Justin Summerville

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Running head: A PARENTS GUIDE TO THE NICU

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A Parents Guide to the NICU

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Sometimes brand new babies come out sick. Maybe they were born too early, maybe they

were born with physical malformations that need immediate attention, and maybe they just were

not ready to come out of the oven when they did. Having an infant in the Neonatal Intensive

Care Unit (NICU) can be overwhelming for parents. To assist with coping and understanding

during such a difficult time, this essay aims to guide you in what to expect. It will guide you

through medical devices and testing, diapers and bathing, sounds to expect, encounters with the

care team, lonesome babies and your feeling of utter helplessness. This Parents Guide to the

NICU will help you through.

It does not much matter the reason for your babys admission to the NICU, the attending

physician will order a variety of testing to make sure your babys entire body is functioning

properly. Sometimes these tests may be as simple as an x-ray. Sometimes the tests are more

invasive. If a baby cannot eat then they cannot be hydrated, so do not be surprised when your

baby has an IV. Babies develop from their head, down. The blood vessels in their head are bigger

and easier to stick to insert the IV. If your child cannot nurse or suck from a bottle, a nasogastric

feeding tube will be inserted through the nose and into the stomach. Once inserted, the tube is

taped to their cheek so it does not move. To monitor respirations and pulse, a Pulse Oxygen

meter will be strapped to their foot with a long cord going from your little one to the wall. Blood

counts are important, too, so your sweet little one may be poked on their heel. A small band aid is

used to cover the site, so expect that as well. As magical as a unicorn would be, seeing your baby

with a unicorn horn made from IV tape will break the pieces of your heart into grains of sand. All

these devices can be unnerving, but now you are prepared.

The average weight of a newborn baby is 7.5lbs (Newborn Weight, 2017, par. 3). If

your baby was born early, then he/she is probably significantly smaller than the average
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newborn. While they receive nutrients via IV or feeding tube, your baby will still need diaper

changes. That little body will be difficult enough to handle based on sheer size alone, but adding

the tubing and dressings to the equation make it like walking a tight rope. Like all newborns,

their skin is very sensitive and their diaper areas must be thoroughly cleaned to remove waste

particles and avoid irritation and infection. Be sure to work around the tubes and tape, but work

quickly so you have the diaper catch the waste that comes out at random. Bathing your child may

be difficult while in the NICU because of the cords and wires, so you may need to provide a bed-

bath. Simply put, use a baby wipe and clean your baby from foot to head. Start with the feet and

work your way up, doing diaper areas with a wipe of their own. The head should be last because

babies control their body heat from their head. If their head is wet and cold you will have a very

uncomfortable baby. Be conscious of the tubes and machinery attached to your little one.

Accidental removal could result in discomfort for your child when the device is reapplied and

unhappy medical staff for having to reapply said device.

Nobody likes to hear a heart monitor ping. Those squirmy babies tend to kick off the

heart and oxygen monitors wrapped around their tiny feet, but sometimes those alarms sound

when there is a real emergency. You are in the Neonatal Intensive Care Unit, after all. It will

make your heart figuratively skip a beat when you hear that sound, whether it be the first time or

the hundredth. Sadly, the alarm sounds frequently in one patient bay or another, so expect to hear

it numerous times a day. It is alright to jump, so do not feel silly if you do. Medical staff will

rush to the bedside of whichever patients alarm sounds, so be sure to step aside and make room

for the care team.

The nurses are in the NICU for a specific purpose; to care for your child. They are not

there for you. Be aware of this so the lack of affection you receive does not offend. Rounding
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physicians put orders in your babys chart regarding things like skin-to-skin, but the nurses make

the executive decision as to whether you should be handling your baby. Know that your medical

team wants you to handle your baby. The nurse wants you to do diaper changes, feedings and

much needed snuggle time. Baby having that time with his/her parents can help in the recovery

process. Know that whatever can be done to help them recover fully, and quickly, will be done to

get your family on your way. The abrasive nature of the medical staff and the contradictory

orders you are given can be scary and confusing but take heart in that your baby is the main

priority. Do not be surprised if a grief or trauma counselor comes to find you in your childs

NICU bay. They are not there for your little one, they are your sounding board. If you are

confused about a procedure or need to discuss how you are feeling, this counselor is can provide

answers, or find them, for you.

While you visit your baby in the NICU, you will see bays with lonely babies. The nursing

staff can only spend limited time with each baby and if they have a high-risk patient, that time

can be allocated more to those babies needs. Not all parents have the financial stability to miss

work or hire a sitter for older siblings. In those instances, the patient in the NICU spends most of

their day alone or with their medical care team. Some hospitals allow retired volunteers come

and show affection to those lonely babies. If you must be away from the NICU for a time, ask if

there will be volunteers in to rock and soothe while you are out.

Your medical team does not want your baby in the NICU longer than necessary. Some

babies may be jaundiced and get to spend a few days under the special lamps, while other babies

may be very sick and need quite a bit more attention and treatment. Regardless of the reason for

your babys admission, the NICU team will discharge your baby as soon as they feel comfortable

doing so. They do not want you to return.

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The heartache and genuine fear you will feel for the well-being of your child can

consume you, but remember that babies can feel what you feel. NICU moms and dad can attest

to wanting to take away the pain and sickness from their child. You do not want to be anxious or

uneasy while near your baby. Be calm and show him/her that you are there with them. Your

feelings of helplessness can hinder that tiny miracles recovery. You may think, there is nothing I

can do to make this better but being there and showing love is enough. According to a journal

created by the American Academy of Pediatrics (NICU Journey: A Parents Journal, 2010, page

5), while in utero, babies develop their sense of hearing during the second trimester. Between 13

and 26 weeks your baby will be able to hear Moms voice from inside the womb. When your

baby is out in the world and in the noisy NICU, hearing the voices of Mom and Dad can

encourage comfort and the feeling of safety. Even if you have nothing to say, say something.

Now that you have walked through a NICU experience, the hope is that you know you

will survive it. From medical devices and diaper changes to the ambient noise and brash nurses,

to lonely babies and your emotions, you know what to expect and that you are not alone.
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References

Newborn Weight Gain and Loss. (2017, Jan. & feb.). Retrieved February 17, 2017, from

http://www.whattoexpect.com/first-year/health-and-safety/newborn-weight-average-gains-loss/

Bissinger, R., PhD, APRN, NNP-BC, Underwood, C., MBA, CAE, . Imaizumi,
S., , MD, FAAP, Couto, J., MA, Berns, S. D., MD, MPH, FAAP, Gooding, J.,
BA, . . . Thorne, V. B. (2010). NICU Journal: A Parent's Journey. NICU
Journal: A Parent's Journey, 3-5. Retrieved March, 2017, from
https://www2.aap.org/sections/perinatal/pdf/NICUTab1.pdf.