About five percent of all newborns require special medical care shortly after birth due to problems such as premature birth, low blood sugar, birth defects, and infections. Although most of these children do very well, they often require care in a special care unit. Often they are transferred to a neonatal intensive care unit (NICU), a special nursing unit where the baby can be observed more closely and receive more intensive nursing care than would be possible in the normal newborn nursery.

Parents' Feelings
When a baby has a problem severe enough to require transfer to the NICU, parents will face many numerous emotions. People spend months to years anticipating the arrival of a healthy newborn baby; when their infant does not meet that expectation, they may feel grief, anger, guilt, and an intense sense of loss. These are all normal emotions. Parents may also feel a loss of control as nurses, doctors, and others provide medical and basic care for their infant. These feelings are a normal consequence of having a sick newborn infant.

One of the first emotions that mothers often feel is guilt. They think that somehow they are responsible for their child's medical problem. Even after being repeatedly told that it was not something that they did, many mothers remain convinced they caused their child's illness. There are very, very few situations where a mother's actions contribute to an infant's difficulties. Mothers need and deserve a lot of reassurance during this time.

What To Do
There are two important ways to cope with this difficult situation. You must have enough information about your child's condition to understand what is wrong and what is being done about it. You need to know your baby's diagnosis, primary doctor's name, and what tests or treatments are being given. Ask lots of questions and take notes. Doing this will help you feel better, and help the doctors and the nurses give you the information you need. Chances are good that your child will do quite well. Survival and long-term outcomes have improved dramatically over the past few years for many babies' problems.

The second and equally important way to cope with this situation is to have someone in whom you can confide. For many couples it is each other; however, some parents find it difficult to discuss these issues with each other and need to confide in a friend, grandparent, or social worker. Whoever it is, your experience will be easier and less stressful if you have someone with whom you can discuss feelings.

Transfer of the Baby to Another Hospital
Many hospitals deliver enough babies and possess the skills to care for about 98 percent of the babies they deliver, yet some sick babies require transfer to a specialized facility for care. This may occur by ground ambulance or helicopter. If your child is transferred, you should be given a packet of information about the hospital where your baby will be. This should include phone numbers and contact people at the new hospital.

Speaking With the Baby's Doctor
When you speak with the doctor caring for your baby, you should be direct with him about your fears. Even when parents don't ask the question, most are silently thinking their baby may die. Depending on their anxiety, parents may think this even when the problem is relatively minor. Survival even in the most serious cases has been improving over the past few years. Ask the doctor about your child's risk of death and get this out in the open.

The second most common fear is that the baby will be handicapped. For most conditions, the usual outcome is for the child to grow and develop normally, yet it varies from baby to baby. You must ask your doctor about your child's specific outcome. Sometimes the doctor cannot say with certainty what will occur. For many parents this uncertainty is the worst part of the problem.

Will This Happen Again?
Finally, some families think that a difficult pregnancy, delivery, or first few days for the baby is a rare occurrence unlikely to recur. Unfortunately, once you have had a complicated pregnancy, you may be at higher risk for the same or a different complication with the next pregnancy. For example, your risk of having an infant with a birth defect is about two percent; however, having one infant with a birth defect more than doubles your risk (to about five percent) of having another baby with the same or a different birth defect. Numerous factors may affect your risk of having an infant with a birth defect. Ask your doctor about your specific risk.

Plainly Speaking
Most infants hospitalized in the NICU do quite well, but it is still a highly stressful situation for parents. Finding someone in whom you can confide and asking enough questions to understand the situation are the two best ways to reduce your own stress. Spending time with your child even when he is sick can benefit both you and your child.