First Night Home from the NICU: What to Expect

The first night home from the NICU (neonatal intensive care unit) is full of a whole host of feelings.

As a Clinical Psychologist but also as a NICU mom myself, I know all too well that excitement isn’t the only thing that you feel, and I am here to tell you that that’s OK.

When I was told I could bring my preemie home from NICU, my first reaction wasn’t joy.

I’d been waiting for this moment and wishing it to come, but I was suddenly met with a whole bunch of different emotions and thoughts.

I felt apprehensive, anxious, and worried that I wouldn’t have the monitors and the staff to help us.

I was concerned that I’d feel isolated and that I may end up needing to come back to the hospital if my baby caught a cold or got ill again.

There were so many things spinning around in my head.

As we walked to the car, I remember saying to my husband, “It feels like we’re kidnapping him”.

I didn’t quite believe that he was my baby — I got to keep him and look after him.

We cuddled him on our sofa — something we’d been waiting to do for weeks — and we felt incredibly lucky, but so uncertain about what the night, the next week, and the future would look like with our preemie baby.

Through my personal journey and professional experience, I’ve learned invaluable insights about helping NICU parents prepare for and cope with bringing their preemie babies home.

Along with my private clinical practice, I’ve co-founded an online community, Miracle Moon, to provide support and guidance for parents who have been through neonatal care.

In this guide, I’ll be addressing the most asked questions and concerns you might have about taking your premature baby home from the NICU for the first time.

And remember: you’re not alone in this.

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Can you take your baby home from NICU?

Yes, you can.

Most preemies and full-term sick babies at the NICU will eventually get to go home.

But it can take some time (anywhere from a few hours to months), depending on the reason why your baby’s in the NICU, and the whole process requires patience, careful planning, and a supportive network.

Every baby’s journey is unique, but rest assured that the goal for everyone is to bring your preemie baby home as soon as it’s safe and medically advisable.

How do I prepare for my preemie coming home?

You may have time to prepare for your preemie or full-term sick baby to come home, but you may not know exactly when it’s likely to be (this is one of the hardest questions to answer).

But there are some practical things you can do to make sure that you’re ready for when that time comes.

• Buy a car seat, making sure to check it’s suitable for a low-weight or premature baby. Most NICUs may carry out a car seat test to check your baby can safely sit in your car seat for the travel home.
  
• Set up a safe sleeping space, ideally in your bedroom, following the recommended safe sleep guidelines, so your preemie can sleep comfortably and safely when they come home, since, sadly, preterm and low birth weight babies are 2-3 times more likely to be affected by SIDS (sudden infant death syndrome). Your healthcare provider should be able to offer advice on preemie-safe sleeping practices.
  
• Set boundaries around visitation from family and friends. If baby has low immunity, keeping them away from germs is key. So it’s worth asking friends and family to not come to your home or visit baby if they’re feeling under the weather, and, if they do come to visit, to wash their hands and not kiss baby.
  
• Stock up on different-sized diapers and baby clothes. Anything you’d expect to buy for a full-term newborn. Plus, you can do this from cot-side — most hospitals will have Amazon or other delivery lockers, so you don’t need to worry about being home for a delivery.
  
• Ask your healthcare team any questions you have, especially any special care instructions. Bring a notebook or take notes on your phone so you don’t forget anything important later on — although you can always ask again.
  
• Ask for and accept help from other people.** If someone offers to cook, prepare freezer meals, help with cleaning, or set up baby’s nursery space, say yes! You don’t have to do everything on your own. If your friends aren’t sure what they can do to help, here’s a list of suggestions — after all, every little helps.

How do I transition my baby from NICU to home?

Moving from constant monitoring and support to being on your own with your NICU baby can, at times, feel stressful.

But know that you are the best person to look after your child and it is a period of adjustment, for you, your partner, and your baby.

It doesn’t have to look perfect.

You’re learning and discovering how to trust your gut instead of relying on monitors and hospital staff.

It’s totally normal for this to take time.

It’s also worth trying to keep to your NICU routine when you first bring baby home, to make the transition easier for both you and baby.

Then, as time goes on, and baby becomes stronger, it’s OK to become more flexible with feeding and sleeping times, as long as your healthcare provider agrees.

Your baby’s sleep might also be different at home compared to at the NICU, since they’re used to the noise, smells, and general environment of NICU.

Things like white noise (which could help with your preemie’s weight gain), music, baby massage (it’s stress-relieving and great for bonding with your baby), and baths (following NICU baby-safe guidelines) may be helpful as building blocks of a bedtime routine, but it will be a process of trial and error, so don’t worry if you don’t get it right the first time.

You’re all learning how to do this for the first time, so give yourself some patience.

What to expect when bringing baby home from NICU?

It all might feel like a bit of a whirlwind when you bring baby for their first night home from NICU.

If you’re getting ready to collect baby from the hospital to their new home, here are some things you can expect:

• Know that any emotion you feel is valid, even if it’s a mixed bag of emotions or something you feel “guilty” about. Find someone you can talk to, your partner, a friend, a family member, a fellow NICU mom on Peanut, or a health professional, to process how and what you’re feeling. For me, I definitely didn’t just feel excited to bring my baby home from NICU — I was nervous, uncertain, and felt like I was leaving a place that was both difficult, but also safe, stepping into the unknown.
  
• Take some time to still live in the “newborn bubble”. Just because you were in the hospital for the start of your baby’s life doesn’t mean you have to miss out on all the things that you were hoping to experience. You can absolutely take time to sit on the sofa, cuddle, feed, put your feet up, and do whatever you thought the “newborn bubble” would look like.
  
• There could be more medical appointments to attend. This is another reason why it’s OK to accept help from others. And you can also ask your healthcare provider to move appointments and home visits so they fit you and your family better.

Do NICU babies have trouble bonding?

One of the most important things to know about your NICU baby is that it is possible to develop a secure and well-rounded relationship and attachment.

Their start in life doesn’t dictate how they will be in the future.

A lot of parents may struggle to bond with their baby at the beginning, this is normal, since there’s so much disconnection and trauma in NICU.

But, at the same time, there’s also so much love and strength in the bond because of what you have been through, too.

How do I bond with my baby after NICU?

Essentially, the same way you’d bond with a baby who wasn’t in NICU, including:

• Continuing with skin-to-skin
  
• Talking to baby (they’ll recognize your voice!)
  
• Singing to baby
  
• Reading to baby (scientifically proven to reduce your stress levels and help you bond with baby)
  
• Watching over baby
  
• Touching baby
  
• Smelling baby
  
• Taking part in caring tasks

Bonding is a two-way process and it is normal for the love to build over time rather than just be the “flood” of instant love that we see all over social media.

Do NICU babies know their mom?

Yes, your preemie baby will recognize you through your scent, voice, and touch.

They were getting to know you as you carried them, and they’ll continue to learn who you are when they are born.

They might not fully understand the concept of “mom” yet, but they can certainly feel your presence and comfort.

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Do NICU babies have separation anxiety?

Not necessarily, although it’s normal for any baby to have anxiety around separation.

Separation anxiety is an adaptive instinct, helping your baby to survive, especially in the first years of their life.

It’s not something to worry about while it’s developmentally appropriate, but some older children may need more support surrounding separation.

If baby does show signs of separation anxiety when they’re older, they’ll need to learn that you’ll always come back — a consistent routine, grading the separation, validating emotions, and using loveys or toys can help this process.

Do babies remember NICU?

Honestly, we don’t really know how much babies remember of birth.

Some studies suggest that early experiences can impact a child’s development, but others, like this small study where they played sounds of NICU to former NICU babies, found that they didn’t respond to the noises, so they might not remember.

Your baby’s NICU journey may have other lasting effects, but with love and support, they can thrive.

Why do I feel detached from my baby in the NICU?

If you’re feeling disconnected from your NICU baby, you’re not alone — feelings of detachment are common among NICU parents.

The stress and uncertainty of the NICU environment can be overwhelming, there are so many things that create physical and emotional barriers between you and your baby.

There are monitors, wires, tubes, a plastic box, you are possibly on another ward, being told when and how you can touch your baby.

All of this can trigger your “stress” hormone (cortisol), which can block the production of the “love” hormone (oxytocin), so if you’re finding things more physically and emotionally difficult, it’s a natural physiological response.

We’re also often in survival mode in challenging or traumatic times, launching us into fight, flight, or freeze mode.

You might feel emotionally numb, like you just want to get away.

Or like you’re constantly tense, ready for combat.

We don’t choose these reactions — they’re instinctive protective methods our brain and body use to keep us safe in threatening and traumatic situations.

But, unfortunately, these automatic, reflexive responses aren’t exactly helpful when it comes to bonding with your new baby.

This is normal.

It might take some time, but by regulating your emotions, your mind and body can feel safer, so you will be able to develop a healthy, strong bond with your baby.

Can you get PTSD from having a baby in NICU?

Yes, post-traumatic stress disorder (PTSD) can affect some parents who have experienced a NICU stay.

That’s why it’s important to recognize the symptoms of PTSD and know that it’s OK to get help.

It can also take some time for conditions like PTSD, depression, and anxiety to develop — even up to 6 months after birth, so give yourself space and patience, no matter how long it’s been after NICU.

There are lots of treatments for PTSD, like eye movement desensitization reprocessing (EMDR) or trauma-focused cognitive behavioral therapy (TF-CBT) — it doesn’t always have to be this way.

As you bring your baby for their first night home from the NICU, know that you’re not alone.

There is support and guidance for NICU moms like you and me.

And if you want to talk with other moms who have been there, Peanut is always here for you.

Together, we can navigate the challenges and celebrate the rollercoaster journey of motherhood after the NICU.