A new addition to a family always requires a period of adjusting. When a baby arrives prematurely however, the family has to adjust not only to its new member, but possibly life in the NICU and the inherent emotional roller coaster of stress and anxiety. During this time, assessing and addressing the coping needs of siblings may fall by the wayside. As a neonatologist or NICU nurse, some things you may notice happening with your patient's siblings include:

  1. Missing parents and their brother or sister
  2. May have a limited understanding the situation
  3. May want to help out, but aren’t sure how
  4. May feel angry, jealous, or guilty and aren’t sure if that is OK  

Recognizing this, one hospital developed a sibling support program, run by child life and music therapy specialists. In this program, siblings participate in the following activities to help them cope:

  1. Drawing a picture of the family: Helps specialists assess the child's perspective of family and where they include the new baby.
  2. Write a song about being a big brother or sister: Determine the child's understanding of their new role and aspects he or she is looking towards.
  3. Draw a picture of the hospital: Examine the child's perspective of the hospital (their own hospital experience and care the premature baby is receiving).
  4. Role play using toys or real equipment, pacifiers, diapers, etc.: Reveals the child's knowledge of equipment and reduces fear of it, can also clarify any misconceptions.
  5. Play instruments or singing to match the sound level required in the NICU: Demonstrate sound difference so that siblings will understand to speak or sing softly to the new baby.
  6. Draw or write your favorite things: Provides an opportunity to focus solely on the sibling.

Even without a devoted sibling support program, NICU staff can use these activities, like role playing with equipment, to help siblings understand what's happening with their baby brother/sister. Check out these additional resources for siblings, then join the conversation about how your NICU/hospital unit supports sibling coping on our Facebook page.