Two days past her due date, Jennifer Pileggi finally went into labor. After several hours, the baby monitor showed that each time the 32-year-old from Orlando, Florida, had a strong contraction, her baby's heart rate dropped. Worried, the doctor recommended a Cesarean section. Pileggi was relieved when Anson was born the next day and seemed perfectly healthy, weighing 7 pounds 13 ounces. But soon a nurse noticed the baby seemed to be breathing too rapidly and took him for further evaluation. Within two hours, Anson had landed in the neonatal intensive care unit (NICU, pronounced “nick-you”). “I was shocked,” says Pileggi. “Nothing seemed wrong with him.” Anson had retained fluid in his lungs, a condition called transient tachypnea of the newborn, or TTN. When Pileggi next saw her newborn, he was hooked up to monitors and had an IV in his hand and an oxygen tube in his nose to help him breathe. After two nights he was released back to his mom's room, and the family left the hospital together.
No pregnant woman expects her baby to wind up in the NICU, but every year 10 to 15 percent of babies born in the United States (roughly half a million) do for reasons including prematurity (born before 37 weeks gestation), heart problems, birth defects, breathing irregularities and infections, among others. One in eight babies born in the United States are preterm, making that the number-one reason babies are admitted to the NICU; of those, 98 percent survive. If you're an expectant parent, it's good to know what goes on in these special hospital units — just in case.
Not All NICUs are Created Equal
Whether yours is a high-risk pregnancy or not, it's a good idea to learn where the nearest NICU is located and what level of care it provides. Each is rated level I to III, depending on the health problems the hospital can treat and the availability of specialized equipment. For instance, only NICUs rated level III are equipped to care for babies born before 32 weeks or those born with serious health issues.
The NICU's tubes, ventilators, IVs, incubators and high-tech monitoring equipment may look scary, but they're part of what makes the NICU the safest place for a sick or premature baby. The NICU's incubators (unlike the regular nursery bassinets) regulate their body temperatures for them. A (nasogastric) tube delivers breast milk or formula directly into baby's stomach via the nostrils. Immature lungs and respiratory complications are a common reason for NICU admission, so babies may also require oxygen hoods, a clear plastic box that fits over the baby's head and supplies oxygen. IV needles provide fluids to keep babies hydrated and deliver medication. Monitors taped to the baby's skin keep track of vital signs. Of course, if there's any kind of emergency, help is available instantly; the NICU nurses and doctors are experts in treating the tiniest patients, plus nurses are often assigned to only one baby for close monitoring, though they may care for up to four babies.