{Professional Insight} Preparing Children for a Sibling’s NICU Stay

October 29, 2012

O'Brien Family siblings
My last post was about preparing for a NICU stay when you know your baby will need one. This post is about preparing your other children! As a mom of four boys, there was something amazingly special about introducing my first son to his new baby brother, and then two years later, introducing them to their new brother. Seeing their faces light up in amazement as they met for the first time, and us taking those first photos together, are memories that still can bring tears to my eyes without effort. Yet, I knew Reece joining our family was going to be different—much different. There would be no newborn family pictures, no face-to-face introductions, and certainly my children would be confronted with their parents constantly feeling divided between being with them at home and being with Reece at the NICU. I made a commitment to do everything in my power to prepare them for what lay ahead and ensure they felt a sense of understanding and security, despite a sea of unknown variables.

As a child psychologist, I know that kids are very perceptive and quickly pick up when something is “not right”. If children are not given correct information, they will often fill in the blanks with erroneous information, creating  anxiety and fear. Therefore, I gave them the basics and then let their questions guide what I told them next.  I took very specific steps to prepare them, too.  I am so blessed to have a close friend who is a child life specialist. CL specialists help children cope with medical procedures and hospital stays using developmentally appropriate tools and language. I enlisted her help in preparing the boys, and together we created a photo book. The boys and I looked at the book together and used it as a tool to generate questions and demystify what would happen once Reece was born. If you would like to create one yourself, ours contained:

  • pictures of the hospital I would be at
  • generic pictures of what a hospital room looks like
  • what a NICU looks like
  • what some of the NICU instruments look like
  • pictures of nurses/doctors who would be caring for the baby, etc.

I met with the school counselor, and she gave the boys’ special journals to write in at school and agreed to check in on them daily.

I took the boys to Build-a-Bear, and let them make a new stuffed animal with an audio recording inside of my voice tucking them in at night and saying “I love you.” My husband planned special outings to the hospital with the boys for us to eat dinner together, do homework together, etc. Plus, with Facetime on our iPhones, we could always see each other! Here are some additional guidelines that can help:

  1. Set aside some special time each day with each of your older children. It’s not the quantity, but quality that matters! Small, but meaningful, moments like snuggling together while reading a bedtime story, preparing breakfast together or singing songs  can help show and reassure your children that they still are important.
  2. Be honest with your children. Let their questions guide you and how much you disclose, but let them know what to expect.
  3. Don’t hide your feelings. Let them know you may cry because you are worried about the baby, but you are not upset over anything they did. Teach them it’s okay to have feelings.
  4. Try to maintain structure and your children’s’ usual routines as much as possible. Children feel safe and less stressed when day to day life is predictable. When you can’t be there, ask a favorite relative, friend, or sitter to keep up activities your children enjoy and that are familiar.
  5. Address your child’s fears. Some children may fear that you will love them less now that the new baby is here, especially since you will be “less present” physically and emotionally than before the baby was born. Reassure them that this is not the case, and describe the qualities in each child that make her special and unique. Make sure your children understand that nothing they did or felt contributed to the baby’s illness.
  6. Get them involved from the beginning. It’s important for your children to become involved with their baby brother or sister right from the start. Here are some ideas:
  • Color pictures to put up near the baby’s bed
  • Select a favorite photo of themselves or the entire family for the bedside
  • Choose a stuffed animal/soft toy to put in the baby’s bed
  • Put together a photo album of pictures of the baby
  • Create their own storybook about the birth of their baby brother or sister
  • Help prepare the baby’s nursery for homecoming
  • Each NICU has its own guidelines about siblings.  Find out what the rules are in your NICU, and then prepare your older children in advance for what they will see and hear.
  • Consider reading books together about NICU babies and siblings. Here’s a good reading list from Amazon.

After 39 days, my three boys finally got to meet their baby brother. Their eyes still lit up in amazement, my eyes still overflowed with tears, and we still took family pictures—it was just on a different time line and we traveled a different road to get there! We can’t always control what road we are put on, but we certainly can control what we do when we’re on it.