Growing Together: Ways to Involve Siblings in a NICU Experience and After

Alter Sisters, Photo courtesy Alter Family

Photo credit: Alter Family

by Laura Romero, Family Support Navigator

Having a baby in the hospital NICU is a very stressful time for families. Children in the family experience stress and worry just like parents and caregivers do. The following list contains suggestions and ideas for supporting your other child(ren) during this time. The activities listed are only suggestions and may not be appropriate for all ages, families or situations. Your children’s developmental ages and hospital policies for sibling participation always need to be considered.

Celebrating the Baby’s Birth

  • Siblings can help make phone calls, send email messages or text friends and family to announce that the baby has arrived.
  • Bake cupcakes or cookies that the sibling can take to school and share with friends, classmates and neighbors.
  • Create memory books that tell the story of your family and the new baby.
  • Give siblings a special big brother or sister t-shirt, ribbon or badge that they can wear.

Concerns and Questions

  • Allow and encourage siblings to ask questions.
  • Provide explanations, pictures and definitions when appropriate.
  • Show siblings their own baby pictures and discuss similarities and differences between their picture and their new brother or sister.
  • Create a family tree to remind siblings how everyone in the family has a special place and how everyone fits together.
  • Read books about the NICU, premature babies and about hospitalization.
  • Give older siblings a personal journal to record their feelings about the baby, the baby’s birth, hospitalization and homecoming as well as any concerns or questions they want to ask.

Baby’s Hospitalization

  • Have siblings choose a balloon (non-latex) or a toy for the baby.
  • Help siblings make a calendar to mark off the days that the baby is in the hospital. Use this calendar to reinforce the idea that each day marked off is a day closer to the baby coming home.
  • Siblings can make a brag book to share with friends. Include things such as the baby’s picture, footprints and hospital information. Be sure to leave room for letters from family and messages of support from friends.
  • Read children’s books about having a sibling in the hospital.
  • Have siblings draw a picture that can be placed on the baby’s isolette.
  • Take pictures of siblings that can be placed near or on the baby’s isolette.
  • Contact NICU staff to see what kinds of sibling programs are offered at the hospital. Some hospitals offer sibling specific NICU education programs like Hand to Hold’s Sibling Sundaes.
  • Check to see if your hospital has Child Life Services. Child Life Specialists are trained to help children deal with change and difficult circumstances. They are a wonderful resource for siblings.
  • Siblings can create name tags for their new brother’s or sister’s isolette or hospital room.
  • Older siblings can keep a journal to write notes and messages for the baby. Parents or caregivers can respond for the baby.
  • Older siblings may be involved in making decisions and in conversations with medical staff.
  • Siblings can take pictures of the baby and the baby’s room in the hospital to share with friends at school.

Participation after the Baby Comes Home

  • Include older siblings in the hospital discharge meeting.
  • Encourage and plan discussions with siblings about what life will be like when the baby does come home.
  • If the baby needs continuous medical care at home, siblings can help parents by distracting, playing with or reading to the baby while parents perform medical procedures.
  • Have siblings help decorate the baby’s room and pick out items such as toys, books and clothes for the baby.
  • Older siblings may enjoy creating a time capsule for the day/month/year that the sibling was born.
  • When appropriate, older siblings may be able to feed the baby.
  • Give siblings a specific job such as being in charge of getting a diaper during changing time or picking an outfit for the baby to wear.


Rector, Linda (2007). Supporting Siblings & Their Families During Intensive Baby Care. Baltimore, MD: Brookes Publishing.

Anne Claire Hickman, CCLS, CIMI, Child Life Specialist at Dell Children’s Medical Center of Central Texas (Personal Communication, June 9, 2012).

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