Services and Programs
Neonatology
Neonatal Intensive Care Unit (NICU) — Information for Parents
Visitation Policy
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Parent and grandparent visitation is
permitted 24 hours/day except
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During the nursing change of shift
(6:45 a.m.-7:45 a.m. and 6:45 p.m.-7:45 p.m.)
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During morning medical
rounds on other patients who share their infant’s
pod (parents may stay during discussion of their baby)
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You
will be asked to leave during these times.
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Brothers and sisters over 3 years of age may visit
under the established sibling
visitation guidelines. Sibling
visitation
is permitted from the hours of 12:00 p.m. – 6:45 p.m.,
7 days a week. Brothers and sisters 12 years of age and older
may also
visit from 7:45 p.m. – 9:00 p.m. Sibling visits are
a maximum of 30 minutes.
-
Two extended support people over 14 years of age can
visit each day. Grandparents are not included in this number.
The visitation hours for extended support people are 12:00
p.m. – 3:00 p.m.
and 7:45 p.m. – 9:00 p.m.
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No more than 2 adults at the bedside at any time.
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In order to protect and respect the privacy of all
our patients, please remain at your infant’s bedside
when visiting. Although you will meet other families during
your
NICU stay,
visiting with these families will need to take place outside
of the patient care pods (i.e. NICU waiting room).
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Visitors who have colds, coughs, vomiting, diarrhea,
fever, or other infections may not visit.
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All visitors must perform a 3-minute scrub before
entering the NICU.
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All visitors including parents and grandparents
must sign in with the secretary before proceeding into the
unit.
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At all times the medical and nursing staff reserve
the right to ask visitors to leave if the need arises.
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Please do not call during the nursing shift change from 6:45-7:45
a.m. and 6:45-7:45 p.m. If there is any serious change
in your baby’s
condition, we will call you as soon as possible.
-
We ask that parents make all phone calls concerning their baby
and then relay the information to family members. We do not give
information to family members or friends. If you are calling
long distance, do not call collect. Instead, speak to your nurse
to arrange daily calls to you.
Who's Who and What They Do
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-
Neonatologist: a pediatrician who specializes in the care of
sick and premature newborns
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Neonatal fellow: a doctor who has finished
pediatric training and is receiving additional training
to become a
neonatologist
- Pediatric resident: a doctor receiving special training
to become a pediatrician
- Pediatric intern: a doctor in the first year
of training following graduation
from medical school
- Nurses
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Nurse manager: a registered nurse who oversees all unit operations
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Neonatal nurse practitioner: a registered nurse who has received
additional specialized training to perform specific
procedures and develop patient-focused care plans
- Neonatal nurse leader: a registered nurse who assists the
nurse manager in overseeing unit operations
-
Neonatal nurse: a registered nurse who specializes
in the care of sick and premature newborns
in the NICU
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Discharge coordinator: a registered nurse who
assists with patient education
and preparations for parents
to take their baby
home. She or he also helps with the
transfer of babies to and from
regional nurseries.
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Technical Support
- Social Support
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Social Worker: a health team member trained
to help families cope with problems related to their baby’s
hospitalization
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Chaplains: ministers, priests, and rabbis who
are available to families any time for spiritual support
or prayer
-
Parent
to Parent Support Group: an organization
of volunteer parents who have had
an infant in the NICU
- Cuddlers
Program volunteers: specially trained hospital
volunteers who hold babies who need some extra TLC when parents
can't be there
- Child Life Support
The Vocabulary of the NICU
The
NICU staff uses terms that are probably unfamiliar to you.
Here is a list to help you understand what we are saying.
Term |
Definition |
| A’s and B’s |
Apnea and bradycardia |
| Antibiotics |
Medicine given to treat an infection. |
| Apgar score |
A number from 0-10 given to a baby in the delivery room
at one and five minutes of age, which describes how well
the baby is at that time. |
| Apnea |
A prolonged pause or stopping of breathing. It is a common
problem in premature babies. |
| Bagging |
Filling the baby’s lungs with air using a rubber
bag, mask, and oxygen. |
| Bilirubin |
A waste product that occurs when the body naturally gets
rid of old red blood cells. It is a yellow-colored substance
that may sometimes color the skin. If a blood test shows
there is too much bilirubin in the baby’s blood, the
baby may be placed under special lights that help get rid
of the bilirubin. The baby’s eyes will be covered to
protect them. |
| Blood gas |
A measurement of the amount of oxygen, carbon dioxide,
and acid in the baby’s blood. |
| Bradycardia |
A slowing of the baby’s heart rate. |
| CPAP |
Continuous Positive Airway Pressure, a low pressure of
air that is maintained in the airways to help a baby with
breathing difficulty or with apnea. |
| Cyanosis |
Blueness (duskiness) of the skin as a result of oxygen
levels in the blood that are too low. |
| Desats |
Short periods of time when the oxygen level in the baby’s
system drops below the accepted level. |
| Endotracheal (ET) tube |
A tube that passes through a baby’s mouth into the
trachea (windpipe) to allow oxygen to be delivered into the
lungs.
|
| Gram |
A unit of weight. 28 grams = 1 ounce; 454 grams = one pound;
1 kilogram
= 2.2 pounds. |
| Hyperalimentation/Hyperal/TPN |
Giving of nutrition into a vein: used in infants who cannot
be fed or who are not yet taking all of their fluid by mouth.
|
| Intravenous (IV) |
Fluids given into a vein. |
| Lines |
Refers to IVs that are placed into the umbilical artery
or the umbilical vein (two blood vessels in the baby’s
umbilical cord), through which sugar solutions and medications
may be given. Blood samples may also be obtained through
them. |
| Meconium |
A newborn’s first several bowel movements. It is
thick, dark green/black, and sticky. Babies sometimes pass
meconium before birth. |
| Nasal Cannula |
A small tube positioned at the baby’s nose, through
which oxygen may be delivered. |
| NG/OG Tube |
Nasogastric or orogastric tube—a small, soft, plastic
tube placed through the nose or mouth into the baby’s
stomach. This may be used for “gavage” or tube
feedings. |
| NPO |
Latin abbreviation for nothing by mouth. |
| Oxygen |
Part of the air we breathe. Room air contains 21% oxygen.
Sick or premature babies may need extra oxygen, sometimes
even pure (100%) oxygen. |
| Premature infant, Premie |
Any infant born before the 37th week of pregnancy. Full
term babies are born between 37 and 42 weeks. |
| Residual |
The amount of formula remaining in a baby’s stomach
before the next feeding. |
| Respirator |
Ventilator, a machine to help with breathing. |
| Sepsis |
An infection, symptoms may include fever, poor feeding,
continued apnea, and bradycardia. |
| Surfactant |
A substance made by mature lungs that makes it easier to
breathe. Babies born before the 37th week of pregnancy may
not have enough surfactant and may need to receive some to
make breathing easier. |
| Tachypnea |
Fast breathing, more than 60 breaths a minute. |
| Vital signs |
Measurement of heart rate, breathing rate, temperature,
and blood pressure. In the NICU, we may also measure the
baby’s abdominal girth. |
| Weight |
Your baby is weighed at least daily. Babies usually lose
weight during the first several days after birth. Once they
begin to gain weight, they will gain 10 to 30 grams (1/3
to 1 ounce) a day, on average. |
Feeding Your Baby
At first, most babies get their fluids by vein. We begin to give
your baby breast milk or formula as soon as his or
her condition allows. Babies weighing less than 1500 grams (3
pounds, 5 ounces)
are often fed through an OG or NG tube at first. When
your baby is ready, he or she will begin breast/bottle feeding.
When bottle
feeding, a nurse gives the first feeding and arranges
times that you can give your baby a bottle. We hope this allows
you to become
more familiar with your baby’s care and that
it gives you some special time with your baby.
If you planned to breast feed your baby, we encourage you not
to change your plans. We help you learn how to collect
and store your milk if your baby is not yet ready to nurse at
your breast.
Then, when your baby is ready, we will help you with
the breastfeeding or the change from bottle to breastfeeding.
There is an electric
breast pump available for you to use while you’re
in the hospital or visiting your baby. If your baby
will be hospitalized
for a long time, you may want to rent a pump to have
at home. Ask your baby’s nurse, the lactation
consultant, or the NICU social worker for more information.
If you need help with breastfeeding, call the Breastfeeding
Hotline at 585-275-9575. A consultant is available on Monday,
Wednesday, and Friday from 12:00-1:00 p.m.
Holding Your Baby
Premature babies often have a difficult time
keeping their temperature stable. You can reach into the isolette
to touch
and talk to your baby through the portholes. You may also help
change your
baby’s diaper or take his or her temperature.
When your baby is big enough to be held, it will
be for short periods
of time, one or two times per day.
Kangaroo care (skin-to-skin contact between
parent and baby) is available
in the NICU. Ask your baby’s nurse for more information
about this.
Toys and Clothing for Your Baby
You may bring outfits, hats, and special blankets. While your
baby is in the isolette, he or she will just be
wearing a diaper, so we may better observe him or her.
Infant stimulation is necessary for your baby’s growth
and development. Toys or gifts you can bring for your baby include:
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Small plastic or rubber toys
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Small stuffed animals
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Musical toys
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Pictures of family members or those colored by brothers and
sisters
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Tapes with your voice or store-bought tapes
Remember, the isolette is small. Also, remember to label items
with your baby’s name.
Leaving the NICU
On the day your baby is admitted to the NICU, we like to begin
thinking about the day you will take your baby
home. We want you to start talking, singing, and reading to
your baby as
soon as your baby is stable. We would like you
to join in the baby’s care by changing the baby’s diaper, taking
the baby’s temperature, and talking with the nurse about
your baby’s care. We want you to have a chance to feed
your baby many times before you take your baby home. We have
daily classes so you can learn about baby care. We will teach
you special things you need to know about your baby before
you take him or her home. Your baby may need to go home with
medicines, and we will teach you how to give those. Your baby
may need special equipment, and we will teach you about that
before you take your baby home. If there is anything special
you want to learn (like infant CPR), let us know and we will
teach it to you.
The staff of the NICU looks at many factors to determine when
a baby can go home. All signs are positive when your baby is
able to:
By visiting your baby regularly, you
can work with our staff in planning for your baby to go home.
As soon as you know who your baby’s doctor will be after
he or she goes home, tell us. If you don't have
a primary care physician for your baby, our staff can help you
find one. We will talk with your baby’s
doctor so he or she will know your baby was in the NICU and what
happened
while your baby was with us.
Car Seats
New York State requires that children age 4
years and under or less than 40 pounds be restrained in an approved
car seat. Car seats are essential for your baby’s safety.
We ask you to bring your car seat to the nursery before your
baby’s
discharge. It’s a good idea to practice
putting the car seat in and out of your car and
buckling the belts before that
special trip home with your baby. Read Car
Seats for Children with Special Needs - Premature Babies from the
American Academy of Pediatrics.
Transfer
Your baby may be well enough to leave the NICU,
but not be ready to go home with you. He or she may not need
intensive
care any more, but may need special care. Your baby may need
antibiotics,
time to gain weight and grow, or more monitoring
for apnea and bradycardia. In these cases, he or she may be
transferred
to another hospital, to the newborn nursery/birthing
center, or to one of the pediatric floors at the Golisano Children’s
Hospital at Strong.
Although we would like to have each of our babies discharged
home, this is not always possible. The NICU at
the Golisano Children’s
Hospital at Strong is the only Neonatal Intensive
Care unit for a 14-county
region. Transfer to a special care unit at a community
hospital or to one of the pediatric floors allows
a family the opportunity to transition to home.
Many families are nervous about the transfer of their baby to
a regional hospital This is a common feeling related to meeting
a new medical team, becoming familiar with a new hospital, and
leaving behind a familiar nursery with familiar faces. Transferring
your baby to a hospital closer to your home can be a positive
experience. Your own pediatrician will become familiar with you
and your baby at this time. The atmosphere at most of the regional
nurseries is less hectic than that of the NICU. This is a wonderful
opportunity to get to know, cuddle, and enjoy your baby prior
to his or her discharge to home.
Parking Expense
We encourage you to visit your baby frequently.
There are several services to help you lower the cost of parking.
More information.
If the parking cost is a financial hardship, check with the
NICU social worker for transportation assistance.
Getting More Information
Our staff is available to answer your questions and we want
you to understand everything we are doing for your baby.
It may
be helpful to choose two or three people
with whom you are most comfortable talking to get most of
your information.
We know sometimes we tell you so much that it's hard to remember
everything. So, during your baby’s stay
in the nursery, we'll give you information
sheets. You can
read the sheets at your convenience. You can
use them to help your memory or help explain
your baby’s
condition to family and friends.
We also have many books, articles, and videotapes that may be
of interest to you. A TV and VCR are available
on the unit to view the videotapes. Ask your baby’s nurse
for more information.
Related Information
Ronald
McDonald Houses
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