NICU - Guest Blog

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NICU - Guest Blog

When it comes to the birth of a baby, most moms will agree that things did not go the way that they were expecting.   Maybe the baby was born two weeks early while the father was on a business trip. Or perhaps, the baby decided to enter this world in the front seat of your pick-up truck while on the way to the hospital. Every birth story is unique, and most mothers are more than eager to share every detail of the birth story with anyone who will listen.  Unfortunately, for some parents, their unexpected birth story includes a detour into the NICU (Neonatal Intensive Care Unit). 

According to Dartmouth Institute for Health, approximately 78 infants out of 1,000 are admitted into the NICU (JAMA, 2015).  Some NICU’s have the capability to admit babies 23 weeks gestation and above. Those babies are considered micro-preemies and are usually quite ill. They will require intensive care by a multi-disciplinary team of NICU nurses, Neonatologist, Neonatal Nurse Practitioners, Nutritionists, Occupational Therapists and Physical Therapists.  Thankfully, most babies admitted into the NICU are not micro-preemies. In fact, babies are admitted into the NICU for a variety of reasons, including; respiratory distress, blood sugar instability, infection, feeding problems, and low birth weight.  Whatever the reason, an admission into the NICU can be a scary time for the parents…

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M is for Meconium

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M is for Meconium

Your baby’s first bowel movement is called meconium.  Meconium is nearly black and extremely sticky, it also typically doesn’t smell.  This first poop usually passes in the first 24 hours of life.  This first stool is comprised of lanugo, amniotic fluid, shed skin cells, and anything else floating in the uterus with the baby.  To help with diaper clean up consider rubbing a small layer of Vaseline on your baby’s bottom before putting on the diaper.  For the first few days of life your baby will have meconium before it starts to transition to breastfed or formula fed poop, to learn more about these stools and other baby diaper expectations, read my blog on D is for Diapers.  If your baby hasn’t passed meconium in the first 2 days of life they may not eat well, may begin vomiting, and could end up having a bloated belly.  If any of this occurs, your doctors will begin checking for what conditions may be causing this complication.  To figure out if there is a problem your baby may need and X-ray or other tests.  This is not a very common occurrence; the most common complication with meconium is if your baby swallows it…

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L is for Lanugo

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L is for Lanugo

The very soft, almost invisible, hair that sometimes covers newborn babies is called lanugo. Sometimes this hair may be dark or even white.  Lanugo starts to develop in the womb around five months gestation and starts to fall out around eight months.  This hair may completely fall out before the baby is born, or your baby may still be covered in, or have patches of, the thin fuzz.  Lanugo is more common in premature babies who are born before the hair falls out.  This covering of lanugo also helps the protective coating of vernix to stick to and coat your baby in the womb.  As the lanugo sheds in the womb it combines with the amniotic fluid which is swallowed by your baby and creates the substance of their first poop, or meconium…

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K is for Kangaroo Care

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K is for Kangaroo Care

Kangaroo Care is just another way of saying skin-to-skin contact.  It is called kangaroo care due to the similarities it has to a mother kangaroo carrying her baby joey in her pouch.  This doesn’t mean you are both naked.  You or your partner are simply topless and your baby will still be in a diaper.  You can then wear a robe or jacket, or wrap a blanket around your both to stay warm.  When your baby is a bit older you can even hold them skin-to-skin with a wrap. Kangaroo Care can be one of the best ways to help your preterm baby, and is great for full term babies as well!  When you hold your baby skin-to-skin you help your baby stabilize their heart rate and respiratory rate, improve their oxygen saturation rate, and help them regulate their body temperature.  Helping their body with all of these tasks helps them conserve energy and thus they will be less likely to lose too much weight. Kangaroo care can also help with brain development and immune system function. The benefits are amazing!  Most tests and procedures can be preformed while you hold your baby skin-to-skin…

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J is for Juice

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J is for Juice

Something that can be a topic of conflict between new parents and grandparents is when it is okay to give your baby water or juice.  Grandparents may be telling you to give your baby extra water or juice to fill them up more or to help cool them down; this is now outdated information and should definitely be avoided in babies under 6 months.

Babies under 6 months should only be drinking breastmilk or formula.  Do not give your baby juice or water until they are 6 months old.  The American Academy of Pediatrics recommends avoiding any juice until your baby turns one year old…

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I is for Infant Massage

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I is for Infant Massage

Do you feel refreshed and relaxed after having a massage?  I know I do.  Having the tension in your muscles worked out can make you feel like a new person.  Believe it or not, newborns can benefit from massage therapy as well – and it is safe to start as soon as you would like.  Birth was a difficult journey and they are growing rapidly inside and out, so they are bound to have a few kinks that can get worked out.  Infant massage is a great way to help relax your baby, decrease stress, relieve their gas, and bond.  While they may benefit from professional massage or chiropractic therapy, there are some basic massage techniques you can do from home.  If you are in the military I highly recommend contacting your local New Parent Support Program (NPSP) and scheduling a group class or private home visitation where they can provide hands on instruction for massaging your baby safely…

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H is for Heel Stick

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H is for Heel Stick

The heel stick is likely the first blood draw your baby will have.  When this is performed on your newborn a small lancet will be used to prick your baby’s heel and then your baby’s foot will be squeezed until an adequate amount of blood has been obtained.  This heel stick typically occurs at the 24 hour mark and is part of the newborn screening which includes a hearing test and sometimes a congenital heart disease screening.  The newborn heel stick tests for serious genetic medical conditions.  Which specific conditions your baby is screened for varies by state, to learn what your state tests for you can visit Baby’s First Test.  Virginia screens for 31 different conditions.  Screening your newborn at birth will allow any medical conditions to be diagnosed and treated early, possibly saving your baby’s life.  The newborn screening is required in all states, but can be refused for religious reasons…

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G is for Gas

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G is for Gas

Gas is very common in babies.  Most gas in babies is caused when they are digesting milk or food; it is a normal byproduct of digestion!  Digestion gas usually passes through the bottom as a toot instead of as a burp.  But gas can also occur from swallowing air – this gas usually comes out as a burp or spit up.

When they eat, cry, or use a pacifier babies may swallow some air, which can pass as a toot or a burp.  This may make your baby bloated, fussy, have a hard tummy, cry, burp, or toot.  Unless your baby seems to be in constant pain, there is nothing to worry about with gas.  It is okay for your baby to cry, and even redden when passing gas, but as long as he/she goes back to his/her normal behavior after passing the gas, all is well.  Sometimes the gas is passed very loudly, often startling everyone in the room including your baby.  As your baby grows and his/her organs grow, gas will be less common or at least more tolerable…

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F is for Feeding

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F is for Feeding

There is so much involved with the different options of how to feed your baby.  I will not be able to go into that much detail on this blog post, but if you have specific questions about anything to do with feeding your baby please comment or send me a message and I would be happy to help.

There are essentially three ways you can feed your baby.  Breastfeeding, bottle feeding pumped milk, and formula feeding – or any combination of the three.  I will present the basic information covering the essentials of each option…

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E is for Erythromycin

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E is for Erythromycin

The gel that nurses or doctors put in your baby’s eyes after birth is call Erythromycin Ointment, although some simply refer to it as “the eye goo”.  Erythromycin along with a Vitamin K shot, and Hepatitis B vaccine are routinely given to baby’s shortly after birth.  It is recommended to give the ointment to babies within 24 hours after birth to prevent ophthalmia neonatorum, commonly known as pink eye, which in severe cases can cause blindness.  Pink eye in newborns is much more serious than the infection is in adults.  The previous treatment was silver nitrate drops; thankfully they no longer use this method of treatment…

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D is for Diapers

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D is for Diapers

By diapers I don’t mean what kind of diaper you should buy or how to put one on your baby, I mean what your baby is making for you inside those diapers!  Whether you cloth diaper, or use Pampers or Huggies or some other type of diaper, isn’t of concern – although you may want to wait a few days to use cloth diapers.  What you see in your baby’s diapers will change during the first week of life…

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C is for Cradle Cap

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C is for Cradle Cap

…Or what most parents frustratingly or accidentally call cradle crap-- it just rolls off the tongue so much easier than cradle cap.  Cradle cap looks like scabs or scales and can completely cover your baby’s scalp or may be in patches.  DO NOT WORRY!  This doesn’t itch, hurt, or irritate your baby.  These scales are thick and white or yellow of color and are nearly IMPOSSIBLE to remove!  Cradle cap usually affects babies from newborn to about three months old, but can last a year or more.

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B is for Bilirubin

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B is for Bilirubin

Bilirubin is a pigment in blood that causes neonatal hyperbilirubinemia, jaundice, in newborns.  This happens when the red blood cells break down.  The pigment is orange-yellow, and excessive levels can cause the skin and/or eyes to appear yellowed, this is referred to as jaundice.  Normally the liver removes the bilirubin from your baby’s blood and excretes it through the initial stools, or meconium.  High bilirubin levels can be caused by two key things: blood breaking down at a faster than normal rate or by a liver that isn’t functioning properly.  High bilirubin levels in adults can be a sign of cirrhosis, hepatitis, gallstones, or sickle cell disease…

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A is for APGAR

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A is for APGAR

APGAR is a test that is performed on your baby twice after birth, at 1 minute and at 5 minutes of life.  The tests can be done while you hold your baby as they are merely observations.  The score at 1 minute indicates how well your baby tolerated being born and the score at 5 minutes indicates how well your baby is doing now that he/she is outside of the womb.  If the scores are poor at 1 and/or 5 minutes the test may be performed again at 10 minutes…

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