Newborns who are ill or preterm often receive medical care in a special care nursery or neonatal intensive care unit (NICU). The opportunity for parents to interact with their infant during this challenging time may be limited by the infant's medical needs. However, most hospitals try to give parents as much contact with their infant as possible, and almost no infant, even one on a ventilator, is too ill for parents to see and touch. In addition, parents are usually emotionally distressed by their infant's condition and may feel helpless at a time when they are needed most. This may reinforce feelings of inadequacy or guilt, particularly in parents whose severely ill or preterm infant is hospitalized for a long time.
In the unfortunate circumstance when an infant dies, this loss is always emotionally traumatic for parents.
(See also Death and Dying in Children and see Introduction to Death and Dying.)
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Illness in Infants
Parents should see, hold, and interact with their infant as soon as possible and as much as possible. Even with severely ill or preterm infants, parents often can help with feeding, bathing, and changing. Parents are usually encouraged to provide direct care for their infant as a way to get to know their infant and to prepare for taking their infant home.
Skin-to-skin contact between parents and infants (sometimes called kangaroo care) is encouraged because it has many benefits for parents and infants. In kangaroo care, the infant usually wears only a diaper and is held against a parent's bare chest. Infants who experience skin-to-skin contact may gain weight, stay warm, sleep better, and have a better chance at breastfeeding (chestfeeding) faster than those who do not. Parents who experience skin-to-skin contact have less stress and build a close bond with their infant, and mothers may produce more milk. Breastfeeding may be possible while the infant is in the special care nursery or NICU, even if the infant must be fed through a tube at first. Many neonatal nurseries help families store and use human milk for their child.
Many hospitals encourage parents to stay at their infant's bedside around the clock and even participate in family-oriented hospital rounds where they can interact with doctors, nurses, and other staff and discuss treatment plans. Many hospitals have unlimited visiting hours for parents, and some have areas in which parents can stay for long periods to be near their infant.
If an infant has a birth defect (also called a congenital anomaly), parents may feel guilt, sadness, anger, or other emotions. Many feel even more guilt because they have such feelings. Seeing and touching the infant as soon as possible after birth can help parents bond with the infant as they would with any other child. Counseling and support sessions about the birth defect, possible treatments, and the infant's prognosis can help the parents understand their infant’s condition, prepare to care for their infant at home, plan for the best medical care, and take care of their mental health. Contact with families who have a child with a similar birth defect or contact with support groups also may be helpful.
Infant Loss (Death of an Infant)
If a newborn dies before being seen or touched by the parents, some parents may feel as though they never really had a baby. Although painful, holding or seeing the baby after death can help parents begin the grieving process. Parents of an infant who is stillborn sometimes find comfort in dressing the infant or wrapping the infant in a baby blanket and taking photographs, footprints, or other keepsakes they can save to remember their child. This practice humanizes the infant and reinforces that the infant was a real part of their family.
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Emptiness, lost hopes and dreams, and fear may overwhelm parents, who may become depressed. Parents tend to feel guilty, blaming themselves even when they are not responsible for the death. The grief and guilt that follow may strain the relationship between parents. The grieving process may also mean that parents are unable to attend to the needs of other family members, including other children.
Many families whose infants are severely ill, are born preterm, or have died can benefit from counseling from psychological or religious personnel. Parent and family support groups also may help.
More Information
The following English-language resources may be useful. Please note that The Manual is not responsible for the content of these resources.
