When your baby is in the NICU: A survival guide for parents
Having your baby in the NICU can be very overwhelming for parents. This article gives you plenty of information on what happens in a hospital's NICU, who takes care of babies there and importantly, how you can prepare yourself and cope with the experience...
Having a baby and taking him home is something all mums and dads look forward to, whether they are first time parents or not.
So it can be really frightening and overwhelming for parents if they need to leave their newborn in the NICU (Neonatal Intensive Care Unit) instead.
But it doesn’t have to be this scary if you understand the NICU and what happens in there — which is what you will learn in this article.
What is an NICU?
The NICU is an intensive care unit especially designed for the tiniest of patients who need special care. It contains equipment designed for this purpose and is manned by staff specially trained in neonatal care — so you can rest assured that your infant will get only the very best of care.
Some hospitals do not have an NICU and babies who need specialised care will have to be transferred to a hospital that has one.
A hospital’s NICU is very different from a regular baby nursery. If you take a tour of a NICU unit, you’ll notice that the babies there are often smaller and quieter than their regular nursery counterparts.
Some might be inside incubators while others might be lying in cots under heat lamps to help regulate their body temperatures.
Then, you may also notice another group of babies who are still small but healthy, and in open cots free of equipment. These little ones are known as the “feeders and growers” — they are busy getting ready to either be moved to the regular nursery, or go home with mummy and daddy.
How long a baby will stay in the NICU depends on how severe his condition is and the type of treatment he needs.
Why do babies need to go to the NICU?
The most common reason that babies end up in the hospital’s NICU is because of premature birth — which is one that occurs before the start of the 37th week of pregnancy, according to Mayo Clinic.
Other babies may be cared for in the NICU because they have had a difficult birth, have medical conditions such as health problems or infections, or need surgery.
The following list, adapted from Stanford Children’s Health, details the factors that may increase the chances of a baby being admitted to the NICU after birth:
- Drug or alcohol exposure
- Hypertension (high blood pressure)
- Age younger than 16 or older than 40 years
- Multiple pregnancies
- Premature rupture of the amniotic sac
- Sexually transmitted diseases
- Breech delivery (buttocks delivered first)
- Fetal distress/ birth asphyxia (due to lack of oxygen)
- Forceps or C-section
- Presence of meconium (baby’s first stool) in the amniotic fluid
- Nuchal cord (umbilical cord around baby’s neck)
- Birth at gestational age less than 37 weeks or more than 42 weeks
- Birth weight less than 2,500 grams or over 4,000 grams
- Medication or resuscitation soon after delivery
- Infection such as chlamydia, herpes or group B streprococcus
- Birth defects
- Need for extra oxygen or monitoring, medications or intravenous (IV) therapy
- Need for special procedures such as a blood transfusion
Who will care for your baby in the NICU? Which hospitals in Singapore have an NICU? All this and more on the next page.
Who will look after your baby in the NICU?
An NICU will have a team of highly specialised health care professionals involved in the care of babies there. This team may include:
- Neonatologist,who is a paediatrician with specialised training in the care of sick and premature babies.
- Respiratory therapists
- Occupational therapists
- Lactation consultants
- Social workers
- Hospital chaplains
All members of an NICU team work closely with parents also, to develop an appropriate plan of care for their baby.
An NICU will also usually have parents support groups and other programmes especially designed for maximum parental involvement.
NICUs in Singapore
*The following information is adapted from MargaretJane.org.
There are nine NICUs in Singapore
- National University Hospital
- KK Women’s and Children’s Hospital
- Singapore General Hospital
- Gleneagles Hospital
- Mt Elizabeth Hospital
- Parkway East Hospital
- Mount Alvernia Hospital
- Raffles Hospital
- Thomson Medical Centre
NICUs are usually ranked by the complexity of cases they can handle. For example, a Level 3 NICU will handle the most complicated cases.
Singapore’s public hospital NICUs are all Level 3, and some private hospitals (e.g. Gleneagles Hospital) also have Level 3 NICUs.
NICUs in Singapore encourage parental involvement, including kangaroo care and breastfeeding, and will loan breastpumps to mums and also offer breastfeeding advice and assistance.
The difference between NICUs in Singapore
The biggest difference is related to cost, with public hospital NICU charges linked to the category charges of the mother.
So, if you check in as a Class A mother for a private room, then your baby’s NICU stay will also be charged under class A.
However, the quality of care babies get in Singaporean NICUs is exactly the same, even though the bills can vary greatly.
- You can ask to be downgraded, which will result in all charges being downgraded too. Your request will usually be processed on the same day you ask for it.
- If you know in advance that your baby will probably spend time in an NICU, choose a public hospital to give birth at.
- Public hospitals employ medical social workers who can assist you with applying for financial aid if needed. Private hospitals are also usually flexible about working out payment plans too.
- Both parents’ Medisave can be used towards costs. In exceptional cases, grandparents’ medisave can be used too.
- Depending on the package you go for, some insurance policies will cover NICU charges.
Getting through the NICU experience
Some parents know well in advance that their baby will have an NICU stay. However, others won’t know until they are in the delivery room. Either way, it’s good for parents to prepare themselves for this possibility.
Here are some tips to help you do this.
Take a tour
If you know, or there’s a chance you may deliver preterm, or have other risk factors that might mean your baby will have to stay in the NICU, ask to take a tour of the NICU and meet the neonatologist in advance.
This way, you can build a rapport with the NICU staff even before your baby is born, and learn about what to expect, should your baby be admitted there, says Dr. Terri Slagle, the Director of California Pacific’s Neonatal Outreach Program, in San Francisco.
Expect ups and downs
If your baby is admitted to the NICU, you will probably experience a rollercoaster of emotional highs and lows — including a sense of powerlessness.
The most important thing to do is not blame yourself and focus on thinking about the day you will take your baby home.
Be prepared to pump
Many premature babies are not strong enough to directly breastfeed. But they benefit immensely from your breastmilk which is especially rich in certain proteins and amino acids in comparison to the milk of full-term babies.
Pumping also gives you back a small sense of power — that you are able to do something to help your baby.
Your baby might look so tiny and fragile. But he needs you more than ever, especially your touch. And you can do this through “kangaroo care”.
This is a therapeutic touch technique which involves skin-to-skin contact between baby and parent, and is offered and encouraged in some NICUs.
Skin-to-skin contact will also help you bond with your baby, and like pumping, gives you the opportunity to help your baby thrive.
Talk to other parents
The NICU can feel like a very lonely place for parents, even though it’s a bustling hive of activity. So connect with other parents of NICU babies through support groups where talking bout your experience can help you cope.
Be there for each other and look after yourself
Give yourself some downtime and take turns in the NICU bedside vigil. Getting enough rest will help keep your spirits up, knowing that your baby is getting the best possible medical care.
Don’t forget to communicate your feelings and emotions to your partner, asking them too how they’re feeling and coping at the same time.
Watch this video now to see what a day in the life of an NICU nurse is like:
We hope you have found this article useful. Have you had an NICU experience? Do share it with us in a comment below.