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Caring For Your Baby

NICU Education

Specialty care for your baby's needs.

Staff What to expect Tests Equipment Kangaroo Care Feeding Ready to go? Home care

Welcome to the NICU

When your baby is in the neonatal intensive care unit, called the NICU, it’s normal to feel overwhelmed. It may help to know that the NICU is a place where everyone is caring for the health of your baby.

It's hard when your baby’s delivery does not go as planned. Know that your baby’s care team is well prepared and specially trained to care for your baby’s needs. Our team is here to support you and your baby. 

Learning About the Staff in the NICU

Your baby’s care team is made up of specially trained caregivers. Their job is to give your baby the best care possible.

A neonatologist is a doctor who specializes in the treatment of newborns. They direct your baby's care.

A neonatal advanced practitioner is a caregiver with advanced training in the care of newborns. They may be called physician assistants or nurse practitioners.

Specialists are doctors who focus on certain areas of medicine. For example, your baby's doctor may get help from a cardiologist for treating a heart problem.

Nurses care for your baby at all times. They are specially trained to watch over your baby. The nurses are also your teachers. As your baby gets stronger, they'll teach you how to be involved in your baby’s care.

Lactation consultants are available to assist you with any pumping and breastfeeding questions or concerns. If you would like to have a visit from a lactation consultant, ask a member of your baby’s care team.

Respiratory therapists help support your baby’s breathing.

Technicians operate some of the equipment in the NICU. This may include equipment used for certain tests.

The pharmacist prepares your baby's medicines.

Occupational therapists and physical therapists help with your baby’s motion, positioning, strength, and development. For some babies, occupational therapists may help test if your baby can safely ride in a car seat.

Speech therapists help make sure your baby is safe during feedings. They make recommendations for special equipment and testing to help with feeding if your baby needs it.

The social worker is your guide to resources including emotional support, special equipment or services, and discharge planning when your baby is ready to go home.

A chaplain is available to help give emotional and spiritual support.

The NICU clerk greets you as you enter the NICU. They will help to keep your baby safe and will help you prepare to enter the NICU.

Patient Care Techs help hold, feed, and bathe your baby. They also check your baby’s blood pressure, heart rate, and breathing rate.

What can you expect?

Your baby will always be in good hands. The care team members may change often, but they will always get updated on your baby and be prepared to care for their needs.

The care team will meet daily to make a care plan during a session called rounds. There is no set time or schedule for each baby, but your baby will be seen during rounds every day. You are encouraged and welcome to participate in rounds.

  • The NICU must be as clean as possible to help prevent infections. You will be expected to wash your hands and clean your phone each time you enter the NICU.
  • Start by taking off any jewelry or watches. They should not be worn in the NICU.
  • To clean your phone: Use the special wipes and directions given by the NICU Clerk.
  • Clean your hands and forearms up to the elbows by following the special steps given by the NICU Clerk.
  • Be healthy: free from fever, cough, colds, nausea, vomiting, diarrhea, or any open sores.
  • You may want to bring in items to celebrate your baby. Don’t bring in balloons, flowers, or stuffed animals. These items are considered unsafe in the NICU.
  • Keep personal items off the floor. Car seats will need to be stored on the floor. Ask the NICU clerk for a plastic bag to put it in to keep it clean.
  • Covered drinks are safe to have in your baby’s room, but we strongly encourage eating food outside of the unit. The Ronald McDonald Rooms in the NICU are a good place to eat meals and snacks.

What is March of Dimes?

Find out more about our NICU Family Support Program and download the Compass app at marchofdimes.org/compassbymarchofdimes.

Learning About Tests in the NICU

What tests might your child have?

It may seem that your baby is getting lots of tests. All these tests help your doctor keep track of your baby's condition and give the best treatment possible. Some tests are done only once. Others may be done more often to give the doctor up-to-the-minute information. Imaging and blood tests are two of the most common types of tests done in the NICU. Which tests your baby gets will depend on your baby's condition.

Small blood samples may be taken from a quick prick of your baby's heel. Bigger samples may come from a blood vessel. The list below is a sample of the more common blood tests.

This tests the blood cells. It shows if your baby has enough blood cells. It also tells the doctor how much of the oxygen-carrying substance (hemoglobin) is in the blood. A CBC can also show if your baby has an infection.

This test measures how much oxygen and carbon dioxide (CO2) are being carried in the blood. It tells the doctor how well the lungs are supplying the body with oxygen. The doctor may do this test several times a day when a ventilator or CPAP is being used.

This test measures the amount of sugar in the blood. Premature or ill babies sometimes have problems with their blood sugar levels.

This test checks for a substance in blood that can make the skin and eyes look yellow (jaundice).

This tests for over 40 health problems that affect how the body works. Early testing and treatment of these health problems can prevent long-term problems for your baby.

Imaging

Imaging tests give pictures of parts of the body. Here are some common imaging tests:

This test shows the condition of the heart and lungs. It helps the doctor manage the treatment of breathing problems.

This test uses sound waves to find bleeding in the brain.

This type of ultrasound shows how the heart and the valves in the heart are working.

Learning About Equipment in the NICU

What equipment is used in the NICU?

It can be scary to see your baby in a room filled with unfamiliar machines. Some of them are noisy. But all of them help the doctor and the NICU staff take good care of your baby.

The incubator, or isolette, is a special crib that keeps your baby warm. It also serves as a barrier to drafts and germs.

A ventilator is a machine that breathes for your baby while the lungs are growing or healing. It sends oxygen or air into the lungs through a thin tube. The tube is placed in the mouth.

A continuous positive airway pressure (CPAP) machine may be used when a ventilator isn't needed. It gently pushes oxygen or air into the lungs through a mask over the baby's nose. The baby can breathe on his or her own with this extra help.

A nasal cannula or a high flow nasal cannula is a thin tube with two prongs that are placed in the nostrils when the baby just needs more oxygen. The oxygen goes through the openings in the prongs and into the baby's nostrils. 

A medicine pump is a machine that delivers exactly the right amounts of medicines at the right times through an IV site, central line, or umbilical venous catheter.

An intravenous (IV) site gives access to a vein. It may be placed in the back of the hand, foot, arm, leg, or scalp. One end of a tube is attached to the site. The other end may be attached to a medicine pump. It can also be used to take samples of blood for testing.

A PICC (peripheral inserted central catheter), or central line, is a long, thin tube that can be placed in an IV site. It is threaded through a vein until it reaches a larger vein near the heart. It can stay in place longer than an IV and can deliver fluids or medicines quickly if needed.

An umbilical catheter or arterial catheter is a thin, flexible tube. It's inserted into a blood vessel in the belly button (umbilicus). The tube may be attached to a medicine pump.

An inflatable cuff on the arm or leg takes the baby's blood pressure.

A temperature probe attached to the baby's skin keeps track of your baby's temperature. It can be used to adjust the heat in the isolette or an overhead heater.

The heart monitor has a sensor attached to the chest. It tracks breathing and heart rate.

A pulse oximeter wraps around the baby's hand or foot. It measures how much oxygen is in the blood.

Our camera gives you the ability to watch your baby when you are not here. Your baby will have a unique username and password, so you have control over who can see your baby. We try to keep the camera on as much as possible, but they are turned off any time a care team member is directly caring for your baby.

You don't have to remember what each piece of equipment does. The care team will answer your questions and tell you how these tools are helping your baby.

Learning about Kangaroo Care in the NICU

Kangaroo care is a special way to hold your baby by holding the baby skin-to-skin on your chest. Your baby is placed directly on your bare chest while wearing only a diaper. You then cover your baby’s back with a blanket or your own clothing. This creates a snuggly pouch for your baby like how a kangaroo mom holds her baby in her pouch.

Mother holding her newborn at bathroom

Moms and dads can do kangaroo care. In fact, anyone can hold an infant this way. You can start in the hospital and keep doing it when you are home.

Check with the care team about when and how to hold your baby. Depending on your child's condition, you may need to wait. But skin-to-skin holding can be good for babies who are sick or underweight. Even if your baby is attached to feeding and breathing machines, you may be able to do kangaroo care.

The care team knows that you want to hold your baby as soon as possible. They will help make this happen and decide when your baby is ready. Our goal is to help you hold your baby as soon as possible.

Kangaroo care is one of the best ways you can help your baby grow stronger and healthier while in the NICU. It can be helpful for parents by increasing milk flow for breast feeding parents and decreasing stress.

Tips for Kangaroo Care
  • Wear a shirt or blouse that opens in the front.
  • If you wear a bra, it can be helpful to remove it.
  • Relax and enjoy this bonding experience with your baby.

Learn About Feeding your Baby in the NICU

Sick and very premature infants may need help with feeding. They may be too weak or small to suck on a breast or bottle. Maybe their bodies aren't ready to digest breast milk or formula. This can be frustrating and scary for parents. Taking care of your baby is something you want and expect to do. The care team will involve you in your baby's care as much as possible. Know that your baby is getting the nourishment he or she needs to grow.

Ask if you can feed your baby or be present for feedings. If you can’t feed your baby, ask if you can hold your baby or hold their hand or foot while they are feeding. Touch can help you bond.

Your breastmilk is like medicine for your baby and every drop counts. After your baby is delivered:

  • Start pumping right away to help your milk increase. The staff will show you how to use an electric pump and they will show you how and where to store pumped milk.
  • Pump 8 to 10 times every day including overnight.
  • When pumping, pump for at least 15 minutes on each side
  • When your milk comes in, pump until your milk flow slows to drops and then continue for 5 minutes.
  • Hand expressing with pumping tells your body to make more milk for your baby.

Yes, one time each day you will need to sterilize the pieces of your kit that touch your breast or your breast milk:

After you pump and clean the kit pieces with soap and water, you will sterilize the kit pieces by doing 1 of the below:

  • Use the “sterilization bag” or
  • Boil the kit pieces in water for 20 minutes or
  • Place the kit pieces on the top rack of your dishwasher and use the sanitizing cycle

The Milk Bank specializes in preparing and handling your breast milk, donated human milk, and specialty formulas. Your baby’s doctor may recommend using donated human milk for your baby. Donor human milk is screened to make sure it is safe for your baby and supports their growth.

If you choose to feed your baby with formula, the NICU can make specialty formulas to meet your baby’s needs. Your baby’s doctor will recommend an appropriate formula for your baby. Talk to your baby’s doctor if you have any questions about your baby’s feeding plan or formula.

Stored breast milk is the next best thing to fresh breast milk as a complete and nutritious food source for your baby. When your baby is in the NICU, storing your breastmilk will be different than at home. Milk should be refrigerated within an hour if not being used right away. Use this chart as a guide for storing your milk while your baby is in the NICU:

How Will You Know When Your Baby is Ready to Go Home?

Your baby’s care team will make sure that your baby is ready to go home. And they'll help you get the support you need.

The care team will know that your baby is ready to go home when:

  • Your baby keeps gaining weight and can feed by breast or bottle.
  • Your baby's body temperature stays normal in an open infant bed.
  • Your baby's heart rate and breathing rate stay normal long enough for the care team to feel confident they are safe to go home.

The care team will make sure that you know everything you need to know to safely go home.

Before you and your baby go home, you'll meet with a member of the care team. You'll discuss a medical care plan. The plan will include checkups, specialist care, and ongoing tests. This is a great time to ask any questions you may have. 

Learning About Caring for Your Baby at Home

Your baby may have extra medical concerns, but his or her basic needs are the same as those of any newborn baby. You can use your Care of You and Your Baby book for information on how to provide basic care like bathing, diapering, safe sleep and more.

Remember, storing breast milk for your baby at home will be different than while they were in the NICU. Follow this chart to learn how to store your breast milk safely after your baby comes home.

The change from being a parent in the NICU to being a parent at home can be stressful. It's helpful to be open and honest and to talk about your daily challenges as well as your joys. Sometimes the best support comes from people who are facing the same things that you are. Consider joining a support group to talk to other parents. Remember that your baby’s doctor is just a phone call away if you have questions or a problem.

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