Patient education: What to expect in the NICU (The Basics)

What is the NICU? — "NICU" is short for "neonatal intensive care unit." It is a part of the hospital where doctors and nurses take care of babies who are sick or who were born too early.

The NICU is sometimes called the special care nursery, intensive care nursery, or newborn intensive care unit. ("Neonatal" means newborn.)

Why might my baby need to go to the NICU? — Your baby might need to go to the NICU if they:

●Are born sick or premature (3 or more weeks before the due date)

●Have problems during birth, such as infection or trouble breathing

●Show health problems within a few days of being born, such as jaundice (when the skin or white part of the eyes turn yellow) or problems with the heart, lungs, or intestines

Who takes care of my baby in the NICU? — The doctors and nurses in the NICU are specially trained to take care of sick and premature newborns. The NICU staff might include:

●Neonatologist – This is the doctor in charge. Neonatologists are trained in caring for newborn babies.

●Nurses – There will be 1 or more nurses assigned to take care of your baby.

●Respiratory therapist – This person's job is to give treatments that help with babies' breathing.

●Nutritionist – This person is specially trained to take care of newborns' feeding needs.

●Specialists – These are doctors who are trained to treat problems with certain parts of the body, like the brain or heart.

What happens in the NICU? — Lots of different things happen in the NICU. First, your baby is placed in a special bed, such as:

●Incubator or "isolette" – This is a bed that is surrounded by clear plastic to help keep your baby safe and warm.

●Warmer – This is an open bed with an overhead heater.

Some of the things that usually happen in the NICU include:

●Monitoring – The doctors and nurses carefully monitor, or watch, each baby. You might see wires connecting your baby to a screen (similar to a TV screen). These wires are attached to the skin with stickers and are not painful for the baby. The screen keeps track of the baby's vital signs. Vital signs include temperature, heart rate, breathing rate, and blood pressure.

●Tests – The NICU doctors and nurses will probably do tests to make sure that they are giving your baby the best care. These might include blood tests, urine tests, or X-rays.

●Medicines – Most babies in the NICU need to take 1 or more medicines. These can include antibiotics (to fight infection) or medicines to help their heart or lungs work. Your baby might have an "IV" (a thin tube placed in a vein) to make it easier for the doctors and nurses to give medicine.

●Other treatments – Depending on the reason why your baby is in the NICU, they might need other treatments, too. Babies with jaundice are put under a special light. Babies who have trouble breathing might be attached to a ventilator, which is a machine to help them breathe.

Can I visit my baby in the NICU? — Yes. You can and should spend time with your baby if they are in the NICU.

●Holding the baby – In some cases, you will be able to hold your baby. This can help you bond with and comfort your baby. The doctor or nurse might suggest that you try "skin-to-skin" contact. This is when you hold your baby on your bare chest while they are wearing only a diaper (and sometimes a hat).

It might not be possible to hold your baby if they are very sick or were born very early. But you might still be able to hold your baby's hand or stroke their head. Even if you cannot touch your baby at all, you can still talk or sing to them. The NICU doctors and nurses can help you figure out what kind of touch is safe for your baby.

●Visitors – Other family members can usually visit your baby in the NICU, too. But there might be rules about when they can visit, and what they need to do. For example, they might need to wash their hands or wear special hospital gowns or masks. Children might not be allowed to visit, since they are more likely to carry germs that could hurt a very small or sick newborn.

How does my baby eat in the NICU? — It depends on how sick your baby is or how premature they are. Your baby might be able to breastfeed, or drink breast milk or formula from a bottle.

In some cases, the baby might need a feeding tube. A feeding tube is a small tube that goes into the baby's mouth or nose, down their throat, and into their stomach. The tube can deliver breast milk or formula right into the baby's stomach. For babies who are too sick to be fed even through a feeding tube, nutrition is given through an IV.

If you want to breastfeed your baby, talk to the NICU doctors and nurses. There are also breastfeeding experts called "lactation consultants" who can help. If your baby is not able to suck from the breast, you can try using a breast pump. A breast pump is a device that pumps milk from the breasts. The milk can then be fed to the baby from a bottle or through a feeding tube. If your baby can't yet have milk, your breast milk can be stored to feed to your baby later.

When can I bring my baby home? — It depends on your baby's condition. For some health problems, a baby only needs to stay in the NICU for a few days. Babies who are very sick or premature might need to stay for weeks or even months.

Your baby's doctors and nurses will work with you to help you understand how your baby is doing and when they might be able to go home. You will also get instructions on how to take care of your baby at home, and what kinds of follow-up appointments your baby will need.

How can I get support while my baby is in the NICU? — Having your baby in the NICU can be hard and stressful. Social workers and hospital chaplains (spiritual counselors) can provide support during this difficult time.

There are also support groups for parents of sick or premature babies. It can be helpful to talk to other people who are going through the same things. Try to get help from these sources and from relatives and friends. That way, you will have support both in the hospital and at home.

More on this topic

Patient education: Deciding to breastfeed (The Basics)
Patient education: Pumping and storing breast milk (The Basics)
Patient education: Jaundice in babies (The Basics)
Patient education: Labor and childbirth (The Basics)
Patient education: When a baby is born premature (The Basics)
Patient education: When your baby is measuring small during pregnancy (The Basics)
Patient education: Having twins (The Basics)
Patient education: Enteral (tube) feeding (The Basics)
Patient education: How to care for a G tube or G button (The Basics)

Patient education: Deciding to breastfeed (Beyond the Basics)
Patient education: Pumping breast milk (Beyond the Basics)
Patient education: Jaundice in newborn infants (Beyond the Basics)