Welcome to the world of parenting. Here you can learn about your newborn’s development week by week and get ideas about toys and activities to share with your new baby. We have advice on the best way to keep your baby safe , as well as tried and tested tips for soothing a fussy baby
The premature baby - What to expect in the NICU
Premature births can occur at the edge of viability at 23 to 24 weeks gestation or at 36 weeks gestation.
The implications for parents at these two extremes are radically different. For example, in many hospitals, babies born beyond 34 weeks gestation are treated much like full-term infants and are not admitted to a neonatal intensive care unit (NICU). On the other hand, all babies born very early spend weeks or months in the NICU and are always seriously ill.
Preemie drinking breastmilk from a bottle
At the time of a premature birth, parents will notice a team of specialists in neonatal resuscitation ready to take care of their baby. The baby will be placed on a warmer, dried, and quickly assessed for adequacy of breathing and heart rate. Depending upon the baby’s size, the baby will be placed inside a special kind of plastic bag up to the neck to keep him warm. Since many premature babies need help establishing breathing, the resuscitation team may use a mask to provide pressurized air and oxygen. For especially small babies, the team may decide to place a tube into the baby’s trachea (windpipe) to help breathing and to give a medication called Surfactant directly into the tube. The surfactant helps the lungs to open more easily. Once the baby is stable, parents should have a chance to see the baby before he is placed in a transport incubator for a trip to the NICU.
Once in the NICU, nurses will place the baby in an incubator or an open warmer and do a thorough assessment of the baby. They will work with the baby’s doctor and other staff members to make plans for the baby’s immediate care. Once again, depending upon the baby’s status, plastic tubes called ‘catheters’ may need to be placed in the blood vessels of the umbilicus and x-rays taken to ensure that the catheters are properly placed. The catheters are used to provide intravenous fluids and medicines and to remove blood for laboratory sampling. Alternatively, for larger premature babies, intravenous fluids may be given through a vein in the hand, arm, or leg.
The processes described above usually take an hour or two. When completed, parents should be able to come to the NICU to be with their baby and to learn about the baby’s condition from the staff. At first sight, the environment can be confusing and, at times, overwhelming. Some NICUs consist of rooms containing several babies and can be filled with staff members and be quite noisy. In other units, babies may be in single rooms or in a room with one other baby.
The baby will likely be in an incubator, and except for a diaper, will be naked. He will have adhesive discs placed on the chest and abdomen from which wires will go to monitoring equipment that provides information about heart rate and breathing. Other monitoring equipment may be used to determine the baby’s oxygen status and blood pressure.
Babies with breathing problems may have a tube in the mouth that goes to the trachea (called an endotracheal tube) and is attached to a ventilator, a device that provides breaths. Instead of an endotracheal tube, some babies with breathing problems may have a device in both nostrils called nasal prongs to provide pressure to the lungs so that the lungs don’t collapse. This treatment is called CPAP. Finally, as babies recover from more serious breathing problems, they may receive extra oxygen by way of a nasal cannula, a tube with small prongs that fit into each nostril.
The nurse having primary responsibility for the baby will meet with the parents to identify and explain the surroundings, the various people providing care for their baby and the equipment being used. The nurse will also provide information about NICU policies concerning visiting for parents, siblings, relatives, and friends. Usually, parents will also be given printed information that describes the unit and its policies.
Please share you story of your experience in the NICU in the comment section below.
This article is an extract from our book: Caring for your newborn - How to enjoy the first 60 days as a new mom
 (312x440)_New.jpg)
By Dr Robert Dillard - Dr Dillard is the Professor of Pediatrics at the Wake Forest University School of Medicine. He is the Medical Director of the Neonatal Intensive Care Unit at the Sara Lee Center for Women’s Health at Forsyth Medical Center.
Preemie drinking breastmilk from a bottle
What to expect in the neonatal intensive care unit (NICU)
If there is time before the birth of a premature baby, it’s especially helpful for parents to receive a visit from a staff member of the NICU who can describe the process of care after delivery and the baby’s early stay in the NICU. The mother’s obstetrician or nurse can arrange such a visit.At the time of a premature birth, parents will notice a team of specialists in neonatal resuscitation ready to take care of their baby. The baby will be placed on a warmer, dried, and quickly assessed for adequacy of breathing and heart rate. Depending upon the baby’s size, the baby will be placed inside a special kind of plastic bag up to the neck to keep him warm. Since many premature babies need help establishing breathing, the resuscitation team may use a mask to provide pressurized air and oxygen. For especially small babies, the team may decide to place a tube into the baby’s trachea (windpipe) to help breathing and to give a medication called Surfactant directly into the tube. The surfactant helps the lungs to open more easily. Once the baby is stable, parents should have a chance to see the baby before he is placed in a transport incubator for a trip to the NICU.
Once in the NICU, nurses will place the baby in an incubator or an open warmer and do a thorough assessment of the baby. They will work with the baby’s doctor and other staff members to make plans for the baby’s immediate care. Once again, depending upon the baby’s status, plastic tubes called ‘catheters’ may need to be placed in the blood vessels of the umbilicus and x-rays taken to ensure that the catheters are properly placed. The catheters are used to provide intravenous fluids and medicines and to remove blood for laboratory sampling. Alternatively, for larger premature babies, intravenous fluids may be given through a vein in the hand, arm, or leg.
The processes described above usually take an hour or two. When completed, parents should be able to come to the NICU to be with their baby and to learn about the baby’s condition from the staff. At first sight, the environment can be confusing and, at times, overwhelming. Some NICUs consist of rooms containing several babies and can be filled with staff members and be quite noisy. In other units, babies may be in single rooms or in a room with one other baby.
The baby will likely be in an incubator, and except for a diaper, will be naked. He will have adhesive discs placed on the chest and abdomen from which wires will go to monitoring equipment that provides information about heart rate and breathing. Other monitoring equipment may be used to determine the baby’s oxygen status and blood pressure.
Babies with breathing problems may have a tube in the mouth that goes to the trachea (called an endotracheal tube) and is attached to a ventilator, a device that provides breaths. Instead of an endotracheal tube, some babies with breathing problems may have a device in both nostrils called nasal prongs to provide pressure to the lungs so that the lungs don’t collapse. This treatment is called CPAP. Finally, as babies recover from more serious breathing problems, they may receive extra oxygen by way of a nasal cannula, a tube with small prongs that fit into each nostril.
The nurse having primary responsibility for the baby will meet with the parents to identify and explain the surroundings, the various people providing care for their baby and the equipment being used. The nurse will also provide information about NICU policies concerning visiting for parents, siblings, relatives, and friends. Usually, parents will also be given printed information that describes the unit and its policies.
Please share you story of your experience in the NICU in the comment section below.
This article is an extract from our book: Caring for your newborn - How to enjoy the first 60 days as a new mom
By Dr Robert Dillard - Dr Dillard is the Professor of Pediatrics at the Wake Forest University School of Medicine. He is the Medical Director of the Neonatal Intensive Care Unit at the Sara Lee Center for Women’s Health at Forsyth Medical Center.
You may also be interested in...
- The premature baby - Bonding in the NICU
- Developing an attachment with a baby who appears (and often is) fragile and who is attached to wires and tubes and living in an incubator can be difficult for parents.
- more
- The premature baby - Caring for your baby in the NICU
- A seemingly endless list of healthcare professionals is involved in providing newborn intensive care.
- more
- The premature baby - Coming home
- Premature infants are ready to come home when they can maintain their temperature outside an incubator, feed well and experience good growth, and be free of periods of not breathing for a week or so.
- more
- The premature baby - NICU staff explained
- A seemingly endless list of healthcare professionals is involved in providing newborn intensive care.
- more
Comments
Search:
