Neonatal care has made amazing advances over the decades. This article hopes to demystify what's happening and explain why and how you can participate in your baby's care while they are under medical supervision.
Why Babies Might Need Monitoring After Birth
Some babies do not arrive ready for life outside the womb without a helping hand. Reasons a newborn may require closer monitoring or support in the hours and days after birth abound, and most are well understood and manageable.
Some of the more common reasons are:
- Premature birth
- Low birth weight
- Difficult or prolonged labour
- Infection
- Mother's health conditions
- Meconium in the amniotic fluid
- Multiple birth
Monitoring is not always an indication of a serious problem. In fact, many times monitoring will simply alert staff to a concern before it grows into an issue that requires more intensive intervention.
Newborn Breathing Problems
Breathing is perhaps the most important first function for a newborn. In some cases, it may not proceed smoothly, and breathing difficulties are some of the most common reasons that a newborn requires more intense monitoring.
Transient Tachypnea of the Newborn (TTN)
This is the most common condition affecting newborns, particularly those born via C-section. It is caused by the delay in fluid clearance in the lungs after birth. Babies born with TTN breathe rapidly and then recover within 24 to 72 hours with supportive care, and potentially some oxygen.
Respiratory Distress Syndrome (RDS)
Premature babies are more at risk of developing this condition, where the lungs have not yet been exposed to adequate levels of surfactant, the substance that allows the lungs to stay open. Babies may be treated with a replacement surfactant or breathing assistance.
Meconium Aspiration Syndrome
When a baby breathes in meconium, which is the first stool the baby produces, this can block air passages and inflame the lungs. Babies can recover fully with close observation, though some may require artificial ventilation.
A baby having difficulty breathing will likely display rapid breathing, have a grunting noise accompanying each breath, flare the nostrils, and you may note a dimpling of the skin on the abdomen with each intake of air. These symptoms will not go unnoticed by the neonatal care team.
Premature Babies Have Additional Special Care Needs
Babies born earlier than 37 weeks of gestation are considered premature. The earlier a baby is born, the more supportive care they are likely to require as their different body systems mature at different rates during pregnancy.
- Lungs: The lungs will not be fully developed until approximately 36 weeks, so these babies will often require breathing support from simple oxygen administration through to mechanical ventilation.
- Brain: Brain development takes place at a rapid rate during late pregnancy, so premature babies will be monitored very closely for signs of injury and brain bleeds.
- Digestive System: The premature baby's digestive system is often not ready to take adequate feeds at first, and they may be given feeds through a tube or via an IV line until they are more mature.
- Temperature: The premature baby lacks body fat and is therefore unable to maintain their own temperature and will be kept warm in an incubator.
- Immune System: The premature baby's immune system is underdeveloped, and this can make them prone to infection. For this reason, very stringent hygiene practices are observed in the NICU.
- Eyes: Very early born babies are screened for retinopathy of prematurity, an abnormal blood vessel growth within the eyes that can impact vision if left undetected.
Care is always a multidisciplinary effort between neonatologists, nurses and a whole team of specialists, all committed to helping the baby recover and thrive so they can be sent home as soon as it is possible.
Observing Babies in NICU
The Neonatal Intensive Care Unit, or NICU, is an area that is specially designed to care for sick babies or those who require high-level medical intervention. Walking into a NICU for the first time may feel quite overwhelming with all the monitoring, equipment and tubes. By understanding what each piece of equipment is doing, this anxiety will be reduced.
What the equipment does
- Cardiorespiratory monitor
- Pulse oximeter
- Incubator or radiant warmer
- Feeding tube
- Intravenous line
What Other Conditions Might Doctors Check and Monitor for After Birth?
Apart from breathing problems, some other conditions that might be observed or treated after the birth include:
- Neonatal jaundice
- Hypoglycaemia
- Neonatal infection
- Neonatal seizures
- Congenital heart condition
What Signs Should You Look Out for?
Once discharged home, be aware of the following and contact a health professional immediately should you see them:
- Fast, laboured, or irregular breathing
- Bluish appearance of the lips, tongue, or torso (centre of body)
- Poor feeding or refusing to feed consistently
- Limp or non-responsive in demeanour
- Extremes of temperature
- Jaundice that seems to be getting worse after discharge
- Any behaviour or signs which seem uncharacteristic for your baby
Trust your instincts; you will have spent time with your baby and seen him in an environment where even the most minute changes were closely monitored, so this does not have to end when you go home.
When Should You Contact the Doctor?
Contact your paediatrician or go back to the hospital if:
- Your baby exhibits any of the above warning signs after discharge
- You are worried about feeding, weight gain or development following discharge
- You are unsure of any aspect of care and future management for your baby
- You feel stressed and need support for yourself, as well as your baby
The NICU experience is far from being the end; often, it is a start. Every day, babies treated in neonatology departments return home, growing into inquisitive toddlers, energetic children and thriving young people. The days spent in the unit may seem to be stretching into eternity, but essentially, they are just one chapter of the story, not the entire story. You and your baby are coping with something remarkably difficult, and you are not alone.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.
FAQs on Why Some Newborn Babies Need Extra Medical Care After Birth
- Will the time in the NICU affect my baby’s development in the long term?
It is generally a fact that many babies who have been in the NICU develop absolutely normally in the long term. The development is dependent on the illness they had when in the NICU and what stage they were in (how mature they were). Regular checks with a follow-up appointment are crucial. - Can I stay with my baby while in the NICU?
Yes, in most NICUs, parents are encouraged to spend as much time with their baby as they can; most are open to visiting. Practical difficulties in being able to spend that amount of time there, due to travel or if there are other children at home to look after, can occur, but brief visits are always encouraged and make a positive difference for the baby.