Events during my pregnancy have made it more likely that I will give birth prematurely, according to my obstetrician. She has told me that should this happen, the baby may need to stay in the neonatal intensive care unit for at least a few days. All I know about the N.I.C.U. is that it is a place where the “baby incubators” are, so I can’t help but be scared for what lies ahead. Can you tell me a bit more about what a N.I.C.U. is and what goes on there?
My best wishes to you and your family during what must be an uncertain time; you are not alone in your situation. Approximately 12 percent of births in the United States are premature deliveries, occurring before the 36th week of pregnancy, so I’m happy to help shed some light on the purpose of a neonatal intensive care unit, and what generally merits treatment in one.
To start, not all babies born early will necessarily need to stay in a neonatal intensive care unit. A preterm newborn usually receives treatment in the unit if he or she weighs less than 2,000 grams (4.4 pounds) at birth, is at risk of infection, has respiratory issues, a congenital heart defect, or other conditions that require constant monitoring and medical treatment. They are staffed by neonatologists, who are specialists in caring for high-risk newborns, and nurses with training in neonatology.
Medical devices in an unit are designed specifically for newborn infants. Incubators allow neonatologists to replicate the conditions in the womb, and have soundproofing that reduces noise to the levels a baby experiences in a mother’s uterus. Specially designed pillow-like devices are used to hold babies in the in-utero position. Ventilators, which assist newborns who have underdeveloped lungs with breathing, also warm and humidify the air before it enters the baby’s body. For a baby with especially weak lungs, neonatal intensive care units have devices that can maintain the circulation of oxygen throughout the baby’s body until his or her lungs grow stronger.
Over the past decade, family-centered care has become crucial to any neonatal intensive care unit, because the stress that parents experience during the time that their newborn is in a neonatal intensive care unit can be considerable. In many neonatal intensive care units, parents are welcome to visit 24 hours per day, seven days per week, and can count on the presence of a physician or nurse who can answer any questions they have. Parents are also encouraged to listen and ask questions about their baby during daily bedside rounds, during which the attending physicians examine the babies, often with a team that includes resident physicians, medical students, nurse practitioners, and nurses.
Whether or not your baby will ultimately need to stay in a neonatal intensive care unit, take heart: advances in medicine and neonatology are increasing the chances that high-risk births will have good outcomes, and help to ensure that both newborns and parents have the best chance of leaving the hospital strong and healthy.
