Newborn babies that require intensive medical care are often taken care of in a specialized area called the neonatal intensive care unit or NICU. NICU consist of advanced technology and healthcare professionals that provide special care to your children.  

Which Babies Require Special Care? 

Most of the babies admitted to the NICU are preterm, that is, born before 37 weeks of pregnancy have low birth weight, that is, less than 5.5 pounds, or have a health condition that requires special attention. 

In general, your baby may require NICU if, he is: 

• Small for gestational age. 

• Having birth defects. 

• Having respiratory distress. 

• Infected with herpes or chlamydia. 

• Having seizures. 

• Having low blood sugar. 

• Needing extra oxygen or monitoring. 

Who Takes Care of Your Baby in the NICU? 

NICU comprises specially trained professionals that take care of your baby, this includes: 

• Neonatologist. 

• Neonatal fellow. 

• Paediatric resident. 

• Neonatal nurse. 

• Respiratory therapist. 

• Dieticians. 

• Lactation consultants. 

• Physical, occupational, and speech therapists. 

Premature or preterm or “preemie” baby is a baby that is born too early or about 3 weeks before their due date. A full-term baby is born after 40 weeks. On the other hand, a preterm baby is born at 37 weeks or earlier. 

A premature birth can pose serious health risks to a newborn baby including to their brain, lungs, liver, and heart which may cause developmental delays. Hence, a premature baby requires specialized attention and care. 

What Are the Signs of a Premature Baby? 

A premature baby has: 

• Low birth weight. 

• Breathing difficulties. 

• Low body temperature. 

• Feeding difficulties. 

• Fine hair on their body. 

How Are Premature Baby Treated? 

Premature babies require specialized care in the NICU. Some babies are required to stay in the NICU for weeks or months. A preterm baby may need help with: 

• Feeding. 

• Gaining weight. 

• Breathing. 

• Maintaining their body temperature. 

Neonatal resuscitation includes a series of emergency procedures to revive babies who are not breathing are gasping for air or are having a weak heartbeat at birth. 

Your baby might require resuscitation in case of: 

1. Twins. 

2. Preterm or small babies. 

3. Mothers with infection or bleeding during pregnancy. 

4. Prolonged labour. 

What Are the Steps of Neonatal Resuscitation? 

The first 60 seconds after the delivery are the most critical and your doctor will immediately assess the condition if your baby requires a resuscitation. If your baby requires resuscitation, the doctor will: 

• Keep the baby warm by wrapping it in a dry and warm towel. 

• Clear the airway by sucking mouth secretions with a bulb syringe. 

• Clamp and cut the cord. 

• Open the airway for breathing. 

• Keep the baby breathing by placing a mask over the mouth and nose. 

If your baby has having heart rate higher than 100 beats/minute, your doctor will perform chest compression to save the baby.

Total parenteral nutrition or TPN refers to nutrition that is fed intravenously to babies who cannot use their digestive system at all.  

What is TPN? 

TPN delivers a mixture of fluid, electrolytes, sugars, amino acids, vitamins, minerals, and lipids into your infant’s vein. It is done as a lifesaving measure for extremely sick babies.  

How is TPN Given? 

TPN is given through an intravenous (IV) line in the baby’s vein located in the hand, foot, or scalp. At times, a large vein in the belly button or umbilical vein may also be used.  

What Are the Risks of TPN? 

TPN is a boon for babies who cannot get nutrition in other ways. This nutrition, however, can cause blood sugar, fat, and electrolyte levels to spike. Hence, close monitoring and continuous tests are required to prevent this from happening. 

Jaundice in newborns is characterized by a yellow colour in the infant’s skin. It occurs due to a substance called bilirubin which builds up in your baby’s blood.  

What Are the Symptoms of Jaundice in Newborns? 

The main sign of jaundice in newborns is the yellowing of skin which usually starts off from the face. Eventually, you may notice their eyes and tongue also turning yellow. As the bilirubin levels increase, the yellowing may even move to the chest, belly, arms, and legs. 

What Causes Jaundice in Newborns? 

Jaundice in newborns can be due to: 

• Blood infection. 

• Different blood type than you. 

• Bruising. 

• Excess red blood cells. 

• Low oxygen levels. 

• Biliary atresia. 

How is Jaundice in Newborns Treated? 

Jaundice treatment for newborns is usually not required as mild jaundice levels typically go away on their own as your baby’s liver continues to develop. This can take up to 1-2 weeks. Feeding your baby often up to 10-12 times a day will encourage bowel movement and help your baby get rid of the accumulated bilirubin. 

If the bilirubin levels are still high, your doctor may recommend phototherapy. During this, your baby will be exposed to blue light and help your baby’s liver get rid of the bilirubin. 

In cases when even phototherapy may not work, your doctor will recommend a blood transfusion wherein the blood of your baby will be replaced with freshly donated blood.

Congenital anomalies in your baby can be diagnosed during pregnancy with prenatal testing or after birth with physical examination including X-rays, MRIs, or CT scans. 

The management of these anomalies depends on the type and its severity. Some anomalies can be treated with medications, surgery, and therapies. On the other hand, other anomalies may require ongoing medical care and management. For instance, a child with a heart defect may require surgery to repair the defect and may be required to take medications to manage the condition. In addition, a child with a genetic disorder may also require ongoing medical care and management. 

In some babies, congenital anomalies may cause disability or developmental delays. In such cases, rehabilitation and developmental therapies are required.  

In all of these cases, family counselling and support is important. Adjusting to a child with a birth defect can be emotionally, physically, and financially challenging for families. Support from medical professionals, counsellors, and support groups can help families cope with the challenges and make informed decisions about their children. 

When your baby is 1-2 days old, he may require special tests called newborn screening. This involves a variety of checks including blood, hearing, and heart screening to ensure that your baby is safe. 

How Does Newborn Screening Happen? 

Newborn screening is conducted in 3 parts: 

• Blood Test: 

Most newborn screening is done with a blood test to check for rare but serious health conditions. A healthcare provider pricks your baby’s heel to get a few drops of blood. He collects the blood on a special paper and sends it to a lab for testing. Blood test results are usually ready by the time your baby is 5 to 7 days old.  

• Hearing Screening: 

This test checks for hearing loss. For this test, your provider places tiny earphones in your baby’s ears and uses special computers to check how your baby responds to sound. 

•  Heart Screening: 

This test is used to screen babies for a group of heart conditions called critical congenital heart defects (also called critical CHDs or CCHDs). It uses a simple test called pulse oximetry. Pulse oximetry checks the amount of oxygen in your baby’s blood by using a pulse oximeter machine and sensors placed on your baby’s skin. 

What if Your Newborn Screening Results Are Not Normal? 

Most newborn screening results are normal. If your baby’s screening results aren’t normal, it may simply mean she needs more testing. Your baby’s provider then recommends another kind of test, called a diagnostic test, to see if there is a health problem. If the diagnostic test results are normal, no more testing is needed. If the diagnostic test results are not normal, your doctor will guide you about the next steps for your baby.