Usually not during the roughly 72 hours of cooling, because the baby must stay on the cooling equipment at a tightly controlled temperature with continuous monitoring, and lifting them can disturb that. But most units strongly encourage other closeness in the meantime: touching, hand-holding, talking, reading, and helping with cares. After rewarming, once the baby is stable, holding and skin-to-skin usually begin.

Introduction: why this question matters for your family

Families often arrive at this question during or soon after the NICU stay, when a new term, test, or piece of the medical picture raises questions. This article is written for parents wanting to hold their newborn during cooling treatment and explains what the question really means, what to expect, and the next steps other families have found most useful.

What this really points to

Behind the question are patterns that a NICU and neonatology team can recognize quickly. The specific thing parents typically describe is a pause in holding during cooling, with other closeness encouraged instead. One observation rarely answers the question on its own; a clear picture comes together from what parents notice, the history, and a focused evaluation [1].

The most useful next step is usually an evaluation by a NICU and neonatology team, often with guidance from the bedside NICU team on safe contact during and after cooling [3].

Example 1: During cooling, a mother sits at the bedside with a hand resting on her baby and reads aloud each evening.

Why early action makes a real difference

Acting early matters because intervention windows in infancy and early childhood are real. The developing brain is most adaptive in the first two to three years of life [3].

Every U.S. state runs an Early Intervention (Part C) program offering free evaluations and therapy for eligible children under 3 [5].

Decision flow: from observation to support
Step 1Note the finding and keep the records
Step 2Bring it to your pediatrician
Step 3Get a referral or call EI
Step 4Start the right therapy
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What usually lies behind it

The most relevant contributing factor here is the need to keep body temperature tightly controlled during cooling. This is the underlying mechanism behind what parents notice: a pause in holding during cooling, with other closeness encouraged instead [2].

The cause may have been present before birth, may have happened during labor or delivery, may have occurred during the NICU stay, or may have only become apparent as your child grew.

If you also notice this, here is what to consider next
Sleep disturbance
Consider: Trauma-informed therapy assessment
Intrusive memories
Consider: Perinatal mental health referral
Avoidance of hospitals
Consider: NICU-trauma counseling
Relationship strain
Consider: Couples therapy with perinatal focus
Thoughts of self-harm
Consider: Same-day call to your provider or 988
Withdrawing from your baby
Consider: Perinatal mood and anxiety disorder eval

How a real evaluation works

A typical evaluation here combines a careful history, a focused examination, and the tests that fit the concern. Where useful, the team adds guidance from the bedside NICU team on safe contact during and after cooling [4].

Therapy referrals frequently happen at the same evaluation, before any formal diagnosis is finalized.

What each therapy actually does
PTPhysical Therapy
Helps with gross motor: rolling, sitting, crawling, standing, walking, gait, balance, tone management.
OTOccupational Therapy
Helps with fine motor, hand use, feeding, self-care skills, sensory processing.
SLPSpeech & Language Therapy
Helps with speech, language, communication, oral motor coordination, swallowing, AAC.
FTFeeding Therapy
Helps with bottle/breast feeding, swallowing safety, transition to solids, oral aversion.
DTDevelopmental Therapy
Helps with cognitive, social, adaptive skills – milestones across all developmental domains.
VTVision Therapy
Helps with visual tracking, focusing, and eye-hand coordination when vision is affected.
2-3 per 1,000Term babies affected by HIE [1]
Within 6 hrsStandard window to start cooling [3]
25%Reduction in death/disability with cooling [3]
38U.S. states CP Family Help works in
“The hardest part of HIE was not the diagnosis. It was every milestone afterward feeling like a test we were not allowed to relax during.”
– HIE mother, Texas

Mistakes families often make

The most common mistakes we see: waiting too long on a quiet ‘let us wait and see,’ comparing one child to another, skipping NICU follow-up visits, and not requesting the full medical record.

Trusting your own observation is one of the strongest tools you have [3].

Example 2: After rewarming, the team helps a family begin their first skin-to-skin hold.

Step-by-step: what parents can do next

If the patterns described above match what you are seeing, here is a practical sequence other parents wanting to hold their newborn during cooling treatment have found useful.

1
Gather and keep the key records and results (NICU discharge summary, imaging, and any lab values), and note any new concerns about your baby’s breathing, feeding, muscle tone, or development.
2
At your next visit, describe your concern in concrete terms and share any notes you have. Ask whether a referral to a NICU and neonatology team is appropriate now.
3
Call your state’s Early Intervention (Part C) line yourself [5]. You do not need a doctor referral to start.
4
Request the records that matter: NICU discharge summary, imaging reports, MRI or cranial ultrasound, and labor and delivery flow sheets.
5
If the evaluation suggests family-centered developmental NICU care would help, begin it as soon as you can.
6
For major decisions, get a second opinion at a children’s hospital with subspecialty depth in your child’s area of concern. Bring all reports.
7
If a birth event may have played a role, schedule a free, no-pressure case review with CP Family Help.
Print-friendly checklist
Tear-off summary to bring to your next pediatric or therapy visit. Use the Print button below.
  1. Gather and keep the key records and results (NICU discharge summary, imaging, and any lab values), and note any new concerns about your baby’s breathing, feeding, muscle tone, or development.
  2. At your next visit, describe your concern in concrete terms and share any notes you have. Ask whether a referral to a NICU and neonatology team is appropriate now.
  3. Call your state’s Early Intervention (Part C) line yourself [5]. You do not need a doctor referral to start.
  4. Request the records that matter: NICU discharge summary, imaging reports, MRI or cranial ultrasound, and labor and delivery flow sheets.
  5. If the evaluation suggests family-centered developmental NICU care would help, begin it as soon as you can.
  6. For major decisions, get a second opinion at a children’s hospital with subspecialty depth in your child’s area of concern. Bring all reports.
  7. If a birth event may have played a role, schedule a free, no-pressure case review with CP Family Help.
Find your state’s Early Intervention (Part C) program
CP Family Help works with families in 38 U.S. states. Click the button below to see all states we cover.
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When to get help quickly

Some symptoms are emergencies. If your baby has a seizure, stops breathing or has breathing pauses, turns blue or very pale, becomes very hard to wake, or suddenly goes limp or unusually stiff, call 911 or go to the nearest emergency room right away. For non-emergency concerns, such as poor feeding, a change in your baby’s usual pattern, or anything that worries you, call your care team or pediatrician the same day.

What to bring to every follow-up visit

Bring three things: a short list of what has changed since last time, one or two phone videos, and a single specific question.

How CP Family Help supports families

CP Family Help works with families across 38 U.S. states whose children were diagnosed with cerebral palsy, HIE, or other birth injuries. Every initial consultation is free and confidential.

HIE outcomes are individual

Talk to a parent advocate who works with HIE families every day.

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Important exceptions and case-specific factors

Every child’s situation is different. Factors that can change the picture include your child’s gestational age, NICU history, imaging results, family history, your state’s Early Intervention eligibility rules, and statute of limitations.

Reviewed by CP Family HelpContent reviewed for accuracy by our editorial team. Last reviewed: July 22, 2026.
Why experience, verification, and case-specific guidance matter
  • Experience: CP Family Help works exclusively with cerebral palsy, HIE, and birth-injury cases across 38 U.S. states.
  • Expertise to verify: Information like this should be cross-checked with CDC, NIH/NINDS, AAP, and ACOG.
  • Professional guidance: Confirm medical decisions with your pediatrician and, where appropriate, a NICU and neonatology team.
  • Case-specific: Your child’s gestational age, NICU history, MRI findings, and state-specific rules all shape application.
Fact-Check Notes

High-confidence information

  • Cerebral palsy is a group of permanent movement disorders that appear in early childhood (CDC, NIH/NINDS).
  • Hypoxic ischemic encephalopathy (HIE) is brain injury from reduced oxygen and blood flow around birth (AAP, ACOG).
  • Early Intervention (Part C) is a federally mandated program in every U.S. state for eligible children under 3.
  • Early evaluation and early support are recognized, evidence-based steps for developmental concerns.

Case-specific information

  • Whether a pause in holding during cooling, with other closeness encouraged instead reflects a lasting difference or an expected, temporary pattern depends on the individual child and is best judged by the care team.
  • Early Intervention eligibility rules vary slightly by state.
  • Statutes of limitations for birth-injury claims vary by state and child’s age.
  • Therapy access, Medicaid waivers, and insurance coverage vary by plan and state.

Related reading for parents

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