Stage 1: Learning you are going to the NICU and recovering from birth
What's Happening
Mother has just given birth to a preterm infant or infant with a complexity who requires NICU admission. She is simultaneously a patient herself recovering from birth while trying to be present for her newborn in intensive care. Father may be heading to the NICU alone with baby.
Emotional State
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Emotional distress related to admission
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Fear and anxiety about infant's survival
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Concerns about bonding with baby
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Worry about disrupted parent-infant attachment
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Mental health vulnerability (anxiety, sadness, fear)
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Guilt – what did I do wrong
Unique Challenges
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Recovering from cesarean section or vaginal birth
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Health complications requiring treatment
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Physical separation from baby (different floors/units)
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Unable to see infant for up to 12 hours after birth
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Navigating between postpartum unit and NICU
What Parents Need
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Permission and support to prioritize their own recovery
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Facilitation of early parent-infant contact
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Mental health support and screening
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Encouragement to rest, get fresh air, take breaks
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Understanding that they're balancing dual patient/parent roles
Helpful resources at this stage:
Healthy Parents Healthy Children - taking care of yourself
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My Health Alberta - taking care of yourself in the NICU
Stage 2: Adapting to the NICU
What's Happening
Parents are learning to navigate the expected but unfamiliar environment of the NICU - a highly technological critical care setting that can be overwhelming.
Emotional State
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Emotional distress
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Overwhelmed by technology and environment
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Constantly on edge from sounding alarms
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Anxious, sad, and scared
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Emotionally disconnecting as coping mechanism
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Uncertainty about infant's medical stability
Unique Challenges
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Navigating physical layout of NICU
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Lack of private space (shared rooms with other families)
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Overwhelming technology: monitors, cables, tubes, alarms
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Frequent changes in nursing assignments
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Feeling like 'starting from scratch' with each new nurse
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Inconsistent information from different healthcare providers
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Minor discrepancies in care approaches (e.g., how to swaddle)
What Parents Need
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Welcoming, comfortable physical environment
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Opportunities to stay overnight when ready
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Education about alarms and monitoring equipment
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Support understanding which alarms require action vs. are routine
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Consistent nursing assignments to build trust
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Consistent information and care practices across staff
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Gradual introduction to navigating medical equipment
Helpful resources at this stage:
Healthy Parents Healthy Children - getting to know the NICU, the NICU team, and more!
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My Health Alberta - NICU information
Stage 3: Caring for your baby in the NICU
What's Happening
As parents adapt to the NICU, they begin engaging in caring for their baby - from basic presence to full involvement in non-medical care.
Emotional State
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Growing confidence and competence
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Feeling more involved in baby's care
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Pride in contributing to healthcare team
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Feeling valued as expert on their own baby
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Risk of post-natal depression
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Adapting to parenting role and affirming identities
Type of Care
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Skin-to-skin contact (kangaroo care)
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Changing diapers
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Providing baths
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Feeding (bottle, breast, tube feeding assistance)
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Temperature checks
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Managing non-medical care with supervision
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Learning baby's cues and preferences
What Parents Need
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Active invitation to participate (not just permission)
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Support and supervision (not takeover) during care tasks
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Recognition that their involvement eases staff workload
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Structured participation in bedside rounds
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Validation as the expert on their baby's non-medical status
Helpful resources at this stage:
Healthy Parents Healthy Children - if your baby is born preterm, newborn - 2 months.
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Canadian Premature Babies Foundation (CPBF) - What to expect when your baby is in the NICU
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My Health Alberta - Special care in the NICU
Stage 4: Coping with daily disruption
What's Happening
Throughout the NICU stay, parents must cope with significant disruptions to their normal daily routines and life circumstances.
Emotional State
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Emotional toll of leaving baby overnight
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Guilt about time away from other children
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Missing partner's support and presence if separated
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Feeling torn between NICU and home life
Disruptions
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Organizing travel between home and NICU
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Financial burden of parking costs
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Separation from partners
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Separation from other children
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Distance from home community and support network
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Reliance on family for childcare
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Balancing time between NICU and home responsibilities
What Parents Need
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Financial support (parking passes, meal vouchers)
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Accommodation options for families traveling from distance
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Flexible visiting policies for partners and siblings
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Recognition of their complex life circumstances
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Support coordinating care with work/family obligations
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Understanding when they cannot be present 24/7
Helpful resources at this stage:
Access parent support Facebook groups
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Check if your hospital has a peer family mentorship program
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Canadian Premature Babies Foundation (CPBF) - Support for Families in the NICU
Stage 5: Seeing Progress
What's Happening
Parents track their infant's development and medical stability, experiencing joy at milestones and frustration/disappointment at regressions.
Emotional State
Good Days:
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Greatest joy in seeing baby make progress
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Hope with each milestone
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Feeling closer to discharge
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Validation from healthcare team
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Bad Days:
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Feeling like baby has regressed
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Setback when more medical intervention needed
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Feeling further from discharge
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Worry about trajectory and timeline
Milestones and Setbacks
​Milestones that matter:
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Taking all feeds successfully
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Gaining weight
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Monitors removed (no longer needed)
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Out of the isolette, or off respiratory assistance
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Validation during bedside rounds about progress
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Getting stronger visibly and measurably
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Setbacks that hurt:
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A & B’s
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Sepsis
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Oxygen needed again
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Failure to gain weight
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Catching a cold or infection
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Feeding difficulties
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Any regression in medical status
What Parents Need
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Help understanding positive and negative milestones
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Context for setbacks (normal vs. concerning)
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Celebration of achievements
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Realistic timeline and expectations
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Support during regressions
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Clear criteria to work towards discharge
Helpful resources at this stage:
My Health Alberta - NICU resources and feeding video
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Healthy Parents Healthy Children - feeding your baby in the NICU
Stage 6: Supporting parenting (preparing for home)
What's Happening
As discharge approaches, healthcare providers support parents' confidence and competence to care for their infant independently at home.
Emotional State
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Growing confidence in caring for infant
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Feeling valued, respected, supported
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Empowered as part of care team
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Intimidation about taking baby home
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Gratitude for support received
Types of Support
Educational Support
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Nurses teaching hands-on care
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Lactation consultant guidance
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Social worker support
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Physician education about medical care
Emotional Support
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Nurses providing support during vulnerable moments
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Simple tangible actions (nipple shield, glass of water)
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Stepping in when family supports absent
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Mental health screening and referrals
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Peer support from family mentors (parents with NICU experience)
Practical Support
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Parking passes
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Parent journals to track progress
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Resources and tools for home care
What Parents Need
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Healthcare providers who understand their whole life context
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To feel valued as a member of the care team
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Consistent, clear information about discharge timeline
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Comprehensive discharge preparation
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Advocacy when they feel voiceless
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Presence during vulnerable moments
Helpful resources at this stage:
My Health Alberta - getting ready to take your baby home
Healthy Parents Healthy Children - getting ready to go home