What Happens in NICU

Why Your Baby is in NICU

Babies are admitted to NICU for a variety of reasons that include:

• Premature birth
• Respiratory difficulties
• Infection
• Low blood sugar
• Jaundice
• Birth defects

What to Expect in NICU

When your baby is born, initial resuscitation is complete and your baby is stable, we can then assess whether or not your baby needs special care in the NICU. Because of the urgent nature of care needed, we don’t usually allow anyone but parents in the room at this time.

Initially, while your baby is in the warmer, a cardio-respiratory monitor (CRM) will give us a continuous reading of your baby’s heart and breathing rates. It will also tell us about your baby’s blood pressure and blood oxygen levels.

Most NICU babies who need extra oxygen are placed in round, plastic oxygen hoods where the amount of oxygen can be adjusted.

Additional breathing support is helped by a Nasal CPAP which also helps keep airways and lung sacs open.

Ventilators (breathing machines) provide increased oxygen pressure for babies having a difficult time breathing on their own. A throat tube is necessary for a ventilator.

Early tests in the NICU include:

• Complete Blood Count (CBC) measures white and red blood cells
• Blood Sugar or Blood Glucose
• Blood Gas tests help us determine the level of help your baby needs with breathing
• X-rays help us evaluate lungs, heart, bowel gas and bones

Apgar Scoring

To set a basis for comparison, the Apgar Scoring System is used to assess a NICU baby’s condition and response to resuscitation at one and five minutes after birth. Scores are zero to ten (ten is the highest score — seven is considered normal). Premature babies often score low because they have low muscle tone and a weak cry. Apgar scores are given in different categories such as:

• General condition
• Heart rate
• Breathing
• Muscle tone
• Reflexes

At-risk Babies at Birth

Many women know in advance of birth that their baby might have a difficult time. Tracking your baby’s development and lab tests could reveal that your baby will, most likely, be premature. Or perhaps tests indicate that your baby might be sick. If you know your baby could be at risk at birth, please be sure you know what to expect. Talk with your healthcare team which should include a neonatologist / pediatrician, a neonatal nurse and perhaps, a respiratory therapist.

Should advance estimates prove true and your baby needs NICU care, your baby will be brought to NICU and placed in a warming bed.

Warming bed first steps:

• Clean and dry your baby
• Clear airways by suction
• Administer oxygen, if necessary
• Assist breathing with an ambu-bag, ET tube (endo-tracheal tube) and additional measures when necessary

Special Medical Concerns

Because each baby is unique, your NICU team will prepare a set of concerns with recommended care. Please help us by asking questions and keep asking until you understand. It’s often a good idea to appoint a family member or close friend to be the one person who updates other family members and friends about your baby’s condition. We want all your energies focused on your recovery from delivery, time spent with your baby, and staying close with your baby’s NICU healthcare team.

Your baby’s head NICU nurse will keep you informed of developments. Talk to the NICU nurse and your neonatologist.