues, identify changes
in their baby’s states and confidently meet their baby’s medical and developmental needs.
 Identify support in their community – Learn about the people and resources in their community that can help. Share
them with the family and your colleagues.
MAKE A PLAN FOR SUCCESS
 Identify who will care for baby – Every baby needs at least two responsible adults who can assist each other in the
baby’s care. Find these caregivers and include them in discharge planning and education.
 Build the baby’s team – Point out the specialists who provide care in the NICU, introduce them to the parents and
explain how they contribute to the baby’s success. Talk about who the family can call upon for support. Make a
plan for how and when they should contact them.
 Educate caregivers about what to watch for – Teach them about common reasons for rehospitalization and how
to minimize those risks. Help them understand when to call the doctor and when to call 911.
 Plan where to go for help – Every parent needs support. Asking for it is a sign of strength. Use every opportunity to
model help-seeking behavior for parents. Then model appropriate interventions. This will build their confidence and
willingness to get help when they need it.
 Follow the family – Families have learned to depend on the NICU staff when they need support and information,
but they may wonder if it is still appropriate to ask them for help after discharge. Develop and implement a follow-
up plan for NICU families. Let them know that they can expect a call or other contact from the NICU. Also make
sure they know who to call or contact both in the NICU and with their transition care team when they go home.
As a neonatal medical professional, you can play a vital role in ensuring the best outcome not only for the baby in your
care, but their entire family. Begin with the end in mind and have faith that the time, knowledge and skills you invest in
parents are worth the return on your investment. Your patients will thank you.
For more information check out www.handtohold.org