Looking for a way to make it easier, and less terrifying to get your NICU baby out of their crib with all the wires and tubes? Here are 8 essential tips and helpful strategies to help you take the first step.

Wish you could walk into the neonatal intensive care unit (NICU) and pick your baby up out of their crib without feeling nervous or afraid of the wires?

Have you wanted to do it yourself without the “pass off”?! 

As a NICU occupational therapist, I spend a lot of time educating and empowering families on how to get their baby out of their bed to hold on their own…from start to finish. 

Most parents and caregivers have a very strong desire to do it, but it can be an intimidating and overwhelming experience.

Today, I want to share some MUST HAVE tips that will help you get comfortable transferring your sweet NICU baby out of their crib. 

By learning more and exploring these tips, you can:

• Rely less on your baby’s bedside nurse.
• Take back some control.
• Feel more involved at your baby’s bedside.
• Fight fear.
• Take on that mom or dad role confidently.

Please know, there are a lot of exceptions to what I am about to share. It is very important to talk with your baby’s bedside nurse or neonatal therapist before trying any of these tips on your own or getting your baby out of their crib. This information is not meant to take the place of medical advice and supervision given by your baby’s medical team. These transfers may also differ greatly from NICU to NICU.

1. SPEAK UP

Let’s be honest, NICU nurses and medical professionals can be intimidating. 

It’s okay—I feel the same way too sometimes (and I work in the NICU!). 

But…we cannot read your mind. 

Do you want to hold your baby, but you’re terrified of the IV? Let us know.

If you have been secretly longing to get your baby out of their crib, warmer, or incubator with less help—please, speak up.

Sometimes, we assume you’re not ready to get your baby out by yourself.

We don’t want you to feel like we’re pushing you into the deep end, if you’re not ready.

Sometimes we start doing it without even realizing that we are taking over the experience.

Every NICU parent and family has different expectations, desires, and goals. 

Share yours with us, so we know.

NICU professionals:

Do you naturally take on the main role of transferring a baby for holding? I would encourage you to ask mom or dad if they have had the chance to get their baby out of bed by themselves yet (using your best medical judgment, of course). 

Offer them the opportunity; ask if they would like to try. 

Let parents and caregivers know you will help walk them through the entire process…and provide help with “line management”

2. PRACTICE, PRACTICE, PRACTICE

The NICU is unexpected. 

You can’t prepare for it.

Before the NICU stopped you in your tracks, you probably had taken steps to prepare for your baby. 

You were practicing diaper changes, prepping the nursery, googling how to put on that long baby wrap, and watching YouTube videos on swaddling or breastfeeding. 

Then, the NICU hit. And it hit hard. 

All of a sudden, you aren’t prepared.

One way to get more comfortable in this new and frightening environment is to practice a new kind of parenting.

Practice getting your baby out of bed with the nurses help, and gradually move toward more independence. 

Many parents are intimidated when they practice their baby’s care, not only because of all the medical equipment, but because it feels like the nurse is looking over their shoulder and assessing how they are doing. 

I want you to focus on your baby.

Push the self-doubt aside.

The nurse is there to monitor your baby’s status, help manage their medical equipment, and encourage you along the way.

Along with holding your baby, are you also trying to get comfortable changing your baby’s diaper in an incubator?

Man, that takes practice! It’s okay if you feel fumbly at first!

I have 5 AMAZING tips to make things easier for you here!

5 TIPS FOR CHANGING YOUR PREMATURE BABY’S DIAPER WHEN THEY’RE IN AN ISOLETTE

We are in your corner.

3. LEARN ABOUT YOUR BABY’S MEDICAL EQUIPMENT

I think the most intimidating thing about transferring a NICU baby out of their crib to be held, is managing all of their lines and tubes. Some of us call that “line management”.

When I started in the NICU, this was incredibly stressful for me.

I know it is for you too—because parents tell me it is!

It’s scary, and THAT’S OKAY.

It’s  important to be careful, but I want you to know that you can do it.

The BEST way to get comfortable is to ask your nurse or neonatal therapist:

• What each line is called,
• What it’s there for, and
• Where it connects.

The March of Dimes has outlined common NICU equipment as a resource just for you! 

And here’s a video from Children’s Hospital of Philadelphia on common NICU equipment, so you can see what it looks like.

it can be helpful to understand which wire is which.

IVs vs. cardiac leads vs. a nasal cannula…

I always like to take note of the most important piece(s) of equipment when I’m picking up a baby. 

Of course, it’s ALL important, and it all has purpose.

BUT…if something were to happen during a transfer, I would rather know the baby’s breathing tube is secure, than worry that their temperature probe came off.

4. SET UP THE SPACE BEFORE PICKING UP YOUR BABY

To keep yourself from feeling flustered, set up your space BEFORE picking up your baby. 

Make sure your chair is pulled up next to your baby’s isolette or crib and locked in place. 

Keeping your chair close means you don’t have to travel far or worry about whether lines and tubes will reach.

Also, think about what you may want within reach during your holding session. 

Place your water, phone, a book, or camera within arm’s reach.

5. USE CLIPS TO ORGANIZE MEDICAL LINES

Most NICUs use clips to connect your baby’s medical lines (like IVs or PICC lines) to your baby’s clothing, their swaddle, or your own shirt.

Clipping oxygen tubing or IVs to your baby’s shirt or swaddle can make getting your baby out of bed easier. The medical lines and tubes won’t be dangling or hanging from your baby. 

It also helps with the fear of lines getting pulled, dislodged, or even accidentally removed completely!

I prefer to use clips when some of the medical lines are heavy—like multiple PICC lines or ventilator tubing.

Ask your nurse (or whoever is helping with the transfer!) what kind of line and/or tubing clips your unit has.

6. TALK OUT THE TRANSFER BEFORE YOU DO IT.

I started using this strategy  when I was finishing up a clinical rotation in the adult intensive care unit.

My supervisor left me to fend for myself as a way to teach a lesson…I was terrible at line management. 

I kept getting myself and my patient twisted up in their medical lines.

Not okay…and not safe!

Talking yourself through what you’re about to do will help you catch potential flaws or mistakes in the plan. 

It may seem silly, but saying, 

“Okay, first I’m going to get all the lines, IVs, and cords organized and make sure they will reach. Then, I’m going to put one hand under his/her head and bottom and turn them towards me while keeping their arms and legs supported. The nurse or neonatal therapist will be there to watch the cords and tubes. Next, I’m going to bend forward and bring my baby to my chest. Then, I’m going to stand up tall with my baby on my chest. I will make sure no lines are caught or tugging before I go to sit down. And then I will back up until I feel my chair touching the back of my legs, and then I’ll sit down.”

This is a helpful exercise as you get familiar and comfortable with the NICU world.

It will keep you organized AND build your confidence as you learn about your baby’s medical lines. 

Feel silly doing this outloud? You shouldn’t! 

But just in case, talk it through before your nurse comes in the room, or just do it in your head.

7. SUPPORT YOUR BABY IN A TUCKED POSITION, CLOSE TO YOUR BODY

Getting your NICU baby out for holding can feel like a big ordeal (especially if they are on a ventilator or have a lot of medical lines and equipment).

To keep your baby happy and less stressed during the transfer, support them in what we call ‘flexion and midline’.

Flexion and midline = the arms and legs are tucked in towards the body instead of straight out and away.

This can look a couple of different ways depending on how you’re planning on holding your NICU baby.

Regardless of the holding position you’re going for, let’s try and minimize the startle or “flailing movements” that many NICU babies have during transfers.

Those “flailing” behaviors can be a sign of stress in NICU babies, and we want to make the transfer as positive as possible. 

If you’re interested in learning more about how your NICU baby shows you how they’re feeling, check out,

LEARN HOW YOUR NICU BABY COMMUNICATES: THE NICU MOM’S GUIDE!

To support your baby during the process of getting them out of bed, you have several options:

• Swaddle your baby before getting them out.
• Support your baby’s hands to their face during the transfer to prevent a startle response.
• Bring your body down to meet your baby, instead of reaching in and bringing your baby to you, 

Remember, keeping your baby “tucked” during transfers and handling, helps them self-regulate, and stay organized, and decreases their feelings of stress. 

All REALLY good things!

8. PRACTICE IN A CALM, RELAXED ENVIRONMENT

When you’re learning something new and potentially stressful, make sure your environment and space is as calm and relaxing as possible.

Make sure the lights are dim, your baby’s eyes are shielded, there are low sound levels, people are talking quietly, and there isn’t too much going on near your bed space.

You will feel a LOT more relaxed when you can practice without chaos surrounding you. 

Plus, your baby prefers a low stimulation environment too! 

Good for mama, good for baby!

There you are…8 tips to help you feel more confident when getting your baby out to hold while they are in the NICU. 

1. Speak Up
2. Practice, Practice, Practice
3. Learn about your baby’s medical equipment.
4. Set up the space before picking up your baby.
5. Use clips to organize medical lines.
6. Talk out the transfer before you do it.
7. Support your baby in a tucked position, close to your body.
8. Practice in a calm, relaxed environment.

There are always exceptions to the rule, your baby may not be ready to be held outside of their bed, or off their warmer bed yet, depending on what their medical status is.

If you talk with your nurse, and they say it’s not a good time to get your baby out…you can ALWAYS provide your baby with a hand hug.

Even the sickest and most fragile babies can benefit from therapeutic touch, like a hand hug!

I would love to hear how it goes.

Did these tips help you feel more confident as a NICU parent?

What was the first time like holding your baby?

Any tips you would add to the list that you’ve learned as a NICU nurse, therapist or parent?