GUEST CONTRIBUTOR
Dr. Mandy Brown Belfort, MD, MPH
Approximately one in ten babies born in the United States will spend time in a Neonatal Intensive Care Unit (NICU). That’s nearly 400,000 families every year beginning parenthood in a place they never expected to be.
For many parents, a NICU stay begins in a blur. There are monitors that beep around the clock, medical terms you’ve never heard before, and more emotions than you ever imagined.
At Mothers’ Milk Bank Northeast, we’ve spent 20 years supporting NICU teams and the families they care for. For NICU Awareness Month, we asked Dr. Mandy Brown Belfort, MD, MPH, a neonatologist at Brigham and Women’s Hospital, researcher, and longtime member of our Medical Advisory Committee, to share her perspective.
If you could sit down with a family on their first day in the NICU—and again on the day they finally bring their baby home—what would you want them to know?
Here’s what she told us.
Even the smallest babies can surprise you
When you picture a premature baby, it’s easy to focus on just how small they are. Tiny fingers. Tiny feet. A body that seems impossibly fragile beneath wires and tubes. But here’s something NICU professionals never stop believing:
Even the smallest babies can surprise you.
Strength in the NICU doesn’t always look dramatic. Sometimes it’s a baby taking a few more breaths on their own. Sometimes it’s gaining 20 g after a difficult week. Sometimes it’s simply making it through another day.
Babies like TyQuell, who was born at just 24 weeks weighing only 1 lb 11 oz, remind us that strength isn’t measured by size.
Progress is measured in moments, not milestones
Most of us think about milestones as big events. The NICU teaches families to celebrate different kinds of milestones.
One less breathing tube. A first feed. A tiny outfit instead of a hospital blanket. These moments can represent enormous progress.
Some NICU stays last only a few days. Others last weeks or even months. While the average stay is about two weeks, every baby’s timeline is different. Along the way, there are often steps forward followed by unexpected setbacks. Those setbacks can feel discouraging. But they rarely erase the progress that came before them.
In the NICU, hope often grows quietly. Families learn to recognize the victories that others might never see. They also discover something their baby needs that no machine can provide.
You’re already doing more than you realize
One of the hardest parts of having a baby in the NICU is feeling like there’s nothing you can do. The truth is that your presence matters more than you know. Holding your baby skin-to-skin. Pumping one ounce of milk after an exhausting day. These may seem like small acts. To your baby, they are anything but.
Decades of research have shown that skin-to-skin care, often called kangaroo care, does more than strengthen the bond between parent and child. It can help stabilize a premature baby’s breathing, heart rate, and body temperature. Likewise, every drop of a mother’s own milk provides important protection and nutrition, especially for vulnerable babies.
Families aren’t just watching their baby’s care. They’re helping shape it. Even when you feel helpless, your presence matters.
Of course, that doesn’t mean you have to do everything alone.
You don’t have to do this alone
Support comes in many forms. Sometimes, it comes in a tiny bottle.
Many parents don’t realize donor human milk is a routine part of NICU care until their own baby needs it. In fact, nearly 90% of NICUs in the United States use donor milk to care for their tiny patients.
The important thing to know is this: you’re not doing anything wrong. Early feeding is rarely straightforward, and many families need extra support.
For premature and medically fragile babies, donor milk is more than nutrition. It is the recommended alternative for very low birth weight infants when a mother’s own milk isn’t available, helping protect against serious complications like necrotizing enterocolitis (NEC).
As with so many things, knowing your options and making the best decision you can for your family isn’t giving up. It’s one of the strongest things you can do.
So…
Accept the meal.
Take the shower.
Ask the same question until you understand.
Going home is a beginning, not an ending
The day you’ve been waiting for can also be one of the hardest.
After a stay in the NICU, home can feel surprisingly unfamiliar. The experts who answered every question aren’t just down the hall anymore. Suddenly, the confidence you’ve been building can feel harder to find.
Many parents tell us they miss their NICU team more than they expected. That’s normal. Give yourself permission to keep asking for help. Lean on your support system. Keep your follow-up appointments. Connect with other NICU families if you have the chance.
Progress takes time—for babies and for parents.
One last thing
Every NICU journey is different.
No two babies follow the same path. No two families do, either.
One day, you’ll look back and realize just how far you’ve come.
