The First 24 Hours in the NICU: A Parent’s Guide
A gentle walkthrough of what to expect — and how to stay grounded in a brand-new world.
The moment you hear the words “Your baby needs the NICU,” your world shifts. Even when you know your little one is in the hands of an expert team, the emotions, alarms, equipment, and unfamiliar routines can feel overwhelming. If you’re reading this with a racing heart and a hundred questions, take a slow breath. You’re not alone, and you don’t have to figure this out all at once.
Here’s a soft, reassuring guide to what many families experience in those first 24 hours.
1. The Arrival: Stepping Into a New Space
The NICU may look and sound very different from what you imagined. Dimmed lights. Soft beeping. Nurses moving with calm precision. Most parents feel a swirl of emotions, relief, fear, hope, confusion, and every feeling is valid.
You’ll usually be greeted by a nurse or provider who will:
Tell you how your baby is doing right now
Give an overview of the next steps
Explain any immediate concerns the team is watching closely
Answer your first questions (even if you don’t know what to ask yet)
It's okay if you don’t remember everything. There will be time.
2. Meeting Your Baby
Your baby may be in an incubator (isolette) or an open warmer depending on their needs. You might see:
Wires or leads for monitoring
A feeding tube
CPAP, oxygen, or a ventilator
An IV for fluids or medications
This equipment can look intimidating, but each piece plays a protective role. Your baby is not alone in this journey, every monitor and tube has a purpose.
Most parents wonder: Can I touch my baby?
Often, yes, and the nurses will guide you. A firm, still hand (rather than light strokes) is usually more calming for premature or medically fragile babies.
3. Understanding the Alarms
NICU alarms can make any parent jump, especially at first. Many alarms are not emergencies, they simply alert the nurses to small changes in heart rate, breathing, or oxygen levels.
Nurses quickly learn each baby’s patterns. They act when needed and silence alarms when it’s just a brief dip or wiggle.
You’ll soon notice the rhythm too, and it becomes less startling over time.
4. The Medical Plan: What the Team Is Watching
In the first 24 hours, the NICU team monitors:
Breathing and oxygen levels
Temperature regulation
Blood sugar
Feeding readiness (tube feeds, IV fluids, or breastmilk)
Infection screens if needed
Blood work or imaging to guide treatment
During this time, you may hear terms like “apnea,” “desaturations,” “gavage feeding,” or “phototherapy.”
You’ll learn the language slowly, and there’s no pressure to understand everything immediately.
5. Meeting Your Baby’s Care Team
You’ll likely interact with:
A bedside nurse
A neonatologist
Respiratory therapists
Feeding specialists (SLP/OT)
Lactation consultants
Social workers
Child Life specialists (depending on the hospital)
Each person has a role in supporting your baby, and you.
Ask questions. Repeat questions. You’re learning a whole new world, and the team expects that.
6. Your Role as a Parent (Even When You Feel Helpless)
In those first hours, bonding may look different than you imagined, and that’s okay. You can still:
Place your hand gently on your baby
Talk, hum, or read aloud
Provide a breastmilk swab if pumping
Bring a scent cloth
Take pictures or write down your baby’s first milestones
Tiny acts of connection matter deeply.
7. Kangaroo Care: If and When It’s Possible
Depending on your baby’s stability, some families can hold their baby within the first 24 hours.
Other times, the team recommends waiting until the baby is more stable.
Both experiences are normal.
Holding your baby in the NICU may feel different, with wires, tubes, and extra hands helping you, but it’s still incredibly meaningful. Kangaroo care supports bonding, helps regulate baby’s temperature and breathing, and can even support milk production.
8. The First Night
NICU parents often say the first night is the hardest. Whether you stay bedside, go home, or sleep in a parent lounge, you may feel torn, grateful for the care but aching for your baby.
If you can, take a moment to:
Eat something
Drink water
Rest
Call the unit for updates
Ask what time rounds are tomorrow
You are still the center of your baby’s world, even from a distance.
9. A New Beginning
The first 24 hours in the NICU are the start of a journey, one filled with strength you didn’t know you had and a community you didn’t expect to rely on. As you settle in, you’ll begin to understand your baby’s cues, the routines of the unit, and the language of the monitors.
And with every small step, you’ll discover a new kind of courage.
You can do this. Your baby can do this. And you are not walking this path alone.
