Caring For Your Baby in NICU by Dr Lathiesh Kumar Kambham

Generally, the following categories of babies need to stay in the NICU or the Neonatal Intensive Care Unit.

1. Premature Babies

Babies born before 37 weeks of gestational age are termed preterm or premature babies. Babies who are born early need a lot of care and are admitted to NICU so that they can be provided with all the necessary support.

2. Sick Babies

Some babies may be born full term but still need extra care due to underlying health conditions at birth such as respiratory distress, severe jaundice, infections etc. Such babies will need to spend some time in the NICU till they can get better.

3. Babies Born With Birth Defects

Babies born with certain birth or congenital defects such as heart issues, kidney issues or any other major disorders and need surgical intervention or medical support will spend a few days or months in the NICU till the condition stabilizes and they are ready to go home

If your newborn baby has any of the above conditions or health issues, it is quite likely that he will be kept at the NICU for some days for specialized and better treatment.

[Read : Understanding Birth Defects And Their Symptoms]

How Long Will My Baby Stay in NICU?

The length of the stay in the NICU depends on

• The severity of the issue the baby is facing.
• The condition of the baby.
• The type of support the baby needs (breathing support/surgical intervention etc).
• The speed at which the baby is able to recover.

Who Will Take Care of My Baby in NICU?

The neonatal staff who take care of your baby in the NICU comprise of

1. Neonatologists

These are expert pediatricians who specialize in critical conditions and care pertaining to a newborn baby both preterm and full-term. Fellows assist neonatologists in a learning process towards becoming experts themselves.

2. Junior Doctors

They provide round-the-clock support throughout your baby’s stay. They take instructions from the neonatologist or senior doctor and ensure that all the necessary treatments and medications are provided to your baby on time. Junior doctors usually work in shifts and maintain your baby’s charts and make decisions about your baby’s treatments in case of emergency when the experts are not available

3. Staff Nurses

Nurses play a vital role in maintaining your baby’s hygiene. They take care of your baby’s cleaning up, changing diapers, etc. They are also responsible for monitoring your baby’s vitals and ensuring that everything is fine.

Then there are lactation consultants who help new mothers with latching and breastfeeding support and help them provide the right feed at the right time to babies. Physiotherapists help babies with unique needs such as breathing difficulties or other physiological issues

What Are All Those Machines in the NICU?

To monitor your baby, your little sweetheart may be attached to various machines, it can be quite a scary thing, and many mothers have known to break down at such a sight. However, you should know that all these machines and tubes are only going to help your baby grow and be strong, so as to be able to go home with you.

Here are some machines you can commonly find in an NICU.

1. Ventilators for breathing support.
2. CPAP to help open up the lungs and maintain airways (less-invasive breathing support).
3. Glucometer to monitor baby’s blood glucose levels.
4. Incubators to regulate and maintain body temperature.
5. Radiant warmers to help maintain body temperatures for premature and low birth weight babies.
6. Infusion pumps to help inject the right amounts of nutrients and other infusions to help the baby recover quickly.
7. Pulse oximeter to monitor blood oxygen levels.

Bonding With the Baby in NICU

Bonding with the baby is very important but ICU has its limitations and safety measures that should be kept in mind while visiting. Doctors will allow the mothers to visit the baby in the NICU once the baby is stable. Fathers can have a limited number of visits once the doctor is satisfied with the baby’s progress.

The mother will be allowed to spend some time with the baby for multiple purposes.

1. To provide kangaroo care therapy or skin-to-skin touch which will allow the baby to grow and thrive better.
2. Nurse the baby if the doctor feels the baby is ready for it.
3. General bonding between mother and the baby, which will have a direct positive influence on the baby’s health.

Nursing the Baby in the NICU

Most NICU babies will be put on drip or tube feeds as they are still not in a condition to such milk from mothers. This is especially true for preemies whose sucking reflexes were not given enough time to mature within the mother’s womb.

For most NICU babies, the mothers will be asked to provide expressed milk, which the trained hospital staff will feed to the baby in specific quantities as per doctor’s recommendations.

In some cases, as the baby gains some strength, the mother may be instructed to breastfeed the baby. In such a case, the nurses will assist in nursing your baby in the NICU. Some NICUs also have dedicated feeding areas for mothers who are breastfeeding.

[Read : Spoon Feeding a Newborn]

Can I Touch My Baby in NICU?

Depending upon the severity of the illness, you will be allowed to hold the baby. If the newborn has an IV or is on a ventilator, you will be allowed only to touch the baby’s hand or stroke her/his head. But a consistent gentle touch is also very assuring for the baby.

In the case of very delicate premature babies, touching is not allowed as they are extremely vulnerable to catching infections. Doctors advise parents to have minimal physical contact with their premature babies. You can ask the staff or doctor to tell you what type and how much contact is safe.

Once your baby is ready for physical touch, the doctor will ask you to give kangaroo therapy to your munchkin and spend some time with them.

Kangaroo Care in NICU

Kangaroo care or skin-to-skin touch is a proven therapy that has many benefits for the baby. The bonding time with the mother increases and regulates the body temperature of the baby which results in increased body weight. As the baby lays on the mother’s bare chest, the baby’s heartbeat along with the body temperature get regularized. Bonding time is important for the baby to thrive well under the extreme circumstances he/she is in. This is also a form of therapy for the mother who may be worried about the wellness of her baby.

In cases where the mother cannot provide kangaroo therapy due to illness, any other family member such as the father or the grandparents can also provide this skin-to-skin touch therapy to the newborn.

[Read : Kangaroo Mother Care For Newborn Babies]

NICU Basic Guidelines

While in ICU you need to learn certain important etiquette and follow it. Here are a few basics to help you learn ICU basics.

• Wash your hands every time you enter the ICU. Use a medicated antibacterial soap to clean your hands before you step into ICU. This is vital to minimize the baby’s exposure to infections and microorganisms. You may need to sanitize from time to time.
• Visitors’ gowns, gloves, and masks are provided at the door of the ICU, wear them before you enter the ICU.
• Anyone suffering from cough, cold or any type of fever or infection should strictly stay away from ICU.
• Those interacting with the baby should remove any jewellery to minimize contamination and chances of injury.
• While in the ICU, minimize the bright lights and noise as this disturbs the baby.
• Photography may not be allowed as flashes can be disturbing to the baby and disturb the treating doctors.
• Avoid talking loudly.
• Be compassionate towards other babies too. Make sure you do not disturb other babies in ICU.
• Do not touch ICU machines or other equipment unless the staff nurse asks you.

Coping With Your Stay in NICU

Your stay in the hospital, while your baby is being treated, is very stressful. A myriad of thoughts keeps flashing in your mind and you feel apprehensive every now and then. Your life has turned topsy-turvy and you eagerly wait for the day when the little joy bundle will be given back to you smiling at your face.

Follow the following tips:

• Pay attention to your health and look after your needs too. Keep yourself composed and calm.
• Talk to other parents whose babies are in ICU. Such interactions will give you comfort, and you will feel better.
• You can share your feelings and worries with them.
• Do spend time with a counsellor if your hospital has the facility.
• Plan about what you want to do when your baby is with you. You can shop for the baby or plan how you will decorate the baby’s room.
• Do not panic if your baby is in the ICU. Be positive as he/she is getting the right treatment and soon you will have your baby in your arms.

Though having your baby in NICU can be disturbing for parents, please be assured that there are many parents going through the same. Caring for your baby in the NICU has become a lot easier thanks to all the advances in medical sciences and compassionate doctors and staff. The fact that your baby is in the safe hands of an expert neonatal team should ease your worries. Help your baby by staying positive and being cooperative.

FAQ’s

1. How Much Does a Baby Have to Weigh to Leave the NICU?

Different hospitals may have different guidelines according to multiple factors including the baby’s health condition. But in most cases, the baby is allowed to leave the NICU once it reaches 2 kg weight.

2. Where Do Parents Stay When the Baby is in NICU?

Some hospitals may allow the mother to stay in the room they booked for giving birth. Others may offer special rooms for the mother for the length of the baby’s ICU stay. If the baby is staying in the NICU for longer months, the hospital may advise the parents to go home and come back during set visiting hours. It all depends on a case-to-case basis.

3. How Often Should I Pump While Baby is in NICU?

In most cases, mothers will be asked to express breast milk so that babies can be given through different ways such as tube feed. Depending on your baby’s health and intake, you may need to express once every couple of hours during the day and 2 to 3 times at night if you are in the hospital. If you are staying far away from the hospital during your baby’s NICU stay, the lactation consultant may advise you on the number of feeds required and how many times you would need to express.

4. Why Do Preemies Grunt so Much?

Preemies have an immature body as they did not have enough time to grow and mature in their mother’s womb. Due to weak abdominal muscles, they may produce a grunting noise when passing gas or stool. But as they grow, preemie babies will figure out how to manage silently without grunting.

Read Also: Taking Your Premature Baby Home