Glossary of Terms



Medical Staff


Your Baby's Nurse

a specially trained R.N. (registered nurse) who will deliver nursing care to your baby. The R.N. works 12 hour shifts.

Clinical Nurse IV (CN IV)

a nurse who oversees and supervises the care given to each baby. There is usually one CN IV for each shift (day and night). CN IVs serve as the Charge Nurses. They are available to assist nurses, doctors and parents in problem solving and planning.

Charge Nurse

a nurse who is "in charge" of the nursing care during a shift and assists doctors and parents in problem solving and planning.

Clinical Nurse Specialist

a nurse with an advanced degree in nursing of the newborn. She educates and oversees major changes in nursing care. She also discusses and gives care in special clinical situations.

Discharge Coordinator

a nurse who plans for discharge with the family and health care team. This helps make everyone ready when the baby goes home. She makes sure teaching has been completed, and works with hospital staff and home health agencies. She arranges for the parents to room-in and for home care, community services and Infant Progress Clinic.

NCT

Unit Secretary (Nursing Care Technician)

Nurse Manager

a nurse who is primarily a manager. The nurse manager has 24 hour responsibility of nursing for the NICU. Her schedule is flexible, and she may be reached by the Charge Nurse after hours. She assists nurses, doctors, and parents in problem solving and planning.

Primary Nurse Team

a team of nurses who cares for a baby who is expected to be in the NICU a long time. The team plans for the baby's nursing care.

Logistics Technician (Log Tech)

staff who care for the supplies and tidiness of the NICU.

Neonatologist

a pediatrician who takes care of sick or premature newborns.

Neonatal Fellow

a pediatrician receiving more training in the care of sick newborns.

Pediatrician

a medical doctor trained in pediatrics.

Pediatric Resident

a medical doctor training in pediatrics.

Neonatal Nurse Practitioner (NNP)

a registered nurse with Master's Degree training in neonatology. The NNP does exams and procedures under the supervision of the neonatologist.

Medical Student

a person who has completed the first two or three years of medical school, learning clinical care of children and newborns. Not yet a licensed medical doctor.

Consulting Physician (Cardiologist, Neurologist, Ophthalmologist, etc)

A medical doctor trained in some area other than pediatrics.

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Other Members of the Team


Social Worker

a clinician with a Master's degree who helps families with their feelings about having a tiny or sick baby. They also help with community resources and financial concerns.

Case Manager

a staff member who works with insurance agencies and helps with discharge and home care plans.

Parent Liaison (Parent-to-Parent Coordinator)

a member of the NICU team who has had her own infant in the NICU. She helps with parent-to-¬parent support programs.

Respiratory Therapist

a licensed person trained in the management of breathing disorders, treatments, and procedures, oxygen and ventilators. Referred to as an RT or RCP (Respiratory Care Practitioner).

Occupational/Physical Therapist (OT/PT)

is a person who has special training in growth and development of infants. She does exercises that help improve development and muscle control. This helps with feeding skills.

Technician (X-Ray, EEG, EKG, Ultrasound, etc.)

a person who performs specific tests ordered by the doctor.

Transport Coordinator

a nurse who oversees the entire neonatal transport program, which brings sick babies into the NICU from other hospitals.

IPC Coordinator

a nurse who will help plan developmental follow-up for some babies.

Chaplain

a pastor, priest, minister, or rabbi who offers spiritual care to families.

Volunteers

people who give their time to help in the NICU - greeting, answering phones, and assisting the nursing staff. All volunteers receive an orientation and training by the hospital Volunteer Services Department and the supervisors in the NICU. "Cuddlers" help the nurses when a baby needs extra holding and comforting, when parents are not available. Parent-to-Parent volunteers support NICU families by telephone and other programs.

Parents

You too, are members of your baby's team. As parents, you are the most important people in your baby's life. There will be many different staff with your baby to provide care. However, you are the only ones who will remain absolutely constant. By being here as often as you can, your baby will come to know your touch and face. (He already knows your voice.) You will get to know him, too: what seems to comfort him most, what he likes and dislikes. We hope you will share these thoughts with us so we can all give him personalized care. Don't ever feel that your presence, calls or questions are an inconvenience to the staff. Remember, they not only care for your baby -- they also care about him, and about you.

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NICU Terms


A's and B's

an abbreviation referring to episodes of apnea and bradycardia; see APNEA and BRADYCARDIA.

ANEMIA

less than the normal number of red blood cells in the blood.

APNEA

The cessation of breathing.

ASPHYXIA

A condition where there has been a lack of sufficient oxygen to the tissues of the body. The brain and the kidneys are the most sensitive organs to a lack of oxygen.

ASPIRATION

Breathing a foreign material (such as formula, stomach fluids, meconium, etc.) into the lungs.

ATTENDING PHYSICIAN

a doctor who has the primary responsibility for coordinating the medical care for a patient. In the NICU this will generally be the neonatologist.

BAGGING

Filling the lungs with air or oxygen by squeezing a bag which is connected to an endotracheal tube or attached to a mask fitted over the face. This allows us to breathe for the baby when his own breaths are not enough.

BILILIGHTS (Phototherapy)

special lights used in the treatment of jaundice; see JAUNDICE.

BILIRUBIN

A breakdown product of red blood cells. See JAUNDICE.

BLOOD GASES

The amounts of oxygen, carbon dioxide and degree of acidity in the blood. A small amount of blood is taken from the heel (by heel stick), umbilical catheter or from the artery near the wrist where your pulse is felt to test for these levels.

BLOOD PRESSURE (BP)

The pressure of the blood in the arteries with each pulsation of the heart.

BRADYCARDIA

An abnormally slow heart rate.

BROVIAC

see CENTRAL CATHETER

CARDIOLOGIST

A medical doctor who specializes in the heart and circulation.

CASE MANAGER

A staff member who interfaces with insurance agencies regarding medical necessity and length of stay, as required, helps with discharge planning, arranging for medical equipment and visiting nurses when necessary, and makes referrals to CCS for medically eligible infants. Many insurance companies also have CASE MANAGERS who are assigned to customize and individualize benefits for those with extensive or complex health care needs.

CBC (Complete Blood Count)

A count of the various types of cells present in the blood, chiefly: red cells (for carrying oxygen), white cells (for fighting infection), and platelets (for prevention of bleeding).

CCS (California Children's Services)

a state agency, operating by county, which assists with medical benefits and ongoing therapies for infants and children who meet certain diagnostic criteria.

CENTRAL CATHETER or CENTRAL LINE

a thin, flexible tube (catheter) placed in a larger vein or artery to deliver medications or necessary fluids and nutrients to the body. Broviac catheters are usually placed in the upper chest and tunnel under the skin to enter the vena cava, the large blood vessel in the center of the body carrying blood to the heart. PICC lines (percutaneously inserted central catheters) are usually threaded through a vein in the arm to the vena cava. Central catheters also include umbilical venous and umbilical artery catheters which may be inserted into the vein or artery of the umbilical stump (belly button) shortly after birth.

CHEMSTRIP

a test in which a drop of the baby's blood is placed on a strip of special paper to determine the amount of sugar in the blood.

CHEST TUBE

A small plastic tube placed through the chest wall into the space between the lung and chest wall to remove air or fluid from this space. See PNEUMOTHORAX.

CIRCUMCISION

A surgical procedure done to remove the foreskin of the penis. Usually done just before the baby goes home and only on request.

CONGENITAL

Existing at the time of birth.

CPAP

Continuous Positive Airway Pressure - a form of ventilator assistance which helps to keep the baby's lungs properly expanded. CPAP does not breathe for the baby, but allows the baby to breathe into a "wind."

CT SCAN (of the head)

Computerized x-rays which show the size and position of many parts of the brain. A CT scan also can be done on other parts of the body. The baby must go to another area of the hospital to have a CT scan.

CULTURE

A laboratory test of blood, spinal fluid, urine, or other specimens which shows if germs are present and which ones they are.

CYANOSIS

Blue color of the skin occurring when there is not enough oxygen in the blood.

DIFFERENTIAL

A test which divides the white blood cell count (from the CBC) into several categories, chiefly: "polys" (short for polymorphonuclear leukocytes), "bands" (immature "polys"), "lymphs" (lymphocytes), "monos" (monocytes), "cos" (eosinophils), "basos" (basophils). The percentages of each cell type may vary in different kinds of infections; for example, polys and bands usually will predominate in bacterial infections, while the number of lymphs usually will increase in viral infections.

ECHOCARDIOGRAM

A test done to look at the heart using soundwaves through the chest wall. This is much like an ultrasound done during pregnancy and is neither harmful nor painful.

EDEMA

"Puffy" skin from a build-up of fluid in body tissues.

ENDOTRACHEAL TUBE (ET Tube)

A plastic tube which goes from the baby's nose or mouth past the vocal cords and into the upper trachea (windpipe).

EXCHANGE TRANSFUSION

A treatment which removes the baby's blood in small quantities and replaces it with donor blood. This procedure is used most frequently to lower the level of bilirubin in the baby's blood. (See also Jaundice.) It also may be used to raise or lower the number of red blood cells, and improve the ability of the blood to clot.

EXTUBATION

removal of a tube which has been placed through the nose or mouth into the trachea; see ENDOTRACHEAL TUBE.

FELLOW (in Neonatology)

A trained pediatrician who is receiving additional specialized training in the care of sick newborns.

GASTROENTEROLOGIST

a medical doctor who specializes in the digestive system.

GASTROSTOMY

a surgically created opening in the abdominal wall to provide nutrition directly into the stomach.

GAVAGE FEEDINGS

Feedings delivered by a small plastic tube placed through the nose or mouth and down into the stomach when the baby is too weak or too premature to suck and swallow.

GENETICS

the branch of medicine that deals with heredity, the variation of individuals, prognosis for development and function, and risks of recurrence of genetic conditions.

HEART MURMUR

A rushing sound made by the blood within the heart, usually heard with a stethoscope. This may or may not be a sign of a problem for a baby.

HEELSTICK

A quick prick of the heel with a sterile instrument (much like a finger prick) to obtain small blood samples for tests.

HEMATOCRIT (crit)

A test done to determine if the amount of red blood cells in the blood is adequate.

HOUSESTAFF

a term referring to medical doctors who are enrolled in a supervised training program in an area of specialization, such as Pediatrics; see also INTERN and RESIDENT

HUMOR, SENSE OF

something you used to have before your baby was in the NICU. Don't lose your sense of humor, it helps parents get through these difficult times.

HYDROCEPHALUS

an abnormal accumulation of cerebrospinal fluid (the normal fluid which bathes the brain and spinal cord) in the ventricles of the brain.

HYPERALIMENTATION

see PARENTERAL NUTRITION

HYPERBILIRUBINEMIA

An elevated level of bilirubin in the blood. See JAUNDICE.

HYPOGLYCEMIA

A low amount of sugar (glucose) in the blood.

I:E RATIO

The ratio of the length of the forced breath provided by a ventilator to the length of the time between two breaths.

INFILTRATE (IV Inflitrate)

the slipping of an IV needle out of a vein, allowing IV fluid to accumulate in the surrounding tissues.

INTERN

a medical doctor in his or her first year of "residency." See also RESIDENT

INTRAVENOUS (IV)

A small plastic tube or hollow metal needle placed into one of the baby's veins, through which fluids, sugar, and minerals can be given when the baby cannot take all of his nourishment by feedings.

INSPIRATORY TIME (IT)

The length of a forced breath provided to the baby by a ventilator.

INTRAVENTRICULAR HEMORRHAGE (IVH)

A collection of blood in and around the ventricles (hollow portions) of the brain.

INTUBATION

Placing an endotracheal tube in the baby's trachea (windpipe). See Endotracheal Tube.

JAUNDICE

A yellow coloration of the skin and eyes caused by increased amounts of bilirubin in the blood. Bilirubin is a break-down product of red blood cells; it is processed and excreted by the liver. Treatments for jaundice include phototherapy ("bili-lights") and (rarely) exchange transfusion.

LUMBAR PUNCTURE ("Spinal Tap")

A procedure in which a small needle is placed in the small of the back, between the vertebrae (back bones), to obtain spinal fluid for bacterial cultures and other tests.

MAS (Meconium Aspiration Syndrome)

see MECONIUM ASPIRATION.

MECONIUM

The first bowel movements that a baby has which are thick, sticky, and dark green to black in color.

MECONIUM ASPIRATION

The inhalation of meconium into the lungs. If a baby passes meconium before delivery, the meconium may be inhaled into the lungs, causing problems with breathing after the baby is born. This condition is called meconium aspiration syndrome (MAS).

MENINGITIS

Infection of the fluid that cushions and surrounds the brain and spinal cord.

MRI (Magnetic Resonance Imaging)

A computerized method of viewing any portion of the body. It uses magnetism rather than x-rays. All metal must be removed from around the baby. The baby must go to another area of the hospital to have an MRI.

MURMUR

see HEART MURMUR.

NASAL CANNULA

A clear plastic tube which passes under the nose to provide supplemental oxygen.

NECROTIZING ENTEROCOLITIS (NEC)

An infection of the wall of the intestines, which may spread to the blood. Premature babies are particularly vulnerable to this disease. Surgery is sometimes necessary to remove damaged intestine, and the baby may need prolonged feeding by vein until he recovers. See also PARENTERAL NUTRITION, SEPSIS.

NEONATOLOGY

The medical specialty concerned with diseases of newborn infants (neonates). Neonatologists are pediatricians who have received several years of additional training.

NEPHROLOGY

A medical doctor who specializes in disorders of the kidneys.

NEUROLOGIST

A medical doctor who specializes in the brain and nervous system.

NPO

Nothing to be given by mouth.

OPHTHALMOLOGIST

A medical doctor who specializes in disorders of the eye.

OTOLARYNGOLOGIST

A medical doctor who specializes in the ear, nose, and throat.

OXYHOOD (02 hood)

A clear plastic hood placed over the baby's head through which oxygen is given.

PARENTERAL NUTRITION (also called Total Parenteral Nutrition, or TPN)

Protein and sometimes fats (lipids) given along with sugars and salts by vein when the baby cannot tolerate complete feedings by nipple or gavage.

PATENT DUCTUS ARTERIOSUS (PDA)

A small vessel which allows blood to bypass the lungs. This vessel is open while the baby is in the womb, but normally closes shortly after delivery. If the vessel fails to close on its own, special medication or surgery may be needed.

PEAK INSPIRATORY PRESSURE (PIP)

The highest pressure that is delivered to the baby by the ventilator during a forced breath.

PEDIATRICIAN

A medical doctor who specializes in infants and children.

PEEP

See POSITIVE END-EXPIRATORY PRESSURE.

PHOTOTHERAPY

A treatment in which the baby is placed under bright lights (frequently blue in color) or on a special light blanket which helps bilirubin to be excreted into the intestine. See also BILIRUBIN, JAUNDICE.

PICC LINE

see CENTRAL CATHETER

PIP

see PEAK INSPIRATORY PRESSURE.

PKU

A rare disorder in which one of the amino acids (a building block of protein) cannot be handled normally by the baby, leading to elevated levels in the blood. Babies with PKU require a special diet. All babies are routinely tested for PKU, as well as several other disorders, before going home from the nursery. This test is required by law.

PNEUMOMEDIASTINUM

Leakage of air from the normal passageways of the lung into the space surrounding the heart inside the chest. A pneumomediastinum is usually harmless in itself, but is often associated with a pneumothorax (which can be life-threatening if large). See PNEUMOTHORAX.

PNEUMOTHORAX

Leakage of air from the normal passageways of the lung into the space surrounding the lung inside the chest wall, causing a partial or complete collapse of the lung.

POSITIVE END-EXPIRATORY PRESSURE (PEEP)

The lowest pressure that is delivered by the ventilator to the baby between forced breaths. See also PEAK INSPIRATORY PRESSURE (PIP).

PROGNOSIS

What is expected in the future.

RED BLOOD CELLS

The cells in the blood which carry oxygen.

REFLUX

A return or backward flow; gastroesophageal (GE) reflux occurs when portions of feedings or other stomach contents flow back up into the esophagus.

REGIONAL CENTER

One of a network of state-funded agencies which helps to coordinate community services and resources to infants at risk of having a developmental delay; also provides services and coordination of resources to children and adults with specific developmental disabilities.

RESIDENT (Pediatric)

A medical doctor who is training to become a Pediatrician. A residency program is usually three years long. First year residents are sometimes referred to as interns. Third year residents are sometimes called senior residents.

RESPIRATORY DISTRESS SYNDROME (RDS)

A common breathing problem of premature infants caused by insufficient surfactant in the baby's lung. This results in an excessive stiffness of the baby's lungs. See also SURFACTANT

SEIZURE

A "short circuiting" of the electrical activity in the brain, sometimes causing involuntary muscle activity or stiffening. There are many causes of seizures. If your child has a seizure, speak with your baby's doctor about this condition and its implications.

SEPSIS

Infection of the blood. See also MENINGITIS, NECROTIZING ENTEROCOLITIS.

SEPTIC WORKUP

An assortment of tests performed on an infant who is suspected of having an infection. This may include a chest x-ray and/or abdominal x-ray, as well as blood, urine, and spinal fluid cultures. Because infections in babies can progress very rapidly, the baby is frequently started on antibiotics until the results of the cultures are known.

SUPRA-PUBIC TAP

Obtaining an uncontaminated sample of urine by first cleaning off the lower abdomen, then inserting a needle directly into the urinary bladder.

SURFACTANT

A material secreted by special cells within the alveoli (air sacs) of the lung, which makes the lung flexible and helps to keep the lung from collapsing. Deficiency of surfactant is the main problem in Respiratory Distress Syndrome (RDS). Commercial products are available which can be put into the lungs through the tube in the windpipe. These products frequently are very helpful to the premature baby with RDS.

TRACHEOSTOMY

A surgical opening in the trachea, below the larynx (voice box) to allow air to enter the lungs; usually done to by-pass a narrowing in the area immediately below the larynx.

TRANSFUSION

Giving donated blood to the baby by vein or artery.

ULTRASOUND OF THE HEAD

A test done using soundwaves which shows an image of the brain. The test is not harmful or painful to the baby and may be done at the bedside.

UMBILICAL CATHETER

A small plastic tube in one of the umbilical (belly button) blood vessels (either an artery or a vein).

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Common NICU Disorders


Prematurity

Normally, pregnancy lasts from 37 to 42 Weeks (approximately nine months). Infants born before 37 weeks are considered to be premature. Although a premature baby may not be fully prepared for life outside the womb, he has been completely formed (even fingers, toes, and nails) since he was 12 weeks old! Most of a premature baby's problems result from a lack of time: to acquire the more mature characteristics such as fat, some enzymes, and internal body regulators. The size and frailty of your premature baby may frighten you at first. This will lessen as you visit more often and get to know him. Most parents search for the reason for their child's premature birth and feel some responsibility for it. Was there something they did or didn't do that could have caused it? Often a premature e birth cannot be explained or related to anything. Your obstetrician will be able to answer some of your questions and help you sort through this problem. It is important to begin resolving some of' these feelings in your mind early, so you can focus your attention and energy on your baby.

Premature babies look different than full term babies. The most apparent difference is size. They may weigh anywhere from just over one pound to five or six pounds or more, depending on the length of the pregnancy They have less fat than a term baby and smaller muscles. Because of this, they may seem skinny or bony (especially around the ribs). With time they will fill out. Their skin is softer and thinner and may be covered with a line, light hair (lanugo). It will disappear- in a few weeks just as it would have inside the uterus. The muscular reflexes are usually acquired late in pregnancy. Because of this, your baby's movements may seem shaky or jerky. He will become increasingly coordinated as he grows older. His sucking and swallowing reflexes usually do not occur in a coordinated fashion until 32 to 34 weeks' gestation. When your baby is ready to digest milk, tube feedings can be given until this sucking and swallowing coordination has been acquired. Meanwhile, you can help him practice with a pacifier.

Prematurity carries with it a wide range of potential problems, from mild to severe. Fortunately, in the last decade or set, great advances have been made in the understanding of- premature babies. Now, the chances are much greater for premature babies to grow up to live happy, healthy lives.

Respiratory Distress Syndrome

The most common difficulty premature babies have is Respiratory Distress syndrome (RDS), also known as Hyaline Membrane Disease (HMD). In this disease, there is a relative lack of surfactant. Surfactant coats the lining of the lungs and allows them to inflate easily and retain air. Surfactant frequently is not present in sufficient amounts until the last month of pregnancy. Insufficient amounts will cause the baby to work harder to take deep breaths. This can be very tiring. Some of the medical help required may be oxygen, CPAP, a ventilator, or adding surfactant into the baby's windpipe (trachea). These treatments will be discussed later in this section. RDS frequently improves between the third and fifth day of life, although these babies may be ill for some time with related problems. Our staff is very familiar with RDS and has much experience helping babies through it. Even when a baby is not ready to be held, he can be comforted by the warm touch of his parent's finger.

Patent Ductus Arteriosus

Before birth, a lot of blood does not need to go to the baby's lungs to pick up oxygen because oxygen is supplied by the mother's bloodstream through the placenta. The blood is directed away from his lungs and to the rest of his body by a vessel called the ductus arteriosus. The ductus arteriosus is located just outside the heart and normally closes shortly after birth because it is no longer necessary. Often, in premature babies it fails to close. This open vessel is called a patent ductus arteriosus (PDA). If the ductus remains open, mild to severe problems can occur. The therapy given will depend on the severity of the problem. Two possible treatments to close a PDA are medication and surgical closure. Usually medication is the preferred treatment and most often is successful. Either will be explained to you before it is begun.

Apnea

It is normal for premature babies to have an irregular pattern of breathing. At times, they may even stop breathing. If this occurs, the breathing monitor and sometimes the heart monitor alarm and the nurse will help the baby to begin breathing again. She may tickle him or rub his body to remind him to breathe. She may also have to give him breaths of air with the resuscitation bag at his bedside. These "apnea spells" (episodes of stopped breathing) may be caused by many things. Most frequently, they are due to an immaturity of the breathing control center in the brain and will go away in time.

Infection

Babies are generally more prone to infection than adults. If the medical team suspects your baby has an infection, tests may be needed. Samples of blood and/or other body fluids may be sent to the laboratory. Tests to detect infection may take many days. Antibiotics may be started right away.

Necrotizing Enter colitis (NEC)

NEC is an infection of the wall of the intestines (gut). It may spread to the blood. Premature babies are prone to this disease. They cannot be fed by usual means, and will need nourishment by vein. Although often mild, some cases are very serious. Surgery is sometimes necessary to repair or remove damaged intestine.

Retinopathy of Prematurity (ROP)

ROP is a problem of the retina (back part of the eye that "sees"). It occurs mostly in very premature infants. Most cases are not severe and get better on their own. However, on occasion, it can threaten vision in one or both eyes, and surgery may be necessary to improve the chance for sight. Cedars-Sinai's NICU is recognized for its low incidence of ROP.

Pneumothorax

Occasionally, air will "leak" from the baby's lungs into a space between the lung and the chest wall. This trapped air prevents the lung from fully expanding. If large enough, this will cause difficulty breathing and the air may need removal by placing either a needle (for one time removal) or a plastic tube (for continuous removal) in the chest. The tube may need gentle suction to draw out the trapped air. This tube is left in place until the air is removed and the lung is no longer leaking air. This may take a few or many days.

Meconium Aspiration

Occasionally, while still in the mom, babies may pass stool (meconium). If the baby breathes it into his lungs (aspirates), it can cause difficulty breathing. Treatment for this problem may include placing a tube into the baby's lungs and cleaning them out with suction. The baby may need oxygen, chest therapy and even the help of a ventilator. The body clears the last traces naturally.

Jaundice

Jaundice (yellowing of the skin) is a common problem in babies. It occurs when a pigment called bilirubin enters the blood. Bilirubin is formed by the normal breakdown of red blood cells. Bilirubin is cleared by the liver and removed from the body. A baby's liver may not be able to perform this job efficiently. A blood test can be done to check the amount of bilirubin in the blood. If it is more than the normal amount, treatment will be started. Light of a specific wave-length and intensity (phototherapy or bililights) will help lower the bilirubin. We will keep your baby's eyes covered with small eye patches and allow his body to be completely exposed to light. Usually a few days of this treatment will resolve the jaundice. Rarely, the jaundice may be severe enough to require an exchange transfusion. (The baby's blood, which is high in bilirubin, would be slowly replaced by donated blood low in bilirubin.

Intraventricular Hemorrhage (IVH)

IVH is bleeding in the area of the normal hollow spaces (ventricles) of the brain. Sometimes the bleeding is so minor that it does not get into the ventricles at all, but only causes minor blood clots at their edges. At other times, bleeding can get into the hollow spaces themselves or even extend into the brain. The most common hemorrhages are minor and do little if any harm. The bleeding is graded from 1-4. Grades 1 and 2 are usually minor. Grades 3 and 4 also can result in little or no harm, but with these grades of hemorrhages the baby's development must be observed more closely, as there is an increased possibility of brain damage. Babies are tested for this by ultrasound of the head. Sometimes more than one test is needed. At times other studies such as Computed Tomography (CT scan) or Magnetic Resonance Imaging (MRI scan) are needed.

Multiple Births

It is common for twins, triplets, or quadruplets to need some time in the NICU before going home. Often, this is because they are born prematurely. Sometimes, they have special medical problems related to their growth in the womb together. Also, birth defects are more common in multiple births. Parenting multiples is challenging. You will have to plan for extra clothing, supplies, space, and help you may need when they come home. You will also have two (or three or four) times the emotional ups and downs of the NICU. It may be difficult to keep track of information on more than one baby at the same time. If one baby is having a problem, it may be difficult to be happy for the one/others doing well. Also, it is not unusual for one baby to go home before the other. Visiting may become more difficult when you have one new baby at home and one in the hospital. Many parents find it helpful to keep a journal or notes about each baby, so that things do not get confused. Getting the support of other parents of multiples, who can understand this complex time, often helps parents. These other parents can share things that helped them when they were dealing with more than one baby at once. Your social worker or the parent liaison can help you contact a parent-to-parent volunteer or an organization for parents of multiples in the community.

Infants with Congenital Defects (Defect Present at Birth)

There are 4 million live births in the United States each year. Of these, 1 in every 33 babies is born with a defect. These defects may vary from simple to life threatening. Sometimes the defect needs quick correction while at other times surgery is best delayed. These decisions are made on an individual basis, by a team. The team includes parents, social worker, geneticist, pediatrician, surgeon, physical therapist, etc. Genetics is involved to educate the family and the health care team about several aspects of care. Often, more than one birth defect may be present. Thus, several tests may be needed to make sure that no occult (hidden) defect is overlooked. The most common organ to be affected by a defect at birth is the heart. Infants born with congenital heart disease (Heart defect present at birth)

Infants Born with Congenital Heart Disease (Heart Defect Present at Birth)

Some babies are born with problems in the form or function of their heart. The heart is responsible for pumping blood to all parts of the body. The healthy heart has four chambers which each serve a specific function. The heart receives "used blood" from the body, pumping it to the lungs for oxygen. It then receives "fresh blood" from the lungs, and sends it out to the body again. When any part of the heart or its major vessels is abnormal or does not function well, medical or surgical treatment may be necessary. A variety of tests will help to determine the specific problem in the heart. Some problems can be treated easily, while others may be very complex and life threatening. When a heart problem is suspected or diagnosed, a cardiologist and a cardiac surgeon, if needed, will be added to the team. They will be able to give you more details about your baby's heart and what treatments may be needed.

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