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Parenting through Trauma: Q&A with Dr. LaTrice L. Dowtin

April 16th, 2024  | Care  | HIE Education  | News  | Resources  | Self Care  | Therapy


No matter its length, whether it’s a NICU stay, PICU stay, or hospitalization, the experience is often accompanied by trauma, and our HIE families want an anchor amidst the storm.

In our recent conversation with Dr. Latrice L. Dowtin, Co-Chair of the National Network of NICU Psychologists, founder and clinician at PlayfulLeigh Psyched, and Hope for HIE Medical Advisory Board Member, we confronted a pressing question: how do we authentically support families facing PTSD, emotional burnout, and trauma without merely pouring notions of resilience and self-care upon them? Because, let’s face it, you’ve likely displayed enough resilience for a lifetime, and you’re due for other effective ways to cope and parent through the trauma. 

Missed the live stream Q&A? No worries. We took notes, and like any good partner, we are willing to share! Read our key takeaways below.

Play is a powerful healing tool. 

You’d think “trauma” and “play” belong on opposite sides of the spectrum, especially for parents navigating through the thickets of hardship, but as Dr. Dowtin explains, play is actually a vital healing tool, as it allows parents to nurture joy and wellness amid turmoil. 

That’s why play is one of the pillars of her organization, PlayfulLeigh Psyched, which specializes in providing trauma therapy to historically marginalized and minoritized populations: it has a forgiving nature. While trauma may loom large, it does not define the entirety of your existence and experiences. Embracing play, whether through observation, nature walks, moments of reflection, or miniature dance parties, can allow you to acknowledge your hardship while still finding delight in moments of laughter and small pleasures. 

Play is also universally a child’s first language—it’s their primary mode of expression and engagement with the world, and it doesn’t discriminate by ability. It’s important for adults to model play for their children, as it teaches that moments of joy are not confined to specific moments and can still exist in times of hardship.  

We can debunk popular coping myths to make space for more effective tools and strategies.

According to Dr. Dowtin, how parents naturally cope during a NICU, PICU, or hospitalization experience is not always the most effective way to cope. That’s because there are some unwritten—and untrue—rules parents feel they need to follow to come out the other side. 

Myth 1: In times of trauma, parents must either be wholly sad or toxically positive.

Debunk: Dr. Dowtin isn’t saying you can’t be sad or optimistic throughout this experience; it’s only natural to experience these emotions. Instead, she wants to encourage parents to express and process all of their emotions during the journey and to do so without the pressure to display complete sadness or toxic positivity — this idea that you have to maintain a positive mindset at all costs, which dismisses any genuine feelings of distress, sadness, or anger. 

Myth 2: Parents should never second-guess difficult decisions. 

Debunk: The myth suggests that any doubts or uncertainties about tough choices are signs of inadequacy or incompetence. Nope. Recognize you’re grappling with big decisions, and give yourself some grace. You’re using all the information you have, and ultimately, you are the only one qualified to make the right choice for yourself and your family. 

Myth 3: Guilt is the price for parents who feel they could have altered the outcome of events. 

Debunk: The “what ifs” and the following guilt will come. That’s unavoidable. But the truth is, parents cannot control every aspect of their child’s health or circumstances, especially in complex medical situations like those encountered in the NICU. So, in those moments when guilt floods your emotions, Dr. Dowtin says to create a mantra to repeat to yourself when you most need it: I didn’t do anything to deserve or cause this. 

Myth 4: Parents must always prioritize their child’s needs above their own. 

Debunk: Selflessness, while pure-intentioned, can cause you more harm because it can take away from your own mental and emotional stability. Especially in circumstances like the NICU, parents and caregivers need to have enough in their buckets to make decisions and provide care to their babies. If this seems impossible, start small. Perhaps it’s a coffee break, a trip home to shower, or a quick walk around the hospital grounds — give yourself ways to refill your bucket when it gets low.

Myth 5: Parents can protect themselves from trauma symptoms caused by witnessing the challenges faced by others in similar circumstances. 

Debunk: That’s just not how trauma works. It doesn’t matter if what you’re witnessing another family go through in the not-so-private NICU setting is not directly happening to you. You can still have trauma symptoms because your fear center is naturally telling you, “That can happen to my baby. We’re next.” While you ultimately can’t control every aspect of your surroundings, there are some solutions to help take your focus away from others’ lived experiences and more on your own. Find comforting distractions at the bedside: use earphones to listen to music or find a book to read to your baby. 

Myth 6: Parents who ask a lot of questions are burdensome to the healthcare team.

Debunk: Maintaining a facade of knowledge and confidence in the NICU and avoiding asking questions doesn’t alleviate trauma; it enhances it. It’s proven that parents’ stress levels decrease the more knowledgeable they feel. The only way to do that is by asking questions. Develop a relationship with the bedside nurses, who can answer your question directly or help find another staff member to provide the information you need. They’re there to support you and your baby, so don’t hesitate to reach out and ask for assistance whenever you have doubts or concerns.

You have the right to express your needs and openly voice your concerns. 

This is especially true upon a NICU, PICU, or hospitalization discharge. Dr. Dowtin explains how many parents and caregivers expect their anxiety levels to lower upon discharge, mainly as that milestone served as a beacon of light at the end of the tunnel, but this is not often the case. In fact, most parents report having higher levels of worry upon NICU discharge because, while that usually signifies a transition to a less intense level of care, it also marks the beginning of new challenges and responsibilities, most of whom feel unqualified to take on (at least at first.) 

How can this be combated? First, you must know that a hospital discharge goes beyond just receiving a packet of information. We’d like to repeat that. A hospital discharge goes beyond just receiving a packet of information. If it’s not initiated, request a discharge meeting with the healthcare team.

Unfortunately, we know some families have experienced not being heard or marginalized, but you always have the right to ask questions and speak up for what you need to feel more comfortable. Also, while you may not think you need support resources, ask the social worker for them anyway. There might come a time at home when you wish you had them, and just the simple knowledge of what resources are available can provide you with peace of mind, reassurance, and, most importantly, support and connection. 

Trauma symptoms aren’t always immediate. 

We’re afraid the “post” in “post-traumatic stress disorder” doesn’t have a clear statute of limitations. Trauma symptoms may not manifest immediately following a challenging medical event; sometimes, these symptoms emerge months or even years later, catching parents and caregivers off guard. 

Then, there’s the diagnosis-traumatization loop. Especially with HIE, where there is a range of impacts, outcomes, and onsets, each new diagnosis or medical complication can feel like reopening a wound, contributing to a cycle of re-traumatization. The relentless nature of this cycle can be exhausting and doesn’t bode well in terms of healing. 

Dr. Dowtin also wants to debunk societal stigmas of mental health: the maternity mortality rate and thoughts of suicide are considerably high in parents of medically fragile children, as they often experience heightened levels of stress, anxiety, and depression due to the ongoing medical needs and uncertainties surrounding their child’s health. 

This is often confounded by guilt and fear — how dare I think these thoughts when my child needs me, and what happens if I voice concerns about my mental health? Will they deem me unfit to care for my child?

Societally, we have to better support the mental health of our parents… 

and there are some steps we can take to do just that: 

  • Encourage involvement of partners and family members: If a parent or caregiver is afraid to voice their concerns, then close family members or friends can take on the responsibility of asking about these supports. 
  • Incorporate mental health conversations into discharge planning: Clinicians, social workers, and NICU psychologists should prioritize discussions about mental health during discharge planning, regardless of the results of mental health screeners. These conversations should focus on equipping parents and other family members with the knowledge and resources to identify signs of declining mental health and access appropriate support services.
  • Destigmatize mental health issues: This effort includes acknowledging that non-birthing partners can also experience PTSD. By challenging societal stigmas surrounding mental health, we can create a more supportive and understanding environment for everyone to voice their feelings and concerns, even in their most vulnerable moments. 

Trauma manifests in a lot of different ways.

Trauma impacts individuals uniquely based on their experiences and circumstances, but no matter its manifestation, this is an important distinction to note: trauma exists in the past but affects us now; anxiety exists in the future but affects us now. Either way, they both have the power to shape our perceptions, responses, and overall well-being.

  • Interrupted sleep: As many HIE families know all too well, sleep can be hard to come by, whether that’s because your child has a sleep-related disorder, requires consistent monitoring, or because your fear of their well-being and safety is keeping you awake. Tailored support can be powerful in providing you with the help you deserve. 
  • Vulnerable child syndrome: This happens when a parent continues to parent their child at the same intense level of vigilance and care even after transitioning out of the hospital setting. For some, it’s tough to get unstuck from that hospitalized framework and mindset, but remaining in that space can inadvertently stunt some of the child’s development and progress. 
  • Heightened irritability: We don’t think it’s talked about enough — anger is a very real and prominent emotion people experience throughout this process that is underlooked or underrecognized. It can lead to difficulty concentrating, significant mood swings, and quicker routes to feeling overwhelmed or emotionally reactive. 
  • Feelings of disconnection: Many parents and caregivers report feelings of isolation and disconnectedness from their partners, family members, or friends during times of trauma. Unless it’s a shared, lived experience, it’s almost too complicated to explain to others in a way that accurately captures all of the complex emotions, thoughts, and nuances involved. 

Support networks and community are at the heart of healing.  

Honestly, self-care may feel like another task on an already overwhelming to-do list, so let’s consider a different yet powerful alternative: building a community of care. Surrounding yourself with people who provide a safe space for honesty, vulnerability, and support can be immensely beneficial.

  • “Be With” moments: Dr. Dowtin reminds us not to underplay the power of a “be with moment,” which is time spent with someone you trust during moments of hardship. Having friends or family members in your life with whom you can trust with your honesty and vulnerability is both cathartic and therapeutic. 
  • Help wishlist: Sometimes, families may have a community of people who want to help, but they don’t know how to do so, and you may not have the time or emotional capacity to walk them through what you really need. Making a wishlist of supports, whether making a meal for your family or doing a load of laundry, and posting it for people to see can help bridge that gap. 

We also know this is a luxury and privilege for some and isn’t readily available to everyone, especially since so many variables go into building a support network. Building that community support network can feel overwhelming when considering elements like where you live and family dynamics.

This is when you can turn to support organizations, many of which are listed below, to build that community.

There are resources to provide additional support to those experiencing the aftermath of trauma. 

  • NICU to Home: This program aims to ease the transition from the NICU to home by providing families with educational resources on caring for a medically fragile child, assistance in coordinating medical care and equipment needs, access to support groups or peer mentors who have experienced similar journeys, and ongoing emotional support to help families cope with the stress and challenges of caring for their child at home.
  • Postpartum Support International: Offers support, resources, and education for individuals and families dealing with perinatal mood disorders, including postpartum depression and anxiety.
  • National Perinatal Association: This professional organization aims to support healthcare professionals, families, and communities in improving perinatal health outcomes. These resources include educational materials, best practice guidelines, research initiatives, and networking opportunities for professionals working in perinatal care. 
  • NICU Parent Network: This support network connects parents who have experienced the NICU journey, offering guidance, resources, and peer support.
  • Hand to Hold: Offers support and resources for families of preterm or medically fragile infants, including peer support programs and educational resources on topics such as neonatal care, medical interventions, developmental milestones, navigating the healthcare system, and more. 
  • Referrals: Aside from a pediatrician’s referral, early intervention and special education programs have the resources to connect families to specific support networks, groups, and organizations. Thanks to the Individuals with Disabilities Act (IDEA), every state and region offers community support and guidance to families navigating special education services and resources.
  • Hope for HIE’s Comprehensive Support Network: This hub will connect you to our social worker, child life specialist, peer support mentors, and other support resources that can help you on your journey.

To watch the full live stream, visit our YouTube channel below, or click on our Key Takeaways for an at-a-glance view of this session!



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