Q&A: Understanding the NICU journey

LEXINGTON, Ky. (Sept. 22, 2025) — For parents of a new baby, whether it’s their first or third, the prospect of having their baby in the neonatal intensive care unit (NICU) can be overwhelming — even terrifying. They spend months dreaming about the day they can bring their new baby home as they decorate the nursery and stock up on diapers. But sometimes things don’t always go according to plan, and their new baby may need intensive medical care right after birth. Some babies may only need a few days in the NICU. Others may spend the first year of their lives there. No matter the length of stay, the experience is life-changing for every family.

September is NICU Awareness Month, a time to raise awareness about the critical care provided in NICUs and the significant impact it has on families and communities. Kentucky Children’s Hospital (KCH) is home to a Level IV NICU, the highest level of care for critically ill or premature babies, as well as a neonatal abstinence care unit (NACU) to provide medical care for newborns who are experiencing withdrawal symptoms due to exposure to substance in pregnancy. UK pediatric psychologist Brittney A. C. Gray, Psy.D., NICU psychosocial director, works with families as they navigate life in the NICU and care for a baby that may have complex medical needs. These are some of the most frequently asked questions from parents and families.

Will I be able to touch and hold my baby? Will I be able to bond?

As a new parent, bonding with your baby is about responding to and caring for your baby’s needs. The bonding process can help you feel more connected with your baby and more attuned to your baby’s unique needs. Sometimes, bonding with your baby in the NICU may feel difficult or different that you expected. Due to the environment of the NICU, bonding may take some extra time because of the unique circumstances. Some ways you can feel close to your baby while they are in the NICU may include:

• The power of touch. Spending time skin-to-skin when both you are your baby are ready can be a great way to feel connected. Work closely with your baby’s nursing and medical team to determine when your baby can safely be held. Even if you can’t hold your baby right away, prioritizing comforting positive touch can also help. You can do things like hold your baby’s hand, cup their feet and use a quiet calming voice.
• Notice the ways your baby communicates with you. Babies can communicate with you through their body language, facial expressions and sounds. Getting to know your baby’s cues can help build your connection with them and help you advocate for what they need.
• Play with your baby. Playing with your baby may look different in the NICU. Based on how your baby is feeling, playing can look like making faces, talking, playing calming music, smiling and reading to them.
• Make the NICU feel like home. Bring clothes for yourself and your baby, blankets, sentimental items, gifts from family or decorations for your baby’s room.
• Celebrate milestones of your baby’s NICU journey. Our team loves to celebrate your baby’s wins, both big and small. Our psychosocial care team may be able to come up with some creative ways to celebrate your baby and family including, taking special photos, recording videos, writing memories in baby books or doing milestone crafts together.

How can I be involved in my baby’s care throughout the NICU journey? 

There are many ways that parents can be involved in their baby’s care during the NICU/NACU stay. One primary way that you can be involved in your baby’s hospital stay is by being present and active during your baby’s care times. Throughout the day, each baby has designated time where they are fed, diapered and assessed by the medical team. Work closely with your bedside nurse to identify ways you can be hands on during this process.

Every day your baby’s interdisciplinary medical team meets together to discuss your baby’s progress and plan for the day. This meeting most often happens in the mornings at your baby’s bedside. The NICU/NACU team invites parents and caregivers to be present for morning rounds to speak with the team, ask questions and get additional information about your baby’s goals for the day and the medical team’s plans to help them reach those goals. Working with physical therapy, occupational therapy, speech therapy service teams on your baby’s daily exercises is another great way to bond and play with your baby while also staying updated on their developmental goals.

What support services are available for parents?

The NICU/NACU at KCH has a robust psychosocial team of care providers who are dedicated to ensuring family-centered care as a priority. Our interdisciplinary psychosocial team is made up of a psychologist, licensed clinical social worker, social workers, chaplains, child life specialists and more. This team meets together weekly to discuss patient and family needs and coordinate ways to ensure all families are getting the support and intervention they need to navigate the significant stressors of a NICU/NACU hospitalization. If you are in the NICU and are feeling overwhelmed, stressed or down, ask your provider or bedside nursing staff to speak to one of our mental health care providers. Sometimes all folks need is a listening ear and some support around the NICU experience, other times parents need additional interventions for conditions such as postpartum depression or anxiety. Our team is equipped to manage both your supportive and mental health needs during your baby’s NICU stay. We have availability to meet with families weekly and will be available to support you throughout your baby’s NICU stay and can make additional referrals and recommendations on how to take care of your mental health even after your baby’s discharge.

How can I prepare for my baby's discharge and transition home? What advice do you give for helping parents cope when baby is in the NICU? 

There are many moving parts of the NICU journey that can be stressful and taxing on your and your family. In order to ensure that families are as healthy and well as they can be, it is important to take some time to identify some effective coping strategies.

• Prioritize self-care of mental and physical health and ask for more help when you need it. Plenty of people don’t like asking for help, but having a baby in the NICU may be the hardest thing you’ve ever had to do. Think about your support system, who you know you can trust, and contact when you need more help. It’s okay to need help talking through your feelings, it’s also okay to need more help managing things at home while your baby is here with us. Sometimes the NICU team can even take things off your plate, let us know if there are things we can do to help you along this journey.
• Make a mental health plan. When things get difficult, it is important to have a plan to care for your mental health. Take some time to identify important people that you can talk to if you need help. This support list can include a trusted family member and friend, your partner or spouse or a trusted medical provider. Another important part of making a mental health plan is being able to identify what you are feeling and what you need to feel better. By identifying the feeling and where it came from, you can make space to identify healthy ways to cope. For example, if you felt anxious today because of your baby’s NICU stay, maybe what you need in that moment is time to step away from bedside and have an enjoyable meal or a shower at home. Every person is different, and it’s important to take time to get to know yourself in a new way after having a new baby.
• Make a “not-to-do list.” New parents seem to always have a running “to-do list.” One thing I always encourage parents do to care for themselves is taking time to make a “not to-do list.” When things are difficult and stressful, it’s appropriate to set boundaries around things that take your energy and deplete your resources. By identifying a few things that are out of your control, that don’t need to be done today or things that someone else can do for you, you can free up some energy to take care of yourself.

How can parents ask for clarification in learning more about baby’s health concerns and conditions?

Our NICU/NACU care providers are available to you throughout your baby’s care. Attending morning rounds is a great time to meet the care team. The NICU/NACU teams meet every morning to talk about your baby, how they are doing and their plan for the day. If you are able to be present for this meeting, you will get a chance to meet the care team, hear firsthand from the providers about their thoughts and plans for your baby and ask and questions or voice any concerns you may have. Even if you can’t be there in the morning for rounds, you can always ask to speak with a provider.

Your bedside nurse is also a great source of information. Your team of nurses will work with you to learn your baby’s schedule, cares and help you explore ways you can interact with your baby safely with their medical complexities in mind. If you have questions about your baby and their care, your bedside nurse is a great first stop.