The Neonatal Intensive Care Unit (NICU)

The neonatal intensive care unit (NICU)/special care baby unit (SCBU)/neonatal unit becomes the centre of the universe for parents of premature babies, so it's important to familiarise yourself with the way it operates.

As the parent of a premature baby, over the coming days, weeks and possibly months you are likely to spend a lot of time in the baby unit (also called the neonatal unit). This will probably feel very strange at first, but as you become more familiar with the way the unit works and what all the equipment does (see below), you will find it less daunting.

Your baby may need to be moved between units depending on what level of care (see below) they need at a given point in time.

How the baby unit works

Every neonatal unit has its own set routine. Parents are usually allowed to visit their babies almost 24 hours a day, although there may be short periods when you are asked to leave - for example, during shift handover times. There may also be set quiet times when visitors are asked to be very quiet, to give the babies time to sleep. They may also keep the lids on incubators or swaddle babies to help them rest.

Levels of care

Special care baby unit (SCBU) 

Also called the special care baby unit (SCBU, pronounced 'skaboo') or special care unit (SCU), these provide the most simple level of care for babies in their local area and stabilise a baby's condition before transferring them to another unit or provide emergency care if necessary. They may also provide some high-dependency services. They receive babies from other units once they are well enough to be cared for there.

Local neonatal unit (LNU)

Local neonatal units (LNUs) provide special care for babies in their local area, except for those who are very unwell and need complex or longer-term intensive care. The majority of babies over 27 weeks of gestation will usually receive their full care, including short periods of intensive care, within their LNU.

Neonatal intensive care units (NICU)

These specialist units have the facilities to care for critically ill premature babies. Babies will be transferred here from around the country to access the specialised expertise that they offer. They provide the whole range of medical neonatal care for their local population, along with additional care for babies and their families referred from the neonatal network.

Hygiene in baby units

The babies in these units are very vulnerable to infection, so you will be asked to wash your hands every time you enter the unit, and if you have a cough or cold you will be asked not to come in.

Is there somewhere I can take a break?

Most units will have a parents' room where you can doze, catch up with emails, watch TV or even just read a book. Some provide a playroom too, for older siblings.

Can I stay overnight with my premature baby

Some units offer overnight accommodation for parents, which might be a private room or just a reclining chair in a common room. Others will provide contact details of local accommodation where you can stay, such as through the Ronald McDonald House Charities website.

Some baby units have a family room where parents are encouraged to 'room in' with their baby for a few nights before taking them home, to help you all adjust to family life outside the unit.

What does all the equipment in the baby unit do?

The hums, beeps and flashing lights of equipment in the baby unit (whether it is a neonatal unit, special care baby unit (SCBU) or neonatal care intensive care unit) can seem daunting at first, but you will soon become familiar with the machines

Your premature baby will be supported by a lot of different devices. Most of them are involved in helping them breathe, receive nutrients and stay warm.

 

(1) Incubator

 A see-through box on wheels which keeps your baby warm. It may be open, with an overhead heater or heated mattress, or closed, with a lid, to keep the air around your baby warm and humid.

(2) Overhead heater

 A heater for an open incubator to make sure your baby's temperature is correct.

(3) Monitors

These check your baby's breathing rate, heart rate, blood pressure, temperature, and the amount of oxygen, carbon dioxide and acidity in his blood. They also alert staff if your baby has apnoea, in which the baby stops breathing for more than 10-20 seconds. This is quite common in premature babies.

(4) Ambient oxygen analyser

 This small appliance sits inside the incubator to make sure there is enough oxygen in the air.

(5) Intravenous (IV) drip

Your baby can receive fluids, nutrients and medication through this narrow tube and needle. If your baby needs a drip for a long time, the team might insert a catheter (also called a PICC line or long line), which doesn't need to be changed so often.

(6) Feeding pump and tubes

Flexible plastic tubes through which nutrients are passed. They might have one, or all, of the following: a nasogastric tube which goes through your baby's nose, an orogastic tube through their mouth and into their stomach, and a transpyloric tube which goes directly to thier gut.

(7) Power supply

The point from where the power comes to power the other machines. All hospitals have back-up power in case of a power cut.

(8) Ventilator monitor

A monitor on which all the ventilator settings are displayed.

(9) Ventilator

Some babies will be put on a ventilator - a machine that blows air and oxygen through a tube into their nose or throat and into the lungs. A positive pressure ventilator delivers the air mixture in 'breaths' while an oscillatory or high-frequency ventilator delivers it through tiny vibrations.

The baby unit

Caring for your baby

  • Mother holding baby to her chest.

    Kangaroo care

    Skin-to-skin contact with your premature baby is a wonderful way for you both to bond. It also provides health benefits.

  • Mother holding premature baby.

    Caring for your baby: your role

    The healthcare team will cater for your baby's medical needs, but they need you too. As you get to know your premature baby, you will begin to work out what they need.

  • Premature baby using feeding equipment.

    Feeding your premature baby

    Your premature baby's diet will be carefully balanced to suit their tiny digestive system while meeting the needs of their growing body.

  • Premature baby in incubator.

    Positioning your premature baby

    Positioning your premature baby correctly can make them feel secure, improve their breathing ability, strengthen their muscles and reduce the risk of cot death.

Treatment and medical support

Sources

  1. Department of Health (2009) DH Toolkit for high-quality neonatal services, p10
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Last reviewed on April 1st, 2014. Next review date April 1st, 2017.

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Comments

  • By Midwife @Tommys on 18 Apr 2017 - 09:31

    Dear Pat,
    What a wonderful project and very kind offer. As a pregnancy helpline we wouldn't be able to pass the hats onto parents and babies that would benefit from them - if you haven't already please get in touch with your local special care baby/neonatal intensive care unit who would really benefit from such a generous donation.

  • By Anonymous (not verified) on 15 Apr 2017 - 04:43

    I make preemie and newborn hats wondering if you need any. Please give me a stress and will send you some.
    Thank you for your time
    Pat

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