Newborn babies who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained health care professionals to provide specialized care for the tiniest patients. NICUs may also have intermediate or continuing care areas for babies who are not as sick but do need specialized nursing care.
Some newborn babies will require care in a NICU, and giving birth to a sick or premature baby can be quite unexpected for any parent. Unfamiliar sights, sounds, and equipment in the NICU can be overwhelming. This information is provided to help you understand some of the problems of sick and premature babies. You will also find out about some of the procedures that may be needed for the care of your baby.
Most babies admitted to the NICU are premature (born before 37 weeks of pregnancy), have low birth weight (less than 5.5 pounds), or have a medical condition that requires special care. In the U.S., nearly half a million babies are born preterm, and many of these babies also have low birth weights. Twins, triplets, and other multiples often are admitted to the NICU, as they tend to be born earlier and smaller than single birth babies. Babies with medical conditions such as heart problems, infections, or birth defects are also cared for in the NICU.
The following are some factors that can place a baby at high risk and increase the chances of being admitted to the NICU. However, each baby must be evaluated individually to determine the need for admission. High-risk factors include the following:
Age younger than 16 or older than 40 years
Drug or alcohol exposure
Hypertension (high blood pressure)
Sexually transmitted diseases
Multiple pregnancy (twins, triplets, or more)
Too little or too much amniotic fluid
Premature rupture of membranes (also called the amniotic sac or bag of waters)
Fetal distress/birth asphyxia (changes in organ systems due to lack of oxygen)
Breech delivery presentation (buttocks delivered first) or other abnormal presentation
Meconium (the baby's first stool passed during pregnancy into the amniotic fluid)
Nuchal cord (cord around the baby's neck)
Forceps or cesarean delivery
Birth at gestational age less than 37 weeks or more than 42 weeks
Birth weight less than 2,500 grams (5 pounds, 8 ounces) or over 4,000 grams (8 pounds, 13 ounces)
Small for gestational age
Medication or resuscitation in the delivery room
Respiratory distress including rapid breathing, grunting, or apnea (stopping breathing)
Infection such as herpes, group B streptococcus, chlamydia
Hypoglycemia (low blood sugar)
Need for extra oxygen or monitoring, intravenous (IV) therapy, or medications
Need for special treatment or procedures such as a blood transfusion
Neonatologist. A pediatrician with additional training in the care of sick and premature babies. The neonatologist supervises pediatric fellows and residents, nurse practitioners, and nurses who care for babies in the NICU.