The arrival of a preterm or sick newborn can affect older brothers and sisters. It is important to explain the changes to them early on so they can get ready for when their new sibling comes home.

Books written in child-friendly language can help older children understand the situation better. Parents and grandparents can use these resources to explain the changes in an easy way to children. Local parent organisations or online blogs often provide book recommendations on this topic.

Introducing siblings to the new baby 

If possible, it is a good idea to let siblings visit the neonatal unit, if they want to and if the neonatal unit allows it. Units usually have visiting guidelines for other family members of your baby. If the unit welcomes siblings, you can prepare them for what they might see, such as the baby in the incubator⍰, by showing them photos beforehand. Some units let older children help with daily care tasks like Kangaroo Mother Care⍰, changing nappies (diapers) or holding the baby. Explain the baby's health situation to them in simple and age-appropriate terms.

If the unit has strict hygiene regulations, your older children can still stay connected with their preterm or sick brother or sister by drawing a nice picture or sending a photo to hang next to the incubator. Another idea is to record them singing a lullaby that can be played softly for the baby. Be sure to ask your NICU care team what options are available – they may have additional suggestions on how to help your children feel involved and connected with the new family member in the neonatal unit.

Spending time with siblings 

Balancing time between the neonatal unit, home, work, and other responsibilities can be hard when your baby is in the hospital. As a parent, it is natural to feel stretched thin, but spending time with your other children is important for both them and you, as they may also be feeling the emotional weight of this difficult time. Older siblings could feel jealous or upset because the new baby needs so much attention, disrupting their routine. Some may start thumb-sucking, have trouble sleeping, or wet the bed. Others may become quiet and worry about how you are feeling.

Encourage open communication 

Encourage children to express their feelings and concerns and let them know you understand and respond with care. Grandparents or other family members can also support siblings by spending time with them and helping them understand the new situation.