Supporting Siblings While Your Baby Is in the NICU 

It is important to be honest, while tailoring the amount of information to your child’s developmental stage and their questions. Children will show you how much they want to know by what they ask. Answer clearly and simply and be prepared to repeat information as they process it over time.

Yes. Many preschool-age children believe that their thoughts or actions caused the illness. It is important to clearly reassure them that they did not cause the baby’s condition or prematurity. This reassurance may need to be repeated often.

Siblings often ask: • Why the baby is sick or early  • What doctors and nurses are doing to help  • Who will take care of them while parents are at the hospital  • When the baby will come home If you are unsure about the baby’s prognosis, it is okay to say so, while reassuring your child that your family and the medical team are doing everything they can to help.

Toddlers and preschoolers need simple explanations and reassurance. They often process emotions through play.  School-age children are often curious about how the body works and may want more detailed explanations. Teenagers generally understand information similarly to adults and should be given clear, honest explanations. They may prefer talking with friends rather than parents, which is normal.

It is common for:  • Young children to have more tantrums and difficulty with eating and sleeping. Maintain loving but firm limits and keep the routine as normal as possible.  • School-age children to report physical symptoms such as headaches and stomach aches or nightmares.   • Teens to seek support from peers instead of their parents. If symptoms persist, worsen, or include signs of depression, anxiety, or risky behavior, consider consulting a certified mental health professional.

Tell your child they can talk to you anytime, and that you’ll try and help them understand what’s happening. If you are unable to do this at times, identify another trusted adult for them to talk to. Creative outlets—such as play, art, journaling, or poetry—can help children process difficult emotions.

If siblings are allowed in the NICU, ask your child if they would like to come with you, and reassure them that they do not have to. Before they come, help them understand what they may see, hear, smell, and feel. Keep time in the NICU short for younger children and remind them they can step out whenever they need.

Preparation depends on age: • Preschoolers may benefit from using dolls or stuffed animals to demonstrate tubes and equipment.   • School-age children may like photos and explanations beforehand.  • Teens usually do well with verbal explanations.  Explain what each tube does, the sounds of monitors, and why equipment cannot be touched. Let them know it’s okay if the hospital smells unfamiliar. Some parents find it helpful to explain NICU equipment in simple, child-friendly ways, so siblings feel less overwhelmed. For example, one parent described the isolette as the baby’s special safe space, almost like a tiny spaceship. They also explained that the beeping sounds are the machines and monitors helping the care team keep track of how the baby is doing.  Make your child part of the care process, so they feel helpful and that they are a part of their sibling's life at this stage. Bringing a stuffed animal could be a lovely way for your older children to be involved in supporting the new baby while in the NICU.

If your baby’s sibling is not able to be in the NICU in person, virtual options may still help them feel included. If those aren’t available, some children enjoy having a matching stuffed animal with their baby. You can use it to explain equipment, routines, or procedures, helping them feel connected and included.