Marquette General Women's & Children's Center

 

A parents guide to the NICU                

A Caring Place for Your Little Wonder(s)

Your Baby's Doctor, Nurses, & Other Caregivers

Visiting Your Baby

Your Baby's Environment

Your Baby's Nutrition

Your Baby's Breathing

Your Baby's Extended Stay

Your Baby is Ready to Go Home!

Glossary of NICU Terms

 

 

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A Caring Place for Your Little Wonders

The Neonatal Intensive Care Unit or NICU ('nick-you') is a specially designed nursery that helps babies who need a little extra help getting a good start in life. Although it looks scary, it is a place full of love, support, and encouragement.

We know that this is not the beginning you wished for your baby. Allow yourself to grieve the loss of your anticipated birth experience, and take comfort in how much help is available to you and your baby.

 

 

Little Wonders
This section on "Little Wonders..." was submitted by Cathy Norman, proud mother of Andrew (left) and Anthony (right), NICU graduates

 

It is hard to see him/her on a warming table or in an isolette hooked up with wires and tubes to machines and monitors, but all the equipment has a purpose. The NICU nurses are happy to explain what everything does. Feel free to ask questions and raise any concerns you may have with your baby's doctors and nurses. Keep asking until you understand the answers.

 

You may not feel needed with all of your baby's caregivers. However, you are very important to his/her recovery. You are your baby's only parents, and your love and encouragement are irreplaceable.

 

You may think that you will want to forget this difficult time. However, one day you will marvel at the progress your baby has made, so take pictures and keep mementos such as a tiny diaper.

Sometimes it helps to talk to another parent who has been through a similar situation. Ask the social worker for help in finding someone to share with.

 

The information in this parents’ guide is designed to help you with the care of your baby while he/she is in the NICU. Don't hesitate to ask all the questions you wish.

 

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Your Baby's Doctor, Nurses, & Other Care givers

Doctors, Nurses, & Caregivers Your baby's doctor in the NICU will be a neonatologist or pediatrician.  The neonatologist is specially trained in the care of premature and sick newborns. Your infant's pediatrician may also provide his/her care while in the NICU. The nurses in the NICU are also specially trained and have many years of experience in caring for babies like yours.

 

Other caregivers that might be involved in your baby's care include:

bullet Respiratory Therapist (breathing/lungs) bullet Physical Therapist
(body movement/strength)
bullet Speech Therapist (feeding) bullet Ophthalmologist (eye)
bullet Audiologist (hearing) bullet Pediatric Cardiologist (heart)
bullet Social Worker (assistance)

 

The social worker will visit and meet with you routinely. He/she will arrange for any special meetings so you can discuss the care of your baby, arrange for infant CPR training, offer assistance with financial help, as well as be your resource for anything you might need.

Please be sure to let the staff know if you have questions or concerns.

 

You will know your baby better than anyone, so trust your instincts and let the staff know what you need to make you feel comfortable.

 

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Visiting Your Baby

 

You and your baby both need bonding time with one another. When you come in to visit, you will scrub your hands and arms, put on a gown in the outer room, and then come in to be with your baby.

 

We encourage your involvement in your baby's care. We understand that you may feel left out, uncomfortable, or that your baby doesn't need you. However, there are many things you can do right from the start, even if your baby is unable to be held. Ask the nurse how you can help comfort your baby. You can cuddle him/her in your hands; he/she recognizes your touch and voice. You can gently rub his/her mouth with a swab or pacifier.

 

As your baby's condition improves, you can help with diaper changes, take his/her temperature, hold him/her, and provide feedings. The nurse will let you know when this time comes, and will also help you begin kangaroo care (skin-to-skin holding with your infant). You play an important role in caring for your baby!

 

Parents can visit any time, day or night, except during nursing shift reports (ask your baby's nurse for the times in which these occur). During each visit, you should plan to stay at least one hour, so you can be involved in the care of your baby. If you need transportation or a place to stay so that you can visit often, please let your baby's nurse or social worker know right away; assistance may be available. When you cannot be with your baby as often as you would like, feel free to call the NICU any time to follow your baby's progress.

 

Grandparents may visit as allowed by parents. These visits should be prearranged with your baby's nurse. Sometimes, it may be necessary for the nurse to cancel or postpone visiting times. Remember that if this happens, the nurse is doing what is best for all of the babies in the NICU.

 

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Your Baby's Environment

 

Your baby's environment The earlier a baby is born, the less he/she is able to sort out noises and other stimulus (stressors) around him/her. A premature baby is not able to "screen" things in his/her environment; for example, a dripping faucet or a pen being tapped. Because of this, we try to decrease any stimulation that we can. During rest times, noise is kept down as much as possible, although the alarms are unavoidable. We discourage loud conversations. Too much stimulation can cause signs of stress, such as yawning, frowning, sneezing, coughing, hiccups, tongue thrusting, irritability, lethargy, change in heart rate or breathing rate, or a change in color. We encourage you to talk softly to your baby, bring in tapes of you reading a story or singing a lullaby, and bring in small family pictures to place in your baby's bed.

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Your Baby's Nutrition

 

To start, your baby will probably receive his/her nutrition from an IV/IA (intravenous/intraarterial line). When your baby is able to begin feedings, breast milk or formula is usually given through a tube passed through the mouth and down into the stomach. Your baby might also receive vitamin and mineral supplements or extra “fats” to ensure growth.

 

Once your baby is strong enough to suck and swallow, breast or nipple feedings will begin. If you wish to breastfeed, you may provide pumped breastmilk. Please ask for information on pumping and storing breastmilk. If you do not plan to breastfeed, your baby’s doctor will pick a formula best suited for him/her.

 

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Your Baby’s Breathing

 

Premature babies or babies who have been under stress have problems breathing. There are different ways to give your baby extra oxygen or to assist your baby’s breathing. Signs that your baby might need help are flaring nostrils, grunting sounds, and fast breathing and/or retracting (skin pulling in between the ribs). To help your baby’s lungs mature, he/she might receive a drug called Survanta to help lubricate the lungs and make breathing easier. Your Baby's Breathing

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Your Baby’s Extended Stay



Your Baby's Extended Stay
Depending on your baby’s condition, he/she may experience a long stay in the NICU. Stays can range from a few days to one or two months. Regardless of the length of stay, the NICU staff and your baby’s doctor are preparing for discharge soon after admission.

 

There are many things that you will need to learn to care for your baby during this time. This may include monitoring your baby’s breathing, evaluating your baby’s nutritional needs, and learning infant CPR. It is very important for you and any other persons who will be caring for your baby to learn CPR. Your baby’s social worker will be in touch with you so that you can register for the next available class. If you are interested in any reading materials to learn about your baby’s condition, inform your baby’s nurse or social worker. Baby's Extended Stay

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Your Baby is Ready to Go Home!

 

Before your baby is discharged from the NICU, you will need to prepare for the arrival home. Remember to have a car seat ready and brought to the NICU on the day of discharge. You will also want to consider the weather on discharge day and bring appropriate clothing for your baby.

 

The staff will have instructed you on any specific care your baby will require. In most cases, home health visits will be arranged to check on your baby’s progress. In addition to the periodic reports the neonatologist has given to your baby’s pediatrician or family doctor during your baby’s stay, the neonatologist will also inform the doctor when discharge will occur and discuss any follow-up care needed.

 

Most importantly, remember that your baby will not be discharged until he/she is medically ready to go home. Bringing your baby home may seem terrifying. However, the staff will help you make discharge day a joyful event instead of a frightening one.

 

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Glossary of NICU Terms

 

Antibiotics - Medicines used to treat infection.

 

Apnea - Short periods of time when the baby stops breathing. Sometimes when babies have apnea, they need extra oxygen and stimulation.

 

BAER (“Bear”) Exam - A hearing exam performed on all babies in the NICU prior to discharge.

 

Bagging - Providing the infant with artificial breaths using an ambu bag.

 

Betamethasone - A steriod given to the mother by injection prior to delivery to help mature the baby’s lungs by causing the production of Surfactant.

 

Bilirubin - A product formed by the breakdown of red blood cells. Bilirubin can be deposited in a baby’s skin causing jaundice (yellow color of the skin).

 

Blood Transfusions - Special blood given intravenously when the baby is very sick with anemia.

 

Bradycardia - A slowing of the heart rate.

 

Chemstrip - A blood test done to determine your baby’s blood sugar level.

 

Chest Therapy - A respiratory treatment utilizing vibration and a gentle tapping of the chest to help clean mucous in the lungs.

 

CPAP (Continuous Positive Airway Pressure) - The application of air pressure to keep the lungs expanded. CPAP assists the baby’s breathing and can be done through an endotracheal tube or the nose (nasal CPAP).

 

Echocardiogram - An ultrasound of the heart done to check the heart structures and direction of blood flow.

 

Electrolytes - Various salt and mineral substances in the blood (potassium, sodium, and calcium).

 

ETT (Endotrachael Tube) - A breathing tube that is passed through the baby’s mouth into the windpipe. The ETT is attached to a ventilator or breathing machine.

 

Full-Term - A baby whose gestational age is between 37-41 weeks.

 

Gestational Age - The baby’s age calculated from the day of conception to the date of delivery.

 

Head Ultrasound - Premature babies less than 34 weeks gestation will have a series of head ultrasounds to image the brain and to check for bleeding in the brain.

 

Heelstick - The method of obtaining a blood sample by pricking the baby’s heel.

 

Hgb (Hemoglobin) - The particle in the blood that carries iron and oxygen. If your baby’s Hgb is low (anemia), your baby’s doctor may order a blood transfusion.

 

IV (Intravenous) - A very small tube or needle inserted into a vein to provide fluids and/or nutrients to the baby.

 

IVH (Intraventricular Hemorrhage) - Bleeding in the brain caused by prematurity. There is an increased risk of IVH the more premature the baby. IVH is detected by a head ultrasound.

Jaundice - A yellow color of the baby’s skin caused by bilirubin. If your baby becomes too jaundiced, he/she will be placed under special lights (phototherapy).

 

Kangaroo Care - Skin-to-skin holding with the parent(s) and their baby.

 

LGA (Large for Gestational Age) - The baby weighs more than the 90th percentile for age.

 

Meconium - A dark green material present in the baby’s intestines at birth. Meconium is baby’s first stools.

 

Monitor - A machine used to observe and record the heart rate/rhythm and respiratory rate.

 

Neonate - A newborn infant.

 

Neonatologist - A doctor who is specially trained in the care of premature and sick newborns.

 

Newborn Screening - Required by state law in all newborns. A sample of blood is sent to the Michigan Department of Public Health to test for 7 common inherited disorders in infants.

 

OG (Oral Gastric/Gavage Tube) - A small tube passed through the baby’s mouth and into the stomach to feed breastmilk or formula or to check the stomach contents and to release air from the stomach.

 

OJ Tube (Oral jejunum tube) - A small tube passed through the baby’s mouth, then into the stomach, and into the intestines to feed breastmilk or formula.

 

Peripheral Arterial Line (Art Line) - A special IV placed in an artery in the baby’s wrist or foot. This line allows the NICU staff to draw blood for laboratory tests and ABGs.

 

Phototherapy - Used in treatment of jaundice. Florescent lights are placed over the baby or a bili blanket is used to help break down the bilirubin through the skin.

 

Pneumothorax - A condition in which air escapes from the baby’s lung(s) into the chest cavity and flattens the lung(s).

 

Premature - An infant who is born before 37 weeks of gestational age.

 

Radiant Warmer - An open bed with a warmer light above. A warmer is usually the first bed your baby will be in.

 

RDS (Respiratory Distress Syndrome) - A lung disorder often seen in premature babies in which there is a tendency for the tiny air sacs in the lungs to collapse because of the absence of surfactant.

 

Respirator (Ventilator) - A machine that, when hooked up to the endotracheal tube, breathes for the baby or assists with breathing. Babies can be on two different kinds of ventilators, conventional and high frequency (oscillator).

 

ROP (Retinopathy of Prematurity) - A complication of prematurity and oxygen therapy that effects the retina of the eye. If your baby is born less than 34 weeks gestation and requires oxygen, he/she will need an eye exam by an ophthalmologist (eye specialist) at 6 weeks of age.

 

SGA (Small for Gestational Age) - The baby weighs less than the 10th percential for age.

 

Sibling - Brother or sister of the baby.

 

Suctioning - A method used to suck mucous out of the mouth or lungs so that breathing is easier for the baby.

 

Survanta - A drug given through the ETT tube and into the lungs to help mature the lungs and to make breathing easier. Survanta is made up of surfactant, which is a fatty substance in the lungs that helps to keep the lungs expanded. Premature babies do not produce sufactant; therefore, their lungs are immature. This condition is known as Respiratory Distress Syndrome (RDS).

 

TPN (Total Parenteral Nutrition) - Intravenous nutrition consisting of protein, carbohydrate, fat, vitamins, and minerals.

 

UAC (Umbilical Artery Catheter) - A very small tube inserted into the umbilical artery (belly button) to provide fluids and/or nutrients to the baby. A UAC allows the NICU staff to draw blood from the baby for laboratory tests.

 

UVC (Umbilical Venous Catheter) - A very small tube inserted into the umbilical vein (belly button) to provide fluids and/or nutrients to the baby.