At Delivery

If your baby's expected to have special needs, a team of highly-trained specialists from our 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 may 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'll move to the NICU.
 

Routine Care We Give Your Baby

To reduce your baby's stress and promote growth and development.

  • Keep 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
     

Equipment

Your baby will be placed on a cardio-respiratory monitor. This monitor gives a continuous reading of your baby’s heart and breathing rate. It also reads your baby’s blood pressure and oxygen level. Babies who need extra oxygen may receive it in different ways.


Ways Babies May Receive Oxygen

  • Hood (plastic bubble)
  • ​Nasal cannula (small, plastic tube that fits into the nose)
  • 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)
  • Continuous positive airway pressure (CPAP) (specialized headgear that supports the baby's own breathing by giving 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 needs.
 

Lab Tests

Lab tests help us diagnose and monitor your baby's condition. These tests may include:

  • Complete blood count (CBC) - the number and type of blood cells in your baby’s blood

  • Blood glucose (blood sugar) - the amount of glucose (sugar) in your baby’s blood

  • Blood culture - a test for possible infection in your baby's blood. These tests can show the presence and type of infection. This may take at least two days to complete.

  • Blood gases - a test that shows how well oxygenated your baby's blood is. This test helps us know how much oxygen and breathing support your baby needs.

  • X-ray/Ultrasound - images that help us evaluate your baby’s lungs, heart, bowel gas, bones and brain
     

Pain management

We realize 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'll 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'll provide your baby with comfort measures and pain medication as needed. We'll also teach you how to assist us in caregiving and providing those important comfort measures when they're needed.

If you think your baby is in pain here's 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 massaging 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)


A nurse will continually check your baby for signs of pain or stress, and together you'll decide what works best for your baby.
 

Feedings

Your baby may not be able to have feedings at first. To provide adequate nutrition and stablize 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 or her condition. First feedings may need to be received through a tube that's passed into your baby's stomach depending on birth age and development maturity.

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 baby's mouth or nose. Breast milk or formula can then be dripped directly into the baby's stomach by gravity.

Feeding amounts are advanced slowly based on how your baby is tolerating food into the stomach and digesting.

We'll advance your baby to nipple feeding as he or 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're breastfeeding, the amount and 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's anything there, that's body temperature — not too cool or too hot.