When a NICU baby finally transitions home, it is a moment of immense joy and relief for the entire family. Yet, this new normal, especially when combined with the need for ongoing specialized care or in-home nursing care, creates a profound and complex shift for older siblings.
Growing up alongside a brother or sister who requires extra support is a unique journey. Siblings often experience a complicated mix of emotions. They may feel pride, a deepened sense of responsibility, and increased empathy. However, it is also common to feel confusion, fear, jealousy over the attention the baby receives, and even guilt about their sibling’s condition. While some siblings of children with chronic needs are generally well-adjusted, research suggests a small subset may be at risk for increased psychological or social challenges.
For parents navigating medical equipment, appointments, and the presence of a care team, balancing the needs of their typically developing children is a true challenge. The good news is that by integrating support for your older children into your daily plan, you empower the whole family to thrive.
Here are five interventions to support the siblings of your NICU baby when they come home with in-home nursing care:
5 Ways to Support Siblings When a NICU Baby Comes Home
- Validate Their "Big Feelings" (The Good and the Hard)
A child’s world has been fundamentally changed, and they are watching how you, the parents, cope. It’s crucial to create a safe space for them to talk about their experience, whether it’s a feeling of pride or a moment of jealousy.
- Acknowledge the Mixed Emotions: Tell your child, "It's okay to feel happy that your brother is home and also feel frustrated that Mom and Dad are busy right now." This validates their experience without judgment.
- Encourage Open Expression: Use open-ended questions like, "What was the hardest part about today?" Letting them see you model your own healthy coping skills will helo them develop their own.
- Assure Them It’s Not Their Fault: Children sometimes engage in "magical thinking" and can believe they somehow caused the baby's illness. Reassure them that they did nothing wrong to cause their sibling’s need for care.
- Maintain Essential Routines for Stability
After the transition from NICU to home, re-establish and maintain a consistent routine as much as possible to help older children feel secure.
- Prioritize Bedtime/Mealtime: Keep routines like reading a bedtime story or having family dinner consistent. When you maintain these schedules, you provide a necessary sense of normalcy during a time when so much else is changing.
- Seek Support for Drop-offs: Don’t be afraid to lean on your support network—or your in-home care team—to help keep up with daily activities like school drop-offs or playdates. This ensures the older sibling’s world doesn't feel completely upended.
- Give Them Meaningful, Age-Appropriate Roles
When siblings are included, they feel more connected and less left out. While taking on too much responsibility can be detrimental, meaningful, simple participation is empowering.
- Assign Special Jobs: Give the older sibling a role that is helpful but not medically demanding. This could include choosing the baby's clothes, decorating the nursery, helping with a bottle-feeding, or getting the nurse a clean towel.
- Let Them "Teach" the Baby: Remind the sibling that they can do things the baby can’t do yet. Encourage them to read, sing, or talk to their younger sibling. Their voice is familiar and comforting to the baby, which reinforces their importance.
- Create Sacred One-on-One Time
With a high-needs baby, it is easy for a typically developing sibling to feel less important. Setting aside individual time—even if it’s short—is vital for reinforcing their value within the family.
- The "Ten-Minute Tune-In": Commit to ten minutes of dedicated, uninterrupted time each day. This can be as simple as reading a book before bed, sharing a snack, or having a chat in the car.
- Special Outings: Arrange for a trusted friend or your in-home nurse to care for the baby so you can have a short, focused outing with your older child. This reinforces that they are still a priority.
- Leverage Your In-Home Nursing Team
When your family has in-home nursing care, you have a valuable ally who can help your typically developing child feel secure and included.
- Explain the Nurse's Role Clearly: Explain that the nurse is a professional helper who is there to make the baby stronger so the family can be together at home. Help the older sibling understand that the nurse is caring for the baby so that you can also care for your older child.
- Build a Relationship: Encourage the sibling to introduce themselves to the nurse. Your care team can look for opportunities to involve the sibling in simple, non-medical ways, helping the older child see the nurse as part of the family's support system.
- Use the Nurse for Respite: Your nursing care provides a safety net that can allow you to step away and focus on your older children. Utilize this time to engage in the one-on-one activities mentioned above, which is the ultimate benefit of home care.
By giving siblings the space to express their feelings, involving them in the journey, and leveraging the support of your in-home care team, you can help your medically fragile baby’s brother or sister adjust and strengthen the entire family unit.
The transition to pediatric home care brings its own set of demands, but small, intentional daily habits and consistent support can make your new life feel stable and manageable.
Discover how a dedicated in-home nursing care team can provide the specialized support you need to focus on your family's emotional health. Explore BAYADA’s pediatric home care services.