Life in the NICU: What you need to know

When you’ve spent months looking forward to meeting your little one, all you want to do is hold your baby in your arms. So when your little bundle is admitted to the NICU, it can feel like you’re living a heart-wrenching nightmare.  

Most of the fear that moms feel around the NICU stems from the unknown – not knowing what’s happening, what to expect, and what this kind of start means for your baby and your family. So, let’s erase some of the unknown with a glimpse into what life in the NICU can look like.

Why was your baby admitted? 

Did you know that it’s not just premature babies that are admitted to the NICU? Any infant that requires specialized care is admitted to the NICU for additional observation and treatment.

What are some of the most common reasons a baby might be admitted to the NICU? 

• Neonatal Respiratory Distress Syndrome (NRDS). This syndrome is most common in premature infants born six weeks or more before their due date, and is when your infant experiences rapid, shallow breaths and sharp pulling of the chest.
• Prematurity. The most known reason for NICU admittance, prematurity, occurs anytime an infant is born less than 37 weeks into pregnancy.
• Sepsis or infection. This is caused by an infection in your baby’s blood and can get quite severe if not treated, hence being admitted to the NICU to receive the best care possible.
• Hypoglycemia. Also known as low blood sugar. This occurs most often when the mother is diabetic and is experiencing high glucose levels. Signs of this include tachycardia, lethargy, poor feeding, seizures, or hypothermia.
• Congenital anomalies. More commonly known as birth defects, congenital anomalies are when your infant is born with heart defects, neural tube defects, syndromes, etc.  Spending time in the NICU is the best way to help a baby with defects thrive and grow.
• Maternal chorioamnionitis. This is a common complication of pregnancy that can result in postpartum infections and sepsis, premature birth, neonatal sepsis, chronic lung disease, etc. Early diagnosis of this can prevent many effects of it, and treatment in the NICU is far more advanced than what can be done in the delivery room alone.
• Surgical intervention. Any time your new arrival (or you) need some sort of medical intervention by surgery, it can quickly lead to some time in the NICU. This is to ensure that both of you receive the best care possible to get on the mend quickly.

Levels of NICUs

Most people typically assume that every NICU is the same and offers the same level of care, but there are actually 4 different types of NICUs that vary based on the capabilities and care that they can offer.

Level I: The first level of NICU offers your most basic care. This level is for full term or almost full term little ones, and works to stabilize them for the transition home.

Level II: This level is the advanced care NICU. This is the perfect place for little ones born at or after 32 weeks (but before they reach full term), who may be recovering from more severe concerns.

Level III: Specialized Care. This level of NICU is for little ones born before 32 weeks or those suffering from critical illnesses. These NICUs are able to offer specialized equipment and medical professionals to give struggling little ones their best chance.

Level IV: Highest Level of Care. For very serious cases, this NICU has a full range of specialists and equipment to ensure critical-condition babies have the absolute highest level of care. 

Terms to know

When you’ve been moved to the NICU, everything can seem overwhelming and scary, especially if you’re struggling to learn all of the new language. Here’s a brief course in what you’ll likely hear the most.

Staff

Neonatal Nurses. Neonatal nurses are a subspecialty of nurses that are trained and educated to work with newborns who were born with varying problems like prematurity, birth defects, infection, etc. They are specialized to work with those in the first month of life, but extend their care for several months after when necessary.

Neonatologists. A neonatologist is a subspecialty of pediatric doctors that is trained and educated to work with newborns born premature or with defects, infections, etc. You typically only find neonatologists in NICUs.

Pulmonologists. Pulmonologists are doctors who focus on the health of the respiratory system. They work with newborns who have trouble breathing, have respiratory system defects or insufficiencies, or suffer from respiratory issues like asthma.

Gastroenterologists. Gastroenterologists are doctors with a heavy focus on the gastrointestinal tract and liver. You will see a gastroenterologist if your newborn has issues or health concerns regarding the esophagus, stomach, small intestine, colon, pancreas, liver, etc.

Treatments + equipment

Radiant warmers and incubators. These are used to maintain the body temperature of your newborn. This helps expend the energy so that metabolic heat production is minimized. They’ll keep your infant in a womb-like warmth.

Cardiorespiratory monitor. This is a machine that will be used to check on your infant’s breathing and heart rate. It may also be called a CR monitor, an apnea monitor, or an apnea/bradycardia monitor around the NICU.

Pulse Oximeter. This is a small sensor that looks like a small bandage that can be wrapped around your newborn’s foot to measure breathing. It can also be called a Pulse Ox.

Continuous Positive Airway Pressure (CPAP). This is a type of respiratory ventilation that is used for newborn infants who are struggling with respiratory failure. It will deliver a stream of compressed air via a hose so that unobstructed breathing becomes possible.

Intravenous Line (IV). If your little one is too small or sick to take feedings, medications and fluids can be given through veins or arteries. The IV can be placed in the hand, foot or scalp, where the veins are most easily accessed. A bag that contains fluids is connected to the baby through an IV — necessary fluids are carefully delivered and monitored.

Orogastric and nasogastric tubes. These are used for decompression and feeding for newborns in the NICU. They are used as one of the most common nursing procedures and are important for the wellbeing and growth of a critically ill infant.  

Be gentle with yourself

When your little one is in the NICU, it can be so hard not to feel down, frustrated, or discouraged. But there’s always hope. Be gentle with yourself, try to remain positive, and use these ideas to make this tough time a little easier on you: 

• Be an active participant. As soon as you’re able and allowed, make an effort to be active in your little one’s care. Learning early on exactly what’s going on and how you can play a part can help you bond with your little one and feel like a mother. Plus, it’ll make you feel more confident once it’s time for baby to come home.
• Ask questions. Seriously, mama! If anything doesn’t make sense or you have any concerns, ask questions. You and your doctors are all on the same team and part of their job is to educate you and put you at ease.
• Bond with your staff. You’ll be spending a lot of time with the NICU staff, so building a relationship with them can make this time more enjoyable for you. Form a bond, ask questions, and enjoy their company — they can act as a pretty great support system in your time of need.
• Encourage visitors. Depending on your little one’s health and wellbeing, there will definitely be limits on who can visit and how many visitors you can have.  However, once you’re allowed to have visitors, make sure you’re encouraging people to come by in small doses. While you may be absolutely exhausted, the sight of familiar faces may raise your spirits almost immediately.
• Bring items from home. If your family is staying in the NICU, having some comforting items from your home will make everything seem a little more familiar. Grab some blankets, a pillow or two, even frames or books from your home to help make the NICU feel a little more like home.Be an active participant. As soon as you’re able and allowed, make an effort to be active in your little one’s care. Learning early on exactly what’s going on and where you can play a part can help you bond with your little one, feel like a mother and feel more confident once it’s time for baby to come home.

We know the NICU isn’t part of any parent’s plans, but try to remember that the NICU is the BEST place for you and your baby. And lastly, remember that you’re not alone. Reach out to other NICU moms — their support and immediate bond with you will be something you’ll cherish for years to come. And remember, we are ALWAYS here to support you, too!   

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