10 Life Lessons from the NICU - Christine Kane

Today’s post was written by guest blogger, Sue Ludwig. Sue is the President and Founder of the National Association of Neonatal Therapists.  She is a consultant to neonatal intensive care units around the country, a national speaker, and a published poet. She lives in Ohio with her husband and two children.

If you’ve never stepped foot in a neonatal intensive care unit (NICU), you might be tempted to think it’s a bustling place filled with baby noises like fussing, crying, and cooing.

You’d be wrong.

Mostly the babies are quiet. There are monitors, pagers, and ventilators beeping. Phones ringing. Staff and parents talking. But a noticeable lack of fussing coming from the babies. It’s hard to cry loud with small lungs.

So how is it that these fragile, nonverbal, babies have so much to teach me?

Well, like any of us, I learn in direct proportion to how much I pay attention. And by how much I intentionally engage in my work versus just going through the motions.

When you pay attention, these babies speak volumes.

Here are 10 lessons I’ve learned from the babies in the NICU:

1. Being born early does not mean less human, less valuable, less worthy – ONLY less prepared.

Pregnancies are full term by 37 – 40 weeks. So when a mother has her baby at 25 weeks gestation, no matter what I tell her, she often feels shame that her baby is still “in the process” of developing.

Well, who isn’t?

A few years ago I was writing up research for publication. I thought I was a decent writer. After spending countless hours writing this paper, my mentor came back and basically told me to start over.

I sobbed on the spot from exhaustion and the shame of feeling inadequate for this work. I was ashamed to still be developing as a writer.

Here’s the thing. We’re always in process! We are each starting over and over again in an endless cycle of learning and development.  No guilt, no blame, no shame. (Especially when you’ve done all you can to bring your baby safely into the world!)

2. We each communicate differently.

It’s easy to judge another person when she communicates differently, slower, or in a different dialect than you.

The babies have taught me to listen first, assume nothing, and leave judging for the Olympics. And more importantly – that I am responsible for half of every interaction with someone. So if I am busy thinking about what the other person should be doing or saying, I am likely not present for my end of the communication.

3. Small and feisty goes a long way!

Visit a NICU sometime to watch this one in action!

4. Environment Matters.

Loud noises are stressful. The babies respond to this stress by being startled frequently, spending less time in a deep sleep, and having changes in their heart rate and other vital signs.

What about your environment?

When you walk into the door to your home, do your surroundings add to your stress or decrease it? Is it cluttered, do you have space, do you have freedom to move? Are the sounds pleasant, or are they just noise?

The environments we create for ourselves directly affect our mood, our productivity, and our well-being. The babies have taught me that we thrive in an environment that serves us.

5. Connection heals.

There’s nothing better for a baby than loving connection with her mother and family.

Recently a mother in our NICU held her tiny baby on her chest. The baby was still on a ventilator. This is known as “Kangaroo Care” or “skin to skin” holding.  This mother, like so many before her, said that this was the only activity that truly allowed her to feel like a mother since her baby was usually in an incubator. Babies breathe and sleep on their mothers amazingly well even in this fragile state.

We are meant to be in connection with others.

Separation from that connection leaves us more vulnerable and less likely to maintain health. When our connections are loving and consistent, we thrive. Often when we feel vulnerable, angry or sick it’s because we’ve stepped away from the connections that heal us.

6. Eating Should Be Enjoyable!

In the NICU we’re obviously concerned with how much weight babies are gaining. In our quest for improving weight gain, we often overlook the significance of the actual experience the baby has while eating.

We pay too little attention to the fact that feeding is a bonding experience – social and nurturing. But we know that many premature babies nationwide have issues with feeding long after they’ve left the NICU. I believe that part of the problem is that hospitals often view feeding more like a medical intervention than a nurturing experience.

We should enjoy eating! But we often forget it’s a nurturing experience for our bodies and feed only our emotions or are completely distracted while we eat, giving no attention to the experience or the food.

Babies have taught me that eating should not be automatic. It should be intentional and engaging.

7. Tenacity is an inside job.

About a decade ago a boy in our unit was born weighing just about a pound. He had significant lung disease months later when he was discharged home. Now, at age 9 he is the fastest boy on his soccer team.

Who’d have thunk?

He taught me that tenacity isn’t definable at the surface. It’s something deeper, more elusive than brawn and background. It comes from inside. You know you are stronger than anyone would guess. Even when you weigh just a single pound!

When I reflect on that boy’s strength I think, “Who am I to think I can’t achieve something?”

8. Comfort and sleep are crucial to healing.

9. There are times for fighting and times for letting go.

For a premature or sick baby, most days are about fighting and growing.  They are about one more hurdle, one less tube, one more step toward home. And most babies win that fight.

At other times, when all that medicine and love have to offer is not changing the tide, the nurses and doctors do the impossible job of helping a family lovingly let go.

On the letting go days, I know only to go home and hug my own children in humble gratitude. Loss is a powerful instructor. Life is precious, yes.  And the babies teach me that it is hard to comprehend the gravity of that truth until we are asked to let it slip away.

10. Fragility and strength are not necessarily opposites.

If you look around the NICU and witness these tiny babies defying what seems reasonable for such a small person, you observe that fragility is often just strength’s first teacher.

I have rarely witnessed a population of patients that inspire such loyalty in their caregivers. Across the country I’ve noted that the NICU team appears, in my experience, to love this work.

Maybe because we have the best teachers.

  • Maria

    Sue –

    Beautifully expressed. I am more and more amazed by you everytime I read one of your post. It is obvious that you have a large impact on both all of us,large and small. Love You.

  • Lee Salas

    I just wanted to tell you my son, Joel, who is now 21 and attending OSU foe medical school, was a 25,wk preemie at Rainbows, He was in a study there for preemies born under 866 grams. He was 1 lb 3 oz. He is doing outstanding, with absolutely no residual effects from being early.
    Your article is spot on!

  • Cynthia

    My own micro-preemie NICU twins may be healthy 12 year olds now, but the experience of being a NICU Mom never really leaves you. What a beautiful post and so very true- you had me in tears. We were blessed with a miracle for our 1 lb. 14. oz daughter who endured 12 minutes of oxygen deprivation at birth but has had no long term health problems as a result. I thank God frequently and think with great appreciation on the doctors and nurses who didn’t give up at minute 11 when it seemed that all was lost. Bless you for what you do!

  • Cheryl MT

    28 years ago last Oct. the 4th, my 1 lb 4 oz 24 week baby started teaching me patience, hope, strength and perseverance. Now 110 surgeries later, loss of vision, tracheotomy for 3 years because her vocal chords are paralyzed, chronic lung issues and medically fragile, she is preparing for her wedding. Despite all of the set backs she is one of the most encouraging people I know. I wish someone back then had understood what the NICU means and does to people. It is hard to explain what a family sees when they are there. All I had for the first 3 months were pictures. I didn’t get to hold her until she was 3 months old. Whew, this brings back such a flood of memories, some good and some bad. those feeling never go away , they just change.

  • AmandaG

    Thank you for your article. We just brought our 27wk twins home on 12/23 after a 9wk NICU stay. I am grateful for people like you who are able to communicate such thoughtful lessons. I know I learned them, but I haven’t been able to put them into words.

  • jason sullivan

    Ahhh this took me back to when my little one was only 1lb 6oz….. she was such a fighter…now shes almost 10lbs and we call her the dictator… cause she rules this house pretty much…..those NICU nurses and doctors were amazing and gave my baby girl the fighting chance she needed to be the big strong girl she is now

  • Karen

    As someone who was a preemie with holes in her lungs…. thank you for reminding me WHY I want to be a singer in the first place and that my tenacity and unwillingness to give up comes from inside. Thank you for reminding me on the days when I feel fragile that my strength is not gone.

  • liz

    Big Sigh and grateful tears. Sue..you reminded me of why I love what I do and the impact that precious life has on who I am as a person. Passing this on to my team as a reminder to all of us!

  • sue

    After reading Christine’s new post (awesome!) I read these last few comments. Thanks to all of you for taking the time to leave them. They mean more than you know.

    And gotta love my Aunt Betty for leaving me such a great comment. And for being one of my biggest fans. Thanks!

  • Aunt Betty

    Sue – You already know that most things you write touch my heart – you may not know that almost everything you write “goes traveling” to everyone I know – To write like you is a wonderful gift – but to even “feel” things the way you feel them is an even greater gift – Love you, Aunt Betty

  • katherineME

    It is always a treat when I see you are the guest writer on CK’s blog. You are, as you already know, my inspiration. You keep writing and following your passion, for the little ones in NICU, for the big ones outside of it.
    lots of love,

  • Helen During

    We have a almost 6 year old Xhosa boy in our home (in South Africa )and he was born at 30 weeks. For reasons divine he did not have access to an incubator and was instead strapped to his Mums chest for weeks on end – skin on skin . That part is vitally important. He absolutely thrived and is now a highly intelligent, calm and very gentle boy. The last two characteristics I believe are a direct result of the kangaroo care. Minimal medical intervention and just the feel of his mothers skin and the sound of her voice. That’s all a baby needs. Trust that. Its their innate soul choice whether to stay or whether to go back to the place that souls rest and medical intervention won’t change that.That not to say medical intervention does not have a place but rather trust YOUR inner voice on the type of intervention your baby needs and go with that. Your and your baby’s inner wisedom will guide that.And offer gratitude all the time.

  • Christine Kane

    Sheri – nope. i love a-h. but i’ve never been on a call or program of theirs. (i’m about to release my first full length audiobook – so you can see for yourself what i sound like speaking! I’m told that i sound nothing like my singing!)

  • Sheri

    CK, I listen to your music often (love it) BTW, and on your live CD’s I am able to hear your “speaking voice”. So…. the other day I was listening to an old “A/H” CD and I “swear” you are on recorded on a segment titled “Attracting Your Ideal Mate”. Wondering, do you follow A/H teachings and is that you?

  • Lisa

    So much here reminds me of my own inner healing path. I wasn’t a premie, but I spent the first year of my life in an orphanage. Still learning how to treat that little one inside. Learning about babies in institutional settings helps me understand and forgive myself for the patterns I work to transform.

  • Chiqui*Kat Pineda-Azimi

    Learning with you.
    What a beautifully written post.
    Thanks, Sue!
    With Love and Gratitude,

  • Molly

    I want to thank you for sharing this! My daughter spent 2 1/2 weeks in a NICU (she was full term!), and feel that this post was so poignant. Also, I am finishing my Master’s in Occupational Therapy and can attest that this post is so right on in SO many ways!!!

  • Karima

    Thank you for slowing me down to read this article.

    It brought me back to what matters most always. The snow storm in the northeast (US) caused my daughter and I to be at home for over 9 days in our small space. Many days businesses and schools were not even open. At times, I felt like I was going insane–Its a good thing I meditate and use NOT the television to entertain. But how many games can you play together–and she is very clingy.

    My daughter was born at 26 weeks–I went into the hospital at 23 weeks. I was on a supreme bed rest. To lay still all day & night for weeks. Most of us are not even still for 1 hour of the day. I did not know what to do. I had read every book about pregnancy and it never occurred to me to read about pre-mature babies. Why would that ever happen to me? I went to every doctors appointment, took my pre-natal vitamins, pregnant yoga classes, & had a high five from my doc the previous week…I did it all!

    But it did happen to me and I had to make a decision to be still and figure it out. A sense of calm came over me because I felt HER will to live and grow. She needed me to be still, slow down, and “just do her” everyday in the NICU for 78 days. Those angels in the NICU helped me tremendously! My angel (her name means Angel in Swahili) did not have eyebrows, nipples, her vagina was not “complete” yet. My life was very very busy and then everything just stopped. Imagine being responsible for many events at a full time and part-time job and then nothing, but laying still and flat….

    I feel like this recent snowstorm did that to me (us). My life is picking up the pace, but I needed to be still and figure out how to incorporate HER more into my busy life, again. Today, She is now 6 years old-and has not skipped a beat since we bought her home.

    Thank you for helping me remember!

  • sue

    These comments make me very grateful that this way of sharing exists.

    Andrea- What a testament to your resilience and perspective. Your comment will make our whole staff teary. Thank you for sharing your story.

    Terri- Thought of you while writing it, and know the NICU is your first work-love.

  • Terri

    You make me miss it…..

  • Andrea

    Thank you for your post. I was one of the parents that let go and I have to say that I learned so much from the few hours I had with my first born, a daughter, especially after the decision to remove her from all the tubes and equipment and let her just be my child in my arms, on my chest for a few hours. I became a mom even though I did not leave the hospital with a baby. I learned universal compassion for all mothers at the time of birth, no matter what their birth experience. I learned how I wanted to be a mother for the babies I had later in my life. I learned that the doctors and nurses in the NICU can bravely look at death and death itself can be a beautiful thing.

  • pati


    Beautiful. If you have time sometime, could you write more about letting go? I have a hard time with that. Many thanks. Pati

  • Kelly Warren

    Beautiful. Just beautiful. I’m a Mama of twin girls who were born at 33 weeks and spent 3 weeks in NICU. What valuable lessons. And NICU nurses are earthbound angels.

  • elaine

    Awesome post Sue – wonderful. It made me teary reading it, as often your poetry and writing does! Thank you for sharing your amazing work and gifts with us – Lainey

  • Biz

    OMG – #6 nailed it for me – this one is going in my coaching email in the morning, be prepared to get hit from my site! ::giggle:: Thank yo so much!

  • Rob (Husband)

    Sue –

    Beautifully expressed. I am more and more amazed by you everytime I read one of your post. It is obvious that you have a large impact on both all of us,large and small. Love You.

  • Anna

    As always…you leave me with a smile.

  • jean

    Beautifully written…and how true. Babies teach us so much……and continue to teach as they grow. As you know, #4 is near and dear to me!
    I’m thrilled that you love your job so much and am blessed that you have such a gift of sharing through written word!

  • Kerridwen Niner

    Ok so i sit i guess like some before me with tears running down my face. My son was born at 39wks by c section after his measurements had dropped off(sorry that might not be the right phrase my mind whent blank. He was 3lb 9oz and spent 3wks approx between intensive card and the SCBU. It wasn’t fun, it was hard work and like you say juggling, spoon feeds, tube feeds, trying on me etc etc just made it all the more difficult. I didn’t feel like his mum just another female in a long line that did their bit.That said Brett is just over four and all there and half way back again, beautiful and bright and a fantastic Michael Jackson inpired dancer. There are plenty of lessons there that we could all do with bearing in mind 🙂

  • Laura

    Sue, this is so beautiful. You leave me speechless. Thank you.

  • Angie Dwyer

    I’ve said it before and I’ll say it here, you have the coolest job! Your passion for those tiny little lives has such an amazing impact on each and every babe that comes through the UH NICU. They are truly blessed to have you in their lives for even a short time…as I am.

  • Your Joy

    i am moved to tears by your writing
    and by the work you do.

  • sue

    Thanks for the great comments! It’s fun to share some of this NICU world with you.

    ‘Moms of former preemies’ who have commented- thank you. You are brave and resilient! Glad to hear about your kiddos and how well they’re doing now.

  • Linnea

    My son was a 31-weeker thanks to eclampsia on my part. He got Necrotizing Enterocolitis (or NEC, a horrid intestinal disease that affects only preemies). He fought it (with medical help) and won. He had to have surgery to remove the intestinal stricture the NEC left behind. He fought hard to recover, and won. He caught a staph infection from a PIC line. He fought that and won. He had to go back to the hospital to have his temporary colostomy reversed. He was expected to be in the hospital for 10 days. He was in there for half the time, because he fought hard — and won. At almost-13, he’s my very determined man-to-be. He’s my hero, and he still teaches me something new almost every day.

    When I couldn’t hold him post-surgery, I read to him. His breathing was fine, but you could see his pain on the monitor (where he’d suck in breath for a twinge). When I read to him, his breathing patterns would level out, looking like peaceful, rolling hills. So did the baby’s in the crib next to him. His mother had an older child and lived far away and couldn’t come every day. After that, I’d sit between their cribs and read to them every day, and I eventually recorded myself reading stories. The nurse who cared for both of them called that tape their “tranquilizer,” because it would almost always calm both of them. That says so much about the importance of contact and conversation.

  • Leila

    Soooo beautiful.
    If all us perfectionists or fellow anxiety or depressive prone people, ie grown ups (and yep that’s me sometimes)could remember or find ways to access our own desire to protect and love ourselves in the way that you describe these parents, staff, loving, willing and observing the miracle of these little things growing through a difficult start. Wow. Fantastic.
    Loved this post.
    Thank you.

  • geri nishi

    I especially like the part about being present for one’s end of the conversation. Thanks for writing about this – would love to hear more!

  • Jen

    Thank you for this. It is a reminder to me of what is most important — my son, now 17 and strong and smart, spent 2 weeks in the NICU (he wasn’t a preemie, but was called “the sickest baby in here”) and on the night he was born, the longest night of my life, I was kicked out of the NICU to get some rest and then called back two hours later to say goodbye — but he fought to hang on, and after that I never let myself get kicked out… and as I remind him and myself, we got through that, we can get through anything! resiliency is such a gift to oneself.

  • Tracy Stewart

    As usual, a really beautiful, inspiring post, Sue. Thank you.

  • Mindful Mimi

    I love it that those little creatures manage to teach us huge lessons. I surely learned a lot when I had my two babies – and I am still learning.
    Thanks for sharing this.

  • Leigh from 123 blog

    oh, this brought back SUCH memories of our time in NICU with our twins born at 32 weeks.

    You’re right – i was shocked, horrified and blamed myself for months and months despite the doc telling me that it was nothing i did wrong.

    And my babies are 7 months now – thriving if a bit small – my tiniest one, K, is the fiestiest person I have ever met LOL

  • Kelly – Sister of another mother

    You nailed it again. A 10 for sure. Thanks, Kel