The NICU

By: Shelley Nortje (Clinical Psychologist)

Ububele has recently begun offering their services at a local hospital’s Neonatal Intensive Care Unit (NICU). The intervention offered involves offering support to mothers whose babies are admitted in this NICU ward. This usually happens if the baby is born preterm, has a very low birthweight or if there are other medical complications. This is a difficult space to be in as an infant mental health professional, for medical staff, for mothers and their families, as well as for these small babies.

The experience of mothers in this situation is one of trauma and uncertainty. These mothers may become depressed and may feel helpless as they rely on medical staff with specialized knowledge, that isn’t always shared or explained, to assist their babies. One mother for example expressed how confusing and scary the different machines attached to her baby, and the sounds they made, were for her. Mothers are also separated from their babies for certain times during the day. The small babies appear quite vulnerable and alone in their incubators. Mothers are encouraged to feed their babies and touch them however, the contact seems limited and hesitant as mothers appear scared to touch their tiny babies in case they should cause them more harm. One mother apologised to her baby when the baby’s leg tremored when mom touched her sensitive skin. These preterm babies are more sensitive and easily dysregulated, and mothers may feel guilty about their ways of interacting with their baby without sufficient knowledge about their babies’ experience. When the baby reaches a certain weight babies are eligible for discharge. Mothers may at this time begin to panic. Their insecurity and lack of confidence in their ability to care for a preterm baby may be evident.

Preterm babies, unlike full term babies, may behave in slightly different ways. On average, preterm babies are less responsive to sight and sound, their communications may be more difficult to read or understand, they have a limited ability to self-regulate, their sensory thresholds are reached more easily (ie: are easily over stimulated) and it usually takes them more effort and energy to respond. These characteristics of the preterm infant can make it harder for a mother to always understand what the baby needs and how to soothe and support their development.

A mental health professional, with a solid understanding of infant development and infant mental health can offer helpful support at this time for babies and their families. They can help parents understand their baby’s behaviours and share their observations about their baby’s bodily communications and capacities. For these babies that have a more difficult start to life, having this extra support and guidance may be valuable.

Should you or someone you know be struggling to understand babies’ communications please contact Ububele for assistance in strengthening and building these important relationships.

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