Growing stronger, one bead at a time

Some of the tiny necklaces could easily fit around an adult’s wrist. The colourful beads tell a story of growth, healing and of strength.

This isn’t any regular child’s necklace purchased from a store. It is part of an innovative program designed to use beads to recognize milestones in a baby’s treatment.

Staff in the Neonatal Intensive Care Unit (NICU) at Markham Stouffville Hospital are able to care for babies born as early as 30 weeks gestation. The majority of these tiny patients face a number of health challenges. The staff has embraced a number of initiatives designed to enhance the patient and family experience – and the most recent is the Strands of Strength initiative.

The program is based on The Hospital for Sick Children’s “Bravery Beads Program”. This inspiring program began as an initiative between the Women’s Auxiliary volunteers and the child life specialists at Sick Kids as a way for children to document their journey through treatment.


Each baby admitted into the NICU receives a starter necklace with their name in beads. From that point, the family starts collecting beads for every treatment or milestone experienced. Upon discharge, each family is able to take their Strands of Strength home as a memory of their journey while in the NICU.

“The Strands of Strength initiative has been a really positive addition to the culture within the NICU.  It helps to strengthen the bond between nurses and families and also provides the opportunity to create connections with other hospitals throughout Ontario,” says Nancy Fletcher, executive vice president, clinical programs.  “These beautiful necklaces become a visible, tangible reminder of just how far many of these babies have come.”

Many infants are transferred among hospitals as they receive necessary treatment.  Many of those partner hospitals have similar bead programs and families can collect their beads as they move through the health care system and receive care and treatment.

Markham Stouffville Hospital built upon the success of the Sick Kids model and adopted a similar legend and materials.

“The florescent green beads mean IV start and the red beads mean transfusion,” says Cheryl Osborne, patient care manager of the NICU.  “Often our nurses and physicians in the NICU are just as proud of the Strands of Strength as the families. For most of our babies, it means they are getting stronger as their necklace gets longer.”

The program has been embraced by parents and family members.


Looking back, Jen Mascoll is proud of the Strands of Strength that was created for her son Blake. He was born premature and spent five weeks in the NICU at Markham Stouffville Hospital.  He required a number of procedures including a chest tube, an umbilical catheter, IVs and nasal feeding.

“Strands of Strength helped us to focus on how far Blake had come. It reminded us how strong he was and helped us to get through those roller coaster days,” says Mascoll.  “Now that he is home, showing people his strand has made them realize how much he’s been through and it will be something he can look at and be proud of when he gets older.  A nice reminder of just how amazing he is.”

Osborne says she hopes the necklaces will continue to play an important role for the children and families, long after they have left the NICU. “It is our vision that as our little graduates grow, that they look back at their Strands of Strength and see how strong and brave they were and continue to be. It will be a source of inspiration for them in the years to come and will also help inspire those around them.”