ISM ORIGINAL WORK  •  MAY 2020

NICU OVERVIEW
JOANN GEORGE // MENTORED BY DR. RASHMIN SAVANI

TABLE OF INTRODUCTION
CONTENTS WHAT IS A PREMATURE BIRTH?
WHAT TO EXPECT IN THE
A normal pregnancy lasts 40 weeks. A
NICU
- 1 premature birth is considered to be one where
the baby is born before the 37th week. The last
NICU STAFF few weeks of a pregnancy are very important,
- 2 since during those weeks, a baby completes
development of vital organs and gains the
COMMON EQUIPMENT weight needed to survive. Without this
- 3 complete development, premature infants may
have many medical issues, resulting in
INTERACTING WITH YOUR admission to the Neonatal Intensive Care Unit
BABY
(NICU), which is a specialized unit that provides
- 7
intensive care to sick babies after birth.
THE NICU
WHAT CAN I EXPECT IN THE NICU?

The NICU can definitely be

overwhelming for new parents.
With long commutes to and from
the hospital, many sleepless nights,
and uncertainty over your baby’s
condition, the elements of the NICU
can add to that stress. Educating
yourself about the various pieces
of equipment and the medical
jargon that is used will help you
understand what is being provided
for your baby. The staff in the
NICU can help you familiarize
yourself with what you’re going to
experience, and can decrease
stress and anxiety.
NICU STAFF
WHO WILL TAKE CARE OF MY BABY
IN THE NICU?
The NICU team consists of highly qualified
medical and nursing professionals who work
with an entire team to take care of you and
your baby, ensuring that you get the best
care possible:
Neonatologist: The attending physician in
the NICU. This is the doctor who directs the
overall care of your baby.
Neonatal Fellow: A pediatrician receiving
additional training to become a
Neonatologist.
Pediatric Resident: A medical student
training to become a Pediatrician.
Neonatal Nurse Practitioner: Nurse with
extra training in care of babies in intensive
care. These NNPs can prescribe
medications and perform procedures that
your baby might need, such as placing
long IVs.
Respiratory Therapist: Provides
respiratory support, helps with breathing &
oxygen machines.
Physical, Occupational, Speech
Therapists: Make sure that your baby is
developing well physically, and helps your
baby learn to eat by mouth when ready.
Dietician: Makes sure baby is getting
enough nutrients, tracks intake of
nutrients, including calories, balance of
carbohydrates, proteins and fats, vitamins
and minerals. Also ensures that baby is
growing well.
Lactation Consultant: Assists with
optimizing breastfeeding - pumping,
maintaining milk supply, and
starting/continuing breastfeeding
Social Worker & Child Life Specialist:
Work with you and your family to address
any non-medical concerns you may have,
as well as provide information, support,
and comfort
Religious Advisors: Works to provide any
religious needs or spiritual support you
may require while in the NICU
Visit this website for additional information:
https://www.marchofdimes.org/complication
s/nicu-staff.aspx#
COMMON EQUIPMENT
WHAT KINDS OF EQUIPMENT WILL MY BABY BE ON?

Seeing the various pieces of equipment your baby is on can be overwhelming, especially
if you aren’t familiar with what they are being used for. Here is a list of a few of the
most commonly used pieces of equipment in the NICU, as well as their purpose:

Ventilators: These machines help your baby breathe better by providing oxygen and
breaths. A plastic tube is run usually through the mouth and into the windpipe to
connect your baby to the ventilator. There are three common types of ventilators
used in the NICU. Conventional Ventilators are the usual type of ventilators used in
the NICU. They provide breaths and can delivery oxygen and other gases to the baby
to help them exchange air better. In addition, there are specialized ventilators that are
called High Frequency Ventilators. High Frequency Jet Ventilators (HFJVs) utilize jet
pulsations to bypass airway disruptions, such as leaks in the airway. High Frequency
Oscillatory Ventilators (HFOVs) deliver smaller volumes of air to your baby at a faster
rate. These ventilators are the most precise available, with microprocessors allowing
for greater control of ventilation. Should your baby need a ventilator, the
neonatologist will decide which ventilator is best for your baby.
Incubators: These are plastic boxes with controls for temperature and humidity to
keep your baby comfortable and warm.

VENTILATOR & INCUBATOR

Phototherapy: Phototherapy is used to
treat jaundice by using special blue
lights that break down the excess
amount of bilirubin in your baby’s
body. This excess bilirubin is what
causes jaundice. Your baby won’t feel
any pain under the lamp, but he or she
may have a mild rash.
Feeding tubes: Your baby may need to
have a feeding tube if he or she can’t
swallow or breastfeed yet. Feeding
tubes go from the mouth or nose to the
stomach and provide the nutrition your
baby needs with either formula or
breastmilk. These tubes allow the
healthcare team to provide extra
nutrition and medications that may be PHOTOTHERAPY
needed to keep your baby healthy and
allow for growth and maturation. 
IVs: Almost all babies in the NICU have
IVs. These are small tubes that run into
the veins, providing medicine or fluids
as needed by the baby. These tubes
are usually connected to your baby’s
hands/arms, but can also be attached
to the scalp, legs or feet. 
PICC Lines (Percutaneously Inserted
Central Catheter Lines): If your baby
needs more fluids or medicines and for
a longer time than what the IV can
provide, then a central line is inserted
that goes into a large vein in the chest
or abdomen. These lines can be placed
either by the physicians, NNPs or FEEDING TUBE
sometimes by a surgeon.
Arterial Line: An arterial line is like an IV, but it is placed in an artery as opposed to a
vein and is used to monitor blood pressure and allow for blood samples to be
obtained without having to stick the baby with needles. There are two types of arterial
lines. The first, used in the first week of life, makes use of the blood vessels in the
umbilicus to insert tubes that can act both as a central venous line and an arterial
line.
CPAP (Continuous Positive Airway
Pressure): When your baby does
not need a ventilator, but needs
some pressure to keep the lungs
open, a device called CPAP is used.
Prongs fit into the nose of the baby
and the ventilator can provide
pressure at the nose to keep the
lungs open. The baby has to be able
to breathe on its own to use this
device.
Oxygen Hood and Nasal Cannula:
An oxygen hood placed over the
head can be used to give extra
oxygen to babies who may not
necessarily need a ventilator or
CPAP
CPAP. Alternatively, a nasal cannula
serves the same purpose, and is a
plastic tube that has small prongs
that fit into the nose.

OXYGEN HOOD

NASAL CANNULA
 Monitors: Your baby may be attached to many monitors that track heart rate, breaths
and oxygen levels. All these machines can be overwhelming at first, but it helps to know
the purpose of each.
Chest leads are small, painless stickers that attach to your baby’s chest. These
monitor heart rate and respiratory rate to ensure your baby’s heart rate is normal
and that he or she is able to breathe well
A pulse oximetry looks like a bandaid and is wrapped around a baby’s fingers or
toes. It emits a glowing red light and is used to track blood oxygen levels
Temperature probes are thin, coated wires that are usually stuck to your baby’s
body with a small patch or cover. These track your baby’s body temperature
Monitors often beep loudly and can be annoying and scary, adding to your stress. But the
reason they make so much noise is to get the nurses and doctors’ attention, and they have
to be loud enough to be heard, especially if your hospital’s NICU is large. You may also feel
as if your baby’s nurse is ignoring the noises the monitors make, but oftentimes, these
beeps are false alarms, and nurses are trained to know when there’s an actual issue. Rest
assured, these monitors are set to alert staff well before there’s a serious problem, so even
if they’re responding to a certain noise, it may not be critical.

TEMPERATURE PROBE, PICC LINE, PULSE OXIMETRY, CHEST

LEADS
INTERACTING WITH YOUR BABY
WHAT ABOUT VISITING?

It’s extremely important to visit your baby in the NICU and establish a bond. It may
seem difficult to bond with your baby when he or she is in the incubator but be sure
to talk to your nurses and doctors about the best way to touch and talk to your
baby. At first, all you may be able to do is stroke your baby’s skin, but as he or she
develops and improves, you’ll be able to assist with bathing and hold your baby as
well. Kangaroo care, or skin-to-skin contact, with your baby is also a great way to
establish a bond with your baby and improves the long-term outcome of babies
.
The best way to participate in your baby’s care is to visit as often as you can. You
are encouraged to coordinate visits around feeding, care and bathing times so that
you can take part in those activities. In time, your nurse will guide you through
diapering, feeding, taking temperature, and all the other aspects of caring for your
baby. Don’t hesitate to ask questions or discuss any concerns with your baby’s
doctor or nurse; they’re there to help you and your baby. 

Your baby can easily catch infections because their immune systems are weak. Be
sure to follow all procedures of hand-washing and sanitation when visiting your
baby or bringing toys. Be sure to inform your baby’s nurse if you’re experiencing
any symptoms that could be contagious (i.e. a runny nose, cough, sore throat), and
they’ll help you decide whether or not it’s safe for you to be spending time with
your baby. If you are sick, check with your baby’s nurse or doctor about when it’s
safe to continue visiting and taking care of your baby.
SOURCES

.
“NICU Staff.” March of Dimes, March of Dimes, July 2017,
www.marchofdimes.org/complications/nicu-staff.aspx#.
Trish. “NICU Alarms - What's with All the Noise?” Every Tiny Thing,
Every Tiny Thing, 19 Apr. 2013, www.everytinything.com/nicu-
articles/nicu-alarms.
“Visiting Your Baby in the NICU: MedlinePlus Medical Encyclopedia.”
MedlinePlus, U.S. National Library of Medicine, 9 Apr. 2020,
medlineplus.gov/ency/patientinstructions/000590.htm.
“Ways to Participate in Your Baby's Care in the NICU.” Orange
Regional Medical Center, 30 Mar. 2018,
www.ormc.org/blog/maternity/parenting-your-nicu-baby.
“The Neonatal Intensive Care Unit (NICU).” Stanford Children's Health
- Lucile Packard Children's Hospital Stanford,
www.stanfordchildrens.org/en/topic/default?id=the-neonatal-
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“The Neonatal Intensive Care Unit (NICU): What to Expect.” Raising
Children Network, 25 Mar. 2019,
raisingchildren.net.au/newborns/premature-babies/neonatal-
intensive-care/nicu-what-to-expect.
“When Your Baby's in the NICU (for Parents) - Nemours KidsHealth.”
Edited by Mary L. Gavin, KidsHealth, The Nemours Foundation, Jan.
2019, kidshealth.org/en/parents/nicu-caring.html.
Donn, S M. “Neonatal Ventilators: How Do They Differ?” Nature News,
Nature Publishing Group, 28 Apr. 2009,
www.nature.com/articles/jp200923.
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www.healthline.com/health/pregnancy/premature-infant.