Newborns, Hospitalization and PTSD

By Ruchi Kaushik, MD, MPH
Medical Director, ComP-CaN (Comprehensive Peds for Complex Needs)
Medical Director, The Children’s Hospital of San Antonio Blog
Assistant Professor, Pediatrics, Baylor College of Medicine

June 27 is Post-traumatic Stress Disorder Awareness Day; PTSD is a mental health diagnosis that you have likely heard, particularly among the men and women who have served in the armed services.

But did you know that premature babies can have a form of post-traumatic stress after staying in the neonatal intensive care unit (NICU)?  The trauma, or “early adverse experiences,” from a NICU stay can affect your premature baby’s health, development, and behavior.

Why is a NICU stay traumatic?

NICU stays can be traumatic for a variety of reasons:

Stimulation: Babies do not tolerate being overstimulated. Flashing lights, beeping monitors, constant alarms sounds in the NICU can cause a premature baby to suddenly pause in breathing and also result in frequent increases and decreases in heart rate, blood pressure, and oxygen levels.

Procedures: The procedures performed in the NICU are life-saving, but they do have consequences.  In addition to having a tube placed in the airway to help a baby breathe, there are many procedures that cause pain such as placing an IV or undergoing surgery.  These “skin-breaking” procedures can affect a baby’s normal development.

Separation from Mom: Although necessary, separating a premature baby from mom interferes with bonding and can affect the baby’s normal stress responses.  This means that a premature baby’s response to stress may be excessive (prolonged crying, more severe separation anxiety, etc.) compared to that of a baby who was not premature and in the NICU.

What can I do to lessen the effects of this trauma?

The best studied technique to improve the impact of trauma on a premature baby in the NICU is skin-to-skin (or kangaroo) care.  To perform skin-to-skin care, the baby is wearing only a diaper and is held upright on her belly against mom’s chest.  Indeed, in animals, being sensitively touched soon after having been born results in less production of the body’s stress hormones (steroids).

Other methods to decrease stimulation include covering incubators with blankets to reduce light exposure, removing noisy equipment from the area if not necessary, and using sound-absorbing panels if they are available.

Although the  NICU experience is necessary to help save a premature baby’s life, as a parent, you can do their part to lessen the effects of this trauma by being aware that this is a problem, providing skin-to-skin care as often as possible, and always responding quickly to your baby’s needs so your baby feels safe and secure with you once you go home.