The Jennifer Gandel Kachura Neonatal Intensive Care Unit at Sinai Hospital NICU Parent Handbook The Jennifer Gandel Kachura Neonatal Intensive Care Unit at Sinai Hospital NICU Parent Handbook Dear Parents: You may have a lot of questions about your baby’s health and how long he or she will need to stay at Sinai Hospital’s Neonatal Intensive Care Unit (NICU). It may be hard to imagine a time when your baby will be strong enough to bring home. It is normal to feel this way. The good news is that most NICU babies grow up to be normal, healthy children. This booklet will address common concerns, tell you about the NICU and the people who care for your child, and services that are available at Sinai Hospital. You are an important part of your baby’s recovery. We want to work with you to give your child the best care possible. Please feel free to talk with us at any time about your questions or concerns. Let us know how you are feeling. Helping you deal with your emotions is an important part of our job. Even though you cannot take your baby home just yet, his or her birth is still a special event to share with loved ones. We join you in welcoming your child into your family and the world. The NICU staff NICU: 410-601-6077 Special Care Nursery: 410-601-6078 2401 W. Belvedere Ave. Baltimore, MD 21215 CONTENTS 1 Understanding the NICU Your healthcare team (Neonatologist, Pediatrician, Resident, Neonatal Nurse Practitioner [NNP], Registered Nurse [RN], Lactation consultant, Nutritionist, Social worker, Respiratory Therapist [RT], Students) Getting information about your baby What you can do for your baby Your feelings 7 Visitation Parking Illness and visitation 9 Premature infants Size, feeding, breastfeeding, formula feeding 11 Milestones in development Regular sleeping, waking Problems of prematurity (Apnea, Bradycardia –“Slow Heart Rate,” RDS, Jaundice, temperature, infection) 13 Frequently asked questions 14 Going home Mt. Washington Pediatric Hospital Feeding at home Sleeping Patient services (Family room, dining facilities, gift shop, Pastoral Care and Chaplaincy Services) 18 Newborn weight conversion table 19 Temperature conversion table UNDERSTANDING THE NICU The NICU is a place where necessary. This special place specially trained doctors, nurses exists to help your baby. and other staff care for babies who are premature or too sick Your healthcare team to be at home. Sometimes infants In the NICU, the staff functions need to stay in the NICU because as a team to ensure each baby something occurred during the receives the best possible care. birthing process. These babies Here is a brief description of the have special needs that cannot staff members who may be caring be provided for in a standard for your baby: newborn nursery. All of the equipment used in the Neonatologist NICU has alarms. When an alarm A doctor who specializes in goes off, it does not always mean taking care of sick newborns. that there is a problem with your The neonatologist directs the child. For example, an alarm may medical care. You will find that sound upon sudden movement, the neonatologist in charge coughing or crying; it does not will change from week to week. mean that your baby’s condition Pediatrician has changed. The staff quickly A doctor who provides medical responds to alarms and the baby’s care for children until age 21. needs and is prepared to take care After discharge from the NICU, of any problem that may occur. your pediatrician will assume The NICU may seem overwhelming care of your baby. at first, but the staff is there to assist and answer any questions Resident you may have regarding your A doctor who has graduated baby’s care. The physician staff from medical school and is is also available to answer your undergoing hospital training. questions at any time. Do not be Residents are very involved afraid to ask questions. Remind with your baby’s care, doing yourself often that even though a assessments and planning stay in the NICU is not what you medical care. wished for your baby, it is 1 Neonatal Nurse Practitioner Lactation consultant (NNP) A registered nurse who has A registered nurse who has specialized education and advanced training and experience training in breastfeeding. The in managing the care of premature lactation consultant will support and sick newborns. The NNP you and guide you through the works under the direction of breastfeeding process. a neonatologist. Nutritionist Registered Nurse (RN) A staff member who has special A nurse who has specialized training in meeting the nutritional education and preparation to needs of preterm infants. He or care for premature and sick she will evaluate your baby’s newborns. He or she observes nutritional state and make and monitors your baby’s recommendations about caloric condition and progress. The intake, vitamins and mineral RN also coordinates and supplements. carries out your baby’s plan of care, along with notifying Social worker the members of the health A team member who provides care team of any changes counseling and support while with your baby. assisting with discharge planning. The social worker will also 1 have information for you about support in assisting with services in the hospital and in students’ career development. the community. Getting information about Respiratory Therapist (RT) your baby A team member who helps manage the oxygen needs of We encourage parents to ask your baby and who may also questions at any time. We want assist with drawing lab work. to give the best care possible and help your family through Students this difficult time. The NICU Sinai’s mission includes teaching. team will set up family meetings As a result, you may sometimes early during your baby’s hospital see student doctors, nurses or stay to review the plan of care. respiratory therapists. Anytime you need to speak Students are always under to anyone on staff, please let the direct supervision of an someone know. The neonatologist experienced team member. We is available if you have questions appreciate your cooperation and concerning the plan of care. If you cannot be at the hospital, What you can do for your baby please call the NICU whenever In the NICU, there are things you wish. Information regarding you can do for your baby’s a baby’s condition will be given comfort and care. Sitting at the only to the parents. bedside, gentle touches and soft, soothing voices provide the love NICU and attention your baby needs. 410-601-6077 or 1-800-444-8233 As your baby becomes stronger, SPECIAL CARE NURSERY you will be able to hold, rock, 410-601-6078 feed and bathe your baby, as well as change diapers. It’s a good idea to designate As tiny as your baby is, he or someone to be responsible for she is able to communicate his updating your friends and family. or her wants and needs. Learn Ask your baby’s nurse about your baby’s stress signals that setting up special times for indicate too much is happening Facetime or Skype if you are and that he or she needs a break. unable to come in to visit. 4 Your baby may: baby will be ready for skin-to- • Fuss skin care. • Cry The positioning of your baby • Hiccup is very important. Having your • Arch or turn away baby’s hands and legs bent toward • Stiffen his or her arms or legs the middle helps prepare him Let your baby rest when he or she or her for eventual crawling is tired. and using his or her hands Skin-to-skin care is a form of together. You will notice holding that is encouraged in the different positioning aids are NICU. It involves holding your used to help facilitate proper baby inside your shirt against your growth and development. skin. Both parents can participate. To help make the NICU feel Studies show that the baby’s more like home, you may be breathing rate, heart rate and able to bring small items such oxygen levels stay steady during as brightly colored pictures, skin-to-skin care, which helps photos of family members or a them to grow and develop better. mobile if your baby is in a crib. Please ask your nurse when your You are the most consistent also feel fear and anxiety about person in your baby’s life during your baby. his or her hospital stay. If you Your body is healing, because observe any changes in your baby’s you have just given birth. Keep condition, please notify a member your rest and sleep schedules of the healthcare team. as close to normal as you can. If you are having difficulty Your feelings dealing with your feelings, let the social worker or other NICU During this stressful time, you staff know. They want to know may experience a wide range of how you are doing. If you need feelings. Many parents feel guilt more support than what the staff and anger, as well as wanting to or your family can provide, blame their spouse, doctors and there are additional resources even themselves. You probably available. 6 VISITATION We encourage you to visit and security desk before entering the ask that you follow the visitation unit. Parents must only release guidelines to ensure the safety and their infant to authorized staff privacy of our patients and their wearing a proper Sinai ID badge. families. While your baby is working on Visitors designated on the “friends getting stronger, the NICU staff and family” list may visit at any is working hard to protect him time.