What to Expect

At delivery
If your baby is expected to have special needs, a team of highly-trained specialists from the Level 3 neonatal intensive care unit (NICU) will attend the delivery. At delivery, your baby will be dried, stimulated to breathe and placed on a temperature-controlled bed to be warmed. Your baby might need help with breathing; sometimes that includes placing a special breathing tube in the mouth toward the lungs. When your baby has been stabilized, we will move to the NICU.

Routine care for your baby to reduce their stress and promote growth and development:

  • Keep the lights and noise levels low
  • Handle your baby gently and slowly
  • Coordinate and group specialized caregiving activities at the same time
  • Therapeutic positioning, which ensures your baby is "tucked up" into a position they would assume 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 (ETT) that goes into the lungs and is connected to a ventilator (a machine that facilitates and/or controls the baby's breathing) or by continuous positive airway pressure (CPAP) (specialized headgear device that supports the baby's own breathing by providing small amounts of pressure in the airway to keep the tiny air sacs in the lungs open.) The amount of oxygen and breathing support can be adjusted to meet your baby's need.

There are lab tests to help us diagnose and monitor your baby's condition. These tests may include:

  • Complete blood count (CBC) - a measurement of the number and type of blood cells in your baby’s blood
  • Blood glucose (blood sugar) - a measurement of the amount of glucose (sugar) in your baby’s blood
  • Blood culture - a test for possible infection in the blood. The tests can show presence and type of infection and may take at least two days to complete
  • Blood gases - a test that shows how well oxygenatted your baby's blood is. This test helps us know how much oxygen and breathing support 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 the care we provide as pain free as possible. 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. More importantly, we will teach you how to assist us in caregiving and provide those important comfort measures when they are 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 which helps reduce stress and pain)
  • Keep the area around your baby as dark and quiet as possible (reduces environmental stimulation which can cause stress)
  • Rocking, soft talking or singing, gentle massage or giving a pacifier (reduces stress and supports development)
  • Wrap your baby in the snuggle-up or swaddle (this is protective, reduces stress and supports development)

The nurse will continually check your baby for signs of pain or stress, 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 nutrition through 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. Also, depending on your baby's birth age and development maturity, first feedings may have to be received through a tube that is passed into their stomach. Premature babies are usually not strong or coordinated enough to take all feedings by bottle or breast. So, to begin feedings, a soft tube is passed into the stomach through the mouth or nose. Breast milk or formula can then be dripped directly into the stomach by gravity. Feeding amounts are advanced slowly based on how your baby is tolerating food into the stomach and digesting. We will advance your baby to nipple feeding as he/she developmentally matures and shows feeding cues (reflexes and behaviors your baby does to show they are ready to eat from a nipple.) The presence of feeding cues help us know your baby has more stamina and coordination to safely take food through a nipple.

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.