Parent Support

Blount Hospitality House

Blount Hospitality House offers temporary lodging in a home-like setting to parents whose babies are in the hospital. Parents or family members interested in staying at Blount Hospitality House may visit this website for more information.

http://www.blounthospitalityhouse.org

Rooming-in Program

Rooming-in program allows you to get used to caring for your baby at home. You may stay with your baby on the last day and night before discharge from the hospital. Should you have any questions or problems, the nursing staff is close by to help you.

Common Conditions Treated in the NICU

Listed below are some medical conditions that may be seen among premature or sick babies in the NICU. Each baby is unique, however, and may not encounter any of these medical problems. We encourage you to read only what would be helpful to you and your child’s particular circumstances:

Anemia: Premature babies are often anemic, which means that they do not have enough red blood cells. Normally, the fetus stores iron during the latter months of pregnancy and uses it after birth to make red blood cells. Infants born too soon may not have had enough time to store iron. Loss of blood from frequent blood tests also can contribute to anemia. Anemic infants may be treated with dietary iron supplements, drugs that increase red blood cell production or, in some cases, a blood transfusion.

Apnea: Premature babies and babies with other medical conditions sometimes do not breathe regularly. A baby may take a long breath, then a short one, then pause for 5 to 10 seconds before starting to breathe normally. This is called periodic breathing. It usually is not harmful, and the baby will outgrow it. However, premature and sick babies also may stop breathing for 15 to 20 seconds or more. This interruption in breathing is called apnea, and it may be accompanied by a slow heart rate, also called bradycardia. Babies in the NICU are constantly monitored for apnea and bradycardia (often called “A’s and B’s”).

Sensors on the baby’s chest send information about his breathing and heart rate to a machine located near the incubator. If a baby stops breathing, an alarm will begin beeping. A nurse will stimulate the baby to start breathing by patting him or touching the soles of his feet. After these apnea episodes, the neonatologist might consider giving the baby medicine or using equipment, such as C-PAP (continuous positive airway pressure; delivery of air to a baby’s lungs through either small tubes in the baby’s nose or through a tube inserted into the windpipe).

Bronchopulmonary dysplasia (BPD): Lung damage and scarring that occurs in some babies who are treated with oxygen and mechanical ventilation for a prolonged period.

Hypoglycemia: Low blood sugar (glucose) which is diagnosed in a baby shortly after birth. Babies born to mothers with diabetes have their glucose levels checked regularly to assess for hypoglycemia. Early feeding and an intravenous glucose solution help to prevent and treat hypoglycemia.

Intrauterine growth restriction (IUGR): A condition in which a baby grows more slowly than usual in utero, and is smaller than normal for his gestational age at birth. This is ordinarily diagnosed during pregnancy through an ultrasound and usually is due to fetal or maternal complications. Upon admission to the NICU, babies are tested to determine possible causes, although this is not always able to be determined.

Intraventricular hemorrhage (IVH): IVH refers to bleeding in the brain and is most common in the smallest premature babies (those weighing less than 3 1/3 pounds). The bleeds usually occur in the first four days of life. Bleeding generally occurs near the fluid-filled spaces (ventricles) in the center of the brain. An ultrasound examination can show whether a baby has had a brain bleed and how severe it is. Brain bleeds usually are given a number from 1 to 4, with 4 being the most severe. Most brain bleeds are mild (grades 1 and 2) and resolve themselves with no or few lasting problems. More severe bleeds can cause difficulties for the baby during the hospitalization and possible complications in the future. Some will require careful monitoring of the baby’s development throughout infancy and childhood.

Jaundice: Babies with jaundice have a yellowish color to their skin and eyes. Jaundice occurs when the liver can’t remove a waste product called bilirubin from the blood. Bilirubin is formed when old red blood cells break down. Jaundice is especially common in premature babies and in babies who have blood type incompatibilities with their mothers (such as Rh disease, ABO incompatibility) or G6PD disease (not an incompatibility). Jaundice itself does not usually cause harm to a baby. However, a very high bilirubin level can result in more serious problems, especially for premature babies. For this reason, the baby’s bilirubin level is checked frequently. If it gets too high, he will be treated with special blue lights (phototherapy) that help the body break down and eliminate bilirubin. Occasionally, a baby will need a special type of blood transfusion called an exchange transfusion to reduce very high bilirubin levels. In this procedure, some of the baby’s blood is removed and replaced with blood from a donor.

Macrosomia: A condition in which a baby is born with excessive birth weight, that is, 4,500 grams (9 pounds, 14 ounces) or more. This is commonly due to maternal diabetes and may require delivery through cesarean section. These babies are also monitored for hypoglycemia.

Necrotizing enterocolitis (NEC): This potentially dangerous intestinal problem most commonly affects premature babies. The bowel may become damaged when its blood supply is decreased and bacteria that are normally present in the bowel invade the damaged area, causing more damage. Babies with NEC develop feeding problems, abdominal swelling and other complications. If tests show a baby has NEC, he will be fed intravenously while his bowel heals. Sometimes damaged sections of intestine must be surgically removed.

Patent ductus arteriosus (PDA): PDA is the most common heart problem in premature babies. Before birth, much of a fetus’s blood goes through a passageway (ductus arteriosus) from one blood vessel to another, bypassing the lungs, because the lungs are not yet in use. This passageway should close soon after birth, so the blood can take the normal route from heart to lungs and back. If it doesn’t close, blood doesn’t flow correctly. In some cases, drug treatment can help close the passageway. If that doesn’t work, surgery can also close it.

Persistent pulmonary hypertension of the newborn (PPHN): Babies with PPHN cannot breathe properly because they have high blood pressure in their lungs. At birth, in response to the first minutes of breathing air, the blood vessels in the lungs normally relax and allow blood to flow through them. This is how the blood picks up oxygen. In babies with PPHN, this response does not occur, which leads to a lack of oxygen in the blood, and sometimes to other complications. Babies with PPHN often have birth defects (such as heart defects) or have suffered from birth complications. Babies with PPHN often need a ventilator (respirator) to help them breathe. A treatment with a gas called nitric oxide (which is given through a tube in the windpipe) may help the blood vessels in the lungs to relax, and improve breathing.

Pneumonia: This lung infection is common in premature and other sick newborns. A baby’s doctors may suspect pneumonia if the baby has difficulty breathing, if her rate of breathing changes, if blood tests show lowered oxygen levels, or if the baby has an increased number of apnea episodes. The doctor will listen to the baby’s lungs with a stethoscope, then do an x-ray to see if there is excess fluid in the lungs. Babies with pneumonia are generally treated with antibiotics. They also may need additional oxygen until the infection clears up.

Respiratory distress syndrome (RDS): Babies born before 34 weeks of pregnancy often develop this serious breathing problem. Babies with RDS lack a chemical mixture called surfactant, which keeps the small air sacs in the lungs from collapsing. Treatment with surfactant helps affected babies breathe more easily. Babies with RDS also may receive a treatment called C-PAP (continuous positive airway pressure). The air may be delivered through small tubes in the baby’s nose, or through a tube that has been inserted into his windpipe. As with surfactant treatment, C-PAP helps keep small air sacs from collapsing. C-PAP helps the baby breathe, but does not breathe for him. The sickest babies may temporarily need the help of a ventilator to breathe for them while their lungs recover. For more information about the history of surfactant, read “Bubbles, Babies, and Biology: The Story of Surfactant,” published by the Federation of American Societies for Experimental Biology. You will need Adobe Acrobat Reader to view this report. To download a free copy of Acrobat Reader, click here.

Respiratory syncytial virus (RSV): RSV commonly causes infection in childhood. It is highly infectious and almost all babies get it before the age of 2. Many babies (and most older children) get only a slight cold from RSV; however, some babies with RSV develop potentially serious lower respiratory infections such as bronchiolitis (infection of the small breathing tubes in the lungs) and pneumonia (lung infection). These infections are especially dangerous in babies who were born prematurely, have lung or heart problems or certain other chronic illnesses. Your baby can get RSV at any time of year, but it is most common from fall to spring. Contact you health care provider if you have questions.

Retinopathy of prematurity (ROP): ROP, an abnormal growth of blood vessels in the eye, occurs only in preterm babies exposed to high oxygen concentrations. It can lead to bleeding and the formation of scars that can damage the eye’s retina (the lining at the rear of the eye that relays messages to the brain). This can result in vision loss. An ophthalmologist (eye doctor) will examine the baby’s eyes for signs of ROP. Most mild cases heal without treatment, with little or no vision loss. In more severe cases, the ophthalmologist may perform a procedure called cryotherapy, which helps protect the retina.

Sepsis: This is a potentially dangerous infection of the bloodstream which indicates that a germ is present which the baby has difficulty fighting off. Certain lab tests, cultures, and X-rays can help diagnose this condition, which is considered when a baby demonstrates certain symptoms, such as temperature instability or irregular blood sugars. The condition is treated with antibiotics, and the baby is monitored closely for an improvement in symptoms.

Septal defects: A septal defect refers to a hole in the wall (septum) that divides the left and right sides of the heart. Septal defects are usually between the upper (atrial) or lower (ventricular) walls dividing the right and left chambers. Because of this hole, the blood leaks into extra chambers of the heart, and the heart has to work extra hard. A surgeon can close the hole by sewing or patching it. Small holes may heal by themselves and not need repair at all.

http://www.marchofdimes.com/nicu/11021_11034.asp
http://kidshealth.org/parent/pregnancy_newborn/medical_problems/preemies.html