6 Questions to Ask the NICU Team About Your Baby’s Development

March 3, 2021

I'm katie, OTD, OTR/L, NTMTC, CNT & founder of blooming littles

Guess who has the greatest influence on a baby's NICU stay? It's YOU! Let's get you the tools, info, and resources needed to create positive NICU experiences, one interaction at a time.

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Sometimes it’s hard to know what to ask when someone says ,“Do you have any questions?”

Let’s talk about some questions you can ask your baby’s medical team related to their development.

There are so many things to wonder about and so many questions to ask related to the medical equipment and your baby’s medical status. Knowing what to ask about development is tough!

Babies who spend time in the NICU are at greater risk for developmental problems after discharge.

What I want you to know…is that there are things you and your baby’s medical team can do NOW to promote positive developmental outcomes, sensory processing skills, and behavioral organization.

I’m going to share six questions you can ask your baby’s bedside nurse or medical team, so you learn more about all the special ways your baby’s team is supporting your precious baby.

1. When can I hold my baby skin-to-skin and for how long?

Skin-to-skin holding is also called “kangaroo care”. It’s a way to hold your baby where their naked body (except for a diaper and hat) is in direct contact with your skin. Typically this means your baby is placed upright on your chest and a blanket or robe is wrapped around you.

Skin-to-skin has AMAZING benefits and is one of the best things you can do for your baby while they’re in the NICU. 

Benefits of holding your baby skin-to-skin include: 

  • More stable temperature
  • Stable heart rate and oxygen rates
  • Better weight gain
  • Increased milk supply
  • Increased parent confidence 
  • Earlier discharge 
  • More regular breathing rate
  • Better bonding and attachment 

Kangaroo care is one of the best things you can do to support your baby’s development early on.

Sometimes, babies show signs that they aren’t tolerating skin-to-skin holding. Maybe the baby is dropping their oxygen or heart rate after the transition. Maybe they can’t get settled.

If you’ve experienced that, please know…it’s not because of you. There can be MANY reasons why babies need some help from US to get comfy in kangaroo care.

If you can, try and do kangaroo care every day when you visit your baby. Always ask how long you’re able to hold your baby. We typically recommend holding for at least 60 minutes.

2. How can I comfort my baby?

Did you know you have the power to comfort your baby in the NICU?

Ask your baby’s bedside nurse or neonatal therapist how you can comfort your baby in a way that supports their development and is appropriate based on their medical stability. 

Even if your baby has a breathing tube or is in an incubator…you can comfort them in special ways.

By comforting your baby in supportive ways, like providing hand hugs, or decreasing the stimulation around them…you’re building their coping skills.

Comforting babies in the NICU can look different than calming a term baby. Typical ways to calm a baby like rocking or patting their bottom isn’t appropriate stimulation for medically fragile babies in the NICU. 

That doesn’t mean we don’t have options.

Here are some ways you can comfort your baby in the NICU:

  • Give a hand hug
  • Turn down the lights 
  • Quiet the environment 
  • Let your baby hold onto your finger
  • Provide a scent cloth
  • Pump breast milk for your baby
  • Offer a pacifier

There are even ways you can support your baby when you can’t be at the bedside.

3. What are you doing to manage my baby’s pain?

This question takes bravery. Addressing pain is brave.

Here’s the thing, understanding how you can decrease your baby’s pain (as well as what the medical team is doing!) can help alleviate your own worries and help you advocate for your baby.

There are two main ways NICUs address pain.

  1. Pharmacological methods
  2. Non-pharmacological methods

Pharmacological methods are pain medication. The “traditional” way of thinking about pain control. 

Non-pharmacological methods are ways to decrease pain without using medication. There is a lot of research on ways to decrease pain in the NICU using non-pharmacological strategies.

Parents have less control over medications used for pain relief, but it’s ALWAYS important to ask and advocate.

As far as non-medication based ways to provide pain relief…that’s where the next question comes in.

5.What are some ways that I can decrease my baby’s stress and pain while he/she is here?

Yep, there are ways YOU can decrease your baby’s pain and stress during care and procedures.

Maybe you can’t give medication, but you can provide some hands-on techniques that research tells us are effective in decreasing crying and symptoms of pain in NICU babies. 

Here are some things you can try during heel sticks, diaper changes, temperatures…anything you feel like makes your baby show signs they’re stressed and uncomfortable.

Did you know I have a 40 minute webinar on 2 ways you can provide pain relief in the NICU?

Get 2 strategies you can use to support your baby, plus understand a little bit about pain in the NICU.

Sign up to listen here.

5. Do you have a neonatal therapist in this unit who can help me understand my baby’s development?

Ask who’s on your baby’s medical team. One of the most incredible things about the NICU is all the incredible medical professionals who play a role in your baby’s care.

We all get to approach your baby’s care through our unique lens. Find out if your baby’s unit has a neonatal therapist (occupational therapist, physical therapist, or speech language pathologist) who can help you navigate this journey.

Neonatal therapists are typically available in level 3 and 4 NICUs. Some level 2 nurseries also have access to them.

Neonatal therapists are specially trained to understand the unique developmental needs your baby. Plus, they are perfectly equipped to help walk you through the NICU journey as you learn how to parent and care for your baby in a new and inspiring way. 

Neonatal therapists can:

Plus, more!

The neonatal therapist is a wealth of knowledge, specially trained to care for your baby while promoting positive interactions, and preventing developmental concerns related to the NICU stay.

6. Will my baby need physical therapy, occupational therapy, or speech services after discharge?

It’s not uncommon for babies with a NICU stay to need some therapy services after discharge. Typically, your medical team will discuss these options with you depending on your baby’s medical history.

But, sometimes therapy services don’t get brought up, and then parents are left to navigate that journey on their own after going home.

Go ahead and ask the team about occupational therapy, physical therapy, and speech therapy services your baby may need after discharge.

This may be an outpatient follow up, where you visit the clinic and see a developmental therapist…or you may be referred to early intervention services (where they come to your home).

Getting early therapy services after discharge from the NICU is an important piece of the developmental journey. 

You’re not alone, there is a team of professionals that can help you navigate developmental milestones, sleep, feeding, and sensory needs after you’re home.

Are there any questions you would add?

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