Which babies need extra care after delivery?
Babies born at any gestation can have difficulty adjusting to life outside of the womb. Generally, your baby may need to be observed in the special care nursery (NICU) if he or she has any of the following characteristics.
- Less than 36 weeks' gestation.
- Weighs less than 2,268 grams (5 pounds).
- Needs oxygen to breathe.
- Requires closer observation as directed by your healthcare provider.
- Diabetes, high blood sugar.
- Infection, fever.
- High blood pressure.
What will I see in the NICU?
Your baby will be kept warm by an overhead heat source: a radiant warmer. A cardiopulmonary monitor connects to your baby by small pads on his or her chest. It will monitor his or her heart rate and respiratory pattern. The pad around your baby’s foot or hand is called a pulse oximeter, or oxygen saturation monitor. It uses a painless sensor to check the oxygen in the blood. A blood pressure cuff that's wrapped around your baby’s arm or leg will monitor his or her blood pressure.
Every newborn is different, but many babies who are born early have some of the same medical issues. Some of these issues are:
- Breathing.This is one of the biggest concerns for babies born prematurely. Breathing problems can include:
- Apnea, when a baby stops breathing for 20 seconds or more.
- Pneumonia, a lung infection.
- Respiratory distress syndrome (RDS), which is caused by too little of a substance in the lungs called surfactant. Surfactant helps to keep the air sacs in the lungs open.
- Jaundice.There is too much of a waste product called bilirubin in the blood. This causes the baby’s skin to turn a yellowish color and can lead to other problems if not treated. Treatment usually includes phototherapy, or lying under lights called "bili lights."
- Feeding problems. Ababy must breathe between sucking and swallowing to eat from a bottle safely. Babies at less than 32 to 34 weeks' gestation may not be able to do this. Your baby may need to be fed nutrients with an IV at first. After becoming stronger, he or she can be given your breast milk or formula through a feeding tube until he or she can effectively feed by breast or bottle.
- Low body temperature. Ababy grows faster with a normal body temperature, but premature infantshave trouble keeping their body temperature steady. An incubator, or warmer, helps them stay warm.
- Anemia.There aren’t enough red blood cells. Your baby may need extra iron, medicine or a blood transfusion.
- Colds and RSV. The effects of colds, flus, and viruses, like respiratory syncytial virus (RSV), can cause serious breathing problems in babies born prematurely.
When can my baby go home?
Babies' length of stay and type of care depend on how early they were born and their health at birth. Babies go home when they can take all of their feedings with a bottle, gain weight and keep themselves warm in an open crib. A rule of thumb for premature babies is that they might go home by their original due date.
Special care nursery staff
The special care nursery is staffed by a multidisciplinary team of healthcare professionals including those listed below:
- Pediatricians.Pediatricians are available 24 hours a day, 7days a week to manage your newborn’s care.
- Nurses. All registered nurses working in the special care nursery have specialized training in the care of premature and sick newborns. In collaboration with our physicians, our nursing staff administers many aspects of care in addition to parent education and discharge planning.
- Respiratory therapists.Respiratory therapists have skill and experience working with newborns.
- Physical therapists/occupational therapists.Developmental assessments and treatment are provided, if needed, to promote normal muscle tone and motor skills. Parental education for positioning and handling techniques for special-needs infants is also provided.
- Lactation consultants.Registered nurses with advanced certification in breastfeeding are available through the special care nursery to provide education, support, and problem solving to help breastfeeding mothers achieve success.
- Social workers.Professional licensed clinical social workers with special training in the needs and concerns of families with special care infants can assist with a variety of healthcare and financial arrangements.
- Pharmacists. Licensed pharmacists are available 24 hours a day. They are trained to usethe newborn's weight to accurately prepare doses of medications, even for the tiniest of babies.
The special care nursery is dedicated to family-centered care by allowing 24-hour-a-day visitation and involvement in care, except during a change-of-shift hand-off. This is not to exclude you, but to provide privacy for our other infants. We encourage participation in your newborn's care.