Poorly newborn sick premature baby or very tiny baby? New parents eagerly look forward to bringing their baby home, so it can be frightening if your newborn needs to be admitted to the neonatal intensive care unit (NICU). At first it may seem like a foreign place, but understanding the NICU and what goes on there can help reduce your fears and let you better help your baby.
About the NICU
If your baby is sent to the NICU, your first question probably will be: What is this place? With equipment designed for infants and a hospital staff who have special training in newborn care, the NICU is an intensive care unit created for sick newborns who need specialized treatment.
Sometimes the NICU is also called:
a special care nursery
an intensive care nursery
newborn intensive care
Babies who need to go to the unit are often admitted within the first 24 hours after birth. Babies may be sent to the NICU if:
they’re born prematurely
difficulties occur during their delivery
they show signs of a problem in the first few days of life
Only very young babies (or babies with a condition linked to being born prematurely) are treated in the NICU — they’re usually infants who haven’t gone home from the hospital yet after being born. How long these infants remain in the unit depends on the severity of their illness.
Who Will Be Taking Care of My Baby?
Although many people help care for babies in the NICU, those most responsible for day-to-day care are nurses, whom you may come to know very well and rely on to give you information and reassurances about your baby.
The nurses you might interact with include a:
charge nurse (the nurse in charge of the shift)
primary nurse (the one assigned to your baby)
neonatal nurse practitioner (someone with additional training in neonatology care)
Other people who may help care for your baby include:
a neonatologist (a doctor specializing in newborn intensive care who heads up the medical team)
neonatology fellows, medical residents, and medical students (all pursuing their training at different levels)
pediatric hospitalist (a pediatrician who works solely in the hospital setting)
various specialists (such as a neurologist, a cardiologist, or a surgeon) to treat specific issues with the brain, heart, etc.
a respiratory therapist (who helps administer treatments
that help with breathing)
a nutritionist (who can determine what babies on IV nutrition need)
a physical therapist and/or occupational therapist (who work with feeding and movement issues with the infants and their parents)
a pharmacist (who helps manage a baby’s medications)
lab technicians (who process the laboratory tests — i.e., urine, blood — taken)
a chaplain (who can counsel you and try to provide comfort; chaplains may be interfaith or of a particular religious affiliation but they’re there to support anyone looking for a spiritual/religious connection)
a social worker (who helps you get the services you need and also lends emotional support by connecting you to other families and therapists, if needed)
What to Expect in the NICU
Walking into the NICU can feel like stepping onto another planet — the environment is probably unlike anything you’ve experienced. The unit is often busy, with lots of activity, people moving around, and beeping monitors.
Once settled in the unit, your baby will receive care tailored to your little one’s specific needs. Most NICU babies are on special feeding schedules, depending on their level of development or any problems they have. For instance, some infants are too premature or too sick to eat on their own, so they have a feeding tube that runs through the mouth and into the stomach. Others need high-calorie diets to help them grow.
Medications are another crucial part of NICU care — your child may take antibiotics, medicine to stimulate breathing, or something to help his or her blood pressure or heart rate, for example.
To ensure that your baby’s care stays on track, the doctors also will order various tests, possibly including periodic blood and urine tests, X-rays, and ultrasounds. For infants whose care is complicated and involved, the doctors or nurses will place a line into an artery or vein so they can draw blood without having to repeatedly stick the baby. NICU staff try to make the infants’ stay in the nursery as comforting as possible for the infant as well as the families.
Meet some of the staff you may come across if your baby needs to be looked after in special care or on the nicu wards.charge nurse (the nurse in charge of the shift)
Here are some criteria the staff look at to determine which care package your baby needs first.
Each baby must be assessed individually. Some small, but mature babies can be safely nursed on the wards, but other larger babies may not be so stable and need to remain in NICU. Therefore, a cut-off based on the baby’s weight is not entirely appropriate and staff in both ward and intensive care units will need to be flexible with regard to such criteria. However, as a general guide, babies weighing less than 1.8kg should be cared for in NICU when possible. A combined decision must be reached by both medical and nursing staff in all circumstances. A stable neonate weighing 1.6 kg and above may be admitted to a ward with support from the neonatal nurse advisor.
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