A Guide to Navigating the NICU with The Honest Midwife

Q: What does NICU stand for and why might your baby spend time there?

(NICU) stands for Neonatal Intensive Care Unit and is a specialised area in the hospital that is purely focused on the care of premature or poorly newborn babies who require round the clock care. Any baby that is born before 37 weeks of pregnancy is classes as being premature however, not all babies born early need to spend time in NICU.

Q: What are NICUs like?

In most NICUs the unit is split into different areas - there is often three areas: Intensive Care Nursery, Special Care Nursery and the Transitional Ward. 

Babies in the Intensive Care area are usually those that are needing the most care and are often very premature or requiring support with their breathing.  It can be quite overwhelming having your baby in this area as they are often in an incubator and may have various wires attached to monitors.  This helps to keep a close eye on their breathing and temperature without the need to continually disturb them.   

If your baby is in the special care nursery this is because they are generally doing really well but still require more care than can be given on either the transitional ward or at home.   Unlike the intensive care area where your baby will have most of their care given by the nurses you will be able to take a more active role in feeding and caring for your baby.

The Transitional Care ward is hopefully the last stop before you are able to take your baby home.  This area is for babies that don’t really need such close monitoring but time here helps you get feeding established and build your confidence to take baby home.

Q: What does care look like for premature babies?

Our specialist NICUs are amazing areas that have all the equipment needed to help your baby.  Your baby may need support with breathing, feeding and temperature regulation.  The NICU is fully equipped to provide your baby with this support.  Incubators are lovely and warm and help baby maintain their temperature.  It it also not unusual for premature or unwell babies to need support with breathing and they may be put on a ventilator.  If your little one is not yet strong enough to latch to the breast or take a bottle feed, tubes may be used to help ensure your baby gets the nutrients it needs to grow.

These machines also help the doctors and nurses to keep a close eye on your baby’s vital signs and monitor their progress. 

It isn’t all about technology though.  Known as Kangaroo care, whenever possible you will be encouraged to hold your baby skin-to-skin, this close contact is proven to not only help with bonding but will also help to stabilise baby’s heartbeat and temperature.

Q: Is there anything in particular I need to know about caring for my premature baby’s skin?

All babies skin is delicate but a premature baby’s skin often needs that little bit of extra care. Their skin can be easily irritated or broken.  This is why any products that are provided by the NICU for use on your baby’s skin will have this sensitivity in mind.   A product known as emollient is often recommended if your baby’s skin is particularly dry.  This can all seem very over whelming but don’t worry - the team in the unit will be by your side to support and guide you.

Q: What does family-centred care mean in the NICU?

It is commonplace in the UK to take a “Family Centred” approach.  This acknowledges that NICU’s can feel like a scary place so this approach puts important emphasis, not just on the care of your baby but of parents and guardians too. The team will encourage and support you to be as involved in your baby’s care as much as possible, especially in relation to your baby’s daily care routines and being part of daily discussions with the medical team about baby’s care plans and progress.

It may also be possible for you to stay at the hospital overnight as some units have facilities for parents so they can be close by.  This can really help you to feel close to your baby and get feeding and daily care established before you all go home.

Q: Will we be able to touch our baby whilst in NICU?

It is widely recognised that your involvement in your baby’s care is key to their progress and as such you will be encouraged to hold your baby skin to skin whenever possible.  This practice is often referred to as Kangaroo care and is proven to be beneficial to your baby.  The NICU will welcome and encourage your involvement and questions so don’t hesitate to speak to a member of the team if you are unsure or would like something explained further.  The more you understand of your baby’s situation and outlook the less overwhelming the NICU will feel.

Q: Is there any other support for parents with a baby in the NICU?

A family’s time in the NICU can be an emotional and challenging one but there will be support available.  If the maternity team suspect your baby may need to spend time in the newborn unit after birth they will likely arrange for you to have a tour of the unit so you are at least familiar with your surroundings. There are also amazing charities like Tommy’s and Bliss that can provide peer support and general information.  It is also worth asking if your Trust will provide support with parking costs as this can also mount up and may be subsidised due to the circumstance.

Although having a baby in the NICU can be a very daunting experience you will also find that it is a place of hope and many, many success stories and that you will be surrounded by people working hard to ensure your baby gets the best possible start in life.