When Your Baby's in the NICU
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:
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:
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 they'll 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. You might come to know them very well and rely on them for information and reassurances about your baby.
The nurses you might interact with include a:
Other people who may help care for your baby include:
Questions to Ask the Neonatologist or the Nurses
To better help you help your baby during a stay in intensive care, it's wise to get as much information as possible about what to expect. If you have questions, talk to the neonatologist or the nurses.
The nurses see your baby every day, so they can give you frequent updates on your little one. The plan of care for your infant is discussed on "rounds" every day. Nurses can help you to understand the diagnosis and treatment plan, but it's also helpful to discuss these issues with other members of the medical team including:
All of these health professionals are involved in determining the best plan of care for your baby.
You might want to ask the neonatologist and other doctors and/or the nurses:
You may also want to talk to the nurses in more detail about your baby's daily care and what to expect when you spend time with your little one. You should also learn the visiting schedule and any rules of the NICU so you'll know which family members can see the baby and when they can visit.
Questions to Ask the Social Worker
You might want to ask the social worker:
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. The nurses can explain what all of the monitors, tubes, tests, and machines do, which will go a long way toward demystifying the NICU.
Here's a brief look at what some of the unfamiliar equipment does and how it may help your baby, depending on your little one's condition and diagnosis:
Bonding With Your Baby in the NICU
All the machines may seem overwhelming, but don't let them keep you from interacting with your baby. Bonding with a baby in the NICU is as important as bonding with any newborn, sometimes even more so. You simply have to learn the best way to do it.
Parents can visit and spend time with their NICU babies. The number of people who can visit a baby in the NICU may be limited, but parents are usually allowed to stay most of the day (except when the medical team performs its daily examination and evaluation). Ask the NICU's social worker about what accommodations are available for parents — cots, recliners, or nearby housing such as through the Ronald McDonald House Charities.
Other family members can visit only during specified hours and only a few at a time. And siblings may not be allowed in the NICU because children have a greater risk of introducing an infection. Check with the hospital staff about which family members can see your baby.
Depending on how sick your child is, you might be able to hold your little one even if he or she is on a ventilator or has an IV. If the doctors feel that would be too much for your baby, you can still hold his or her hand, stroke his or her head, and talk and sing to him or her. A gentle, consistent touch will be the most reassuring.
But for some very premature infants, touching is extremely stressful (if they were still in the womb, they would have little tactile stimulation). In these cases, doctors may suggest that you minimize physical contact but still spend as much time as possible with your baby. Check with the doctor or nurses to figure out how much and what type of contact is best.
A mother who can hold her baby might be able to breastfeed or pump milk and bottle-feed. Most NICUs have screens to allow mothers to breastfeed their babies at the bedside.
Kangaroo care (or skin-to-skin contact) is another option to help you forge a bond with your new baby. Here's how it works:
Doctors and researchers have suggested that skin-to-skin contact can improve babies' recovery time and help them leave the NICU sooner.
But the best way for parents to help their babies in the NICU is to be there for them and learn to read their behaviors. This will help you to figure out:
Although you want to interact with your infant, you also want to allow periods of undisturbed sleep. Let your baby set the pace for your time together and you'll both get more out of it.
Other NICU Basics
Here are some basics to help make the NICU a little less mysterious:
Everyone who comes into the NICU must wash their hands when they enter. (There will be a sink and antibacterial soap in the room and near the entrance of the NICU.) This is a crucial part of keeping the NICU environment as clean as possible so the babies won't be exposed to infections. Some units require visitors to wear hospital gowns, particularly if a child is in isolation. You may also need to wear gloves and a mask.
Ask the nurses what you're allowed to bring into the unit — the risk of infection limits what you can leave with your baby. Some parents tape pictures to the isolette or decorate the incubator. If you want to give your child a stuffed toy, the staff may wrap it in plastic first.
When you're in the NICU, keep noise and bright lights to a minimum. Try not to bang things on the isolette or infant warmer, talk in a loud voice, or slam doors. If you're concerned about light, ask a nurse if you can drape a blanket partially over the isolette. Most important, let your baby sleep when he or she needs to.
Making the NICU Stay More Manageable
The time when your baby is in the NICU can be stressful — you may be away from your friends and family, including any other children you may have. Your life may seem like it's been turned upside down as you wait for the day when your baby may be able to leave with you.
You may feel like you eat, sleep, and breathe the NICU 24 hours a day, 7 days a week. And you might feel especially confused and overwhelmed if your baby was unexpectedly born prematurely and/or if the NICU is located far away from your home and your usual support system.
As hard as it may be sometimes, it's important to pay attention to your own needs and those of the rest of the family, particularly other kids. Make plans for a weekly family activity, and sit down together and talk about how this experience makes you feel. Doing something for yourself can be as simple as taking a relaxing bath, going for a walk, or reading a favorite book for an hour.
You also can turn to other parents in the NICU for comfort. They'll likely know better than anyone what you're feeling. Also be sure to talk to the NICU's social worker about parents' support groups, where you can share your feelings, worries, and triumphs together. The hospital's chaplain also might be able to provide you with support and even a shoulder to cry on.
When you take care of yourself, you'll be more rested and better prepared to take care of your baby. But that care doesn't have to center on your infant's illness. Enjoy your new baby, spend time together, and get to know your little one.
Your baby's NICU stay can be difficult, but also rewarding as you watch your little one grow and progress day after day.
Reviewed by: Jay S. Greenspan, MD