Babies
Having a baby is supposed to be a time of celebration
But when that tiny newborn is taken straight to the neonatal intensive care unit (NICU), joy can quickly turn into fear, uncertainty, and a sense of helplessness.
For parents of premature or critically ill babies, the experience may be overwhelming. “One of the biggest challenges is a feeling of guilt,” says Dr Fefekazi Mpisane-Jama, a neonatologist at Mediclinic Milnerton. “Parents may question whether they did something wrong, they could have done something differently, or something they did during pregnancy contributed to their baby’s condition.”
Then comes the fear of the unknown.
Once the baby is in ICU, parents may not know whether their baby will come home, what complications they may face, or what the future might look like.
For very premature babies, specialist neonatal care often involves managing complex complications. Dr Mpisane-Jama cares for babies from as early as 25 weeks’ gestation, including babies weighing as little as 500g. Treatment may involve resuscitation, respiratory support, and ventilation, as well as managing complications involving glucose levels, electrolytes, infection, the brain, and the gut.
She adds that for parents already dealing with the physical demands of childbirth, the emotional burden is immense. The mother may be recovering from a caesarean section, coping with pain and sleep deprivation, while processing the separation from her newborn.
There can also be practical and financial pressures. A baby may remain in hospital after the mother has been discharged, requiring daily visits, travel, and time away from work. These pressures add another layer of stress at an already difficult time.
How neonatal care helps parents understand what is happening
Dr Mpisane-Jama says supporting parents emotionally is an important part of neonatal care. It isn’t simply about treating the baby’s medical condition.
“It’s a multidisciplinary effort,” she says. The team may include nurses, occupational therapists, dietitians, social workers, and psychologists, alongside the neonatologist.
Clear communication is key. The team must explain medical terminology in plain language, with regular updates about what’s happening – including both setbacks and small victories.
“Sometimes what we say is a blur at first,” Dr Mpisane-Jama says. “Providing written information gives parents something they can return to later, when they’re better able to process what they’ve heard.”
Being open about possible outcomes is equally vital. “Transparency is very important,” she says. “This means giving parents realistic information while still allowing space for hope.”
Bonding with your premature baby in NICU
A stay in NICU can make parents feel like spectators rather than parents. But even when they can’t hold their baby, there are ways to build that connection.
“Parents can talk or sing softly to their baby, read to them and, where medically appropriate, gently touch or hold their hand,” she says. “Expressing breast milk also gives mothers a meaningful way to contribute to their baby’s care.” When the baby is ready, kangaroo care (skin-to-skin contact) provides another opportunity for closeness.
"There's a lot of bonding that can still happen, even if the baby is separated from the parents by an incubator," Dr Mpisane-Jama adds. "We try not to focus only on the negatives. If the baby has had an uneventful day and we've had a stable day, let's celebrate because that's a win."
From pregnancy to discharge: preparing to take your baby home
Leaving NICU can be just as daunting as arriving there. Parents who’ve become accustomed to having medical professionals nearby now find themselves responsible for their baby at home.
“That’s why preparation starts well before discharge,” Dr Mpisane-Jama says. “Parents are gradually taught how to feed, care for and administer medication to their baby.” They also receive CPR training, so they know how to respond in an emergency while help is on the way.
“The goal is not simply to discharge a medically stable baby, but to empower parents to feel capable and prepared.”
Ultimately, neonatal care is more than helping a fragile baby survive. It means supporting that baby towards the best possible outcome while helping the family navigate an experience they never expected.
And for parents struggling with the emotional weight of it all, support is available. Social workers and psychologists form part of the multidisciplinary team, helping families when the burden becomes too much to carry alone.