The World of Neonatal Intensive Care: What to Expect in the NICU

If there is anything you can count on in pregnancy, it’s surprises. You’re met with symptoms you weren’t expecting, you develop weird skin rashes or food aversions, your birth plan goes out the window when baby decides to come early …the list goes on. Despite all of your best planning, eating the right diet, and following your doctor’s recommendations, sometimes your baby and your body might just have their own plan.

If that plan includes arriving a few weeks early or having some health complications at birth, there is a good chance your little one will get whisked straight to the hospital’s neonatal intensive care unit, or NICU. But this isn’t a cause for worry, the professionals in the NICU are the experts when it comes to complications for little ones, and they will ensure your baby gets the best care possible. Here are a few things to know about the NICU that can help you get acquainted.

What Level am I?

While “NICU” is often known as the generic term for young babies who need extra help, there are actually four different levels of specialty care within a NICU.

  • Level 1 provides basic newborn care for babies born close to full term.
  • Level 2 nurseries care for babies born greater than 32 weeks gestation and may provide things like assisted ventilation.
  • Levels 3 and 4 are for the sickest babies and provide the highest level of neonatal specialty care. This includes open-heart surgeries, advanced ventilation, and other imaging capabilities beyond x-rays. Some may also provide extracorporeal membrane oxygenation (ECMO) through a machine that takes blood from the body, pumps oxygen into it using an artificial lung, and then pumps it back in using an artificial heart. ECMO machines are used for babies who are very sick and rely on this oxygenated blood to survive. Other respiratory equipment in different level nurseries might include nasal cannulas, which are small tubes to provide a little extra oxygen through the baby’s nose, or a ventilator, which uses a tube that goes into the baby’s airway through their throat.

Who is on the NICU staff?

A team of experts cares for all babies in the NICU. The main players in the NICU are neonatologists — pediatricians with special training for newborn babies, and nurses who have special expertise in this area. In addition, there are also respiratory therapists who manage some of the special equipment, provide breathing treatments, and keep an eye on blood gasses to make sure that your baby is making progress to breathing on his or her own.

Premature babies may also need special help from physical or occupational therapists to learn to eat well and position themselves for optimal growth and development. While in the NICU, you are also likely to see lactation consultants who work with moms on proper breastfeeding technique, especially for premature babies.

Other staff members may include pharmacists who prepare special medications for NICU babies or counselors and chaplains who are available to talk with families who are worried about their new baby.

Transitioning Home

After only visiting your baby within the confines of the NICU for a few days or weeks, it’s natural to be thrilled about the prospect of bringing the whole family home. But, if your baby has been receiving expert care around the clock, you may feel anxious about caring for your little one at home without NICU staff over your shoulder.

You can have some peace of mind in knowing that the NICU staff will only let the baby go home once certain milestones are met and they feel confident baby is ready. For example, your baby will need to be able to maintain his or her own temperature outside of an incubator, be able to take all feedings by mouth, be able to breathe on room air, and have a successful newborn screening test done. Once these are all achieved, and you are given the green light from the NICU team, you can feel confident your baby is ready to begin life with you at home.

If you are facing a high-risk pregnancy, such as one that could lead to prematurity, you and your obstetric healthcare provider may be able to co-manage your perinatal care with help from the dedicated MFM specialists at Arizona’s Valley Perinatal Services. You or your physician may call us at 480-756-6000 or fill out our online contact form for more information.