#342 - 👶 Parenting in the NICU: Lina’s Transformative Experience

Hello friends 👋

In this week’s episode of Beyond the Beeps, Leah and Lina explore the often-overlooked but critical role of communication in neonatal intensive care.

The discussion focuses on how clinicians can bridge the gap between technical expertise and human connection. They reflect on practical strategies for listening actively, explaining medical information clearly, and adjusting communication styles to meet the needs of parents and families in high-stress situations. Drawing on real experiences, they highlight the importance of empathy, collaboration, and presence at the bedside, while also addressing the challenges that arise when communication breaks down.

The episode also examines the impact of communication on team dynamics within the NICU, from how providers share updates to how they align on care goals. Lina and Leah underscore that effective communication is not just a soft skill—it’s a core component of safe and compassionate care.

This conversation offers concrete takeaways for neonatal professionals seeking to strengthen how they connect with both families and colleagues. Whether you are a bedside nurse, physician, or allied health provider, the insights shared here will resonate with your daily practice.

Link to episode on youtube: https://youtu.be/NKQFqSxcRxQ

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Short Bio: Lina Acosta Sandaal is a distinguished psychotherapist and child development expert, licensed as a Marriage and Family Therapist (LMFT), who has focused her career on early childhood mental health and emotional wellbeing. She began her work at Vista del Mar in Los Angeles, honing her expertise in infant mental health and holistic family support  .

In 2012, Lina founded Stop Parenting Alone, a parenting education and consultation center rooted in research and compassion. Her approach combines attachment theory, interpersonal neurobiology, and trauma-informed care to support families in finding authenticity and connection  . Through this initiative, she empowers parents to embrace the daily journey of parenting—with warmth, self-awareness, and support.

Lina also shares her expertise broadly: she is a regular parenting expert on Telemundo’s national morning show Un Nuevo Día, a member of the Florida Maternal Mental Health Steering Committee, and a consultant for the early learning team at MomsRising  . Her commitment has earned her recognition as one of Ford’s Mujer Legendaria for excellence in her field  .

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The transcript of today's episode can be found below 👇

Leah (00:04.267)

Welcome back everyone to this next episode of Beyond the Beeps. Today we have a really, really special episode about parenting in the NICU, which is kind of what we do here. Parenting in the NICU is sometimes the very first experience we have at this grand life experience called parenting, right? These are the first moments of our baby's life outside of the womb and our first trials and lots of errors.

with trying to get it right. And the NICU itself has so many added layers of stress and challenge that it can complicate our first moments, our awareness of how we're doing it what we're doing. And parenting is hard enough on alone with all the bells and whistles and beautiful rainbows and butterflies and cupcakes that are told to us when we're having a baby. When we add the NICU, it can be really overwhelming for a lot of us.

We're drinking from a fire hydrant of information, and then our babies go home. And parenting goes on. We don't ever stop being their parent, and their experience goes on. They're not in the NICU anymore, but they have lived that experience just like we're not in the NICU anymore with them, but that never went away either. And now we have to sort of navigate the world maybe a little bit differently than we had if we had a full-term baby or went home on day two or three.

So I wanted to bring in somebody very, very special to me, to ICU Baby and to the world to talk with us about parenting in the NICU and navigating that transition out of the NICU. Today with us is Lina Acosta-Sandal. She is a respected consultant in the social emotional learning developmental expert, speaker and author. She is the head of school at the KLA Academy.

which is an independent school serving preschool through fifth grade here in Miami. Lena also founded Stop Parenting Alone, a digital social emotional learning program for parents and schools. She serves as the human development expert for Telemundo's national broadcast and is an author on social emotional development with the Macmillan Foundation education. Lena's mission is to help adults fall in love with guiding children.

Leah (02:30.591)

Lena is also a NICU mama, twice over in fact. She knows about the research, she knows about the practice, and she also knows about the life of NICU parents, both in the NICU and beyond. We are so honored to have her here to talk with us today. Welcome Lena.

Lina Acosta Sandaal (02:53.312)

I am incredibly honored to be able to be here and actually to give back what was given to me 20 years ago when I had my pre-meet.

Leah (03:04.253)

Yeah, tell me a little bit about that. You had two experiences in the NICU. Tell me about a little the first moment with your first baby that you knew you were going to go to the NICU.

Lina Acosta Sandaal (03:18.21)

so my first baby, was 32 weeks. She was three pounds, 12 ounces. and it was sudden. It was, you know, I have, I have, a difference in my uterus. So we knew that I might have a child early, but we didn't know it was going to be this early. So I did have all the, you know.

specialist paying attention to me, still, you know, was still a shock, right? So the first one was kind of like rushed to Cedar Sinai in Los Angeles, because I was in Los Angeles. And then I had my little preemie. She was smooth until we had a scare with neck.

Leah (04:16.352)

Hmm.

Lina Acosta Sandaal (04:17.55)

which those of you that are in this world, know that, you know, that the, love that this is called Beyond the Beeps because that brought me right back. You know, all the alarms went off. I was by her bedside and everybody rushed in and you know, that's the first thing, right? Like as parents, we are the ones that,

hold, love, and guide our babies. But in the NICU, something very unnatural happens, which is there is this group of people that are making all of the decisions for your baby. And I think that that's today, you know, today, like looking back, you know, 20 years later, right? I recognize that that was the first piece of loss that I felt.

Leah (04:45.056)

Hmm.

Lina Acosta Sandaal (05:11.766)

Right? Where it's like, I wasn't making any decisions for my baby. And then all these people were telling me what to do and how to do it. And, but it was all under the guise of like, an uncertainty. So it was just, it's just, it's just this whirlwind of like, so that's what it was like with Camila. I mean, I had.

I love her and love my NICU nurse and she caught that thing right away and it was all taken care of and that's why Camila is 20 years old. And my 17 year old, it was a completely different experience because they watched me like a hawk. The minute I started acting wanky, they put me on bed rest. So I was on bed rest from like week 29, which was different, right?

Leah (05:44.97)

Mm-hmm, yeah.

Leah (06:00.544)

Hmm.

Leah (06:05.206)

Yeah.

Lina Acosta Sandaal (06:05.39)

But also, you know, he also came early. He came at 33 weeks. I added a week. Yay! But it's a big deal. Yes, I added a week. Exactly. I added a week. But he was like the most embarrassing preemie because he was like a five pound preemie.

Leah (06:14.465)

That's a big deal. That's a really big deal. Every day is a difference.

Leah (06:28.225)

Hmm

Lina Acosta Sandaal (06:29.038)

So it was like this little butterball. So for him, it was kind of, you know, healthy, but he did come out with like difficulty breathing. But it was a completely different experience because it almost felt like I was like alumni and I was like going back to like campus because he was also born in Cedars-Dinai. So it was he was he was less. It was less scary for my son than it was for my daughter. But again, I.

I love having the opportunity to speak to parents that have lived through the NICU experience because it's so personal to me. Yes, it's been 20 years. Yes, it's been 17 years. But I get right back there just talking about it, that sense, that feeling, that driving to the hospital, driving home, it all just bubbles back up.

Leah (07:07.062)

Mm-hmm.

Lina Acosta Sandaal (07:27.694)

If whoever's listening doesn't remember anything else that I said, you know.

honor the emotions that bubble up.

Leah (07:39.829)

Hmm.

Lina Acosta Sandaal (07:41.496)

Give yourself grace because it's perfect. Anything that you are feeling is the right feeling. If you're telling yourself, shouldn't fill in the blank, stop and say, no, this is a long and these are long weeks, these are long days, these are long hours. And I think that that's the one thing that I want everybody to remember.

Because I think that I gave myself grace with my son, but I did it with my daughter, and I think that's why it was harder.

Leah (08:17.503)

Hmm.

That's interesting. Do you think it was having the experience of going through it before and knowing there's something out of there or was there something different about that experience in that time? was it, sorry, that's kind of two, same question, but was it having gone through it with your daughter before or something about the experience with your son?

Lina Acosta Sandaal (08:42.06)

I think that my son was so planned, know, like, because I mean, I took a risk, right? I knew that I had this discrepancy with my uterus and I still went for baby number two. So I think that that

Leah (08:46.443)

Hmm.

Leah (08:50.251)

Yeah.

Lina Acosta Sandaal (09:02.432)

Although it's uncertain, all pregnancies are uncertain, right? It's miraculous that we make babies. I think we take for granted how hard it is to procreate. take it for granted. But I think that the second time I had a really good team around me, you know, it was like, they, so I felt more support than the first time around.

Leah (09:05.995)

Yeah.

Leah (09:11.091)

Yes. Yes.

Leah (09:31.935)

Yeah, that's interesting. Having three pregnancies myself, two premature, one full term, and the big difference was I had so much more support on that full term one. Was that why we went full term? I don't know, but I had a lot more support. It's interesting that you mentioned that too, support. I mean, that's what we do in the world of ICBabies, try to give everybody the support that they need because there isn't much, because it's not built into the hospital system, just by nature of medical systems and healthcare.

Lina Acosta Sandaal (09:33.389)

Mm-hmm.

Lina Acosta Sandaal (09:42.211)

Mm-hmm.

Lina Acosta Sandaal (09:59.374)

Yep.

Leah (10:01.537)

Yeah, you mentioned something about

sort of you were talking about the when you felt like a parent. This is something that our parents struggle with a lot. And it's been a common topic over the last few weeks in our support groups is when that not feeling like a parent, right? Because you said these other people are now kind of in that role as the parent. And so what are some things that are with some advice, I guess, for our parents to know that they are?

Sometimes they're looking for that tangible thing when I could change their diaper, when I could hold them. But as parents of preemies, we can't do that for a long time sometimes. What are some things that our parents could do to be part of their experience earlier or get that feeling back?

Lina Acosta Sandaal (10:59.532)

There are three musts to parenting. Forever. Even when they're in college like mine.

Consistency in how you respond, routine, and teamwork amongst the caregivers. Okay, so consistency in how I respond, routine, and teamwork amongst the caregivers. So if I take these three musts of parenting and I put them into the NICU experience, that's what makes you a parent. So.

the consistency of the visit, right? I know those parents that have to work and could only get there after work. You're a parent when you are creating that consistency and that routine of your visit by the bed. That makes you a parent. Like this parenting expert, this child development expert, this social-emotional learning expert is telling you the minute you have created this consistency and this routine of being by in...

in the hospital by the bed, that is a parenting must. Number two, teamwork amongst the caregivers.

I know that sometimes it can be difficult to ask the 182 questions that you want to ask of the neonatologist, right? I know that it's difficult to come in and ask the nurse the questions, but that's a must in parenting, right? So your questions, your curiosity, your...

Leah (12:27.435)

Yep.

Leah (12:35.894)

Yeah.

Lina Acosta Sandaal (12:44.334)

Because in the NICU, that's what it looks like to work with the other caregivers. Because in the NICU, the other caregivers are the nurse, the neonatologist, the pediatrician that's still doing their rounds because eventually you're going to be out of the hospital and you're going to be with them. So I would say that that makes you a parent when you're part of that team. And don't question your questions. Your questions are valid.

Leah (12:50.527)

Yep. Yeah.

Lina Acosta Sandaal (13:11.667)

so that's, and then, you know, and then just know that.

that your voices are the voices that that baby heard in your world.

Leah (13:28.309)

Mm.

Lina Acosta Sandaal (13:29.946)

It's the sound that they know most. Right? Now they're getting introduced to the beeps and they're getting introduced to the nurse's voices and they're getting introduced to other things now out of your body. But when they were in your body, you are that voice. So your voice is you as parent. So if, if,

Leah (13:51.051)

Yeah.

Lina Acosta Sandaal (13:53.184)

you are not able to hold your baby and I know the pain of that because I wasn't my my son I could hold but my daughter I didn't get to do skin to skin until like the second week.

Leah (14:03.286)

Yeah.

Lina Acosta Sandaal (14:04.928)

Right? And that was hard. So know that connection of the voice. But also it is true because we define parenting as like making choices for our children. Making the choice of when to feed them, when to bathe them, when to all the choices, right? And I do want to...

Leah (14:30.646)

Right?

Lina Acosta Sandaal (14:32.63)

honor that feeling of they make those choices is real, but remember that they make those choices and that's part of a team. So remember the three musts. Now until they're out of your house.

Leah (14:52.437)

Yeah, that's amazing.

Leah (15:16.481)

I love that you share that about the communication piece. It's something that we see and being part of the parent team, right? We even use the language of you're the parent head of the baby's medical team. We have a neonatology head, you have a nursing head, and we also have a parent head. And I love what you're saying about that and the questions, asking all of your questions. It's so crucial. We see it in the bedside when folks feel that

that they're part of it. They're more comfortable at the bedside and that's where we want all of our families to be. So I really value so much what you say about that. You mentioned a little bit about how your experience was a little bit different between the two kids, right? And what I'm hearing in there is a little bit more about how you cared for yourself.

in those two different times. I'm wondering, were there things that you did to care for yourself so you could show up for your baby in the way you wanted to?

Leah (17:03.233)

Yeah.

Lina Acosta Sandaal (17:24.716)

I think my daughter was in the NICU for 32 days. So I think in the first couple of weeks, you're 100 % correct on picking up that I didn't take care of me, right? I had this negative self-talk of like, couldn't.

Leah (17:40.021)

Right.

Lina Acosta Sandaal (17:48.524)

I didn't do what I was supposed to do as the person that carries this child into the world. know, there was like that, that feeling of like my body had failed her, you know? So I think that, and again, whoever's listening to this, if you hear this and all of a sudden, like you're saying, that's how I'm feeling right now, of course you are, right? Because when something happens that we can't make sense of, we start to look for like a reason.

And the easiest thing to do is to blame yourself and blame some salad that you ate before your baby came early. And it's just a simple solution to a very complicated scenario. So I think that what I did, what I eventually did well and what I did well from the get-go with my son was...

Leah (18:21.814)

Right.

Lina Acosta Sandaal (18:46.412)

asking for support in the things I didn't wanna do. So for example, with my daughter, I was worried about the house and the gas in the car and like those extra things, right? And with my son, I was like, drop me off, I don't care, figure it out. My three year old is in the preschool, so Camila is gonna be going to preschool. Like I am not, and...

Leah (19:01.513)

Yeah.

Lina Acosta Sandaal (19:16.75)

And so one way to take care of myself is delegating those things that I didn't want to do because I knew that I wanted to be with baby.

Leah (19:20.415)

Right.

Lina Acosta Sandaal (19:26.606)

so I would say, learn to delegate. You don't have to do it all. You don't, you don't have to leave the hospital and go to the grocery store and go home. You know, if, if you have the older sibling, you, you don't have to buy them a gift, you know, on the way home, all you have to do is come home, snuggle with them and hold them and ask them how they did. Right. Like, so delegate.

Delegating those things that are not important, right? Like we think they're important, but they're really not. What's most important for our relationships, which is what gets, what will feed us in this time is presence. Not presence with a T, presence with a C, right? So, and that's whether that's with your partner, with your family member, with your older child. So,

Leah (19:56.896)

Yum.

Lina Acosta Sandaal (20:23.33)

Delegate so you can have presence is key. And then every day, once a day, do that one thing that just gives you a little spark of joy. With my son, Cedar Sinai gives these hot chocolate chip cookies. So when I was on bed rest, I used to get the hot chocolate chip cookie.

Leah (20:40.939)

Right.

Leah (20:50.708)

Right, right.

Lina Acosta Sandaal (20:53.044)

So, but they also sell them. So that was like my little tiny thing where I would just walk away and get that cookie. So little things like that, you know, those little, sometimes we think that we have to be grand when we do self care, but it really doesn't have to be. And then another thing, I am a huge proponent of journaling.

Leah (21:12.171)

Right.

Lina Acosta Sandaal (21:20.066)

But like freehand journaling, I highly, highly, highly recommend getting a journal and just writing whatever you're thinking. Like all the crazy stuff, like really writing what you're thinking. If you're thinking, my God, if somebody reads this, they're gonna call DCF, right? That's the right, because what I want you to do is that I want you to dump.

Leah (21:29.216)

Yes.

Lina Acosta Sandaal (21:49.184)

all those thoughts. So when they bubble up again, you can tell yourself, no, that belongs in the journal. And then now you've given direction to your brain to be present here because the brain is like, you're gonna hear me and all of my chaos and all my negative talking, right, in that journal of yours. Go find that journal of yours. then, so that helps us separate that those...

Leah (22:12.011)

That is brilliant. I love that. I love that. Yeah, like quieting the brain so you can be present like you were mentioning before. So, so important and so helpful to stay with our babies at the bedside. you have such an amazing set of skills and such a vast portfolio of

Lina Acosta Sandaal (22:14.338)

There's nothing like stress and uncertainty to turn on the negative bias monster, right? The natural reflex of thoughts.

for the brain when we are in a uncertain or stressed out situation is a negative bias. Your brain will give you all the reasons why something is bad, all the reasons of how that the extra step to think positive and the extra step to think productive is exactly that, an extra step.

Leah (22:40.481)

developmental leadership and education and social emotional learning. Were you doing all of that before you had your babies in the NICU or that came after?

Lina Acosta Sandaal (22:48.986)

The first step, your brain will always give you the list of how everything is gonna go wrong. And it gets even worse when you're stressed out or uncertain. So journaling all those bad things that can possibly happen lets your brain know that this is where it belongs. So those are my three little tips.

Leah (23:20.585)

Wow, that's right.

Leah (23:38.219)

Sure.

Lina Acosta Sandaal (23:49.73)

That came after. So prior to having my 32 week daughter, who is now 20, I was actually, had a, my side hustle was a bookkeeping company and my main job was acting. Remember, I was in Los Angeles.

Leah (24:07.093)

Mm-hmm.

Lina Acosta Sandaal (24:16.632)

But so part of my story of bringing Creamy home, right, was, and there's actually a blog that I wrote about it. Maybe I could share it. We could put it in notes later. But I brought her home, you know, and bringing Creamy home is just as terrifying as having Creamy in the NICU, right? And I had to go to an audition.

And I had to get somebody to take care of her. And it happened and I did it, but I was like, in Los Angeles, you have to drive under the airport. Like if you live south, you drive under the airport to get into like Santa Monica. And I was going under the underpass of like, the planes were over me and I'm in the underpass, I'm in that tunnel and I'm just boohoo crying. was like, I don't wanna do an audition for Tylenol. This is so stupid.

I was like, I don't care about the... Literally, I was going to audition for a commercial for Tile and All. And that was the moment where I was like, I can't do this anymore. And I can't do this acting thing anymore. And I had always been interested, and you can't be an actor, you can't be a good actor and not be interested in why your character that you're playing

Leah (25:18.88)

Right.

Lina Acosta Sandaal (25:43.032)

does what they do, right? And the next, the thing that's very similar to that is psychology. And I was always very, very interested. And at the time I thought that I would be working with teenagers that are dealing with drug and alcohol issues. That was kind of like what I wanted to do. So I decided, you know what? If I'm gonna leave my daughter, I'm gonna leave my daughter for something that is worthwhile. And I'm also gonna make sure that I'm gonna learn everything that I need to learn so I don't mess her up.

Leah (26:03.019)

Okay.

Lina Acosta Sandaal (26:11.48)

So that's when I got the master's degree. And it was really interesting for me because I'm like in my 30s, surrounded by 24 year olds. then reading about development and reading about the psyche while having this baby at home. So that's how it happened. And then I was in the right place at the right time in Los Angeles because while I was getting my master's,

Leah (26:31.648)

Mm-hmm.

Lina Acosta Sandaal (26:41.206)

the mental health kind of funding changed in California and everything that the agencies, the mental health agencies were doing in the city had to be a research-based model. And yes, there is a large Central American Latino culture in Los Angeles. However, a lot of them are third or fourth or fifth generation. So they're not necessarily bilingual.

Leah (26:47.17)

wow, that's a big roll to fill.

Leah (27:09.803)

Wow.

Lina Acosta Sandaal (27:12.312)

But I am. So I was doing my, kind of like my internship while I was getting my master's in this really, really big agency in Los Angeles called Vista Del Mar. And because of this shift in, they gave us all these research models that we had to train in. But I was the therapist that was like the new therapist. And they were like, we're gonna train her because she's bilingual. So, name.

Name an evidence-based model. I've been trained in it, know, child parents, psychotherapy, just like PPP, like all the alphabet names. But then I also got trained by Dan Siegel, who is a writer of Whole Brain Child, the writer of, you know, like all those books, right? And so I was just in the right place at the right time.

And then I was trained by Alisa Lieberman, who's kind of like the godmother of like trauma in children. But all of this was happening while being a mother. So the plan to go, the teens and drugs and alcohol kind of got switched to away parenting. And then it also got, and then I like to say I'm a Scorpio, so I got really mad that I was learning all these ways to intervene.

Leah (28:17.803)

Wow, that's an extraordinary story. Like talk about, you know, practice into purpose or experience, life experience into, you know, multi-fold and expanding it out and even paying it forward for all of our NICU families to have you as a resource in the community. As I mentioned, you have all of these levels of things that you're doing to stretch your...

Lina Acosta Sandaal (28:40.526)

with all these research-based models, but nobody was teaching the parents how to prevent.

Leah (28:45.127)

experience and your research and your knowledge to help more folks. I'm wondering,

Lina Acosta Sandaal (28:48.602)

So, right? Because everything that I was being taught, it was like an intervention to a problem, you know, rather than prevention. And prevention starts in early childhood. So that's when I did the whole infant mental health part of it. And here we are, years later.

Leah (28:57.931)

What do you think as folks are making their way towards parenting for the rest of their baby's lives, right? And your deep love of helping that people will enjoy guiding children, right? That's in your mission. What are some things, having had the experience and knowing all the research that we as parents of NICU, soon to be graduates and graduates, should be thinking about as we start to navigate?

the typical world outside of the NICU.

Leah (30:04.318)

Absolutely.

Lina Acosta Sandaal (30:25.144)

First, bringing that preemie home, it's very important to get a good handle on development, normative development.

you're going to be adjusting for age till they're about two, two and a half, sometimes three. So I think it's very important. This is important for all parents, but is a must for NICU parents, because you always have to hold that time, because they're...

they're chronologically this age, but developmentally they're this age, right? And that it's important to really get that good book. Lena, the number one question, what is a good book on development? Brazelton's books, he was the T. Barry Brazelton, Touch Points, that's still a classic. It's a great book, because it tells you what to expect.

Leah (31:35.732)

Yeah.

Lina Acosta Sandaal (31:37.696)

moving forward, right? But be mindful of that, you know, the gap, right, of like correcting. And that helps you stay sane. The other piece, if your preemie was released from the hospital and your pediatrician has told you, enjoy your baby, it's time to enjoy your baby.

A lot of us, parents of preemies, take care of them to a fault, right? We don't give them the opportunity to be kids, to be on the floor, to fall, to put things in their mouth. But I cannot repeat that enough, right? The small t trauma, because it is a small t trauma of being in the NICU.

Leah (32:26.113)

That's beautiful. Yes.

Lina Acosta Sandaal (32:37.614)

causes you to be overprotective of your baby. So I really want to put that out there when you are released from all the medical professionals and they're just like, okay, you're like everybody else now. You have a baby at home, right? I really, really want you to check in with yourself and take your temperature. It's like, I being overprotective or am I allowing my child to research and move and discover? Because the greatest gift we can

Leah (32:54.197)

Yeah.

Lina Acosta Sandaal (33:07.566)

The best scientist in the world is one years old.

Leah (33:16.337)

Yeah, but it sort of is though, right? Because if we think about like having a mother or father or both with, you know, struggling with mental health particularly towards anxiety, that increases the risks, right? So.

Lina Acosta Sandaal (33:17.838)

I don't know if you've been around toddler, but they do A, B experiments on a regular basis. You know, it's gorgeous to watch them, you know, pick something up and like go, huh, and use it a hundred different ways. And sometimes we get in the way of that. You know, a lot of parents get in the way with it, but parents of premature babies are even worse, right? So then you create.

Leah (33:38.315)

Mm.

Lina Acosta Sandaal (33:47.028)

anxiety for them and for you. Right? So there is a little bit like, know, prematurity creates anxiety. I don't know. I don't know that I think how we nurture them and how we take care of them post-hospital might be that we need to do a study. That study is not available yet. But I think that that

Leah (33:54.857)

Hmm.

Lina Acosta Sandaal (34:21.582)

Yep. Yes. Yes. 100%. So, but it is, but that's really like that's key, right? Like that's another thing is that when you bring baby home and curiosity and exploration, you know, in a toddler is curiosity and exploration of a rock. In an adolescent is, I know that I've been playing the piano forever, but now I want to do the bait team.

and not getting in the way of that, right? Not getting in the way of that new curiosity. So that's forever. But again, when you bring Primi home, that's a mistake that people make. And then the other piece is when you bring Primi home, it's... And this, I'll share here because you are my people.

You know, you get followed, right, by you take your baby to early steps, you know, and then, you know, that happened for me and that's a good thing. Don't reject it. That's a really positive thing. have these, but in the early steps report, I watched the lady, right, overprotective of daughter. was just like, I take that very personal.

Leah (35:23.21)

Yeah.

Lina Acosta Sandaal (35:38.092)

but she wasn't wrong. So like, was like my final, I was aging out. She was gonna be 36 months and I was aging out of early steps in Los Angeles. And at this point I had, you know, I was getting my master's so I was paying attention of the evaluation and what they were doing. And, know, it's...

Leah (36:03.017)

Yeah. Yeah.

Lina Acosta Sandaal (36:04.544)

Second guessing or not believing that your child is doing better is also a big culprit.

Leah (36:12.169)

Yeah. Yeah, yeah. The other thing that I wanted to pick your brain about a little bit is the. Something that all of our kids will go through, which is school and you know, they start school depending on where you are, could be two or three and then, you know, hopefully they're at school forever, but I'm lean more towards school. They're going to school for a long time. Are there things particularly educationally?

Lina Acosta Sandaal (36:15.438)

of fear that becomes kind of like self-fulfilling. So be mindful of that. Be very, very mindful of that. And again, I say this both as a professional, but also as me, myself, and the person who are writing, because everything becomes, it's because they were, it's like we filter everything through that pre-me moment.

Leah (36:41.217)

that we should be looking for. I know you've done a lot of work with a lot of people in the Miami area, helping them through navigating that world, which can be really complicated because now there's more care partners. There's more people caring for our kids. But knowing that the educational system isn't always what we want it to be, what can you offer us in that?

Lina Acosta Sandaal (36:45.934)

And that's not necessarily true. So believe them when they tell you that they're done and they're out and they're fine. It's easier said than done, but just be mindful and just making ourselves conscious of it makes us at least have the wondering, right? And the question.

Leah (37:10.101)

Realm for guidance.

Lina Acosta Sandaal (38:06.36)

For those of you that are seeking like a preschool setting, right? Don't assume that this preschool understands about adjusting for age. Be the source, be the advocate of information. like I'm telling you, hey, don't overprotect, but do overeducate.

those in your team, right? Remember the three most apparent inconsistency and response routine and teamwork. And one of the biggest members of your team is your school, right? So for parents in the preschool, make sure that you, because some preschools will also have kind of like the myths of a preemie, right? you know, they're,

there are some statistics that there are learning differences, higher instances of learning differences in premature children. So.

Leah (39:02.411)

Right.

Lina Acosta Sandaal (39:10.484)

Make sure that you speak to your school and tell them how you're adjusting for age. You know, that they have to look at the student through that gap, right? And also pay attention when they tell you, hey, this is a little bit different. We are adjusting like you said, right? But don't push back on the school, right? I want everybody to understand that.

preschool teacher or kindergarten teacher or a first grade teacher where we catch a lot of these learning differences has like 5,000 hours with children. So they may not be able to say it's this, but they just know it's off.

It's like teacher lexicon. When I did a lot of social-emotional consulting with multiple schools in the city, and every time a really good, solid teacher, all she needed was five years of experience, would be like, that one. When I went in and evaluated, it was real. So with prematurity, we do have to...

Lina Acosta Sandaal (40:18.752)

It's that balance, it's like, okay, I don't want you to overprotect, I don't always want you to look at it through the lens of prematurity, because I just said that, right? But now, I do want you to pay attention and be open to checking. So throughout the school years, it's about checking.

and making sure that that child is continuing to do well.

Leah (43:36.586)

yeah. Yeah, that's so true, right? You can't choose your kids' friends, but you can choose the group of friends that they choose from. Right? Okay.

Lina Acosta Sandaal (43:37.656)

So as it pertains to school, as it pertains to school, it is very important to keep an eye out, but be the advocate for your child. Now, school choice, right? This is true for any parent. It's not just a parent with a preemie, right? Make sure that first, logistics are important.

Right? Make sure that you're choosing a school that's near you, whether near home or near work, whatever suits best. Choose a school that shares your values because the minute you choose a school, that school is inside of your house. Right? See, that's the way that you have to think.

Leah (44:24.98)

True, right.

Lina Acosta Sandaal (44:33.653)

Yep.

Lina Acosta Sandaal (44:38.99)

Yes, yes, 100%, right? And lastly, this idea of what and how your child learns.

I think a lot of the time people fall in love with buildings or they fall in love with an idea, but the best school for a child is the school that they will thrive in. And you know, and this is sometimes you even have siblings that don't necessarily fare well in the same school. Right, so it is important to to be very, mindful of what you're choosing.

and why you're choosing it and make sure that you're in a situation where your child will learn there and will thrive there. Right? Because and, and, and let's, and, and, and this is.

Leah (45:39.036)

Right, yeah.

Lina Acosta Sandaal (45:43.894)

A lot of these tips are a little bit privileged because I'm saying that you have choice, but let's pretend that you don't have choice. You have to go to one particular place and one particular setting because that's just what is happening.

make sure that you those things that may be lacking for your child and the way that they learn and the way that they engage with learning. And you see that it's lacking, but you have this one singular choice of school. It is important to kind of give that to them in other ways.

Leah (46:11.988)

Yeah.

Lina Acosta Sandaal (46:18.614)

Right? If your child is more of a tactile learner, you know, perhaps that math homework that you're doing, they shouldn't just be doing it with the handout. Perhaps you do put out the beans and start, you know, teaching them how to count with those beans, you know, at home, even if they don't do that at school. Right? Perhaps your child really, really loves planes. Right? And then the teacher's telling them that they have to write a three-page essay. Okay, well then help them write an essay about that plane. Right? Like,

Leah (46:25.51)

Yeah, that's real. Are there some, you know, with all of your years of experience, are there some things that are ideal for early education, particularly for our little people who have had a more difficult start to life, who have experienced some things already that may or may not have already challenged their

Lina Acosta Sandaal (46:47.16)

There are things that you could do at home that may not be happening at school, right? Because you have this one singular choice. But if you're lucky enough and you're privileged enough where you can choose a setting that really matches the way that your child learns, that's the right setting.

Leah (46:54.766)

social, emotional, nervous systems. What are some of those key things that you have learned that schools should be doing or that we should be looking for in a school if we have that opportunity?

Lina Acosta Sandaal (47:05.89)

Right, so often parents just, well, you're gonna go there because you're gonna go there because your mother and your father and your uncle and your great grandfather went to the school. And it's like, but what if this is in a place where I learn?

Leah (47:37.832)

Yeah, yeah, I just talked about it this week.

Lina Acosta Sandaal (48:03.828)

In early childhood, the littles make sure that there is space for constant movement and activity. Believe it or not, these little ones, these little preemies that have been through a little more, the trauma does live in the body. The body keeps the score. It's still a number one bestseller book.

Leah (48:19.464)

Beautiful, yeah.

Lina Acosta Sandaal (48:33.166)

And I know a lot of parents worry about that, They worry about like, where is this being held in my child's body? We don't need to know, but what we do need is make sure that wherever you're placing your child that they're not making them sit for long hours, especially in early childhood, right?

Leah (48:50.448)

I love that. Yeah, I love that. It gives us a little more information. know, I will kin it to when we talk about how much mothers need to drink to maintain hydration for lactation. I don't say drink a lot of water, I say drink a gallon of fluid a day. So that's another big tangible change. Don't get exercise every day. It's exercise to the point of sweating every day, sweat every day. I love that. That's really helpful.

Lina Acosta Sandaal (48:59.201)

Like, Akela, right? I'm proud to say that every single child at our school, by the end of the day, has had at least 45 to 90 minutes of movement in the day. And we don't give that to children anymore, especially in other settings. So I would say that a child that has lived what our babies have lived,

Leah (49:20.232)

That's really helpful. It's more tangible. It's more, I don't know, maybe it helps us understand where we're trying to go.

Lina Acosta Sandaal (49:28.354)

They need to sweat once a day, every day.

moving the body helps. Right. And that one I'm quoting my friend Nicole Santamaria. She's an occupational therapist here in Miami. She always says, did they sweat? Did they sweat?

Lina Acosta Sandaal (50:07.82)

Mm-hmm. Mm-hmm. Yeah. Yeah, that's

Lina Acosta Sandaal (50:21.91)

100%. And so make sure that especially a preschool, if they're not telling you no, they go to the playground and there's places for them to practice that gross motor mobility, right? Because for a lot of our preemies, that's the piece, that the core, building the core, building the extremities, because they're premature, a lot of their reflexes are a little bit like not, they're not

Leah (50:44.212)

you

Lina Acosta Sandaal (50:50.734)

You know those primitive reflexes that need to get integrated. It just takes a little bit longer. the only, you don't have to do anything special. You just have to make sure that they're climbing and moving and crawling and put the back to put them on the floor. know, time, tummy time, tummy time. And the other piece that be mindful of your baby's temperament. This is true of preemies, but it's also true of all of them.

Leah (50:59.72)

Yeah.

Lina Acosta Sandaal (51:20.93)

You know, when we come out of the womb with flavors, NICU and maternity ward nurses are so good at figuring out the temperament of a baby. They'll be like, ooh, this is a feisty one. So that's kind of like that leader extroverted, know, high energy temperament child. Or they're like, they're so gentle, so quiet. You know, that's that slow to warm kind of observant. Like I've watched.

nurses do this, right? Just scribe the baby as they hand it over, right? Or, oh, he's so easy, right? That's that super flexible temperament. So the other piece that I want you to think about is like, how does your child's temperament match the energy of that preschool, right? Like a...

Leah (51:53.243)

Right, yeah.

Leah (52:14.897)

Yeah.

Lina Acosta Sandaal (52:15.978)

an easygoing, kind of more introverted type child sometimes does really, well in a Montessori classroom, right? Because it flows, it's quiet, it's, you know, a flexible kid, you know, can place them anywhere, they're gonna thrive, right? But that high energy, that high leader child, you most definitely have to put them in a setting that is a little more innovative, that is open to questions, that is open to like the kid that's gonna not shut up.

Leah (52:39.539)

Yeah.

Sure, yeah. Well, you also have in your stop parenting alone, which also is just absolutely the truth, as a saying in life, you have that online courses to help us adjust, right? Some of us just want to learn a little bit more information. We want to educate ourselves or get a little bit more and feel more comfortable and confident in parenting when we know a little more, or even just get validated of all of that. And so those are...

Lina Acosta Sandaal (52:45.398)

Right? So that is also something to look for. if people want to hear, learn more about temperament and they want a really heady, like intellectual book, but it's one of my favorites, it's called The Orchid and the Dandelion. Because the dandelion blossoms anywhere.

Leah (53:11.956)

wonderful courses to have for folks who are out there listening. We'll add the links to all of these things in the show notes too. So if folks are interested, they can go check it out, at least understand what else is out there. Sometimes just knowing something is there helps us to feel more comfortable as we're navigating this wild parenting NICU world.

Lina Acosta Sandaal (53:12.556)

But the Orchid needs very specific environment to succeed. And it's all the studies ever done through temperament. And it's a personal book for the writer because his sister and him were so different and wondered why she suffered more than him.

even though they were growing up in the same home.

Leah (53:55.774)

Brilliant.

Lina Acosta Sandaal (54:27.402)

Yeah, and those are the two places, right? In the Stop Parenting Alone website, you can go and take, you know, you go hit the parent school link in the website and learn, you know, my favorite, I would say that if you're going to a baby shower, gift this to someone, I have this early bundles group of courses that it's like,

Leah (54:38.035)

Right?

Lina Acosta Sandaal (54:49.894)

Things that you need to know about the little ones, right? And they're made for parents. They're like five, 10 minutes long. Even though it's an hour long, there's like little tiny bite-sized lessons that you could just take at piecemeal. And then once you buy it, it's yours. And then the other piece, like if you love what I'm saying, if you love what I'm believing, know that I am guiding a group of teachers and a group of administrators.

in my work here at KLA Academy, you know, it's, I know that, again, like, we have an applications process and all that kind of business because we want to court one another and we want to figure out whether this is the right setting, right? Like, I'm the type of school that I'm gonna have that family meeting with you while you're applying with me and I'm gonna be like, you know what, this isn't the right setting, but you know what is? Like, that's the kind of place that we are, right? But if we're the right setting,

Leah (55:17.65)

Yeah, well, I feel incredibly lucky to be in your world, especially today. And I'm so grateful for your time. I just have my last couple of questions. We talk about hope in the NICU. We use this word hope a lot. And I want to know for you, what does hope mean to you?

Lina Acosta Sandaal (55:43.702)

you know, I'm here too, you know, and all of this that I'm sharing with all of you, as you know, through the lens of like, prematurity and the NICU, I get to do through the lens of social-emotional development and true thinking how a child learns, you know, here at KLA Academy. So like, those are two really great ways to come and be in my world.

Lina Acosta Sandaal (56:39.768)

Hope is holding on to the belief that all is well always.

And

You know, that's how I ground myself, you know, no matter what, no matter what world I'm in, you know, I must come back to that center of like, is well, always, right? In the moment, in the millisecond, in the right here, right now, the two of us, all is well. And even when...

It beeps, the machine scares us in the NICU. It's hope is like, I'm here and all is well right here right now because I am in the hospital. I am in the best setting possible for my baby. I am in the best situation.

Leah (57:30.889)

Yeah.

Lina Acosta Sandaal (57:46.318)

And it's not 100 % of the time, but a lot of the time, when even when the worst case scenario happens, if you stop and you're like, wait, what is actually happening around me? All is well. I say this from my own personal journey of all the trails and tribulations, from being a therapist of, I don't know.

Leah (57:55.732)

Hmm.

Leah (58:12.916)

Mm-hmm.

Lina Acosta Sandaal (58:15.896)

think I'm like in the 500 people, think it's kind of crazy. Like a lot of hours and a lot of people, even when I was speaking and you can like, and I was a trauma therapist for at least three years of my life, like working with physical and sexual abuse of children. And even in those situations, those actually those situations taught me most how in the most unimaginable situation, how things

got well.

Lina Acosta Sandaal (58:50.708)

with soul.

And without hope...

Leah (58:57.458)

Right. Right.

Lina Acosta Sandaal (58:58.574)

without trusting and letting go that everything is moving along as it should, all you have is suffering.

Leah (59:11.56)

Yeah. Yeah, a lot of families talk about feeling dizzy, feeling, you know, just overwhelmed in the body.

Lina Acosta Sandaal (59:11.724)

The more you hold on to an expectation, the more you hold on to certainty, the more suffering you feel.

Leah (59:24.66)

Hmm.

Lina Acosta Sandaal (59:25.836)

So feeling fear is not what's hurting you. Feeling fear and wanting to control how you experience it or how you...

Leah (59:32.404)

Yeah.

Lina Acosta Sandaal (59:40.68)

do or not act on it or judging is what causes the suffering.

Leah (59:42.652)

Yeah, it makes sense. And it makes sense. You know, that's the only way that we can come back to ask for help, like you said, to receive, to be present with our babies, help them regulate with us, connect with them, connect with our older children. It all comes back together. I think from what I hear you saying now is if we can allow those feelings to be, then we can come back to being present and show up for our other our other people to.

Lina Acosta Sandaal (59:48.586)

not the fear. Fear is a wave. you just sit with it and be like, there it is. There's that, like, I don't know about you, but like when I was in the NICU, I felt this heaviness in my chest.

Lina Acosta Sandaal (01:00:09.517)

Yes.

Yeah. Yeah. So that need to stop it is the suffering. If you just get curious about how it's living in your body and how the waves come and go, that's just pain. But then back to that. So yeah, I got all esoteric, but.

Leah (01:00:12.82)

with less suffering and more presence. Yeah. Amazing. Well, I really encourage everybody out there listening to find Lina and all of the places that I'm going to put her here. Thank you so, so much, Lina, and thank you for your time today and for your guidance in my family and so many of the people who I know and their families during traumatic times and...

typical childhood times. I know you've been there for a lot of people and I'm super grateful to be able to share you with millions more today. So all of you out there who might be sitting at your baby's bedside or driving back and forth to the NICU or you might be a provider yourself caring for babies in the NICU, Lena and I want you to know that you are not alone and we look forward to being in your ears or on your phone sometime soon. Take gentle care.