Notes From the NICU Series | Who Comforts the Baby When Parents Can't Be There?

During my recent visits to two NICUs in Phoenix, I had wonderful conversations with the healthcare teams about how they were incorporating babywearing into their departments.

We talked about the practical things, of course. Where carriers were stored, how they were laundered, when staff found opportunities to use them, and what made carrying easier or more challenging.

But one part of our conversations stayed with me long after I'd returned home.

Some parents don't want the nurses or other staff to wear their babies.

This wasn't the first time I'd heard about this. Other healthcare professionals I've trained have shared similar experiences, and I know this conversation can come up when infant carrying is introduced into a hospital setting, or even a home-care setting.

Still, hearing about it again brought me back to a question I keep thinking about.

“What happens to the baby when their parents can't be there?”

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The hours between visits

If you've ever had a baby in the NICU, you know that being at the bedside around the clock isn't necessarily possible, no matter how much you wish it were.

You may have other children at home, work obligations, your own recovery to manage, or a considerable distance to travel. You need to eat, sleep, and attend to the rest of your life, even while a part of you desperately wants to stay beside your baby.

And during those hours when you're away, your baby continues to experience the world around them.

They sleep, wake, become hungry, experience discomfort, and communicate in whatever ways they're developmentally able.

And sometimes, often, they cry.

What happens next depends on many things, including the baby's medical condition, staff demands, available care, and decisions made with the family.

I think this aspect of NICU care deserves more conversation.

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What is the baby experiencing?

When a baby cries, we're hearing one form of communication, and sometimes that is a late form. Depending on the circumstances, crying may reflect hunger, discomfort, distress, fear, or a need for help regulating their experience.

For a medically vulnerable infant, prolonged distress and the physiological effort involved in crying can be especially concerning.

And while not every cry can or should be addressed in exactly the same way, we have considerable evidence supporting the value of developmentally sensitive, responsive care. That might involve gentle touch, containment, changes in positioning, a soothing voice, or being held, depending on the baby's medical needs and tolerance.

I think about those hours when the family isn't present, and I wonder whether we're always helping parents understand what their baby's experience might be during that time.

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When a parent says no

I can imagine many reasons a parent might be uncomfortable with staff babywearing.

Perhaps they haven't had much experience with infant carriers and are concerned about safety. Maybe they worry that their baby is too medically fragile, or they're unsure about another person carrying their child.

There may be emotional considerations, too. Having a baby in the NICU can mean surrendering a great deal of the caregiving experience you'd anticipated, and perhaps the thought of someone else providing that particular kind of closeness feels difficult.

I don't know what was behind the decisions of the families discussed during my visits, and I wouldn't want to make assumptions.

But I do wonder whether some of these conversations happen without fully discussing the infant's experience.

As adults, we naturally approach decisions through our own experiences, beliefs, feelings, and concerns. And when our child is medically vulnerable, those feelings can be especially powerful. Yet the infant is experiencing those same hours from an entirely different perspective.

They don't understand why their parents are absent or when they'll return. They're responding to what's happening in their bodies, to their bodies, and their immediate surroundings, communicating their needs as best they can.

And I want us to keep that perspective in the conversation.

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What if we approached the conversation differently?

Rather than starting with whether a parent wants staff to carry their baby, perhaps we could begin by talking about what happens when they're away.

I wouldn't want a parent to feel pressured into agreeing to something they're uncomfortable with. Nor would I want a healthcare professional to assume that a refusal means the parent doesn't care about their baby's comfort.

But I would love to see more opportunities for conversation, particularly when a family's concerns might be addressed through education, reassurance, or a better understanding of how carrying would be used.

Perhaps a parent who initially says no might feel differently after seeing how the staff use a carrier, learning about the safety considerations, or understanding that babywearing, while powerful, is just one of several ways to provide comfort.

And perhaps they won't. Their choice still deserves respect.

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Thinking about the baby

I've spent many years teaching people about infant carrying, and one thing I return to again and again is the baby's experience.

What are they communicating? How are they responding? What are they experiencing through their senses, their movement, and their contact with another person?

Those questions stay with me whether I'm teaching a class, working with a parent at home, or a healthcare team in a hospital.

And they're the questions that came back to me as I listened to the teams in Phoenix describe their experiences.

I think we have an opportunity to help families better understand what responsive care can look like during the hours they're away, and to make sure the baby's experience is part of those conversations.

I hope that as babywearing becomes more familiar in healthcare settings, we'll become more comfortable having these discussions, including the difficult ones. I also hope we find ways to share the rationale for carrying with families, too, before they need to consider whether this is a form of care they want for their infant.

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