My interest in child life led me on a journey that included two summers of volunteering at my local children’s hospital, working as a child life assistant, completing my practicum in summer 2020, and completing my internship in fall 2021. Since January 2022, I have worked as a Certified Child Life Specialist (CCLS) in the Neonatal Intensive Care Unit (NICU) at Texas Children’s Hospital in Houston! The Newborn Center at Texas Children’s Hospital is one of the largest in the nation with 173 total NICU beds, and we provide Level IV care, which means we see babies with the highest acuity of needs and a wide variety of diagnoses. Every day working in the Texas Children’s Hospital NICU looks different, as with any other unit or area where you might find a CCLS. I start my day by chart reviewing my patients and their families, identifying my highest priority patients, and working on administrative tasks like plans for our unit programming. Being a child life specialist in the NICU means I get to provide a balance of normalization, therapeutic, and educational support.

Normalization is a big part of child life in the NICU. Some of our families were aware before birth that their baby would require a NICU admission, but many of our families experience an unexpected admission for prematurity or other complications and conditions. Celebrating milestones is one way that our team provides normalization to help patients and families adjust during their NICU stay. Milestones are important for every baby, and in the NICU, every little accomplishment is a big deal! We celebrate patients turning 1 week, 1 month, or even 1 year old in our unit, as well as patients reaching a certain weight or doing something new for the first time. The most common ways we recognize these milestones are through photos and footprints, and we love to get family members involved!

To help ensure that every patient and family are able to benefit from our child life services, we also offer unit-wide programming. For example, our child life team does four seasonal photo events each year: Baby’s First Rodeo in March to coincide with the Houston Rodeo, Splash Bash in August to bring summer fun into the unit, Halloween and fall-themed photos in October, and holiday and winter-themed photos in December. We bring themed props and a photo backdrop to each registered baby’s bedside so the event is accessible to as many patients as possible! In September, which is NICU Awareness Month and National Literacy Month, we host a Read-a-Thon through our Little Listeners reading program. Every patient in the NICU receives at least one book each day throughout this weeklong event, and our unit staff provides education about the value of reading and speaking to babies. It is also important to think of our patients’ caregivers in the NICU, so two of our team’s largest events are for Mother’s Day and Father’s Day with snacks, activities, and raffle prizes. Our goal is to give these parents and other caregivers a chance to relax and celebrate themselves, even in the midst of a stressful and difficult experience.

Play is a fundamental part of being a child life specialist, and in the NICU, it is just as important as other areas of the hospital. It helps me build rapport with patients and their families, promote developmental skills, and provide socialization. Some of my favorite toys to introduce to babies in the NICU are mobiles, mirrors, rattles, high-contrast images, and toys with unique textures like books that crinkle. Playing with our patients in the NICU often involves encouraging them to direct their visual attention to a toy, helping them hold a rattle and learn to shake it, or showing them the different textures they can feel. Sometimes I collaborate with our unit’s music therapist, physical therapists, or occupational therapists to play together and work on similar developmental goals.

In addition to supporting patients and their caregivers, we also care for siblings. Big brothers and sisters often need their own education and support to understand what’s happening with their new family member. There are three main ways that I provide diagnosis and treatment education to siblings of NICU patients: 1) supporting sibling visits and in-person education on the unit; 2) creating individualized sibling education books and baby dolls with medical equipment; and 3) discussing appropriate language and forms of support with caregivers. The families in our NICU come from all over Texas and throughout the United States, so siblings are not always able to visit the hospital, which makes it important to be adaptable and creative! When siblings receive honest and appropriate information about their new family member, it reduces their anxiety and they find so much joy in spending time with their baby brother or sister.

Though my job is full of celebrations and play, there are also moments in the NICU that are very difficult. When families experience a loss, my role is generally to support that family in whatever way they need. Specifically, I can provide sibling education and help the family create keepsakes. In these unfortunate cases, I teach adult family members about appropriate language to use and encourage them to be honest with their other children. I provide books to the family as well, so they have helpful tools to start the conversation about loss and resources to refer to after they have left the hospital. My goal for keepsake creation is typically to empower a patient’s family to be as involved as they want to be. Supporting a family as they cope with their child’s passing is never easy, but I know that child life services help to provide them with a more therapeutic experience.

Some of my favorite parts of being a child life specialist in the Texas Children’s Hospital NICU are recognizing milestones and holidays with families who did not think they could celebrate in the hospital, seeing babies play in new ways that they enjoy, helping siblings meet and learn about their newest family member, and empowering caregivers to have open and honest conversations with the children in their lives. The presence of a Certified Child Life Specialist in the NICU is important for the patients who are admitted, as well as their entire families, and I am grateful every day for the honor of being a part of their journeys.

You can learn more about Emma's role in the NICU during her Instagram Takeover on our page @assocchildlife happening all day September 30 on NICU Awareness Day and found in our highlights after October 1.