Nothing prepares you for leaving the hospital without your baby. A stay in the NICU (neonatal intensive care unit) can last a few days or many months, and it turns the first weeks into a strange routine of driving, waiting, pumping and learning. About one in ten babies in the U.S. is born early, and many others need NICU care for other reasons. You are not the only family in that hallway, even when it feels that way.

It is also a postpartum. The parent who gave birth is still bleeding, healing and short on sleep, often while sitting on a hard chair all day. Both parents carry a lot of fear. NICU parents have higher rates of depression, anxiety and trauma symptoms, so support for you is part of the plan, not a distraction from it.

Finding your place in the unit

• You are part of your baby's care team. Ask when rounds happen and whether parents can join. Many units welcome it.
• Ask the nurses what you can do: diaper changes, taking a temperature, mouth care, holding. Small jobs help babies and parents.
• Ask about skin-to-skin (kangaroo) care as soon as the team says your baby is ready. It is good for babies and for you.
• Keep a notebook or a note on your phone for questions, weights and what the doctors said. You won't remember it all, and nobody expects you to.
• Ask for the unit's social worker. They know about parking, meals, lodging for families who live far away, and help with work and money.
• It is okay to go home and sleep. Your baby is watched around the clock, and you can call the unit for an update any time.

Feeding and pumping

• If you plan to give your own milk, start hand expressing or pumping as soon as you can after the birth, ideally within the first few hours, and ask the NICU lactation team for a pumping plan and a hospital-grade pump. Many parents are told to pump about eight times a day, including once at night, to build supply.
• Pumping for a baby you can't hold is hard work. Some parents find it helps to pump at the bedside, or while looking at a photo or holding a blanket that smells like the baby.
• Donor milk or formula may be part of the plan too. However your baby is fed, you are feeding your baby.
• If pumping is taking over your mental health, say so. Your baby needs you well, and there are options.

The parent who gave birth is recovering too

• Keep your own postpartum appointments, and tell them your baby is in the NICU.
• After a C-section, ask when it is safe to drive, and let someone else do the hospital runs until then.
• Eat and drink something every time you pump or visit. Keep snacks in the car and in your bag.
• The warning signs after birth still apply. Heavy bleeding, a fever, a bad headache or a painful swollen leg: call your provider today. Chest pain or trouble breathing: call 911 or go to the emergency department, even if you are already at the hospital. The NICU team cares for your baby, not for you.

Feelings that are common in the NICU

If fear or low mood is there most of the day, if you have flashbacks or nightmares, or if it keeps going after your baby comes home, tell someone: the NICU social worker, your own provider, or the PSI HelpLine (1-800-944-4773). Postpartum Support International runs free online support groups for NICU parents.

• Guilt, even though nothing you did caused this.
• Feeling like a visitor instead of a parent, or unsure how to bond through the plastic.
• Grief for the pregnancy, birth or first days you expected.
• Numbness, then fear, sometimes in the same hour, and a jolt at every alarm.
• Envy of families whose babies went home. It doesn't make you a bad person.

For dads and partners

• You may be back at work while your baby is still in the unit, split between two places. Ask HR about FMLA and any leave you can use now or save for when the baby comes home.
• Take your own turn at skin-to-skin and hands-on care. Babies know both parents.
• Protect the recovering parent's rest and meals, and don't carry every update alone. Ask how they are, not only how the baby is.

For family and friends

• Ask before visiting the unit. Many NICUs limit visitors, and the parents may want their time with the baby to themselves.
• Help with the rest of life: meals at home or at the hospital, gas or parking money, care for older children and pets, laundry.
• Ask "what's today like?" instead of "when is the baby coming home?" The date moves, and every change is hard to explain again.
• Celebrate what they celebrate: an ounce gained, a tube out, the first bath.
• Stay away if you are even a little sick. NICU babies are especially vulnerable to infections.

Going home, and after

• Coming home can be joyful and frightening at once. Practice with any equipment or medicines before you leave, and get the numbers to call.
• Many NICU graduates have extra follow-up appointments. If your baby was born early, the team may talk about "adjusted age": for development, count from the due date rather than the birthday.
• Some parents feel the hardest feelings only once they are home and the adrenaline wears off. That is common, and it is a good time to ask for support.