When your newborn is premature or critically ill, they are cared for in a neonatal intensive care unit, or NICU. NICUs have specialized technology to care for the youngest, most vulnerable patients.
While an infant is in the NICU, board-certified neonatologists and specialized neonatal nurses monitor your infant closely to ensure your baby is continuing to grow and develop correctly.
NICU staff perform similar procedures and monitoring as adult intensive care units. They place breathing tubes, feeding tubes and central and peripherally inserted central catheter (PICC) lines. For some babies, staff can place an intravenous line in the umbilical cord that acts as a central line.
“With the technological advances in the last 40 years, we’re able to treat smaller and smaller babies and help them have positive outcomes,” said Dr. Audra Winder, a neonatologist with Marshfield Children’s Hospital at Marshfield Clinic Health System. “They are able to go on and lead normal lives with fewer long-term complications.”
Specialized intensive care unit
The baby’s incubator, or isolette, is equipped with specialized technology that control heat and humidity and help monitor the baby’s needs. Babies don’t have enough body fat to help them regulate their own temperature which results in heat and moisture loss rapidly through their skin. When a baby loses even a few degrees of heat, they won’t eat, breathing can become irregular and they can develop bradycardia (a low heart rate),” Dr. Winder said.
Even the baby’s pacifier has a high-tech way of helping. Some premature babies haven’t developed the muscles and reflexes to breathe and feed at the same time. Our NICU has a pacifier activated lullaby, or PAL. This is a special pacifier that encourages babies to develop their feeding skills by using lullabies or their parents’ voices as a reward.
Other specialized technology in the NICU includes bili light therapy to treat jaundice, non-invasive ventilator technology to support breathing without the need for a breathing tube, and mother’s breast milk or donated breast milk fortified with extra calories, protein and calcium to help infants grow.
Technology is available to help control the way patients are cooled, maintain goal temperatures safely and allow the care team to rewarm patients in a controlled fashion to avoid rapid temperature shifts.
“Cooling has been shown to slow down and reduce the demand on the patient’s brain in order to prevent further injury to those who qualify for this treatment,” said Dr. Carmen Verwoerd, neonatologist with Marshfield Children’s Hospital. “With most therapies, there are consequences to cooling, however, depending on the severity of the injury, benefits of this treatment outweigh the risks.”
Therapeutic hypothermia can halt the progression of injury in infants diagnosed with hypoxic ischemic encephalopathy (HIE). HIE is a type of brain injury caused by lack of oxygen before or shortly after birth. Therapeutic hypothermia does not repair the injury but can prevent further progression and help improve neurodevelopmental outcomes.
The standard of care for these neonates is therapeutic hypothermia and cooling blankets is one tool NICUs use to help provide this treatment.
“They allow us to achieve goal temperatures and maintain them safely to avoid dramatic swings in temperatures, which can have a negative impact on patient’s development,” said Dr. Verwoerd.
Other technologies available to NICU patients include gel pads, cooling cradles, water pads and special cooling pads for babies being transported.
“The differences in the devices is largely related to the time to reach goal temperatures, but ultimately, all are designed to aid in the treatment of neonates diagnosed with HIE and controlling time to cool, maintain goal temperatures and safely rewarm,” said Dr. Verwoerd.
Support for parents through NICU technology
Marshfield Children’s Hospital also offers support for parents. NicView cameras let parents see their child even when they cannot be by their side.
“They can see their baby on a secure website 24 hours a day. It’s helpful for families who live far away, and some moms find it helpful to watch when they are expressing breast milk,” Dr. Winder said.
With all the technological advances, sometimes mom or dad’s touch is the best medicine. The NICU encourages kangaroo care or skin-to-skin contact with their parent.
“We’ve seen improvement with vital signs, breathing, body temperature and long-term outcomes because of kangaroo care,” Dr. Winder said. Moms also can benefit from kangaroo care with reduced postpartum depression, better milk supply and increased bonding.
Child Life & Expressive Therapies at Marshfield Children’s Hospital has activities that help the babies stay on track with their developmental goals, as well as ways to provide support to baby’s parents and other siblings. Social workers and pediatric psychologists also provide coping strategies.
High quality care, close to home
Marshfield Children’s Hospital has the only NICU connected to a dedicated children’s hospital in the heart of Wisconsin.
“We’re able to take care of the youngest and smallest babies and do so in a gentler way, closer to home,” Dr. Winder said.
The NICU also has access to a wide range of pediatric subspecialties, including pediatric surgery. A dedicated specialty transport team is trained and available to care for the young NICU and pediatric patients while they are transported from around the state and region to receive care at Marshfield Children’s Hospital.
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