Parenting in the NICU

You can be with your baby in the NICU at any time. Most parents find that becoming involved with their baby's care helps bond with their baby. Once both you and your baby are ready, you will be encouraged to hold and rock him/her. 

Staff in the NICU can show you how to care for your baby in many ways. Learning these aspects of care is helpful in preparing you to take your baby home.

Learn more about:

  • Precautions in the NICU
  • Equipment in the NICU
  • Feeding your Baby in the NICU

Precautions in the NICU

NICU babies need to be especially protected against germs or infection and our team takes extra precautions to keep our little patients safe.

  • Germ care: The staff of the NICU will give you instructions on special hand washing techniques before entering the area. Sometimes, masks are needed. 
  • Visiting Family: Although we allow and encourage visitation of babies by other family members, limiting visitors is a good idea. Many sick and premature babies are susceptible to infection. Siblings should be carefully checked for signs of colds or other illness and helped with hand washing before visiting their baby brother or sister.

    Visitation Guidelines:

Equipment in the NICU

There are a lot of machines and medical equipment in the NICU. We use them to monitor and keep your baby comfortable, while supporting his/her care and growth. Understanding what the machines do can help make you more comfortable around them. Learn more about:

  • Warmth and temperature regulation
  • Breathing help
  • Monitoring Devices
  • Diagnostic machines
  • Intravenous lines and tubes

Warmth and Temperature Regulation

All babies need help regulating their body temperatures. Those in the NICU may need additional support because they are small or unwell. 

Once a baby is stable and can maintain his/her own body temperature without added heat, open cribs or bassinets are used. Babies are usually dressed in a gown or T-shirt, a diaper and a hat.

A baby can lose large amounts of heat through his/her head. Often, a blanket is wrapped snugly around the baby, called swaddling.

There are several ways to keep NICU babies warm and comfortable, including the following:

  • Immediate drying and warming after delivery—A baby's wet skin loses heat quickly by evaporation and can lose 2 to 3°F (Immediate drying and warming can be done with warm blankets and skin-to-skin contact with the mother, or another source of warmth such as a heat lamp or over-bed warmer.)
  • Open bed with radiant warmer—An open bed that has a radiant warmer above. A temperature monitor on the baby connects to the warmer to regulate the baby’s temperature. When the baby is cool, the heat increases. We also use these beds in the NICU for initial treatment and for sick babies who need constant attention and care. Babies on radiant warmer beds are usually dressed only in a diaper.
  • Incubator/Isolette—Incubators are walled plastic beds with a heating system to circulate warmth. Babies are often dressed in a T-shirt and diaper.

Breathing Help

Some babies need help breathing while in the NICU. We have several machines and devices we use to monitor and help babies breathe more comfortably and get the oxygen they need, including:

  • Respirator or mechanical ventilator—This machine helps babies who cannot breathe on their own or who need help taking bigger breaths. High frequency ventilators give hundreds of tiny puffs of air to help keep a baby's airways open. Ventilators can also deliver extra oxygen to the baby. 
  • Endotracheal tube (ET)—This tube is placed through the baby's mouth or nose and  connects to a mechanical ventilator (breathing machine) with flexible tubing. 
  • Continuous positive airway pressure (CPAP)—Through small tubes that fit into the baby's nostrils, called nasal CPAP, this machine pushes a continuous flow of air or oxygen to the airways to help keep tiny air passages in the lungs open. CPAP may also be given through an ET tube. 
  • Extracorporeal membrane oxygenation (ECMO)—This is a special technique for babies with respiratory disease that is challenging to treat. With ECMO,  an advanced outside machine  adds more oxygen to the baby’s blood and removes  carbon dioxide. . ECMO was pioneered at Children’s National and our neonatologists are recognized experts. Learn more about ECMO. 

Monitoring Devices

As we care for your baby, we are carefully watching all of his/her vital signs. We use several different types of machines to monitor your baby, including:

  • Heart or cardiorespiratory monitor—This monitor displays a baby's heart and breathing rates and patterns on a screen. Wires from the monitor are attached to adhesive patches on the skin of the baby's chest, abdomen and leg. 
  • Blood pressure monitor—Blood pressure is measured using a small cuff placed around the baby's upper arm or leg. Periodically, a blood pressure monitor pumps up the cuff and measures the level of blood pressure. Some babies need continuous blood pressure monitoring. This can be done using a catheter (small tube) in one of the baby's arteries. 
  • Pulse oximeter—This machine measures the amount of oxygen in the baby's blood through the skin. A tiny light is taped to the baby's finger or toe, or in very tiny babies, a foot or hand. A wire connects the light to the monitor where it displays the amount of oxygen in the baby's red blood cells. “Pulse Ox” is painless and non-invasive, but helps to ensure that your baby’s heart is working properly.  

Diagnostic Machines

Your doctor may want to do tests to monitor any changes in your baby’s conditions. Some of these tests include:

  • Ultrasound—In the NICU, ultrasound may be used to examine the heart, abdomen and internal structures of the baby's brain. Ultrasound is painless and provides much information about a baby's health. 
  • X-ray—Portable X-ray machines may be brought to the baby's bedside in the NICU. X-rays are taken for many reasons, including checking the placement of catheters and other tubes, as well as to help diagnose your baby’s condition and assess progress and recovery.
  • Computed tomography—CT scans are created from multiple X rays to create a detailed 3-dimensional image of a baby’s organs or bone structure, to help in diagnosis and treatment. 

Intravenous Line and Tubes

Babies in the NICU usually have an IV (intravenous line) that helps us to easily   give medications and fluids. A baby may need IV lines or catheters for just a short time or for many days.

There are several different types of lines that help a baby receive needed fluids and medications, including:

  • Intravenous line (IV)—Babies may have an IV placed in a hand, foot or scalp, where the veins are easy to find. Tubing connects the IV to a bag containing fluids that are carefully delivered with a pump.
  • Umbilical catheter—After the umbilical cord is cut at birth, newborn babies have the short stumps of the cord remaining. Because the umbilical cord stump is still connected to their blood and circulatory system, a catheter (small flexible tube) can be inserted into one of the two arteries or the vein of the umbilical cord. We can deliver medications, fluids and blood through this catheter. 
  • Percutaneous line—A catheter is placed in a vein or artery in the baby's arm and is used for meeting a baby's longer-term needs than an IV in the hand or scalp.

As with all care in the NICU, our staff will explain all of our choices and include you in decision making regarding the  care for your baby.