What to Expect

At delivery
If your baby is expected to have special needs, a team of specialists from the Level III neonatal intensive care unit (NICU) will attend the delivery. At delivery, your baby will be placed on a Giraffe Omni bed (all-in-one incubator and warmer), dried and warmed. Your baby might need help with breathing; sometimes that includes a special tube which is placed in the mouth toward the lungs. When your baby has been stabilized, we will move to the NICU.

Routine things we do for your baby:

  • Keep the lights and noise levels low
  • Handle your baby gently and slowly
  • Group care-giving activities at the same time
  • Make sure your baby is “tucked up”, like in the womb

Your baby will be placed on a cardio-respiratory monitor. This monitor gives a continuous reading of your baby’s heart rate and breathing rate. It also can read your baby’s blood pressure and the level of oxygen in your baby’s blood.

Babies who need extra oxygen can receive it in different ways, such as a hood (plastic bubble), nasal cannula (a small, plastic tube that fits into the nose), an endotracheal tube (ET tube) that goes into the lungs and is controlled by a ventilator (device that facilitates breathing) or by continuous positive airway pressure (CPAP). CPAP provides a small amount of pressure in the airway to keep the tiny air sacs in the lungs open. The amount of oxygen and support can be adjusted to give your baby the right amount.

Lab tests
We will follow your baby’s condition and perform lab tests, which may include:

  • Complete blood count (CBC) - a measurement of the number of blood cells in your baby’s blood
  • Blood sugar or blood glucose - a measurement of the amount of sugar in your baby’s blood
  • Blood culture - a test for possible infection in the blood. The results of this test will take at least two days to complete.
  • Blood gases - a test to help us know how much breathing support and oxygen your baby needs
  • X-rays/Ultrasound - images that help us evaluate your baby’s lungs, heart, bowel gas, bones and brain

Pain management
We realize that your baby may have some painful procedures while in the NICU. We always try to make everything less painful. We will watch for signs of pain, which may include crying, a worried face with a frown, tightly fisted hands and feet, a rigid or tense body and high heart rate.

We will provide your baby with comfort measures and pain medication as needed.

If you think your baby is in pain here is what you can do to help:

  • Use Kangaroo Care (skin-to-skin therapeutic holding of your baby)
  • Keep the area as dark and quiet as possible
  • Rock, talk to, massage, give a pacifier and/or wrap your baby snugly

The nurse will continually check your baby for pain, and together you will decide what works best for your baby.

Your baby may not be able to have feedings at first. To provide adequate nutrition and stable blood sugar, we may give your baby intravenous therapy (IV). This might also be used to give your baby medicines.

We might also use the umbilical cord or a special catheter called a peripherally inserted central catheter (PICC). The umbilical catheter can also help us measure blood pressure and take blood samples without disturbing your baby.

When your baby starts feeding depends on his/her condition. Premature babies are usually not strong enough or coordinated to take all feedings by bottle or breast. We usually begin with tube feedings. A thin soft tube is placed into the stomach through the nose or mouth. Breast milk or formula can then be dripped directly into the stomach by gravity. Feeding amounts are advanced slowly. We will advance the number of nipple feedings as your baby builds stamina and coordination.

If you are breastfeeding, the amount and the temperature of the feeding is regulated by nature. Formula and breast milk fed from a bottle should be body temperature. If you place a few drops on the inside of your arm and cannot feel there is anything there, that is body temperature — not too cool or too hot.