Nurturing in Neonatal Intensive Care Unit
WHO states that 15 million babies are born too early worldwide every year, and India alone accounts for 21% of global preterm births.
While high risk pregnancy leading to the risk of delivering a preterm baby in the best of maternal centres in the city has become a common phenomenon today, we still have to improvise our infrastructure, technical facilities, high standard of nursing care and full time dedicated neonatologists to ensure that such babies are discharged healthy.
A preterm birth is when a baby is born before 37 completed weeks of pregnancy. Health issues like blood pressure and diabetes, and maternal infections are the commonest cause. While multiple births and IVF are a few other reasons for preterm deliveries. A preterm baby often faces several discomforts like breathing problems due to lung immaturity, Hypothermia (low body temperature), Hypoglycemia (low blood sugar), Anaemia, Patent Ductus Arteriosus ( a small tube connecting two major blood vessels outside the heart causing mixing of pure and impure blood), feeding issues due to infection to intestines called Necrotising Enterocolitis, failure to gain weight soon after birth in comparison to term babies, Intraventricular Hemorrhage (bleeding in the brain cavity and surrounding brain structure) often leading to minor or major long term neurological disabilities seen especially in babies born less than 28 weeks of gestation or who weigh less than 1000 grams, Jaundice, infection due to poor immunity, and many more.
Newborn babies (term as well as preterm) who need intensive medical attention are often admitted into a special area of the hospital called the Neonatal Intensive Care Unit (NICU). The NICU combines advanced technology and trained healthcare professionals to provide specialized care for the tiniest of babies. NICUs also have intermediate or continuing care areas for babies who are not as sick, but do need specialized nursing care.
The NICU team comprises of expert doctors across various specialties like Neonatology, Cardiology, Neurology, Radiology, Surgery, Ophthalmology, Physiotherapy, and many others inclusive of specially trained nurses.
A NICU is and should be equipped with high tech labs, blood bank, technology and machinery. As premature infants frequently have difficulty maintaining their body temperature, they also have infant warmers or incubators to keep the baby warm. For babies in the NICU who need extra help to breathe, are connected to the ventilator (or breathing machine) by placing a tube in the airway. Babies born before 34 weeks are initially started on tube feeds, and express mother’s breast milk is given in small aliquots and gradually increased. Cup feeds are later initiated and the mother is trained to feed her baby. In addition, preterm babies undergo periodic brain scans and eye-check when they are in the NICU and follow up for a period of up to 3 months post surgery.
The NICU also advises mothers to do Kangaroo Care – a technique where the premature baby is placed in an upright position on its mother’s bare chest, allowing tummy to tummy contact that positions the baby between the mother’s breasts. This care has several benefits, including establishing an enduring bond between the parent and child through touch and smell. The process can help regulate the babys heart and breathing rates, increase weight, calm the baby, provide deeper sleep, and regulate temperature.
The doctors and nurses ensure to give back the new parents a healthy and beaming baby. As the premature baby matures into a fully grown infant, the torch of responsibility will be passed on to the parents, and true parenthood will begin. A holistic approach of doctors, NICU nurses, and parents of the newborn ensures that a growing premiee has optimal nutrition and a normal developmental outcome.