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The birth of a baby is a wonderful and very complex process. Many physical and emotional changes
occur for both mother and baby.
A baby must make many physical adjustments to life outside the mother's body. Leaving the uterus
means that a baby can no longer depend on the mother's blood supply and placenta for important body
functions.
Before birth, the baby depends on functions from the mother. These include breathing, eating,
elimination of waste, and immune protection. When a baby leaves the womb, its body systems must
change. For example:
The digestive system must begin to process food and excrete waste.
The kidneys must begin working to balance fluids and chemicals in the body and excrete waste.
The liver and immune systems must begin working on their own.
Your baby's body systems must work together in a new way. In some cases, a baby has trouble making
the transition outside the womb. Preterm birth, a difficult birth, or birth defects can make these changes
more challenging. But a lot of special care is available to help newborn babies.
Some newborn babies will require care in a NICU. Giving birth to a sick or premature baby can be
unexpected for any parent. The NICU can be overwhelming. This information is to help you understand
why a baby may need to be in the NICU. You will also find out about some of the procedures that may
be needed for the care of your baby.
Below are some factors that can place a baby at high risk and increase the chances of being admitted to
the NICU. But each baby must be assessed to see if he or she needs the NICU. High-risk factors include
the below.
Diabetes
Bleeding
Premature rupture of membranes (also called the amniotic sac or bag of waters)
Changes in a baby’s organ systems due to lack of oxygen (fetal distress or birth asphyxia)
The baby's first stool (meconium) passed during pregnancy into the amniotic fluid
Baby born at gestational age of less than 37 weeks or more than 42 weeks
Birth weight less than 5 pounds, 8 ounces (2,500 grams) or over 8 pounds, 13 ounces (4,000
grams)
Birth defects
Neonatologist. This is a pediatrician with extra training in the care of sick and premature
babies. The neonatologist (often called the attending physician) supervises pediatric fellows and
residents, nurse practitioners, and nurses who care for babies in the NICU.
Neonatal fellow. This is a pediatrician getting extra training in the care of sick and premature
babies. He or she may do procedures and direct your child's care.
Pediatric resident. This is a doctor who is getting extra training in the care of children. He or
she may do or assist in procedures and help direct your child's care.
Neonatal nurse practitioner. This is a registered nurse with extra training in the care of
newborn babies. He or she can do procedures and help direct your child's care.
Respiratory therapist. This is a person with special training in giving respiratory support. This
includes managing breathing machines and oxygen.
Physical, occupational, and speech therapists. These types of therapists make sure a baby is
developing well. They also help with care including positioning and soothing methods. Speech
therapists help babies learn to eat by mouth.
Dietitians. Dietitians ensure the babies are growing well and getting good nutrition. They watch
your baby's intake of calories, protein, vitamins, and minerals.
Lactation consultants. These are healthcare providers with extra training and certification in
helping women and babies breastfeed. They can help with pumping, maintaining milk supply,
and starting and continuing breastfeeding.
Pharmacists. Pharmacists help in the NICU by assisting the care providers choose the best
medicines. They check medicine doses and levels. They keep the team aware of possible side
effects and monitoring that may be needed.
Social workers. Social workers help families cope with many things when a child is ill. They
give emotional support. They help families get information from healthcare providers. They
support the family with other more basic care needs, too. These can include money problems,
transportation, or arranging home healthcare.
Hospital chaplain. The hospital chaplain may be a priest, minister, lay pastor, or other religious
advisor. The chaplain can give spiritual support and counseling to help families cope with the
stress of the NICU.
NICU team members work together with parents to create a plan of care for high-risk newborns. Ask
about the NICU's parent support groups and other programs designed to help parents.