How much time can I spend in the NICU?
We encourage parents, legal guardians, grandparents and significant others to be at the bedside at any time and as much as possible. There is a reclining chair at the bedside for one parent to stay overnight, if desired.
Can my children visit our baby in the NICU?
Siblings must be at least 3 years of age and toilet trained to visit. Any child under the age of 14 entering the Family Waiting Room must be screened by hospital staff at the reception desk in the waiting room. If you think it will be a positive experience, siblings may be at the bedside.
Can we have other visitors in the NICU?
To keep noise, lighting and other outside stimuli to a minimum (which are critical to your infant's proper development), you should limit the number of people who visit at one time. Please be aware of the sound level detector in the ceiling of the unit, which flashes red when the noise level is too high. It is important to make sure that no one who visits the baby is sick. This includes anyone with a runny nose, cough, cold, fever, sore throat, or diarrhea. They should not visit until they feel better. Even a simple cold can cause major problems for a baby.
Can we talk in the NICU?
Your premature baby is not yet ready for the normal stimuli experienced outside the womb. Therefore, it is important to keep noise and other stimuli to a minimum in the NICU to help your baby grow and develop properly. To keep noise and stimuli to a minimum, you should limit the number of people who visit at one time and speak in soft voices. There is also a sound level detector in the ceiling of the unit, which flashes red when the noise level is too high.
Can I breastfeed my baby?
Breast milk is recommended to be the best source of nutrition for your baby. In addition to nutrients, breast milk provides your baby with antibodies and other substances to help fight infection. Premature babies often initially have difficulty with bottle or breastfeeding because unlike full-term babies, they are unable to coordinate their sucking, swallowing and breathing efforts. Until the baby can coordinate this, he will be tube fed. As a rule, feedings by mouth (or oral feedings) are not started until the baby reaches 32 to 33 weeks gestation. This is the age at which we know babies suck their thumbs in the womb.
Can I hold my baby?
Touching and providing developmental support for your baby can help strengthen his or her development. Babies have different skills at different ages and the process of gaining new skills is called development. Developmental care means providing experiences that are right for the baby's age. By giving your baby nurturing experiences, you can strengthen his development. Your baby's age will determine what types of nurturing are most effective and they will change with time. In the most premature and sickest babies, touching your baby can actually be quite stressful. Your nurse will let you know how to provide developmentally supportive care to your baby, when it is okay to touch and hold your baby and how.
Is a baby on a ventilator in pain?
Some babies on ventilators show no signs of pain or agitation. Some preemies don't like the ventilator at all - they gag, become agitated, or fight it. These babies do get medication for pain and agitation to help them relax and ensure that every breath is as effective as possible.
If my baby gets too much pain medication, can he or she become addicted?
Some babies that have been on pain medicines for a long time (more than five to seven days) will need to be weaned slowly from them. Taking them away too quickly can be uncomfortable for your baby. This does not mean that your baby is addicted to the medicine - his body has just gotten used to them. Babies who have been on high doses of pain or sedation medicine for more than a week or two receive enough medicine to cause withdrawal. Behaviors of withdrawal include increased fussiness, crying, jitteriness and frantic movements. Doctors will wean babies from the medicines slowly, watching for signs of discomfort. Other non-medication ways of controlling pain will also be introduced. It is important to remember that providing medication to help control a baby's pain helps boost his recovery from illness.
What is meant by corrected age?
If your baby was born prematurely, it is sometimes better to use his corrected age (the age he would be if he had been born on his due date) than his chronological age (how long it has been since he was actually born). When thinking about developmental progress, we expect a premature baby to act like he should for his corrected age. However, if your baby was born at the expected time or near your due date, then you do not need to correct his age. The corrected age of a baby is based on the expected date of birth. A baby, as a rule, develops in the mother's uterus for 40 weeks before being born. This 40-week time is referred to as the term date or due date. If your baby was born prematurely, add the number of weeks since he was born to his age at delivery to find his corrected age. For example, if your baby was delivered four weeks ago at 28 weeks gestation, his corrected age is 4 + 28, or 32 weeks.
Why does my baby not act like a full-term baby?
Premature babies do not act or respond to stimuli in the same way that full-term babies do. Premature babies will respond in different ways to different sounds, cannot see as well and may open their eyes for only brief periods and have weak flexor tone muscle, meaning they tend to straighten out their legs and arms and are unable to bring them close to their bodies on their own.
Will the treatment in the NICU have long-lasting emotional effects on my baby?
Research indicates that there are no long-term emotional effects of the medical care provided in the NICU. Premature or sick babies can grow up to be just as emotionally normal as babies that are born healthy.
Why do I feel depressed and feel like I have no energy?
Sadness and depression are common reactions to having a sick or premature baby. Everyone dreams of giving birth to a healthy, full-term baby. Not having this dream come true is a natural cause of sadness. Even taking a healthy baby home is a source of stress. Parents who are sad because some of the complications that have happened during pregnancy or birth are having very normal feelings. Sadness and depression may become excessive, however. If feelings of depression become troublesome, it would be wise to ask the medical staff for help.
Could I have postpartum depression?
Postpartum depression can occur in the first six weeks or several months after a birth. Postpartum depression tends to get worse if it is not treated. It is very important to talk to your doctor if you have symptoms. Women with postpartum depression can experience:
- Feelings of hopelessness
- Changes in eating or sleeping habits
- Loss of sex drive
- Poor concentration or memory
- Loss of interest in activities
- Feelings of guilt
- Mental fogginess
- Severe irritability
- Extreme mood changes
- Feelings of inadequacy (or not being able to do what one should)
- Fears that are irrational (the fears seem real but aren't very likely to happen)
How can I involve my family in my baby's care?
Brothers, sisters and grandparents can sometimes feel left out of the NICU experience. Your children especially may resent the amount of time you have had to spend at the hospital and how much attention the new baby requires at home. This resentment is normal. It is important to give your other children time with you and the opportunity to express their feelings about the baby. The baby's condition will determine how much brothers and sisters can do, but the more you can include them in the new baby's care the sooner they will adjust to his presence.
Grandparents may have strong reactions to having a grandchild in the NICU. Not only are they worrying about the baby but also about you, their own child. They also may have outdated information about the care of NICU babies, which can be a source of conflict. In fact, even well-baby care has changed a great deal since they had children. It will help to reduce conflict and worry if you talk with them honestly. Remember that grandparents can be a valuable source of help and are usually willing to do anything they can. There are many ways your parents can help you and it will make them feel good to be needed.
Do all the beeps and buzzers going off mean my baby is in trouble?
Your baby may seem to be lost in a maze of wires and tubes. Their purpose is to help the nurses watch your baby's vital functions such as heart rate, breathing and body temperature. The NICU is set up so your baby can be observed 24 hours a day. Alarms may sound when it is time for your nurse to make an adjustment to your baby's equipment. It does not necessarily mean your baby is in danger.
How experienced are the nurses?
Nurses and other health care professionals who work in the NICU have also received specialized training to ensure your baby receives the safest and highest quality of care possible. Our neonatologists work closely with your child's team of doctors, nurses and other health care specialists to ensure a safe and coordinated plan of care. The NICU multidisciplinary team conducts rounds every morning to discuss each patient's case in detail. Since we are a teaching hospital, your child may be under the care of a medical student, resident or a physician extender (nurse practitioner or physician assistant). However, your child is under the direct supervision of the neonatologist at all times, night and day.
When will my baby be ready to go home?
The following are basic guidelines for discharge of your baby. Your baby is ready to go home when her or she:
- Shows a steady weight gain by taking the right amount of breastfeeding or formula.
- Is able to maintain body temperature in an open crib at room temperature with clothing and a blanket.
- Has had the routine newborn tests completed.
- Is free of any apneic/bradycardic episodes or have self-resolved episodes which are not life-threatening and with which the caregiver is comfortable. Home apnea monitoring will be considered if the baby is having current episodes of apnea/bradycardia. This monitor is often called an A/B monitor.
- Can be cared for by parents and other caregivers.