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Welcome to The NICU Translated Podcast, where we break down the complex world of the NICU into clear, relatable insights for families and the professionals who support them. Hosted by Mary Farrelly—a certified NICU nurse, doula, and educator—this podcast is your go-to resource for navigating the NICU with confidence and compassion.
Whether you’re a doula looking to better support NICU families, a healthcare professional seeking deeper understanding, or a parent preparing for or living through a NICU journey, you’ll find actionable tips, evidence-based guidance, and heartfelt stories to inspire and empower you.
Each week, we’ll explore topics like:
-NICU 101: Terms, diagnoses, and medical equipment explained.
-Preemie care basics and developmental milestones.
-How to advocate for your NICU baby with confidence.
-Emotional and trauma-informed support for NICU families.
-Insights from NICU professionals and families who’ve been there.
With episodes featuring expert advice, list-style guides, and real-life interviews, The NICU Translated Podcast is here to equip you with the tools and knowledge to make the NICU journey less overwhelming and more empowering.
Subscribe now and join our community dedicated to bringing more joy and less trauma to the NICU experience—because the NICU is only the beginning.
Let’s navigate this journey together.
Mary Farrelly (00:00)
When I tell people I work in the NICU, I hear the same myths over and over, some from parents, some from professionals, and some from well-meaning friends and family. And while most of them come from a place of love, they can leave families feeling unprepared, guilty, or misunderstood. Today, we're busting the top five myths about the NICU so you can walk into or support someone through this journey with clear expectations and a lot more confidence. Let's dive in.
Hi everybody and welcome back to this week's episode of the NICU Translated Podcast. Today we're talking about those myths that so many people, non-NICU people, well-meaning people have about the NICU. Because the NICU is oftentimes, I kind of imagine it sometimes in the hospital as almost in its own little ivory tower. Even other people that work in the same hospital system that I worked in had no idea.
how big the NICU was, how many nurses worked there, how many patients we had, or anything about the day-to-day reality of the NICU. So a lot of this just comes from lack of knowledge and the information that we do know and where some of these myths come from unless you've worked or lived in the NICU setting can oftentimes come from social media, TV shows like Grey's Anatomy, and they paint this very specific picture about what the NICU is like.
But because of these myths, which we're gonna go through five of them today, when the NICU is part of a family story, it really steps families up for feelings of
overwhelm, unnecessary fear, or even sometimes some false reassurance about what their NICU journey might look like, or even what types of babies need NICU stay. And it can make families feel a sense of shame or failure when their reality
doesn't match the expectations that they had for their birth, postpartum or early infant journey. For professionals, this can also lead to assumptions that impact care. One of the biggest things that I work on when we talk about prenatal prep around NICU stay is bringing NICU conversations into prenatal conversations and childbirth education classes, because right now it is really not talked about.
And because of that and the assumptions that we share as well-meaning providers, oftentimes doulas, OBs, midwives, other people who are taking care of families prenatally, it then in turn impacts how families perceive their NICU journey if and when it is part of their story. And one of them first myths that we're gonna bust and one of the most common ones that I see is if you prepare enough prenatally and make healthy choices, you can avoid a NICU stay.
This one really hurts my heart and
There's a part of social media that has done amazing things with allowing families, pregnant families, to see the possibilities of birth, to see what a low intervention, low risk birth looks like, to see images of the baby being born and going up and doing uninterrupted skin to skin and having a golden hour experience. And as a doula, I think that it's incredible that families feel like they can have an informed decision and are able to make
prenatal choices about care providers, birth preferences, how they vision their birth experience going to be able to decrease birth trauma and potentially have better outcomes for moms and babies. But the reality is that one in 10 babies born in the United States this year will need a NICU stay. And you can do every single thing quote unquote right. And the baby may still need to have support from the NICU.
And there are lots of reasons why a baby might need a NICU stay. When you think about it in utero, when the baby's developing, they're kind of on cruise control. They're not doing much. They're just hanging out. They have a heart and it's beating, but it's not maintaining blood pressure. They have lungs and they're kind of doing these little practice breaths, but it's not delivering oxygen or exchanging gas. They have a stomach and a digestive system, but it's not digesting food. It's not really creating real poop or real pee or all the things that it needs to do. And then when a baby's born, everything's supposed to just
fire on and work perfectly. And the fact that it does so often, that nine out of 10 babies do not need a NICU stay is kind of a miracle. But some babies simply need additional monitoring, support and care during that transition from life as a little fish inside a belly to life in the real world. And what happens because sometimes, often, we do not speak about the NICU prenatally and it is left out of really any conversation for families that are
pregnant. When it does happen, it can feel like for some families that they must have done something wrong and they will go back. And we know this is not the right thing to be doing, but they'll go back through every decision, every choice that they made throughout their pregnancy journey and find ways to blame themselves for this experience. So if we can change that narrative and introduce the NICU as the place of
transition and support and care and it is not as stigmatized or really as kind of gate-kept. We do a lot of gatekeeping around NICU knowledge and NICU care. If we can decrease that from a place of empowered decision-making, not from fear, I do not support fear-mongering and making every pregnant person fear that they're going to have a NICU stay. I firmly believe that that will allow families to step into a NICU journey if it is part of their experience.
with a lot more confidence and less fear. We're never going to be able to erase fear entirely. If your baby needs additional care, that can feel very scary. But knowing that it is a possibility, what the NICU might look like in the place that you're giving birth, what types of diagnoses and experiences a NICU baby might have, it can help families feel like they can make better decisions and feel less powerless and less overwhelmed through a NICU journey. So a NICU stay is
not a reflection of what somebody did or didn't do. It's about what the baby needs right now in that moment. And that being said, there are things that can help decrease the chance of a NICU stay, right? Like some families are higher risk for different lifestyle, socioeconomic, medical things that are going on. And not all of that is within our control as parents either, but there are some, you know, choosing to have great prenatal care.
and to make healthy feeding choices and all those different layers can decrease the risk of a NICU stay, but it will never entirely erase. And most NICU stays are unexpected. Very few people, some do know prenatally that the NICU will be part of their journey, whether it's from an ultrasound or some other thing that came up prenatally, but most families, it is unexpected. so reframing it to a place of healing and hope and transition rather than
a scary thing that you could, could have, would have, should have avoided. Can help family step into the NICU feeling more confident and less traumatized by the experience. The next common myth that I see, especially from people who have watched Grey's Anatomy and other shows like that, is that all NICU babies are preemies. NICU equals preemies in most people's head. And
There's some truth to that, right? The NICU, the most common reason for admission to a NICU is prematurity. So those babies born less than 37 weeks gestation. But in most NICUs, the statistic is roughly about 60 % of babies are premature and 40 plus percent of babies are term infants. So oftentimes, especially when I'm working with pregnant people as a doula or speaking with other doulas or other healthcare providers that are not NICU related,
they'll say, you know, I'm 36 weeks. We're not preemie anymore. Like we're not going to need the NICU. And it can create that false sense of security that the NICU is, you know, they've escaped the NICU. They've outsmarted the NICU experience. But as we talked about before, babies are going from living in a cruise control type environment to needing to...
do all the things, to be able to breathe independently, to be able to digest and grow, to be able to maintain their own temperature.
babies are born with a immunocompromised immune system. They do not have the ability to fight infection as well. So if they're exposed to infection, whether during pregnancy or during the birth experience, they may need a NICU stay to help them transition through an infection. And then some babies that are born term might need surgery post birth for other types of congenital abnormalities or differences or other things going on. There's a lot of reasons why a term baby might need a NICU stay. So even just including that information,
in general prenatal discussions and conversations, again, not from a place of fear, but from a place of informed education and allowing families to potentially, tentatively wrap their head around a potential outcome, ⁓ again, can decrease the fear of the situation if it does happen. Just like if you're doing birth planning and people's goal and vision is to have an unmedicated vaginal birth, for example.
If we only ever talk about an unmedicated vaginal birth, it does not allow the family to have any idea of what they would maybe want to happen if they needed to have say a C-section or a medicated vaginal birth or any of the above. Bodies are not robots, babies are not robots. There are so many variations of what can happen. And knowing ⁓ having a, what I call a fire drill plan in place.
can help families feel more empowered to navigate those situations. If you're interested as a doula or a pregnant person or someone supporting someone in your life about how to have a conversation about the NICU prenatally, again, from a place of empowered decision-making and not fear, I have a free resource called the NICU Birth Plan Template. It's a downloadable Canva link and PDF that goes through about 10 questions that you can talk through prenatally.
So you have, if the NICU is part of your story, you have a tentative plan in place of how you would want that to look. For example, where the NICU is, what are the different levels of care, who goes with the baby who stays, different conversations that you can have so that if and when the NICU is part of your story, you have a tentative plan in place. If you're interested in that, I'll drop the link in the show notes below, or you can go to my website at thenicutranslator.com.
to be able to download that resource. I just want that out into the world. I want every single pregnant person, low risk, risk in between to be able to have a general, bare minimum understanding of the NICU so that when they come to the NICU nurses at the bedside and they stare at me like a deer in headlights, they're gonna maybe have a little less of that overwhelming fear. And we're never gonna totally take it away, but maybe a little bit less. The next myth that I see often, and this can come sometimes,
even from within the NICU setting is that NICU babies can't be breastfed. That breastfeeding is just completely out of the window if the NICU becomes part of the baby story. Many NICU babies can breastfeed. Sometimes they can breastfeed right away. Sometimes with a little extra support. And oftentimes it is more of a journey and it can change what the breastfeeding timeline looks like, but it doesn't mean that
that dream or that hope or that desire can go away. But it does sometimes require a little bit of innovation and really specific intention around feeding express breast milk. Most NICU babies as a reality of their need to be in the NICU, oftentimes, not always, but often cannot feed directly by breast or bottle during at least a few hours, sometimes days, sometimes weeks.
months, depending on if they were premature or sick of their NICU journey. But that doesn't mean that they will never be able to eat by breast or bottle. Oftentimes they do and they do it really well. But if that is the feeding goal of the family, if they would like to breastfeed, that will almost always NICU families will often need to start with a pumping routine, a pumping schedule.
to be able to allow the body to express breast milk and to create the amazing system that allows the body to produce breast milk so that when the baby is ready to feed directly by breast or bottle or everything in between, that there is milk available to allow that to happen. And so breastfeeding is possible in the NICU. Oftentimes this requires a lot of patience and different expectations.
Sometimes we have that idea of, you know, Instagram versus reality. This is another time when we see and have maybe educated ourselves as pregnant people about the benefits of breast milk and breastfeeding. And we see it happening for people, but we also often don't see the reality of what that is. The kind of grittiness that sometimes is required to getting through the hurdles and the different challenges that are around breastfeeding, producing breast milk, pumping and everything in between.
So it often requires a lot of support too, whether it's from a trained lactation consultant that understands the nuances of pumping and providing breast milk for Nikki babies and oftentimes for preemies and or multiples and all the different kinds of layers of breast milk expression and breastfeeding there too. And then also transition support from people who understand the unique needs of the feeding experience, especially for preemies or babies who had a tougher start around coordinating sucks while I breathe.
latching, stamina, and how do we support babies to create positive oral feeding experiences with different expectations. So if we, as people who are hoping for breastfeeding, have this vision of the baby's immediately going to come on the breast, latch, I'm going to produce enough milk and it'll be perfect. And then when it doesn't meet that expectation, that Instagram versus reality, we beat ourselves up again or feel like it's never going to happen. Or again, have those feelings of shame and doubt and overwhelm.
Going to breastfeeding as curious and supportive and wanting to explore what breastfeeding is like in the NICU setting, it's much more likely to create these long-term positive feeding experiences, which lead to potentially long-term feeding outcomes. But even itty bitty babies can have breastfeeding experiences. They may not be able to establish a milk supply or extract enough milk to be able to grow effectively. Feeding tubes are often a bridge.
Sometimes bottles are a bridge for NICU babies, but it does not mean that NICU babies can't breastfeed. It just means it's going to look a little bit different.
Mary Farrelly (15:53)
Hi friends, this week's episode is brought to you by Navigating the NICU for Doulas If becoming NICU informed is on your heart for the end of the year, I have exciting news. For the first time ever, NTN is officially available as a fully self-paced course so you can learn the same evidence-based content I used to teach live.
anytime you need it and at your own pace. And here's the fun part. Starting December 3rd, it's available at a special discounted price. Plus, if you join in the first three days, you'll get my brand new NICU Toolkit for Doulas for free. It comes with scripts, templates, and a walkthrough video to help you feel grounded and confident in those early NICU conversations. NICU families deserve more than survival. They deserve to truly thrive, and NICU-informed Duelas are such an important part of making that possible. You can learn more at thenicutranslator.com slash get-nicu-informed
I'd love to support you inside.
Mary Farrelly (16:48)
Myth number four is that NICU babies are too fragile to be held or touched by their parents. NICU babies, especially for the first time a family sees their baby, can be very intimidating, right? You see, especially for tiny babies or term infants that are more critically ill.
There's a lot of tubes and wires and machines and beeping and people and the alphabet soup of what's going on, the NICU terms and language and all these different things. So it can feel really, really intimidating. And there's a lot of validity to that, right? Like a baby who is premature or critically ill is going to need different types of touch and care and stimulus. But we know one of the most researched things in NICU
around bonding and developmental care is the essential need for human touch and human connection. Positive touch. A lot of the touch in the NICU, especially from NICU nurses, is not good touch. Like we are doing annoying things to the baby. We're taking their temperature. We're taping things to their body. We are, you know, maybe even have to do painful things like putting in an IV. So those things are necessary. They need these things to be able to survive and be able to
get through the NICU experience, they babies desperately need positive touch to balance, to counterbalance the annoying or negative touch with positive touch. Humans are wired for touch. So we know that babies that are able to have kangaroo care, our kangaroo care or skin to skin has incredible benefits for both the baby and for the family. I'm going to do a whole episode about the benefits and some of the research around kangaroo care.
and skin to skin, even positive touch through simple experiences like a hand hug. Preemie infants do not like to be stroked. Their bodies are still maturing. Their nervous system is not designed to be touched in that way yet, right? They're not used to having light touch when they're in utero and swimming around in water. And when they kick you in their bladder, they're going to feel that firm positive pressure back from really the uterus or whatever organ they're kicking.
So preemies are wired to enjoy that type of touch. So even a hand hug, which is putting gentle pressure on the baby's legs or over their arms and on their head to help them feel contained and safe and really mimic that womb-like environment, that also has many positive benefits. Your hands are skin So skin to skin can look like many different things in the NICU depending on the various tubes and wires and unique medical needs of the baby, because not every baby is going to be able to
do kangaroo care skin-to-skin safely in the same way that a term infant with no wires and tubes are. It's still possible nine out of 10 times. It might require a little bit of creativity, extra training, extra safety resources to be able to make it happen. But even if skin-to-skin can happen on that day, babies truly need the touch and care of their parents. And this may also look like helping families feel confident in being able to do.
Typical parenting tasks, even in the NICU setting, like diapering a baby, cleaning their mouth, doing oral care, things that you would be doing even if the NICU was not part of their story, helping families feel confident to be able to use an isolate, do diaper chains around IVs, be able to know which wires go where and which ones are the don't touch and the do touch. Some of that takes education and confidence and skill, but are essential parts.
of the healing journey for both babies and their families. So they're not too fragile to be touched. In fact, the outcomes are much better with positive touch and positive experience than babies that are always in a low sensory experience. There's a balance between low sensory and like needing those low sensory environments versus positive touch. And we're always gonna follow the lead of the baby.
We assume that touch will feel good if the baby's vital signs and responses are showing that they're not in the mood for that that day. we're following the baby's lead. That's just as important information. But most babies thrive with touch, especially from those that they love. Myth number five is that after discharge from the NICU, everything is back to normal. Everything is just fine. Oftentimes this is one of the hardest myths to overcome.
both for family members that are going through the NICU and for people who are helping to support them. Sometimes with NICU families working as a NICU doula and helping with this transition to home, a lot of times families support systems like maybe their loved ones, family, sometimes even other doulas in their community or things like that. They might rally during the NICU stay. They might be able to create a mail train, figure out how to help support the sibling, come walk their dog.
provide funds for a GoFundMe and all the various things that we do when we have a loved one in crisis. But oftentimes that support kind of dries up during the transition to home because people assume, okay, that crisis is done now, everything can go back to normal. But for most NICU families, that's when the real postpartum intensity starts. They're now, instead of having the support of a medical care team, you know, you have a
question in the NICU, you can literally turn around and there's probably someone within a couple feet of you that can help answer that question or give you a second opinion. If you're like, what do you think about this poop? Does it look normal to you? There's an answer for you. If you're worried about how the baby's breathing, there's a monitor with numbers at home. All of that kind of backup plan and reassurance and support basically tries up overnight, which is really where a certified NICU doula can step in and help bridge that gap.
because the transition can be really intense. It is a huge milestone. It is a joyous milestone. But families go from being a partner in their baby's care and on their care team to being really in charge. They become the attending physician basically of their own baby's care. Even though they're having a lot of support and ⁓ medical advice and experience from maybe their pediatrician or other specialties or follow-up clinics, they're really the ones that are implementing.
and integrating and advocating for their baby at home. And oftentimes these families are still figuring out how to navigate their own postpartum body and the physical changes that happen during their birth experience. Maybe now they're bringing a baby home and there's other siblings at home and they're trying to figure out how do I take care of my two year old while also trying to feed a preemie that takes 30 minutes to eat a bottle every three hours.
How do I feed myself while also taking care of all these other things? How do I go to all these medical appointments and keep track of it all? families are also often at this stage of discharge, finally having some time to maybe get out of that intensity fight or flight mode that was in the NICU stay and are starting to feel some of those real raw emotions from their.
NICU experience or maybe even from a traumatic birth experience as well. So one of the statistics that really shines light on the mental health load of a post-NICU experience is that for NICU families, roughly about 40 % have clinical PTSD or post-traumatic stress disorder symptoms post discharge. But of those 40 % of families, only about 14 % of them have symptoms prior to discharge.
So many, many families are having their first real mental health crisis after discharge, when the support has dried up, when they have time to really sit and process what's going on. So oftentimes families need even more support, even more care than they needed during their acute NICU experience to help heal regroup.
and really step into chapter two, the chapter after the NICU with additional confidence and support and time and space to heal and recover both for them and for their baby and for the family members that support them. And one of the key players in this transition to home that can help support the emotional and practical realities of taking a baby home is a certified NICU doula.
So if you're a family listening to this and you're interested in finding a NICU doula to help support you, I'm so excited to announce that in the next, maybe when you're listening to this or just soon after, the NICU dual directory is going live on the nicu-translator.com where you'll be able to find a list of students who have taken my 10-week certification course for becoming a certified NICU doula.
that are all over the country, they're all over the world even. We've had students graduate from almost every continent at this point. So there is going to be someone that is able to help support you through this journey, whether it's before a NICU stay, navigating a NICU diagnosis, through the NICU journey, or especially during this transition to home. And if you're interested in becoming a certified NICU doula, whether you're a NICU family who's listening to this,
and is trying to figure out how to pay it forward, how to be that support person for other people going through the NICU journey. Maybe you are a doula or nanny or newborn care specialist and preemie and NICU families really have a special place on your heart, but you want to be able to support families from a place of evidence-based and trauma-informed care practices. Or maybe you are a healthcare provider like a NICU nurse or social worker or someone working even for a nonprofit that wants to take their medical knowledge and translate it into
supportive doula work and learn the language of doula care so that you can help support your families at the bedside or beyond in this unique role. So if you're interested in learning more about becoming a NICU doula, you can also go to my website, is the nicutranslator.com and the NICU Doula Academy information is at nicu-doula-academy and I will drop the links in the show notes below. So back to talking about myths.
For parents, we can release the guilt that these myths sometimes can cause and approach the NICU as a place of healing, not of punishment, not of doing something wrong. It is a place of healing and transition. having NICU informed professionals be able to support you along this journey can help ease the experience and make it have more joy and less trauma during that journey. If you are a professional listening to this,
Addressing these myths early, especially prenatally, if you're someone who has prenatal conversations with families, whether you're a doula, a nurse, a newborn care specialist, anybody who talks to pregnant people prenatally, addressing these basic myths early can help set realistic expectations, which again can help decrease the trauma and overwhelm of a NICU experience. And if you're a friend or family member listening to this, and you just want to know how to help,
I strongly encourage you to use this information to avoid assumptions, listen to the family, and ask how you can help. One of the hardest things is, NICU families don't necessarily want you to say, how can I help? But more knowing that they're going to need help. And sometimes it might be, this is how I'm going to help you. I'm going to offer a listening ear. I am going to set up that meal train. I'm going to come clean your house. I'm going to come walk your dog.
I'm going to bring you a mug of soup ⁓ up to the NICU bedside. I'm going to check in with you six months post discharge because I know the intensity doesn't disappear overnight. Those are ways that we can bust these myths and help show up for NICU families so that they can feel more supported along their NICU journey. So when we replace myths with facts, we take away guilt, shame, and confusion and make space for clarity, connection, and hope.
The NICU can be a hard place, but it can also be a place of love and resilience because the NICU is only the beginning and together we can make this journey a lot less overwhelming and a lot more empowering. NICU love, love Mary.