Empowered Messaging: 10 Tips for Communicating with NICU Families
When we meet families in the NICU, it’s often on one of the most challenging days of their lives. They are scared, overwhelmed, and frequently in physical pain. As NICU care providers, doulas, or birth professionals, it’s essential to approach each interaction with empathy and understanding. Families won’t absorb all the information we share with them the first time, and that’s okay. Abrupt or seemingly rude comments from families usually stem from fear and grief—fear of the unknown, fear of losing their baby, fear of missing out on the “normal” new baby experience. In order to decrease the trauma of a NICU experience, we instead should respond from a place of compassion rather than with rigid or dismissive statements.
Avoid Hurtful Language and Statements
It’s important to recognize the power of our words. Generalizations like “wimpy white boy” or “Black girls are stronger,” though may be statistically based, can deeply hurt families. Similarly, avoid dismissive “at least” statements like, “At least you can go home and sleep,” or “At least you’re in a good NICU.” These phrases don’t give families permission to grieve their experience or acknowledge the pain of what they’re going through.
Instead, validate their emotions by saying, “I’m so sorry you have to deal with this,” or, “Being here must be so hard—do you want to talk about it?” Acknowledging their struggle builds trust and opens up space for healing conversations.
2. Alleviate Guilt, Don’t Cause It
Many NICU families face life circumstances that prevent them from visiting the hospital as often as they’d like. Rather than saying, “You need to be here more,” approach from curiosity: “I know it’s hard to juggle everything. Is there any way I can support you in being here more often?” Similarly, when discussing prenatal choices, particularly around maternal substance use or home birth transfers, choose words carefully and avoid gossip. We don’t always know the full story behind these choices, and shaming doesn’t help change future narratives.
3. Mindful Communication
The NICU is a sensitive environment where privacy is paramount. Be mindful of where and when you have personal conversations with families. Avoid discussing medical updates or details in the presence of other NICU families or in open spaces where conversations can be overheard. Families overhearing details about other babies can erode their trust in the medical team.
4. Give Families Autonomy
Empowering families means giving them as much control as possible. Simple questions like, “How do you like to have your day flow?” or “What does your baby like?” allow parents to feel like experts on their baby’s needs. Similarly, asking, “Is there anything you’d like to bring up during rounds?” helps parents feel involved and respected in the care of their baby.
5. Prioritize Parental Updates
One common frustration among NICU families is being left out of the loop on their baby’s care. Make it a priority to provide timely updates, rather than waiting until the end of your shift or after a procedure has already been completed. Ask parents how they would like to receive updates and communicate that preference to other team members.
6. Respect Parental Involvement in Decision Making
The “do and then tell” mentality is prevalent in the NICU, where medical decisions are often made and treatment started without parental input. While there are moments when immediate action is necessary, many decisions can involve the family. Whenever possible, reverse the “do and tell” approach by involving parents in real-time decision-making. This builds trust, ensures informed consent, and fosters a sense of empowerment.
7. Save the Firsts for the Family
One of the most painful things I hear from families is when they miss out on a “first” with their baby—whether it’s the first bath, bottle, or time in an outfit. While it might seem more convenient to do these milestones during care times, waiting for the family to be present can make a huge positive impact. The joy and connection it brings is worth the wait.
8. Don’t Exclude Families in Scary Situations
Unless their presence is directly hindering patient care, families should be allowed to stay during emergencies. Watching the care team do everything possible for their baby reassures families that every effort is being made. This sense of trust and peace can be invaluable, even when outcomes are uncertain.
9. Choose Empowering Words
In moments of fear and uncertainty, families need to hear words of encouragement:
“You can do this. Your baby needs you.”
“I believe in you.”
“I’ve got your back. You’re not doing this alone.”
“Your baby is so lucky to have you.”
10. Prioritize Bonding Opportunities
Developmentally appropriate ways to bond with their baby—such as skin-to-skin, hand hugs, and other gentle touches—aren’t just nice extras. They are critical to a baby’s long-term development. Rather than treating these moments as inconvenient, recognize the vital role they play in the baby’s growth and the family’s emotional well-being.
BONUS! Teach the “Why” Behind NICU Policies
Lastly, explain the reasoning behind NICU policies like care times, clustered care, and visitation rules. When families understand why certain practices are in place, they are more likely to feel engaged and cooperative. This fosters a collaborative atmosphere between the medical team and the family, ultimately benefiting the baby’s care.
By meeting NICU families with empathy, mindful communication, and a focus on empowerment, we can create a supportive and healing environment, even in the most challenging of times.
