Neonatal Intensive Care Unit (NICU) — Information for Parents

Visitation Policy

  • Parent and grandparent visitation is permitted 24 hours/day except
    • During the nursing change of shift
      (6:45 a.m.-7:45 a.m. and 6:45 p.m.-7:45 p.m.)
    • During morning medical rounds on other patients who share their infant’s pod (parents may stay during discussion of their baby)
    • You will be asked to leave during these times.
  • 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.
    • Parents must accompany these extended support people on NICU visits.
  • No more than 2 adults at the bedside at any time.
  • 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).
  • Visitors who have colds, coughs, vomiting, diarrhea, fever, or other infections may not visit.
  • All visitors must perform a 3-minute scrub before entering the NICU.
  • All visitors including parents and grandparents must sign in with the secretary before proceeding into the unit.
  • At all times the medical and nursing staff reserve the right to ask visitors to leave if the need arises.

Calling the NICU

  • You can call the NICU 24 hours a day at 585-275-2267.
  • You may call your baby’s room and speak to the nurse caring for him or her by dialing the Parent Information Line at 585-275-5905. Follow the call processing instructions.
  • 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

  • Doctors
    • Neonatologist: a pediatrician who specializes in the care of sick and premature newborns
    • 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
    • Nurse manager: a registered nurse who oversees all unit operations
    • 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
    • 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.
  • Technical Support
    • Respiratory therapist: a health team member with special knowledge of breathing problems, treatment, and equipment.
    • Radiology technician: a health team member who takes medical images of your baby. This may be done in the NICU or in the radiology department.
  • Social Support
    • Social Worker: a health team member trained to help families cope with problems related to their baby’s hospitalization
    • 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.

TermDefinition
A’s and B’sApnea and bradycardia
AntibioticsMedicine given to treat an infection.
Apgar scoreA 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.
ApneaA prolonged pause or stopping of breathing. It is a common problem in premature babies.
BaggingFilling the baby’s lungs with air using a rubber bag, mask, and oxygen.
BilirubinA 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 gasA measurement of the amount of oxygen, carbon dioxide, and acid in the baby’s blood.
BradycardiaA slowing of the baby’s heart rate.
CPAPContinuous Positive Airway Pressure, a low pressure of air that is maintained in the airways to help a baby with breathing difficulty or with apnea.
CyanosisBlueness (duskiness) of the skin as a result of oxygen levels in the blood that are too low.
DesatsShort periods of time when the oxygen level in the baby’s system drops below the accepted level.
Endotracheal (ET) tubeA tube that passes through a baby’s mouth into the trachea (windpipe) to allow oxygen to be delivered into the lungs.
GramA unit of weight. 28 grams = 1 ounce; 454 grams = one pound; 1 kilogram = 2.2 pounds.
Hyperalimentation/Hyperal/TPNGiving 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.
LinesRefers 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.
MeconiumA newborn’s first several bowel movements. It is thick, dark green/black, and sticky. Babies sometimes pass meconium before birth.
Nasal CannulaA small tube positioned at the baby’s nose, through which oxygen may be delivered.
NG/OG TubeNasogastric 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.
NPOLatin abbreviation for nothing by mouth.
OxygenPart 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, PremieAny infant born before the 37th week of pregnancy. Full term babies are born between 37 and 42 weeks.
ResidualThe amount of formula remaining in a baby’s stomach before the next feeding.
RespiratorVentilator, a machine to help with breathing.
SepsisAn infection, symptoms may include fever, poor feeding, continued apnea, and bradycardia.
SurfactantA 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.
TachypneaFast breathing, more than 60 breaths a minute.
Vital signsMeasurement of heart rate, breathing rate, temperature, and blood pressure. In the NICU, we may also measure the baby’s abdominal girth.
WeightYour 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:

  • Small plastic or rubber toys
  • Small stuffed animals
  • Musical toys
  • Pictures of family members or those colored by brothers and sisters
  • 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:

  • Take all feedings by mouth
  • Maintain his/her temperature in an open bed
  • No longer requires oxygen or monitors

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

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