This chapter explores interprofessional communication in the neonatal intensive care unit (NICU), where the difficult, complex, intensive patient care required makes teamwork more challenging and at the same time more necessary. These challenges stem, in part, from the need for high-reliability communication among professionals who bring differing frames and scripts for problem solving and who must navigate power and status differences in their actions. Furthermore, the requirements of family-centered care, such as collaborative decision making with diverse families, makes interprofessional teamwork even more demanding. The chapter reviews existing communication interventions for high-reliability interprofessional communication in this context, where institutional, organizational, and family dynamics intersect, and it discusses how interprofessional teams address these challenges.