Gosnell Family Neonatal Intensive Care Unit (NICU) — Information for Parents
Calling the NICU
- You can call the NICU 24 hours a day at (585) 275-2267.
- Please do not call during the nursing shift change from 6:45 – 7:45 a.m. and 6:45 – 7:45 p.m. If there is any serious change in your baby’s condition, we will call you as soon as possible.
- We ask that parents make all phone calls concerning their baby and then relay the information to family members. We do not give information to family members or friends. If you are calling long distance, do not call collect. Instead, speak to your nurse to arrange daily calls to you.
Who's Who and What They Do
- Neonatologist: A pediatrician who specializes in the care of sick and premature newborns
- Neonatal fellow: A doctor who has finished pediatric training and is receiving additional training to become a neonatologist
- Pediatric resident: A doctor receiving special training to become a pediatrician
- Pediatric intern: A doctor in the first year of training following graduation from medical school
- Nurse manager: A registered nurse who oversees all unit operations
- Neonatal nurse practitioner: A registered nurse who has received additional specialized training to perform specific procedures and develop patient-focused care plans
- Neonatal nurse leader: A registered nurse who assists the nurse manager in overseeing unit operations
- Neonatal nurse: A registered nurse who specializes in the care of sick and premature newborns in the NICU
- Discharge coordinator: A registered nurse who assists with patient education and preparations for parents to take their baby home. She or he also helps with the transfer of babies to and from regional nurseries.
- Lactation nurse: A neonatal nurse who has an additional certification in lactation.
- Technical Support
- Respiratory therapist: A health team member with special knowledge of breathing problems, treatment, and equipment.
- Radiology technician: A health team member who takes medical images of your baby. This may be done in the NICU or in the radiology department.
- Social Support
- Social Worker: A health team member trained to help families cope with problems related to their baby’s hospitalization
- Chaplains: Ministers, priests, and rabbis who are available to families any time for spiritual support or prayer
- Parent to Parent Support Group: An organization of volunteer parents who have had an infant in the NICU
- Cuddler Program volunteers: Specially trained hospital volunteers who hold babies who need some extra TLC when parents can't be there
- Child Life Support
The Vocabulary of the NICU
The NICU staff uses terms that are probably unfamiliar to you. Here is a list to help you understand what we are saying.
|As and Bs
||Apnea and bradycardia
||Medicine given to treat an infection.
||A number from 0-10 given to a baby in the delivery room at one and five minutes of age, which describes how well the baby is at that time.
||A prolonged pause or stopping of breathing. It is a common problem in premature babies.
||Filling the baby’s lungs with air using a rubber bag, mask, and oxygen.
||A waste product that occurs when the body naturally gets rid of old red blood cells. It is a yellow-colored substance that may sometimes color the skin. If a blood test shows there is too much bilirubin in the baby’s blood, the baby may be placed under special lights that help get rid of the bilirubin. The baby’s eyes will be covered to protect them.
||A measurement of the amount of oxygen, carbon dioxide, and acid in the baby’s blood.
||A slowing of the baby’s heart rate.
||Continuous Positive Airway Pressure, a low pressure of air that is maintained in the airways to help a baby with breathing difficulty or with apnea.
||Blueness (duskiness) of the skin as a result of oxygen levels in the blood that are too low.
||Short periods of time when the oxygen level in the baby’s system drops below the accepted level.
|Endotracheal (ET) tube
||A tube that passes through a baby’s mouth into the trachea (windpipe) to allow oxygen to be delivered into the lungs.
||A unit of weight. 28 grams = 1 ounce; 454 grams = one pound; 1 kilogram = 2.2 pounds.
||Giving of nutrition into a vein: used in infants who cannot be fed or who are not yet taking all of their fluid by mouth.
||Fluids given into a vein.
||Refers to IVs that are placed into the umbilical artery or the umbilical vein (two blood vessels in the baby’s umbilical cord), through which sugar solutions and medications may be given. Blood samples may also be obtained through them.
||A newborn’s first several bowel movements. It is thick, dark green/black, and sticky. Babies sometimes pass meconium before birth.
||A small tube positioned at the baby’s nose, through which oxygen may be delivered.
||Nasogastric or orogastric tube—a small, soft, plastic tube placed through the nose or mouth into the baby’s stomach. This may be used for “gavage” or tube feedings.
||Latin abbreviation for nothing by mouth.
||Part of the air we breathe. Room air contains 21% oxygen. Sick or premature babies may need extra oxygen, sometimes even pure (100%) oxygen.
|Premature infant, Premie
||Any infant born before the 37th week of pregnancy. Full term babies are born between 37 and 42 weeks.
||The amount of formula remaining in a baby’s stomach before the next feeding.
||Ventilator, a machine to help with breathing.
||An infection, symptoms may include fever, poor feeding, continued apnea, and bradycardia.
||A substance made by mature lungs that makes it easier to breathe. Babies born before the 37th week of pregnancy may not have enough surfactant and may need to receive some to make breathing easier.
||Fast breathing, more than 60 breaths a minute.
||Measurement of heart rate, breathing rate, temperature, and blood pressure. In the NICU, we may also measure the baby’s abdominal girth.
||Your baby is weighed at least daily. Babies usually lose weight during the first several days after birth. Once they begin to gain weight, they will gain 10 to 30 grams (1/3 to 1 ounce) a day, on average.
Feeding Your Baby
At first, most babies get their fluids by vein. We begin to give your baby breast milk or formula as soon as his or her condition allows. Babies weighing less than 1500 grams (3 pounds, 5 ounces) are often fed through an OG or NG tube at first. When your baby is ready, he or she will begin breast/bottle feeding. When bottle feeding, a nurse gives the first feeding and arranges times that you can give your baby a bottle. We hope this allows you to become more familiar with your baby’s care and that it gives you some special time with your baby.
If you planned to breast feed your baby, we encourage you not to change your plans. We help you learn how to collect and store your milk if your baby is not yet ready to nurse at your breast. Then, when your baby is ready, we will help you with the breastfeeding or the change from bottle to breastfeeding. There is an electric breast pump available for you to use while you’re in the hospital or visiting your baby. If your baby will be hospitalized for a long time, you may want to rent a pump to have at home. Ask your baby’s nurse, the lactation consultant, or the NICU social worker for more information.
If you need help with breastfeeding, call the Breastfeeding Hotline at (585) 275-9575. A consultant is available on Monday, Wednesday, and Friday from 12:00 – 1:00 p.m.
Breastfeeding and Lactation Support for Mothers
Holding Your Baby
Premature babies often have a difficult time keeping their temperature stable. You can reach into the isolette to touch and talk to your baby through the portholes. You may also help change your baby’s diaper or take his or her temperature. When your baby is big enough to be held, it will be for short periods of time, one or two times per day.
Kangaroo care (skin-to-skin contact between parent and baby) is available in the NICU. Ask your baby’s nurse for more information about this.
Clothing and Toys for Your Baby
You may bring outfits, hats, and special blankets. While your baby is in the isolette, he or she will just be wearing a diaper, so we may better observe him or her.
Infant stimulation is necessary for your baby’s growth and development. Toys or gifts you can bring for your baby include:
- Small plastic or rubber toys
- Small stuffed animals
- Musical toys
- Pictures of family members or those colored by brothers and sisters
- Tapes with your voice or store-bought tapes
Remember, the isolette is small. Also, remember to label items with your baby’s name.
Leaving the NICU
On the day your baby is admitted to the NICU, we like to begin thinking about the day you will take your baby home. We want you to start talking, singing, and reading to your baby as soon as your baby is stable. We would like you to join in the baby’s care by changing the baby’s diaper, taking the baby’s temperature, and talking with the nurse about your baby’s care. We want you to have a chance to feed your baby many times before you take your baby home. We have daily classes so you can learn about baby care. We will teach you special things you need to know about your baby before you take him or her home. Your baby may need to go home with medicines, and we will teach you how to give those. Your baby may need special equipment, and we will teach you about that before you take your baby home. If there is anything special you want to learn (like infant CPR), let us know and we will teach it to you.
The staff of the NICU looks at many factors to determine when a baby can go home. All signs are positive when your baby is able to:
- Take all feedings by mouth
- Maintain his/her temperature in an open bed
- No longer requires oxygen or monitors
By visiting your baby regularly, you can work with our staff in planning for your baby to go home.
As soon as you know who your baby’s doctor will be after he or she goes home, tell us. If you don't have a primary care physician for your baby, our staff can help you find one. We will talk with your baby’s doctor so he or she will know your baby was in the NICU and what happened while your baby was with us.
As of November 24th, 2009 all children in New York State must be restrained in an appropriate child restraint system while riding in a motor vehicle, until they reach their 8th birthday. According to the American Academy of Pediatrics, it is recommended that infants remain rear facing until their 2nd birthday, or until they reach the height and weight limits of their car seat.
We will ask you to bring in your car seat, before your baby is discharged from the hospital. Infants born earlier than 37 weeks gestation will need a car seat test. Babies with other medical conditions or those who may not tolerate sitting in a semi-reclined position may also need this test. The car seat test will usually be done within one week of your baby being discharged home. During the test, the nurse will monitor your baby’s heart rate, breathing, and oxygen levels for a minimum of 90 minutes.
We recommend practicing putting the car seat in and out of your car, as well as buckling, tightening and loosening the straps before that special trip home with your baby. It is also recommended that you have your car seat installed at a child passenger safety fitting station. Ask your bedside nurse for information regarding locations for these installation sites.
Your baby may be well enough to leave the NICU, but not be ready to go home with you. He or she may not need intensive care any more, but may need special care. Your baby may need antibiotics, time to gain weight and grow, or more monitoring for apnea and bradycardia. In these cases, he or she may be transferred to another hospital, to the newborn nursery/birthing center, or to one of the pediatric floors at the Golisano Children’s Hospital.
Although we would like to have each of our babies discharged home, this is not always possible. The NICU at the Golisano Children’s Hospital is the only Neonatal Intensive Care unit for a 14-county region. Transfer to a special care unit at a community hospital or to one of the pediatric floors allows a family the opportunity to transition to home.
Many families are nervous about the transfer of their baby to a regional hospital This is a common feeling related to meeting a new medical team, becoming familiar with a new hospital, and leaving behind a familiar nursery with familiar faces. Transferring your baby to a hospital closer to your home can be a positive experience. Your own pediatrician will become familiar with you and your baby at this time. The atmosphere at most of the regional nurseries is less hectic than that of the NICU. This is a wonderful opportunity to get to know, cuddle, and enjoy your baby prior to his or her discharge to home.
We encourage you to visit your baby frequently. There are several services to help you lower the cost of parking. Read more parking information.
If the parking cost is a financial hardship, check with the NICU social worker for transportation assistance.
Getting More Information
Our staff is available to answer your questions and we want you to understand everything we are doing for your baby. It may be helpful to choose two or three people with whom you are most comfortable talking to get most of your information.
We know sometimes we tell you so much that it's hard to remember everything. So, during your baby’s stay in the nursery, we'll give you information sheets. You can read the sheets at your convenience. You can use them to help your memory or help explain your baby’s condition to family and friends.
We also have many books, articles, and videotapes that may be of interest to you. A TV and VCR are available on the unit to view the videotapes. Ask your baby’s nurse for more information.