Neonatal ICU (NICU)

Neonatal ICU New Site!

2009-10-12T21:30:00.000-07:00

This site has moved to NeonatalICU.com! Please follow the link to see the upgraded site! This site will shut down in two weeks, so make sure to bookmark the new website!

Again, this site has moved to NeonatalICU.com!

NICU
What is the NICU?

NICU stands for Neonatal Intensive Care Unit. It is a unit for critically ill and sick newborn infants. Babies in the NICU can range from 23 to 35 weeks gestational age (preterm or premature) and 36+ weeks gestational age (full-term).

There are 4 different levels of neonatal intensive care units. They are:

• Level 1 NICU
• Level 2 NICU
• Level 3 NICU
• Level 4 NICU

Each level can accommodate a specific degree of complications and illnesses.

For what reasons is a baby admitted to the NICU?

An infant can be admitted to the neonatal ICU for numerous reasons. SOme of the more common ones are listed here:

• Atrial Septal Defect (ASD)
• Cerebral Palsy
• Clubfoot
• Cytomegalovirus (CMV)
• Coarctation of the Aorta
• Cystic Fibrosis
• Diaphragmatic Hernia
• Duodenal Atresia
• Esophageal Atresia
• Fetal Alcohol Syndrome
• Gastroesophageal Reflux
• Gastroschisis
• Hirschsprung's Disease
• Hydrocephalus
• Hydronephrosis
• Hydrops Fetalis
• Hypoglycemia
• Imperforate Anus
• Intrauterine Growth Restriction (IUGR)
• Meconium Aspiration
• MRSA
• Meningitis
• Necrotizing Enterocolitis (NEC)
• Omphalocele
• Patent Ductus Arteriosis (PDA)
• Periventricular Leukomalacia (PVL)
• Persistent Pulmonary Hypertension (PPHN)
• Pneumothorax
• Respiratory Distress Syndrome (RDS)
• Retinopathy of Prematurity (ROP)
• Spina Bifida
• Syphilis
• Tachypnea
• Trisomy 18
• Trisomy 21 (Down Syndrome)
• Turner Syndrome
• Ventricular Septal Defect (VSD)

There are many other reasons not listed here, but all can be explained by the nurse, practitioner or doctor in the NICU.

What medical personnel can be found in the NICU?

Specialized Doctors called Neonatologists
Pediatricians
Neonatal Nurse Practitioners (NNP)
Specialized Neonatal Nurses
Respiratory Therapists
Physical Therapists
Occupational Therapists
Nutritionists /Dieticians
Lactation Nurses (for breastfeeding help)

What non-medical personnel can be found in the NICU?

Social Workers
Outcomes Management Workers (Administrative Nurses who handle insurance issues)
Spiritual Health /Religious Health Workers

Neonatal Intensive Care Units are the most advanced critical newborn infant care units. They can be overwhelming at first, but parents find comfort in knowing that their baby is being cared for with the the utmost skill and knowledge, and is being given the best chance at recovering from whatever difficult condition that has presented itself to them.

What to Expect in the NICU with a Preterm Baby

2009-09-12T06:06:00.000-07:00

When a mother has a high risk pregnancy, there is a possibility that her baby could be born prematurely, and would need to be placed in the NICU, or neonatal intensive care unit. There is also the chance that a baby could be delivered unexpectedly early to a mother with a normal pregnancy. Regardless of how the preterm delivery came about, many parents are faced with thereality of having a baby in the NICU.

The goal of this article is to prepare parents for what they can expect to see when they walk into the NICU to visit their baby for the first time. It is this first impression that leaves the greatest impact on a parent, a very serious reality of how fragile their baby is at this early age.

No matter how prepared a parent thinks they are, either from their own research, or from information from their doctor, there is nothing like laying their own eyes on their new baby. Having the information can help, though, and can lessen the severity of the impact, especially if they have a beginning understanding on care and treatment in a neonatal unit.

The First Visit to the NICU

When a parent first arrives in the NICU, be prepared to scrub your hands thoroughly before entering. Neonatal staff want to make sure everything is especially sterile and clean, as babies have very low immune systems.

Once scrubbed and clean, walking up to a baby for the first time in their NICU bed can have varying degrees of impact on parents, depending on the severity of the prematurity. For the extremely premature infant (around 23 to 29 weeks gestational age), be prepared to see a very tiny baby inside an incubator or open warmer bed. The neonate may also be connected to one or several lines and tubes. Also nearby may be a ventilator, or another similar machine used to help the baby breathe. A monitor will also be close by to help monitor the baby's vital signs, including respiratory rates (breathing), and heart rates. All of these things are critical for the care of the neonate, but can prove difficult for the parents to see. Any parent understands that seeing your tiny, precious baby in any sort of situation like this is painful, especially if seeing the baby for the first time.

As blunt as all this sounds, it is important to remember that this is a very serious and very real situation. Parents around the world go through this on a day to day basis, so being as prepared as possible can help lessen the impact (however small, any help is still help).

Understanding NICU Equipment

One of the most common questions a parent asks when first visiting their baby in the NICU is what all the equipment does. Often, it is overwhelming to see the tiny neonate surrounded by such large machines, and attached to so many lines. But once explained, the concern is lessened, as knowledge is a strong tool easing uncertainty.

The first thing to notice would be the bed the baby is in. More than likely, it is an incubator or an open warmer bed. The open warmer bed provides a warm environment for the baby, as preterm infants generally are unable to regulate their own body temperatures. Without the warmer, the baby could become dangerously cold.

The incubator bed allows not only for a warmer environment, but can allow for a specific humidity for the baby to be in. Depending on how early the baby was born, he or she could be in one of these beds for an extended period of time.

Babies that are born prematurely often have difficulty breathing on their own, as their lungs are still immature. So, breathing machines, such as ventilators, are often used to help the baby breath. These will have tubes running to the baby's lungs to breathe for them until their lungs are mature enough to breathe on their own. Other methods of oxygen management are available as well, some less invasive than others. If a baby is born preterm, it is best to expect to see a tube of some sort from the baby's mouth helping him or her breathe. Though it can look imposing, it is absolutely crucial to the survival and continued growth of the infant.

Finally, one of the other common pieces of equipment to notice would be the monitor that is displaying the infant's heart rate , respiratory rate, among other vital signs. These monitors are set to sound an alarm if the vital signs go above or below a normal range for the baby.

Many parents do not realize how often some of these monitors will alarm, as babys' vital signs tend to fluctuate. It is natural to feel alarmed if a monitor alert sounds off, but it is a common occurence in the NICU. Rest assured the neonatal nurse is monitoring these alarms very closely. Often, a neonate will recover on it's own, thus silencing the alarm. If immediate response is needed, a neonatal nurse should be close by.

Visitation

For both families and NICU staff, parents viewing their infant for the first time can be a tough situation, so there may be varying needs of comfort. Some parents will want to be with their baby alone for awhile before any visitors are allowed to come in. This gives the parents an opportunity to adjust to the condition their child is in. Others may want family close by for emotional support. Either way, it is important to anticipate these needs, and discuss with the parents what their wishes are for these first moments with their baby.

Sibling visitation is very important for families to be together when a baby is in the neonatal intensive care unit, but the severity of prematurity can have an effect on younger children, so it is best for the parents to talk to their other kids about what is going on with the new baby before bringing them to visit.

Support

Whether the premature birth is expected or unexpected, it is a very difficult situation for many parents. However, medical advancements and new technologies are allowing for premature infants to have a much better chance for survival, as well as reducing complications later on in life.

As imposing as a neonatal intensive care unit may seem, many parents adapt to the environment quite rapidly. They become a part of the NICU family, as they and the medical staff continuously work together to give the best love and care to these tiny infants.

Infant MRSA in the NICU

2009-08-22T06:25:00.001-07:00

An infant in the NICU with MRSA (methicillin resistant staphylococcus aureaus) can initiate immediate precautions to preserve the safety and well-being of not only the infant, but all the other infants, staff, and parents in the NICU. It is important to remember that not all cases of MRSA are as critical as heard about on the news. It is important to remember that even though an infant may have the bacteria, it does not necessarily mean that it is sick from it.

MRSA and Antibiotics

Unlike viruses, bacteria is treatable with anitbiotics. Staphylococcus Aureus is a particular bacteria that has evolved into strains that are resistant to certain common medications, hence the name methicillin resistant staphylococcus aureus. As we as society evolve, so do the bacteria that make us sick. Eventually, they become resistant to certain types of medications normally used as treatment. This means that new medications and treatments must be found.

Diagnosing MRSA in the NICU

MRSA is often discovered in the NICU by form of blood cultures or skin cultures. There is a large difference in the severity of the two.

If MRSA is found via cultures taken from the surface of the skin, then the bacteria is considered to have colonized there. This does not necessarily mean the baby is sick. In fact, the doctor may not even treat for it. There is the potential that the infant may carry MRSA for some time afterwards, but eventually may be completely free of the bacteria as they get older. Remember, you and I may carry MRSA, too. Carrying MRSA does not mean you are sick with it. Complications usually arise when the bacteria somehow enters the body.

If the bacteria does enter the body, it can do so via several ways, including open wounds, surgery, and respiratory procedures. MRSA is acquired through contact, and is not considered an airborne sickness. At this point, medication treatment will be required, and care for the infection is often more complex. Physicians will administer treatments will based on an individual basis, depending on the conditionof the infant.

MRSA and Isolation

Most, if not all, NICUs will place an infant with MRSA in contact isolation. This means that medical staff will wear gowns and gloves to prevent the spread of the bacteria to other infants in the unit. Again, since this is not considered an airborne infection, staff usually does not have the need for masks.

Parents, family (including siblings), and visitors may or may not be asked to gown and glove when visiting their baby, it just depends on the individual NICU's policies. Parents already have an established physical contact relationship with the baby, thus further exposure is usually not a concern. If a parent has mutliples in the unit, such as twins, with one having MRSA and the other not, then the parents may be asked to gown and glove to prevent spreading the bacteria from one baby to the other.

Visitors with compromised imune systems, or immuno-suppressed conditions, should not visit an infant with MRSA, as their risk for contracting an infection is higher.

Every person, staff and parents especially, should be washing their hands and using an alcohol hand sanitizer before and after touching the infant.

How to Improve Infant Reflux in a Newborn Baby

2009-08-12T19:28:00.000-07:00

In a newborn infant, a common concern for many parents is infant reflux (GERD). It can be a scary event, when your baby may appear to choke, gag, or spit up during a reflux episode. As frustrating as it can be, there are several ways to help improve reflux in a newborn infant.

Position after feeding - This is one of the most important factors, as it involves keeping your baby upright for as long as 30 minutes after eating. It is also a good idea to keep your baby's activities to a minimum. The idea behind this is that by being held upright, the breast milk or formula can continue downward into the stomach. By staying in the stomach, it can be digested easier and quicker, reducing the chance for reflux. Babies that are formula fed may need a longer period of time in this position, as formula can be more difficult to digest.
Sleeping Position - Sleeping position is also very important in regards to helping improve reflux. Babies often fall asleep after a feeding, so it is not uncommon for an infant to have a reflux episode during this time. All babies are recommended to sleep on their backs by the American Academy of Pediatrics, however, some babies with reflux may require sleeping at an incline. Some cribs and bassinets can accommodate this, while a wedge can also be used. A wedge is just what it sounds like, usually creating an incline around 30 degrees for the baby to sleep on. This has the same affect as positioning mentioned above, letting gravity help keep the milk or formula in the stomach.
Tight Clothing - Try to avoid tight clothing if your baby has reflux. Loose fitting clothing is ideal, reducing the chance that tighter clothes will apply pressure to the area around the stomach, increasing the chance of reflux.
Thickening Feeds - Another option that works for some babies is to thicken feeds using rice cereal. This will make for a heavier feed, increasing the likelihood that it will stay in the baby's stomach.
Burping - It is always important to burp a baby after feedings, but even more so when the baby has reflux. This may help reduce the chance of reflux if done several times during a feedings.

Always ask your pediatrician for advice regarding any questions you may have about your infant's reflux. If ti is severe enough, they may prescribe a medication. More thank likely though, they may encourage alternative methods, so try them out and see what works best for your baby!

NICU Gavage Feeding

2009-08-12T15:07:00.001-07:00

Gavage feeding in the NICU is where a small, narrow tube is inserted through the infant's nostril and is placed down the throat, esophagus, and into the baby's stomach. This allows for the baby to be fed if it cannot get the nutrition it needs from breastmilk or formula alone (via breastfeeding or bottle feeding).

Reasons for Gavage Feeding

There can be several reasons for feeding a newborn this way. There are many combining factors that can be summed up in one of these reasons:

Babies who lack the sucking coordination required to feed from a breast or bottle.
Babies who are born premature and may not have the ability or strength to suck from a bottle or breast.
Babies with conditions or anomalies involving the esophagus or stomach.

Hospital and Home

Infants can be gavage fed in the hospital's neonatal intensive care unit, but can also be gavage fed at home. This requires a parent to learn how to do the gavage feedings themselves. A very helpful .pdf article can be found here on gavage feeding newborns. As always, this is considered educational information, and a physician should always be sought for medical advice and application of treatment.

What is the NICU?

2009-07-30T21:59:00.001-07:00

NICU
What is the NICU?

NICU stands for Neonatal Intensive Care Unit. It is a unit for critically ill and sick newborn infants. Babies in the NICU can range from 23 to 35 weeks gestational age (preterm or premature) and 36+ weeks gestational age (full-term).

There are 4 different levels of neonatal intensive care units. They are:

• Level 1 NICU
• Level 2 NICU
• Level 3 NICU
• Level 4 NICU

Each level can accommodate a specific degree of complications and illnesses.

For what reasons is a baby admitted to the NICU?

An infant can be admitted to the neonatal ICU for numerous reasons. SOme of the more common ones are listed here:

• Atrial Septal Defect (ASD)
• Cerebral Palsy
• Clubfoot
• Cytomegalovirus (CMV)
• Coarctation of the Aorta
• Cystic Fibrosis
• Diaphragmatic Hernia
• Duodenal Atresia
• Esophageal Atresia
• Fetal Alcohol Syndrome
• Gastroesophageal Reflux
• Gastroschisis
• Hirschsprung's Disease
• Hydrocephalus
• Hydronephrosis
• Hydrops Fetalis
• Hypoglycemia
• Imperforate Anus
• Intrauterine Growth Restriction (IUGR)
• Meconium Aspiration
• MRSA
• Meningitis
• Necrotizing Enterocolitis (NEC)
• Omphalocele
• Patent Ductus Arteriosis (PDA)
• Periventricular Leukomalacia (PVL)
• Persistent Pulmonary Hypertension (PPHN)
• Pneumothorax
• Respiratory Distress Syndrome (RDS)
• Retinopathy of Prematurity (ROP)
• Spina Bifida
• Syphilis
• Tachypnea
• Trisomy 18
• Trisomy 21 (Down Syndrome)
• Turner Syndrome
• Ventricular Septal Defect (VSD)

There are many other reasons not listed here, but all can be explained by the nurse, practitioner or doctor in the NICU.

What medical personnel can be found in the NICU?

Specialized Doctors called Neonatologists
Pediatricians
Neonatal Nurse Practitioners (NNP)
Specialized Neonatal Nurses
Respiratory Therapists
Physical Therapists
Occupational Therapists
Nutritionists /Dieticians
Lactation Nurses (for breastfeeding help)

What non-medical personnel can be found in the NICU?

Social Workers
Outcomes Management Workers (Administrative Nurses who handle insurance issues)
Spiritual Health /Religious Health Workers

Copyright

2009-07-30T21:54:00.000-07:00

Copyright 2009 to the author of nicu-info.blogspot.com. The content within this site is not to be duplicated or reproduced in any way or form. Certain content on this site comes from government health care websites, and is noted as such with source citations.

Images used on this site were located on photobucket.com as part of the public domain. The photobucket.com terms of use can be found here.

Privacy Policy

2009-07-30T20:56:00.000-07:00

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Disclaimer / Terms of Use

2009-07-30T20:49:00.000-07:00

This site is NOT medical advice

The contents of the nicu-info.blogspot.com, such as text, images, and information are for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult with your physician or doctor regarding any medical advice. Never disregard professional medical advice because of something you have read on nicu-info.blogspot.com.

For medical emergencies, call your doctor or 911 immediately.

Nicu-info.blogspot.com and its author are not liable or responsible for the accuracy or completeness of any information provided on its website. I assume no liability or responsibility for any damages arising from a visitor's use of, or inability to use, the site. The contents are provided as general information only and are not intended as medical, legal, or insurance advice. Nicu-info.blogspot.com and its author makes no warranty, either express or implied, regarding the completeness, accuracy, or currency of this information or its suitability for any particular purpose.

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Contact

Questions, comments, and feedback can be sent to neokhor@gmail.com.

NICU - Kangaroo Care

2009-07-30T19:48:00.000-07:00

NICU
Kangaroo Care

Kangaroo Care is one of the most intimate ways a mother can bond with her infant. Often, when mom's deliver a preterm baby, the ability to bond between the two can be suddenly be taken away. Kangaroo Care allows for that physical and emotional connection to be reestablished.

So what exactly is kangaroo care? It is when the baby is places against the mother or father's bare skin )chest area) in only it's diaper. Even premature babies on oxygen and IVs can be placed in kangaroo care when they are stable enough.

Infants that are breastfeeding can benefit from this as well, as the baby is allowed to feed while kangaroo care is ongoing.

There have been numerous studies on the benefits of kangaroo care, and while varying reports debate how successful it is in helping improve the condition of the infant, there is one thing they all agree on. Kangaroo care poses no harm for the baby or the mother.

The studies done favoring kangaroo care have shown that it can help regulate an infant's body temperature (which is hard for them to do at preterm ages) by the mother's body cooling if the baby is too hot, or warming if the baby is too cold.

It has also proven to help keep a normal breathing rate and heart rate.

While kangaroo care cannot be done consistently and all the time, it can last for several hours.

Today, most neonatal intensive care units in the United States encourage kangaroo care. The benefits of helping keep the intimate bond between a mother and baby intact are completely worthwhile, and utterly priceless.

NICU - Preterm Infants Under 23 Weeks

2009-07-30T19:16:00.000-07:00

NICU
Preterm Infants Under 23 Weeks

Premature infants born at less than 23 weeks gestational age are generally too young and too immature in terms of development to survive. Most doctors do not consider this age compatible with life, and will opt not to resuscitate the baby at birth.

NICU - Length of Stay

2009-07-30T19:04:00.001-07:00

NICU
Length of Stay

How long will my baby be in the NICU? That is a question many, many parents ask time and time again. The honest answer is that it completely depends on the specific condition of the infant and how they respond to medicine and treatment. Every baby is unique, so each will react in their own way while in the neonatal intensive care unit.

A neonatalogist can offer his or her best guess, usually a time frame ranging from days to weeks to months. Obviously, in extremely premature babies, parents can expect to be in the NICU for as many as 3 or 4 months.

Some preterm babies born at 33 weeks may be out of the NICU in 2-3 weeks, while others may stay as many as 8 weeks or longer. Again, it depends on how the baby responds to treatment and medicine in his or her own unique way.

The best suggestion is not to place hope on a set day. If that day comes and goes, it can be a huge let down, and cause unnecessary frustration. Just take it one day at a time, and trust that every day spent in the NICU is one more day your baby is growing healthier and stronger.

NICU - Religion and Beliefs

2009-07-30T18:45:00.001-07:00

NICU
Religion and Beliefs

Hospitals across the United States have very understanding policies regarding the religion and beliefs of parents and families that have and infant in the neonatal ICU. It is imoprtant to talk to the nurse, doctor, or practitioner caring for the infant, and address any customs or care that are important to your baby. Also, informing the charge nurse and nurse manager help ensure that your desires are met to the fullest extent.

For example, with an infant about to pass away, many cultures and religions have different ways to care for this situation. There may be a baptism for a baby for some parents, or there may be a shaman to perform a ritual for others. There is no wrong and no right. Every belief is honored and respected, and it is important that parents are allowed to say good-bye in their own way.

Remember to discuss your beliefs and customs with the NICU staff caring for your baby, and if you have any questions, remember that NICU staff is trained to accommodate the many different beliefs and traditions of cultures should they ever arise.

NICU Communication

2009-07-30T14:12:00.001-07:00

NICU Communication
Click the following links to see more on NICU communication:

• Asking Questions
• Medical Records
• Infant's Medical Chart

NICU Visitation

2009-07-30T14:09:00.000-07:00

NICU Visitation
Click on the following links to ee more on NICU visitation:

• Siblings
• Family
• Underage Visitors

NICU Respiratory Care

2009-07-30T13:59:00.000-07:00

NICU Respiratory Care
Click on the following links for respiratory care / oxygen management:

• Ventilator
• Oscillator
• CPAP
• Nasal Cannula

NICU Nutrition and Feedings

2009-07-30T13:56:00.000-07:00

NICU Nutrition
Click the following links for NICU infant nutrition and feedings:

• Total Parenteral Nutrition (TPN)
• Breast Milk / Breastfeeding
• Formula
• Gavage Feeding

NICU Levels Of Care

2009-07-30T13:53:00.000-07:00

NICU Levels of Care
Click on the following links to view levels of care:

• Level 1 NICU
• Level 2 NICU
• Level 3 NICU
• Level 4 NICU

NICU Admission Criteria

2009-07-30T13:46:00.000-07:00

NICU Admission Criteria
Click the following links to find out more about each condition

• What to Expect in the NICU with a Preterm Baby

• Atrial Septal Defect (ASD)
• Cerebral Palsy
• Clubfoot
• Cytomegalovirus (CMV)
• Coarctation of the Aorta
• Cystic Fibrosis
• Diaphragmatic Hernia
• Duodenal Atresia
• Esophageal Atresia
• Fetal Alcohol Syndrome
• Gastroesophageal Reflux
• Gastroschisis
• Hirschsprung's Disease
• Hydrocephalus
• Hydronephrosis
• Hydrops Fetalis
• Hypoglycemia
• Imperforate Anus
• Intrauterine Growth Restriction (IUGR)
• Meconium Aspiration
• MRSA
• Infant MRSA in the NICU
• Meningitis
• Necrotizing Enterocolitis (NEC)
• Omphalocele
• Patent Ductus Arteriosis (PDA)
• Periventricular Leukomalacia (PVL)
• Persistent Pulmonary Hypertension (PPHN)
• Pneumothorax
• Respiratory Distress Syndrome (RDS)
• Retinopathy of Prematurity (ROP)
• Spina Bifida
• Syphilis
• Tachypnea
• Trisomy 18
• Trisomy 21 (Down Syndrome)
• Turner Syndrome
• Ventricular Septal Defect (VSD)

When Life Means Loss - Infant Bereavement

2009-07-30T10:09:00.000-07:00

NICU
Infant Death / Infant Bereavement

Losing your baby will probably be the hardest thing you will ever go through. The grief a parent goes through after the death of their infant is called bereavement. It is a normal process that everyone goes through when they lose someone they love.

What is Grief?
Courtesy of the National Mental Health Information Center [Source]

Grief is the normal response of sorrow, emotion, and confusion that comes from losing someone or something important to you. It is a natural part of life. Grief is a typical reaction to death, divorce, job loss, a move away from friends anf family, or loss of good health due to illness.

How does grief feel?

Just after a death or loss, you may feel empty and numb, as if you are in shock. You may notice physical changes such as trembling, nausea, trouble breathing, muscle weakness, dry mouth, or trouble sleeping and eating.

You may become angry - at a situation, a particular person, or just angry in general. Almost everyone in grief also experiences guilt. Guilt is often expressed as "I could have, I should have, and I wish I would have" statements.

People in grief may have strange dreams or nightmares, be absent-minded, withdraw socially, or lack the desire to return to work. While these feelings and behaviors are normal during grief, they will pass.

How long does grief last?

Grief lasts as long as it takes you to accept and learn to live with your loss. For some people, grief lasts a few months. For others, grieving may take years.

The length of time spent grieving is different for each person. There are many reasons for the differences, including personality, health, coping style, culture, family background, and life experiences. The time spent grieving also depends on your relationship with the person lost and how prepared you were for the loss.

How will I know when I'm done grieving?

Every person who experiences a death or other loss must complete a four-step grieving process:

(1) Accept the loss;
(2) Work through and feel the physical and emotional pain of grief;
(3) Adjust to living in a world without the person or item lost; and
(4) Move on with life.

The grieving process is over only when a person completes the four steps.

How does grief differ from depression?

Depression is more than a feeling of grief after losing someone or something you love. Clinical depression is a whole body disorder. It can take over the way you think and feel. Symptoms of depression include:

A sad, anxious, or "empty" mood that won't go away;
Loss of interest in what you used to enjoy;
Low energy, fatigue, feeling "slowed down;"
Changes in sleep patterns;
Loss of appetite, weight loss, or weight gain;
Trouble concentrating, remembering, or making decisions;
Feeling hopeless or gloomy;
Feeling guilty, worthless, or helpless;
Thoughts of death or suicide or a suicide attempt; and
Recurring aches and pains that don't respond to treatment.

If you recently experienced a death or other loss, these feelings may be part of a normal grief reaction. But if these feelings persist with no lifting mood, ask for help.

Please visit the following resources to better help cope with and understand infant bereavement:

• The Compassionate Friends
• Baby Steps
• A Place to Remember
• M.E.N.D. (Mommies Enduring Neonatal Death)
• Mental Health America - Bereavement
• National Cancer Institute - Bereavement

NICU - Asking Questions

2009-07-30T09:49:00.000-07:00

NICU
Asking Questions

Asking questions in regards to your baby's condition and care is absolutely recommended and encouraged. Medical staff want parents to be as informed as possible. If something is explained, and a parent does not quite understand, ask for an explanation again, and the doctor, practitioner, or nurse will often try to find a different way to explain it.

Keep in mind that medical staff are surrounded by medical terminology 24/7 when they are at their job, so when they explain a baby's condition and care, they may say things a parent doesn't quite understand. This is absolutely normal, and a parent should not feel bad about asking questions so that they can fully understand their baby's condition.

If a parent is away form the neonatal intensive care unit and does research on their own, such as viewing educational information sites such as this one, it is best to write down questions they have and bring them to the hospital the next time they visit the neonatal ICU, they will not forget.

It is important to remember that there is a wide variation and interpretation of medical treatment and care, so each doctor may present their information differently. If a parent has questions about their understanding of a situation that differs from what the doctor is telling them, make sure to ask and have everything explained clearly. There is nothing worse than a parent who does not fully understand what is happening to their baby or why certain treatments and care are being used for their baby.

Again, do not feel bad about asking questions. Make sure to understand what is going on with your baby in the NICU. Medical staff will be more than happy to help you in any way they can.

NICU - Medical Records

2009-07-30T09:39:00.000-07:00

NICU
Medical Records

Medical Records refers to the Health Information Department in a hospital. This is where all patient info is stored after a patient has been discharged. It also may be where medical transcriptionists work and file medical reports and dictations.

An NICU parent may need to go to Medical Records for the following reasons:

Obtain their infant's chart - If a parent wishes to obtain their copy baby's chart, they must come to the Medical Records department to do so. Often, it will require a one-time fee as well. A consent must also be signed. It is best to call in advance, so the staff has a chance to copy ahead of time, as some charts are quite large.
Birth Certificate information - Often, any questions regarding birth certificates can be handled in this department as well. Medical Records often has a devoted employee to handling and following up on birth certificates. With an infant in the NICU, many parents' focus shifts primarily to their baby, and they tend to let other issues take a back seat. If this happens, when the parent has the time, they can complete any birth certificate documentation in Medical Records.

NICU - Infant's Medical Chart

2009-07-30T09:30:00.000-07:00

NICU
Medical / Patient Chart

Every infant in the NICU has their own medical chart. This includes:

Graphical information (Address, parents, insurance, etc.)
Consents
Doctor's Orders
Progress Notes
Radiology Reports
Cardiology Reports
Social Work Consultations
Physical Therapy and Occupational Therapy Reports
Nutritional Information
Nurse's Notes
Discharge Paperwork
Medication Records
Family Paperwork
Lab Results

All of these are stored in a computer under a computerized medical chart, or at a bedside hospital chart. Many hospitals now use both.

If a parent wishes to view their baby's chart, a doctor or practitioner is usually required to be present. Medical charts are very intricate and complex, and even the smartest parent will need some form of explanation to questions they might have.

If a parent wishes to acquire a copy of their infant's chart, permission must come through the Health Information Department, also referred to as Medical Records. The NICU in most cases cannot consent to copying a chart due to legal liabilities.

NICU Precautions - Hand Washing

2009-07-30T09:13:00.000-07:00

NICU Precautions
Hand Washing

In the NICU, be prepared to wash your hands...a lot. Germs pose a great threat to infants in the NICU, since their immune systems are very weak. Handwashing is the number one way of preventing the spread of germs that can cause illness.

There are two methods of hand washing you can expect to perform in the neonatal unit.

Hand Washing / Scrubbing - Use of a very special antiseptic soap applied with a scrub brush or out of a dispenser. A good thorough hand washing in the NICU will be from elbows to fingertips, including under the nails. A solid two to three minutes can be expected to thoroughly wash your hands.
Hand Sanitizers / Foam Sanitizers - Many NICUs are switching to a foam sanitizer, as it kills 99.9% of germs, even MRSA. You should use foam sanitizer every time before touching your baby. It is the safest way to prevent the spread of germs. It is also a good idea to use a hand sanitizer before leaving the NICU as well.

NICU Precautions - Underage Visitors

2009-07-29T21:34:00.000-07:00

NICU
Precautions - Underage Visitors

So what does 'underage' precisely mean in the Neonatal Intensive Care Unit? While it may vary from unit to unit, generally it means anyone under the age of 18. With the exception of siblings of the infant, many NICUs will not allow any children under the age of 18 visitation privileges.

The reasons are mainly three-fold:

Children under the age of 18 have immune systems that have not quite completely adapted to all the bacteria and viruses out in the everyday environment. This leads to the stronger likelihood they can easily contract illness, thus making it a higher probability to get the infant sick.
Many children under 18 have not had their complete set of vaccinations yet. This risks the NICU infant to exposure to very harmful diseases and illnesses.
Children in this age range are constantly around other children of similar ranges who share risk factors 1 and 2. This creates even further risk that the child visiting the NICU is more likely to pass on something to the infant.

While it is not the same as seeing a baby in person, videos and pictures can help friends and family under the age of 18 share the NICU experience.

NICU Respiratory Care - Nasal Cannula

2009-07-29T21:24:00.000-07:00

NICU
Oxygen Management / Respiratory Care
Nasal Cannula

The following information is from wikipedia: [Source]

The nasal cannula (NC) is a device used to deliver supplemental oxygen to a patient or person in need of extra oxygen. This device consists of a plastic tube which fits behind the ears, and a set of two prongs which are placed in the nostrils. Oxygen flows from these prongs. The nasal cannula is connected to an oxygen tank, a portable oxygen generator, or a wall connection in a hospital via a flowmeter. The nasal cannula carries 1–6 litres of oxygen per minute. There are also infant or neonatal nasal cannulas which carry less than one litre per minute; these also have smaller prongs. The oxygen fraction provided to the patient ranges roughly from 24% to 35%.

NICU Respiratory Care - CPAP

2009-07-29T20:52:00.000-07:00

NICU
Oxygen Management / Respiratory Care
CPAP

CPAP stands for Continuous Positive Airway Pressure. This common form of infant respiratory care helps a baby breathe by providing a small amount of pressurized air.

Severe respiratory conditions may require a ventilator or oscillator, while less critical infants may be placed on CPAP. This is a mask of sorts that will fit over the baby's mouth and nose. Straps are often used to secure the mask around the infant's head.

NICU Respiratory Care - Oscillator

2009-07-29T20:38:00.000-07:00

NICU
Oxygen Management / Respiratory Care
Oscillator

An oscillator is a more recent version of a ventilator that keeps the lungs open with a constant positive end-expiratiory pressure, also referred to as 'PEEP'. What is different between this and a ventilator is that while the ventilator will inflate and deflate the baby's lungs, simulating breathing, an oscillator will vibrate the oxygen at a very high pace. This allows for gasses in the airway to be diffused rapidly and efficiently. By doing so, there is far less risk for damage to the lungs when exposed to the oscillator for longer periods of time.

Each infant presents a specific condition and case, and an oscillator may or may not be the best choice fr the infant. It definitely can make caring for critically ill infants much safer and much easier.

NICU Respiratory Care - Ventilator

2009-07-29T20:27:00.000-07:00

NICU
Oxygen Management / Respiratory Care
Ventilator

A ventilator in the Neonatal Intensive Care Unit is a machine that is used to breathe for an infant when the baby is incapable breathing on its own. A ventilator simulates breaths by basically inflating and deflating the infant's lungs.

Premature babies in particular will not have fully developed their lungs, so the baby must be placed on a respiratory breathing machine, such as a ventilator. This is considered life support.

There are many different types of ventilators in use today, each to accommodate specific NICU needs.

NICU - Infant Formula

2009-07-28T11:00:00.000-07:00

NICU
Infant Formula
Information

Formula is specifically created to be the best possible alternative to breast milk for infants. While formula cannot replicate the antibodies or full nutritional value of breast milk, there's no reason to feel bad for using it.

There are 3 types of forumla:

Powder
Concentrated Liquid
Ready to Use

In addition to the different types, there are many different kinds of formula as well, each made for a specific purpose or condition. Talk to your pediatrician about what formula is best for your baby, and if you should use powder, concentrated liquid, or ready to use.

NICU - Breast Milk / Breastfeeding

2009-07-28T10:18:00.000-07:00

NICU
Breast Milk / Breastfeeding
Information

This information is courtesy of WomensHealth.gov: [Source]

Breastfeeding is more than a lifestyle choice — it's an important health choice. Any amount of time that you can do it will help both you and your baby. There are many benefits of breast milk for mothers, babies, and others.

Breastfeeding is normal and healthy for infants and moms.
Breast milk has disease-fighting cells called antibodies that help protect infants from germs, illness, and even SIDS. Infant formula cannot match the exact chemical makeup of human milk, especially the cells, hormones, and antibodies that fight disease.

Studies are still looking at the effects of breastfeeding on osteoporosis and weight loss after birth.

Breast milk is different from infant formula. Colostrum, the thick yellow first breast milk that you make during pregnancy and just after birth, will give your baby the best start at life. It is known as "liquid gold." It is very rich in nutrients and antibodies to protect your baby as he or she first enters the world. Although your baby only gets a small amount of colostrum at each feeding, it matches the amount his or her tiny stomach can hold. A newborn stomach is only the size of a large marble at first!
Your milk changes over time to meet your baby's needs. Your breast milk that begins to be made by the third to fifth day after birth has just the right amount of fat, sugar, water, and protein that is needed for a baby's growth. It will be a thinner type of milk, but just as full of all of the nutrients and antibodies for your baby.
For most babies, breast milk is easier to digest than formula. It takes time for their stomachs to adjust to digesting the proteins in formula because they are made from cow's milk.
Premature babies do better when breastfed compared to premature babies who are fed formula.

When you breastfeed, there are no bottles and nipples to sterilize. Unlike human milk straight from the breast, infant formula has a chance of being contaminated.
Breastfeeding makes your life easier. You do not have to purchase, measure, and mix formula. There are no bottles to warm in the middle of the night!
Breastfeeding can save you between $1,160 and $3,915 per year, depending on the brand of formula.
A mother can satisfy her baby's hunger right away with breastfeeding.
Breastfeeding requires a mother to take some quiet relaxed time for herself and her baby, helping them bond. Physical contact is important to newborns and can help them feel more secure, warm, and comforted. Breastfeeding mothers may have increased self-confidence and feelings of closeness and bonding with their infants.
Breastfeeding during an emergency can save lives.

Total Parenteral Nutrition (TPN)

2009-07-28T09:51:00.000-07:00

NICU
Total Parenteral Nutrition (TPN)
Information

What is Total Parenteral Nutrition (TPN)?

Total parenteral nutrition is a way of feeding an infant that delivers nutrients, vitamins, minerals, fats, electrolytes and many other essential components via the bloodstream, bypassing the gastrointestinal tract. This is common in premature infants, as their stomachs and intestines are not quite developed enough to handle breast milk and formula, and cannot adequately absorb nutrients.

TPNs are delivered through intravenous lines, such as an IV in the hand, foot, or sometimes the head. Other methods may be to use a UVC (umbilical vein catheter) or a PICC (peripherally inserted central catheter) line. A UVC or PICC line may be used if the infant will be in the NICU for an extended period of time.

A TPN is very common in extremely preterm NICU infants. It is the best source of nutrition until their bodies are capable of tolerating other feeding methods.

Level IV NICU

2009-07-28T07:54:00.000-07:00

Level IV/ Level 4 NICU
Information

A level 4 NICU is the highest level, and usually can provide the most advanced care for infants, critically ill infants, and premature babies.

Infants with extremely complex and complicated illnesses can be transferred to a level 4 NICU, as well as extremely sick premature infants.

Level III NICU

2009-07-28T07:42:00.000-07:00

Level III / Level 3 NICU
Information

A level 3 NICU is more specialized, and can function as a level 2 NICU as well. Very rarely will a level 3 NICU serve the functions of a level 1 NICU.

Level 3 units care for premature and extremely premature infants, critically ill infants, and infants requiring surgery. The length of stay for an infant in this level of a neonatal unit can last days, weeks, or even months.

Each level 3 NICU is different and has a range of what it can and cannot do. Some will transfer their sickest infants to a more specialized level III NICU, or even a level 4 NICU.

Level II NICU

2009-07-28T07:30:00.000-07:00

Level II / Level 2 NICU
Information

A level 2 NICU is a bit more complex than a level I NICU, in that it is used take care of moderately sick infants who are more than likely to recover in a shorter period of time. It can also perform all the functions of a level I NICU.

A level 2 NICU is also likely to stabilize and transfer critically ill infants, as well as infants under 32 weeks gestational age.

In other cases, a Level III NICU infant who has recovered and no longer requires care from a level III unit can be 'promoted' to a Level 2 unit. The infant can be cared for there until discharged.

Level I NICU

2009-07-28T07:03:00.000-07:00

Level I / Level 1 NICU
Information

A level 1 NICU is often called a newborn nursery. These are mandatory in any hospital that delivers babies in a Labor and Delivery Unit.

Providing a basic level of care to well babies and infants at low risk, these units will stabilize and transfer out any critically ill infant or infant under 35 weeks gestation to a higher level NICU.

NICU Common Medications

2009-07-27T21:54:00.000-07:00

NICU Common Medications List
Please consult with a physician regarding any information on these medications.

Antibiotics
• Ampicillin
• Gentamicin
• Cefotaxime
• Ceftazidime
• Vancomycin
• Imipenim
• Penacillin g
• Amoxicillin

Anitfungals
• Amphotericin B
• Caspofungin
• Fluconazole
• Nystatin

Cardiovascular
• Dopamine
• Dobutamine
• Prostaglandins
• Indomethacin

Code Meds
• Epinephrine
• Sodium bicarbonate
• Calcium gluconate
• Narcan

Diuretics
• Lasix
• Hydrocholorothiazide
• Spironolactone

Pain/sedation:
• Morphine
• Fentanyl
• Lorazepam
• Phenobarbital
• Tylenol
• Chloral hydrate

Gastrointestinal
• Zantac
• Reglan
• Prevacid
• Erythromycin

Nutrition
• Multi-vitamins
• Ferrous Sulfate
• Calcitriol

Respiratory
• Caffiene Citrate
• Albuteral
• Flovent
• Racemic
• Epinephrine

Steroids
• Dexamethasone
• Hydrocortisone
• Prednisolone

Miscellaneous
• Albumin
• Lovenox
• Surfactant
• Heparin
• Sucrose
• Aquafor
• Synagis
• Hepatitis B

NICU - Ventricular Septal Defect (VSD)

2009-07-27T21:21:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Ventricular Septal Defect (VSD)

What is Ventricular Septal Defect?
Information courtesy of Centers for Disease Control and Prevention [Source]

A ventricular septal defect (VSD) is a heart condition that is present at birth and often is called a congenital defect. A VSD occurs when there is a hole (defect) in the wall (septum) that separates the two lower chambers of the heart, called ventricles. This hole between the heart chambers disrupts the flow of blood and oxygen to the body.

Treatment and Ongoing Symptoms

If the hole is small, usually no treatment is needed because many of these defects will close on their own. However, a baby with a VSD should be checked regularly by a doctor to make sure that the hole eventually closes properly and that more serious problems do not occur.

If a defect does not close on its own, the baby often will need surgery. If not treated with surgery, some babies can have additional problems in life. These problems can include:

Heart failure
Infections in the heart, often called Infective endocarditis
Leaking of the valve that separates the left ventricle from the aorta, often called aortic insufficiency
Abnormal heart rhythms, called arrhythmias
Delayed growth and development
High blood pressure in the lungs

Some children with a VSD will need to take antibiotics before undergoing dental work and certain other surgical procedures. Some babies and children will need to take additional medications for blood pressure and other issues.

Luckily, the diagnosis and treatment of VSDs have improved greatly. As a result, a child with a simple heart defect can grow to adulthood and live a normal, active, and productive life.

NICU - Turner Syndrome

2009-07-27T21:07:00.001-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Turner Syndrome

What is Turner Syndrome?
All information courtesy of National Human Genome Research Institute [Source]

Turner syndrome is a chromosomal condition that alters development in females. Women with this condition tend to be shorter than average and are usually unable to conceive a child (infertile) because of an absence of ovarian function. Other features of this condition that can vary among women who have Turner syndrome include: extra skin on the neck (webbed neck), puffiness or swelling (lymphedema) of the hands and feet, skeletal abnormalities, heart defects and kidney problems.

This condition occurs in about 1 in 2,500 female births worldwide, but is much more common among pregnancies that do not survive to term (miscarriages and stillbirths).

Turner syndrome is a chromosomal condition related to the X chromosome. [ghr.nlm.nih.gov]

Researchers have not yet determined which genes on the X chromosome are responsible for most signs and symptoms of Turner syndrome. They have, however, identified one gene called SHOX that is important for bone development and growth. Missing one copy of this gene likely causes short stature and skeletal abnormalities in women with Turner syndrome.

Treatment

During childhood and adolescence, girls may be under the care of a pediatric endocrinologist, who is a specialist in childhood conditions of the hormones and metabolism.

Growth hormone injections are beneficial in some individuals with Turner syndrome. Injections often begin in early childhood and may increase final adult height by a few inches.

Estrogen replacement therapy is usually started at the time of normal puberty, around 12 years to start breast development. Estrogen and progesterone are given a little later to begin a monthly 'period,' which is necessary to keep the womb healthy. Estrogen is also given to prevent osteoporosis.

Babies born with a heart murmur or narrowing of the aorta may need surgery to correct the problem. A heart expert (cardiologist) will assess and follow up any treatment necessary.

Girls who have Turner syndrome are more likely to get middle ear infections. Repeated infections may lead to hearing loss and should be evaluated by the pediatrician. An ear, nose and throat specialist (ENT) may be involved in caring for this health issue.

High blood pressure is quite common in women who have Turner syndrome. In some cases, the elevated blood pressure is due to narrowing of the aorta or a kidney abnormality. However, most of the time, no specific cause for the elevation is identified. Blood pressure should be checked routinely and, if necessary, treated with medication. Women who have Turner syndrome have a slightly higher risk of having an under active thyroid or developing diabetes. This should also be monitored during routine health maintenance visits and treated if necessary.

Regular health checks are very important. Special clinics for the care of girls and women who have Turner syndrome are available in some areas, with access to a variety of specialists. Early preventive care and treatment is very important.

Almost all women are infertile, but pregnancy with donor embryos may be possible.

Having appropriate medical treatment and support allows a woman with Turner syndrome to lead a normal, healthy and happy life.

NICU - Trisomy 21

2009-07-27T20:38:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Trisomy 21 (Causes Down Syndrome)

What is Trisomy 21?
Information courtesy of Genetics Home Reference [Source]

Humans normally have 46 chromosomes in each cell, divided into 23 pairs. Two copies of chromosome 21, one copy inherited from each parent, form one of the pairs. Chromosome 21 is the smallest human chromosome, spanning about 47 million base pairs (the building blocks of DNA) and representing approximately 1.5 percent of the total DNA in cells.

In 2000, researchers working on the Human Genome Project announced that they had determined the sequence of base pairs that make up this chromosome. Chromosome 21 was the second human chromosome to be fully sequenced.

Identifying genes on each chromosome is an active area of genetic research. Because researchers use different approaches to predict the number of genes on each chromosome, the estimated number of genes varies. Chromosome 21 likely contains between 300 and 400 genes.

Genes on chromosome 21 are among the estimated 20,000 to 25,000 total genes in the human genome.

How are changes in Chromosome 21 related to health conditions?

Many genetic conditions are related to changes in particular genes on chromosome 21. This list of disorders associated with genes on chromosome 21 provides links to additional information.

Changes in the structure or number of copies of a chromosome can also cause problems with health and development. The following chromosomal conditions are associated with such changes in chromosome 21.

Cancers

Rearrangements (translocations) of genetic material between chromosome 21 and other chromosomes have been associated with several types of cancer. For example, acute lymphoblastic leukemia (a type of blood cancer most often diagnosed in childhood) has been associated with a translocation between chromosomes 12 and 21. Another form of leukemia, acute myeloid leukemia, has been associated with a translocation between chromosomes 8 and 21.
Down syndrome

Down syndrome is most often caused by trisomy 21. Trisomy 21 means that each cell in the body has three copies of chromosome 21 instead of the usual two copies. Down syndrome can also result from an extra copy of chromosome 21 in only some of the body's cells (mosaic Down syndrome).

In a small percentage of cases, Down syndrome occurs when part of chromosome 21 becomes attached (translocated) to another chromosome during the formation of reproductive cells (eggs and sperm) or very early in fetal development. Affected people have two copies of chromosome 21, plus extra material from chromosome 21 attached to another chromosome. Affected individuals with this genetic change are said to have translocation Down syndrome.

Researchers believe that extra copies of some genes on chromosome 21 disrupt the course of normal development, causing the characteristic features of Down syndrome and the increased risk of medical problems associated with this disorder.
Other chromosomal conditions

Other changes in the number or structure of chromosome 21 have a variety of effects on health and development. Chromosome 21 abnormalities can cause intellectual disability, delayed development, and characteristic facial features. In some cases, the signs and symptoms are similar to those of Down syndrome. Changes to chromosome 21 include a missing segment of the chromosome in each cell (partial monosomy 21) and a circular structure called ring chromosome 21. A ring chromosome occurs when a chromosome breaks in two places and the ends of the chromosome arms fuse together to form a circular structure.

NICU - Trisomy 18

2009-07-27T20:26:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Trisomy 18

What is Trisomy 18?
Information Courtesy of Genetics Home Reference [Source]

Trisomy 18, also called Edwards syndrome, is a chromosomal condition associated with severe intellectual disability and abnormalities in many parts of the body. Individuals with trisomy 18 often have a low birth weight; a small, abnormally shaped head; a small jaw and mouth; clenched fists with overlapping fingers; heart defects; and abnormalities of other organs. Due to the presence of several life-threatening medical problems, many infants with trisomy 18 die within their first month. Five percent to 10 percent of children with this condition live past their first year.

How Common is Trisomy 18?

Trisomy 18 occurs in about 1 in 5,000 newborns. Approximately 80 percent of newborns affected by this disorder are female. Although women of all ages can have a child with trisomy 18, the chance of having a child with this condition increases as a woman gets older.

What are the genetic changes related to Trisomy 18?

Most cases of trisomy 18 result from having three copies of chromosome 18 in each cell in the body instead of the usual two copies. The extra genetic material disrupts the normal course of development, causing the characteristic features of trisomy 18.

Approximately 5 percent of people with trisomy 18 have an extra copy of chromosome 18 in only some of the body's cells. In these people, the condition is called mosaic trisomy 18. The severity of mosaic trisomy 18 depends on the type and number of cells that have the extra chromosome. The development of individuals with this form of trisomy 18 may range from normal to severely affected.

Very rarely, the long (q) arm of chromosome 18 becomes attached (translocated) to another chromosome during the formation of reproductive cells (eggs and sperm) or very early in embryonic development. Affected people have two copies of chromosome 18, plus extra material from chromosome 18 attached to another chromosome. If only part of the q arm is present in three copies, the physical signs of translocation trisomy 18 may be different from those typically seen in trisomy 18. If the entire q arm is present in three copies, individuals may be as severely affected as if they had three full copies of chromosome 18.

NICU - Tachypnea

2009-07-27T17:38:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Tachypnea

What is Tachypnea?

Tachypnea is a condition where a newborn infant is breathing faster than normal at a continuous rate. This can be caused by additional fluid from birth remaining in the infant's lungs. With treatment, tachypnea can resolve within 24 to 48 hours.

Treatment

Oxygen management is usually required, either by an oxygen hood, sometimes known as a 'halo', by nasal canula, a simple oxygen mask, or in more several cases, CPAP.

Tachypnea should last no longer than 72 hours with treatment.

See Also:

• Kid's Health - Tachypnea
• Medline Plus - Tachypnea

NICU - Syphilis

2009-07-27T17:21:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Syphilis

What is Syphilis?

Syphilis is a sexually transmitted disease. It can be passed to a fetus from the mother by way of the placenta. When the infant is born, it poses a life threatening situation.

From the Centers for Disease Control and Prevention: [Source]

The syphilis bacterium can infect the baby of a woman during her pregnancy. Depending on how long a pregnant woman has been infected, she may have a high risk of having a stillbirth (a baby born dead) or of giving birth to a baby who dies shortly after birth. An infected baby may be born without signs or symptoms of disease. However, if not treated immediately, the baby may develop serious problems within a few weeks. Untreated babies may become developmentally delayed, have seizures, or die.

Treatment

Penicillin will cure the disease.

From the Centers for Disease Control and Prevention: [Source]

Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available to treat syphilis. There are no home remedies or over-the-counter drugs that will cure syphilis. Treatment will kill the syphilis bacterium and prevent further damage, but it will not repair damage already done.

Because effective treatment is available, it is important that persons be screened for syphilis on an on-going basis if their sexual behaviors put them at risk for STDs.

Persons who receive syphilis treatment must abstain from sexual contact with new partners until the syphilis sores are completely healed. Persons with syphilis must notify their sex partners so that they also can be tested and receive treatment if necessary.

NICU - Spina Bifida

2009-07-27T14:41:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Spina Bifida

What is Spina Bifida?
All information courtesy of the National Institute of Neurological Disorders and Stroke [Source]

Spina bifida (SB) is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy. Infants born with SB sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred. Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs. Even when there is no lesion present there may be improperly formed or missing vertebrae and accompanying nerve damage.

In addition to physical and mobility difficulties, most individuals have some form of learning disability. The three most common types of SB are: myelomeningocele, the severest form, in which the spinal cord and its protective covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the meninges protrude from a spinal opening; and occulta, the mildest form, in which one or more vertebrae are malformed and covered by a layer of skin. SB may also cause bowel and bladder complications, and many children with SB have hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).

Treatment

There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy. Many individuals with SB will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord.

Prognosis

The prognosis for individuals with SB depends on the number and severity of abnormalities. Prognosis is poorest for those with complete paralysis, hydrocephalus, and other congenital defects. With proper care, most children with SB live well into adulthood.

See Also:

• National Institute of Neurological Disorders and Stroke - Spina Bifida
• Kids Health -Spina Bifida

NICU - Retinopathy of Prematurity (ROP)

2009-07-27T14:05:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Retinopathy of Prematurity (ROP)

What is Retinopathy of Prematurity?
All information courtesy of the National Eye Institute [Source]

Retinopathy of prematurity (ROP) is a potentially blinding eye disorder that primarily affects premature infants weighing about 2¾ pounds (1250 grams) or less that are born before 31 weeks of gestation (A full-term pregnancy has a gestation of 38–42 weeks). The smaller a baby is at birth, the more likely that baby is to develop ROP. This disorder—which usually develops in both eyes—is one of the most common causes of visual loss in childhood and can lead to lifelong vision impairment and blindness. ROP was first diagnosed in 1942.

Causes

ROP occurs when abnormal blood vessels grow and spread throughout the retina, the tissue that lines the back of the eye. These abnormal blood vessels are fragile and can leak, scarring the retina and pulling it out of position. This causes a retinal detachment. Retinal detachment is the main cause of visual impairment and blindness in ROP.

Several complex factors may be responsible for the development of ROP. The eye starts to develop at about 16 weeks of pregnancy, when the blood vessels of the retina begin to form at the optic nerve in the back of the eye. The blood vessels grow gradually toward the edges of the developing retina, supplying oxygen and nutrients. During the last 12 weeks of a pregnancy, the eye develops rapidly. When a baby is born full-term, the retinal blood vessel growth is mostly complete (The retina usually finishes growing a few weeks to a month after birth). But if a baby is born prematurely, before these blood vessels have reached the edges of the retina, normal vessel growth may stop. The edges of the retina—the periphery—may not get enough oxygen and nutrients.

Scientists believe that the periphery of the retina then sends out signals to other areas of the retina for nourishment. As a result, new abnormal vessels begin to grow. These new blood vessels are fragile and weak and can bleed, leading to retinal scarring. When these scars shrink, they pull on the retina, causing it to detach from the back of the eye.

Stages

Yes. ROP is classified in five stages, ranging from mild (stage I) to severe (stage V):

Stage I — Mildly abnormal blood vessel growth. Many children who develop stage I improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.

Stage II — Moderately abnormal blood vessel growth. Many children who develop stage II improve with no treatment and eventually develop normal vision. The disease resolves on its own without further progression.

Stage III — Severely abnormal blood vessel growth. The abnormal blood vessels grow toward the center of the eye instead of following their normal growth pattern along the surface of the retina. Some infants who develop stage III improve with no treatment and eventually develop normal vision. However, when infants have a certain degree of Stage III and "plus disease" develops, treatment is considered. "Plus disease" means that the blood vessels of the retina have become enlarged and twisted, indicating a worsening of the disease. Treatment at this point has a good chance of preventing retinal detachment.

Stage IV — Partially detached retina. Traction from the scar produced by bleeding, abnormal vessels pulls the retina away from the wall of the eye.

Stage V — Completely detached retina and the end stage of the disease. If the eye is left alone at this stage, the baby can have severe visual impairment and even blindness.

Most babies who develop ROP have stages I or II. However, in a small number of babies, ROP worsens, sometimes very rapidly. Untreated ROP threatens to destroy vision.

Treatment

The most effective proven treatments for ROP are laser therapy or cryotherapy. Laser therapy "burns away" the periphery of the retina, which has no normal blood vessels. With cryotherapy, physicians use an instrument that generates freezing temperatures to briefly touch spots on the surface of the eye that overlie the periphery of the retina. Both laser treatment and cryotherapy destroy the peripheral areas of the retina, slowing or reversing the abnormal growth of blood vessels. Unfortunately, the treatments also destroy some side vision. This is done to save the most important part of our sight—the sharp, central vision we need for "straight ahead" activities such as reading, sewing, and driving.

Both laser treatments and cryotherapy are performed only on infants with advanced ROP, particularly stage III with "plus disease." Both treatments are considered invasive surgeries on the eye, and doctors don't know the long-term side effects of each.

In the later stages of ROP, other treatment options include:

Scleral buckle. This involves placing a silicone band around the eye and tightening it. This keeps the vitreous gel from pulling on the scar tissue and allows the retina to flatten back down onto the wall of the eye. Infants who have had a sclera buckle need to have the band removed months or years later, since the eye continues to grow; otherwise they will become nearsighted. Sclera buckles are usually performed on infants with stage IV or V.
Vitrectomy. Vitrectomy involves removing the vitreous and replacing it with a saline solution. After the vitreous has been removed, the scar tissue on the retina can be peeled back or cut away, allowing the retina to relax and lay back down against the eye wall. Vitrectomy is performed only at stage V.

See Also:

• National Eye Institute - ROP
• eMedicine - ROP

NICU - Respiratory Distress Syndrome (RDS)

2009-07-27T13:52:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Respiratory Distress Syndrome (RDS)

What is Respiratory Distress Syndrome?
From the National Heart, Lung, and Blood Institute [Source]

Respiratory distress syndrome (RDS) is a breathing problem that sometimes affects babies born about 6 weeks or more before their due dates. Their lungs aren't developed enough to make surfactant (sur-FAK-tant). Surfactant is a liquid that coats the inside of the lungs and keeps them open so that the baby can breathe in air once he or she is born.

Without surfactant, the lungs collapse and the baby has to work hard to breathe. The baby might not be able to breathe in enough oxygen to support the body's organs.

Most infants who develop RDS show signs of breathing problems at birth or within the next few hours. If they're not given the right treatment, their brains and other organs may suffer from the lack of oxygen.

Treatment
From the National Heart, Lung, and Blood Institute [Source]

reatment of respiratory distress syndrome (RDS) usually begins as soon as the baby is born, sometimes in the delivery room. Most infants who show signs of RDS are quickly moved to a special intensive care unit called a neonatal intensive care unit (NICU). There they receive around-the-clock treatment from a group of health care professionals who specialize in treating premature infants.

The most important treatments for RDS are:

Surfactant replacement therapy
Breathing support

Surfactant Replacement Therapy

The baby is given surfactant until his or her lungs have developed enough to start making their own surfactant. Surfactant usually is given through a tube that's attached to a breathing machine. The machine pushes the surfactant directly into the baby's lungs.

Surfactant may be given right after birth in the delivery room to try to prevent or treat RDS. It can be given two to four more times over the next few days, until the baby is able to breathe on his or her own.

Breathing Support

Babies with RDS often are put on a machine that helps them breathe until their lungs have developed enough to start making their own surfactant. Until recently, these babies usually were put on a mechanical ventilator that was connected to a breathing tube that ran through the baby's mouth or nose into the windpipe.

Today, more and more babies are receiving breathing support from a nasal continuous positive airway pressure (NCPAP) machine, which pushes air into the baby's lungs through prongs in the nostrils.

Other Types of Treatment

Other treatments for babies with RDS include:

Medicines
Supportive therapy
Treatment for patent ductus arteriosus, a condition that affects some premature infants

Medicines

Doctors usually give the baby antibiotics to control infections.

Supportive Therapy

Treatment in the NICU is designed to limit stress on the baby and meet his or her basic needs of warmth, nutrition, and protection. Such treatment usually includes:

Using a radiant warmer or incubator to keep the baby warm and reduce the chances of infection.
Ongoing monitoring of blood pressure, heart rate, breathing, and temperature through sensors taped to the baby's body.
Using a sensor on a finger or toe to monitor the amount of oxygen in the baby's blood.
Giving fluids and nutrients through a needle or tube inserted into a vein to prevent malnutrition and promote growth. Nutrition is critical to the growth and development of the lungs. Later, your baby may be given milk through a tube that's passed through his or her nose into the mouth.
Monitoring fluid intake to make sure that fluid doesn't build up in the baby's lungs.

NICU - Pneumothorax

2009-07-27T13:35:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Pneumothorax

What is Pneumothorax?

Pneumothorax is an area around the lungs where air has gathered. In infants, there are tiny air sacs that can rupture, leaking air into the areas around the lungs. This can be caused in several ways, two common ones being placed on oxygen management, such as a ventilator, or meconium aspiration. The danger with a pneumothorax is the possibility for lung collapse.

Treatment

Treatment for pneumothorax depends on the severity of the condition. If it is less severe, the condition may merely be monitored. For more serious cases, the air may be removed via needle or catheter.

See Also:

• University of Virginia HealthSystem - Pneumothorax
• Medline Plus - Pneumothorax

NICU - Persistent Pulmonary Hypertension (PPHN)

2009-07-27T11:05:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Persistent Pulmonary Hypertension (PPHN)

What is Persistent pulmonary hypertension?

Persistent pulmonary hypertension is a condition where a newborn infant's blood bypasses the lungs. Doing so is very dangerous, because the lungs oxygenate blood to be delivered to the rest of the body. PPHN happens when infants under respiratory stress after birth revert to how the blood bypassed oxygen while in utero.

Treatment

Treatment for PPHN varies depending on the severity of the condition. Medication can be administered, and a wide range of oxygen management can be used, again, depending on how serious the PPHN is.

With help from breathing machines, oxygen can once again be delivered to the rest of the body .

See Also:

• University of Virginia Health System - PPHN
• Merck - PPHN

NICU - Periventricular Leukomalacia (PVL)

2009-07-27T10:46:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Periventricular Leukomalacia (PVL)

What is Periventricular Leukomalacia?
From the National Institute of Neurological Disorders and Stroke [Source]

Periventricular leukomalacia (PVL) is characterized by the death of the white matter of the brain due to softening of the brain tissue. It can affect fetuses or newborns; premature babies are at the greatest risk of the disorder. PVL is caused by a lack of oxygen or blood flow to the periventricular area of the brain, which results in the death or loss of brain tissue. The periventricular area-the area around the spaces in the brain called ventricles-contains nerve fibers that carry messages from the brain to the body's muscles. Although babies with PVL generally have no outward signs or symptoms of the disorder, they are at risk for motor disorders, delayed mental development, coordination problems, and vision and hearing impairments. PVL may be accompanied by a hemorrhage or bleeding in the periventricular-intraventricular area (the area around and inside the ventricles), and can lead to cerebral palsy. The disorder is diagnosed by ultrasound of the head.

Treatment
From the National Institute of Neurological Disorders and Stroke [Source]

There is no specific treatment for PVL. Treatment is symptomatic and supportive. Children with PVL should receive regular medical screenings to determine appropriate interventions.

See Also:

• National Institute of Neurological Disorders and Stroke
• University of Virginia Health System

NICU - Patent Ductus Arteriosis (PDA)

2009-07-27T07:55:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Patent Ductus Arteriosis (PDA)

What is Patent Ductus Arteriosis?
From the National Heart, Lung and Blood Institute [Source]

Patent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart.

Before birth, the two major arteries—the aorta and the pulmonary (PULL-mun-ary) artery—are connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation.

Within minutes or up to a few days after birth, the vessel is supposed to close as part of the normal changes occurring in the baby's circulation.

In some babies, however, the ductus arteriosus remains open (patent). This opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can put strain on the heart and increase blood pressure in the lung arteries.

Treatment
From the National Heart, Lung and Blood Institute [Source]

Patent ductus arteriosus (PDA) is treated with medicines, catheter-based procedures, and surgery. The goal of treatment is to close the PDA to prevent complications and reverse the effects of increased blood volume.

Small PDAs often close without treatment. For full-term infants, treatment is needed if the child's PDA is large or causing health problems.

For premature infants, treatment is needed if the PDA is causing breathing problems or heart problems.

Talk to your child's doctor about treatment options and your family's preferences on treatment decisions.

Medicines

Your child's doctor may prescribe medicines to help close your child's PDA.

Indomethacin is a medicine that helps close PDAs in premature infants. This medicine works by stimulating the PDA to constrict or tighten, closing the opening. Indomethacin usually doesn't work in full-term infants.

Ibuprofen is a medicine in the same family as indomethacin. It's also frequently used to close PDAs in premature infants.

Catheter-Based Procedures

Catheters are thin, flexible tubes used in a procedure called cardiac catheterization (KATH-e-ter-i-ZA-shun). Catheter-based procedures often are used to close PDAs in infants or children who are large enough to have the procedure.

Your child's doctor may refer to the procedure as "transcatheter device closure." The procedure sometimes is done on small PDAs to prevent the risk of infective endocarditis (IE), an infection of the lining of the heart, valves, or arteries.

During the procedure, your child will be sedated or given medicine so that he or she will sleep and not feel any discomfort. The doctor will place a catheter in a large blood vessel in the upper thigh (groin) and guide it to your child's heart.

A small metal coil or other blocking device is then passed up through the catheter and placed in the PDA to block blood flow through the vessel.

Catheter-based procedures don't require the child's chest to be opened. They also let the child recover quickly.

Closing a PDA using a catheter often is done on an outpatient basis. You'll most likely be able to take your child home the same day the procedure is done.

Complications from catheter-based procedures are rare and short term. They can include bleeding, infection, and movement of the blocking device from where it was placed.

Surgery

Surgery for PDA may be done if:

A premature or full-term infant develops health problems from the PDA and is too small to have a catheter-based procedure
A PDA isn't successfully closed by a catheter-based procedure
Surgery is planned for treatment of related congenital heart defects

Often, surgery isn't done until after 6 months of age in infants who don't have health problems from their PDAs. Doctors sometime perform surgery on small PDAs to prevent the risk of IE.

For the surgery, your child will be given medicine so that he or she will sleep and not feel any discomfort. The surgeon will make a small cut between your child's ribs to reach the PDA. He or she will then close the PDA with stitches or clips.

Complications from surgery are rare and usually short term. They can include hoarseness, a paralyzed diaphragm (the muscle below the lungs), infection, bleeding, or fluid buildup around the lungs.

NICU - Omphalocele

2009-07-27T07:19:00.001-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Omphalocele

What is an Omphalocele?

An omphalocele happens while a baby is still developing in utero. Part of the intestines, or possible even an organ remains on the outside of the abdominal wall, usually through the umbilical region, or belly button.

When the infant is born, the omphalocele can easily be seen, protruding from the bellybutton area. While similar in appearance at times, an omphalocele is different from gastroschisis.

Treatment

Surgery is necessary to repair an omphalocele. The contents are placed in a sac that is eventually moved back within the abdominal wall. Once in place, the sac can be removed and the opening repaired.

See Also:

• University of Virginia Health System - Omphalocele
• Medline Plus - Omphalocele

NICU - Necrotizing Enterocolitis (NEC)

2009-07-27T06:59:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Necrotizing Enterocolitis (NEC)

What is Necrotizing Enterocolitis?

Necrotizing enterocolitis is a very severe condition that occurs most commonly in premature infants. The intestinal wall becomes inflamed and infected with bacteria, and the tissue becomes necrotic, or dies. A lack of blood flow to the affected area can also cause NEC. This can lead to several complications, including bowel perforation.

Treatment

Babies with NEC often need surgery, where the dead section of the intestines is removed. The healthy sections are then reconnected. A colostomy is also often needed.

In order to give the intestinal tract the rest and relief it needs, an infant is more than likely to be placed on IV fluids to replace feedings. This will temporarily replace breast milk and/or formula.

NEC is a very serious complication, and can be fatal if not discovered early on. Quick, aggressive treatment often improves the outlook for the baby.

See Also:

• Kid's Health - NEC
• University of Virginia Health System - NEC
• Medline Plus - NEC
• WebMD - NEC

NICU - Meningitis

2009-07-27T06:49:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Meningitis (Spinal Meningitis)

What is Meningitis?
From the CDC Website [Source]

Meningitis is an inflammation of the membranes that cover the brain and spinal cord. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ depending on the cause. Viral meningitis is generally less severe and clears up without specific treatment. But bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disabilities. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis. Hib vaccine is now given to all children as part of their routine immunizations. This vaccine has reduced the number of cases of Hib infection and the number of related meningitis cases. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.

Treatment
From the CDC Website [Source]

Bacterial

Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.

Viral

There is no specific treatment for viral meningitis. Most patients completely recover on their own within 2 weeks. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Doctors often will recommend bed rest, plenty of fluids, and medicine to relieve fever and headache.

A hospital stay may be necessary in more severe cases or for people with weak immune systems.

NICU - MRSA

2009-07-26T20:57:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Methicillin Resistant Staphylococcus Aureus (MRSA)

Other NICU MRSA articles: Infant MRSA in the NICU

What is MRSA?

MRSA is a bacteria that causes infection, most commonly on the skin. This strain of staph can be particularly dangerous among people with low immune systems, such as babies. The reason this this is so dangerous is because it is resistant to numerous antibiotics that once were able to treat it. While there are still medications that can treat this, it is a bacteria that is constantly evolving and adapting.

Infants in the neonatal ICU are often placed in contact isolation, as it can be passed from skin to skin contact, or by touching an object hosting the bacteria. They are put on antibiotics to help clear the MRSA. They will usually remain in isolation until discharged.

Treatment

While many antibiotics cannot treat MRSA, there are still several that can. Practicing good hand washing is an invaluable way to prevent the further spread of MRSA.

See Also:

• Infant MRSA in the NICU
• Centers for Disease Control and Prevention - MRSA
• WebMD - MRSA
• Medline Plus - MRSA

NICU - Meconium Aspiration

2009-07-26T20:25:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Meconium Aspiration

What is Meconium Aspiration?

Meconium aspiration refers to a condition where a newborn infant breathes in his or her own meconium. When an infant is inside the uterus, usually very soon before birth, it may stool, or poop, for the very first time while still inside his or her mother. This first poop is called meconium, and it is a sticky, tar-like, dark green substance. This first stool can mix with the amniotic fluid surrounding the baby. Since a baby breathes in the amniotic fluid, there is a chance meconium could be aspirated as well.

This is extremely dangerous and could potentially be life threatening. The meconium poses a threat to block the airway of the infant after birth, making it difficult for the baby to breathe.

Treatment

An infant who has aspirated meconium will be admitted to the NICU. The baby's lungs will be suctioned out with a tube, to try and evacuate all meconium in the airway. If severe enough, the baby may also be placed on oxygen management, as well as medications.

See also:

• Kid's Health - Meconium Aspiration
• Medline Plus - Meconium Aspiration

NICU - Intrauterine Growth Restriction (IUGR)

2009-07-26T19:43:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Intrauterine Growth Restriction (IUGR)

What is IUGR?

Intrauterine growth restriction is a condition when a baby is born much smaller in size than is normal for their gestational age. This can happen to both full-term infants, as well as preterm infants.

While there is nothing clinically wrong with the baby in specific relation to size, there may be several other conditions that accompany IUGR. These include:

Inability to keep a normal body temperature
Poor feeding
Hypoglycemia
Infant may require oxygen management

Treatment

IUGR is not a treatable condition, as it is a term used to describe the abnormally smaller size of the infant. However, maintaining a healthy lifestyle while pregnant may help increase the chance that any side effects are minimal in severity.

See Also:

• Family Doctor.org
• University of Virginia Health System
• Medline Plus

NICU - Imperforate Anus

2009-07-26T19:32:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Imperforate Anus

What is Imperforate Anus?

An imperforate anus is the absence of the anus in an infant. This is a congenital defect that happens during development in the uterus. With an imperforate anus, the baby has no way to excrete stool from his or her body.

Treatment

Surgery is necessary to repair the defect. Further surgery may be required if the rectum is found to be connected to other organs in the body. Frequently, a colostomy is necessary after surgical repair. The colostomy is not permanent, and may be removed after the defect is healed and repaired.

See also:

• Medline - Imperforate Anus
• University of Michigan Department of Surgery - Imperforate Anus

NICU - Hypoglycemia

2009-07-26T19:16:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Hypoglycemia

What is Hypoglycemia?

Hypoglycemia is when the infant's blood sugar, or glucose levels, drop too low. The result is a lethargic baby, who may have less energy to move and eat.

Treatment

Treatment is relatively simple. A baby in the neonatal ICU with hypoglycemia may just need a simple feeding of breast milk or formula.

If the glucose level is still too low after a feeding, then an IV will be started, and glucose will be given to the infant via IV fluids.

See also:

• eMedicine
• PDRhealth -Hypoglycemia

NICU - Hydrops Fetalis

2009-07-26T18:57:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Hydrops Fetalis

What is Hydrops Fetalis?

Hydrops Fetalis (hydrops) is an extremely dangerous condition in which the body of the fetus or infant has abnormal swelling from additional fluid build-up in the body. The most common type is called non-immune, which is when the baby's ability to control fluid cannot be managed.

Treatment

In the neonatal ICU, an infant with hydrops is treated according to the severity of the condition. This can involve oxygen management, medications, and surgeries or procedures. Severe hydrops can potentially be fatal.

Please see the following links for more detailed information.

NICU - Hydronephrosis

2009-07-26T18:30:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Hydronephrosis

What is Hydronephrosis?

Hydronephrosis is a condition in which there is an obstruction in the urinary tract, preventing urine from exiting the body. The narrowing can cause the urine to back up in the kidney, which is when hydronephrosis occurs. The condition can also happen if urine returns to the kidney from the bladder, which would make it abnormally flow in the opposite direction.

Treatment

In mild cases of hydronephrosis, an infant may simply be monitored by ultrasound and the condition may return to normal on its own. For more serious cases, medications may be administered. Surgery is also an option if the hydronephrosis does not appear it will correct itself, or if there a serious and imminent risk to the infant.

See also:

• Children's Hospital Boston

NICU - Hydrocephalus

2009-07-26T18:04:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Hydrocephalus

What is Hydrocephalus?

Hydrocephalus is a condition where there is a larger than normal amount of fluid in the brain. This fluid is called cerebrospinal fluid, or CSF. This excess fluid can build up and eventually put pressure on the brain, which is extremely harmful and could damage it as well.

This is considered a congenital defect, meaning that infants born with this and placed in the neonatal ICU developed this while in the uterus. CSF serves multiple functions, and flows in and out of the brain. Hydrocephalus disrupts this flow, and the CSF accumulates in and around the brain.

This can be diagnosed while in utero, and is clearly visible by the infant's abnormally large head circumference.

If left untreated, the pressure from the fluid build up can cause so much damage to the brain, that it can be fatal.

Treatment

Hydrocephalus is treated by placing a shunt in the brain to redirect the flow of the CSF to another part of the body where it can be absorbed and released. A shunt is a tube that runs from the brain to another part of the body.

The best chance for a full recovery is if hydrocephalus is diagnosed early, and treatment is done quickly.

See Also:

• Medline Plus - Hydrocephalus
• NINDS - Hydrocephalus

NICU - Hirschsprung's Disease

2009-07-26T15:33:00.001-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Hirschsprung's Disease

What is Hirschsprung's Disease?

Hirschsprung's disease is where ganglion cells, which are nerve cells, are not present in sections of the intestines that help with the continuous movement of stomach contents. With the absence of these nerve cells, the stomach content's can back up, causing a blockage. This is extremely dangerous as it can ultimately lead to a bowel perforation ( a hole in the bowel causing stool to enter the inner body), as well as a possible bacterial infection.

Treatment

Surgery is an absolute must for infants with Hirschsrpung's disease. The affected area with the absence of nerve cells is removed. The remaining healthy sections of intestines are then reconnected.

In some cases, with critically ill or sick infants, a colostomy is needed to allow the baby to recover, at hich surgery will be performed at a later date.

If there is an early diagnosis, and health of the infant is good, then a very minor invasive surgical
procedure can be performed, called a laparoscopy. This reduces scarring and allows for normal bowel movements after the procedure is complete.

See Also:

• Children's Cincinnati - Hirschsprung's Disease
• Mayo Clinic - Hirschsprung's Disease

NICU - Gastroschisis

2009-07-26T14:34:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Gastroschisis

What is Gastroschisis?

Gastroschisis refers to when a baby is born with his or her intestines on the outside of the body. There is usually a very small opening in the adbdominal wall that allows the intestines to grow outside the infant's body, while in the uterus.

There is no known cause for gastroschisis, but a baby born with this condition will be admitted to the NICU promptly, with the intestines wrapped in a sterile gauze and kept moist until surgery can be done.

Treatment

Gastroschisis usually requires immediate surgery once the baby is stabilized. There are two types of surgery, both reliant upon how severe the condition is.

If there is a small amount of intestine on the outside of the stomach, then it can be placed back into its normal position inside the abdominal cavity. The opening in the abdominal wall also be closed.

If the amount of intestine is too large to fit back into the baby, then it will have to be placed in a sac that will be tightened over several days to force the intestine back into its normal position. After this is successful, the opening in the abdominal wall can then be closed.

For more information on gastroschisis, please visit the links below.

See Also:

• Cincinnati Children's - Gastroschisis
• Medline Plus - Gastroschisis

NICU - Gastroesophagel Reflux (GERD, reflux)

2009-07-26T13:47:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Gastroesophageal Reflux (GERD, reflux)

What is Gastroesophageal Reflux?

GERD is what happens when the contents of the stomach move back up, or reflux, into the esophagus after or while eating a meal. In infants, this is extremely common, and often not a huge concern. With reflux, and infant will either spit up or vomit. The difference between the two is that with spit up, the baby more or less will literally spit the food up in a non-volatile manner. With vomiting, the stomach contents come out much more forcefully, often called projectile vomiting.

With neonatal infants, reflux is a concern because feeding habits of NICU babies are watched very closely. Doctors want to make sure a baby is eating enough and keeping enough milk or formula down before being sent home.

Keep in mind that GERD can be very scary to a parent. When a child refluxes and spits up or vomits, it is important they are in an upright position or they make have the appearance that they are choking.

Make sure to ask your pediatrician about how to react and clear the spit up or vomit if this occurs.

Here are some tips on how to help prevent reflux:

Do not overfeed your baby. Ask your pediatrician how much milk or formula your baby should be taking.
Burp your baby after one or two ounces of breast milk or formula.
Keep your baby in an upright position after feeding for approximately 30 minutes.
Have infants sleep on their backs, though this is recommended for all babies, no matter their condition.
Add a thickening agent to your baby's milk or formula. A pediatrician can help you decide what is best, though rice cereal is a common thickener.
Ask you pediatrician what to do if your baby chokes on their own spit up or vomit.

Treatment

Most infants with gastroesophageal reflux will outgrow this condition by 12 to 24 months of age. Thus, no treatment is necessary.

However, if the GERD is severe enough, a medication may be necessary.

See Also:

• National Digestive Diseases
• Colic Calm
• Infant Reflux Disease

NICU - Fetal Alcohol Syndrome

2009-07-24T21:43:00.001-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Fetal Alcohol Syndrome (FAS)

What is Fetal Alcohol Syndrome?

Fetal Alcohol Syndrome is a condition where a mother consumes alcohol during pregnancy, potentially causing birth defects and mental retardation. This is completely avoidable if a mother chooses not to consume any alcohol while pregnant.

Here is a list of possible complications of Fetal Alcohol Syndrome, from the Department of Health and Human Services CDC: [Source]

Small size for gestational age or small stature in relation to peers
Facial abnormalities such as small eye openings
Poor coordination
Hyperactive behavior
Learning disabilities
Developmental disabilities (e.g., speech and language delays)
Mental retardation or low IQ
Problems with daily living
Poor reasoning and judgment skills
Sleep and sucking disturbances in infancy

Treatment

There is no medical treatment for Fetal Alcohol Synrome, but strong home and family support can help the baby live the best life possible.

For more information on what to expect as the baby gets older, please visit the links below.

See Also:

• Centers for Disease Control and Prevention
• Kid's Health - Fetal Alcohol Syndrome

NICU - Esophageal Atresia

2009-07-24T20:42:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Esophageal Atresia

What is Esophageal Atresia?

Esophageal Atresia is when the upper part of the esophagus does not connect to the lower part. The upper end of the lower part of the esophagus is attached to the windpipe. It also could mean that there is a narrowing of the esophagus. Either way, the complication is life-threatening.

If not treated, the infant could aspirate saliva or potentially other secretions, resulting in choking or aspiration pneumonia. This can also be fatal.

Treatment

Surgery is necessary to repair the complication. This must be done as quickly as possible, once the baby is stabilized in the NICU.

See also:

• Medline Plus - Esophageal Atresia

NICU - Duodenal Atresia

2009-07-24T20:24:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Duodenal Atresia

What is Duodenal Atresia?

Duodenal Atresia is where the beginning part of the small bowel (the duodenum) is closed, or potentially not present, disallowing stomach contents to pass freely throughout the rest of the intestinal tract.

If not treated, this condition can be fatal.

Treatment

Surgery is necessary to repair Duodenal Atresia, at which point recovery can normally be expected.

See also:

• Medicine Plus - Duodenal Atresia

NICU - Diaphragmatic Hernia

2009-07-24T19:58:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Diaphragmatic Hernia

What is a Diaphragmatic Hernia?

A diaphragmatic hernia is an opening in the muscle that separates the inner chest area from the inner abdominal area. While the baby is in the uterus, a combination of factors lead to a flaw in where the baby's intestines are located. The intestines are trapped in the upper chest cavity, whereas they should be below.

When this happens, the lungs usually are found to be underdeveloped, and pose serious complications.

There are two types of diaphragmatic hernias:

Bochdalek hernia - This happens on the left side of the body,where the stomach and intestines usually present themselves in the chest cavity. This is the most common form.
Morgagni hernia - This happens on the right side of the body, where the liver and intestines can be found in in the chest cavity. This form is generally rare.

An infant with a diaprhagmatic hernia will be placed in the NICU, and often placed on a ventilator. This is because the underdeveloped lungs cannot breath on their own, so the machine must do it for them.

This condition can be diagnosed in utero, or after the baby is born. It is considered life-threatening and requires surgery to repair.

Treatment

Surgery is necessary to repair the hernia. The intestines and other organs found out of place will be moved into their normal positions in the abdominal cavity, and the hole in the muscle is repaired.

Due to the infant not being able to breathe on its own, it will be on a ventilator before and after the surgery. Babies with this type or surgery can be in the NICU for several weeks.

There is also the possibility, that if severe enough, the infant could be placed on an ECMO machine, which simulates heart and lung functions so that a baby's body has a chance to rest and recover. This is only temporary, as long term exposure to the machine poses additional risks.

Recovery time can be long, the duration being months or even years.

See also:

• University of Virginia Health System - Diaphragmatic Hernia
• Children's Hospital Boston - Diaphragmatic Hernia

NICU - Family Visitation

2009-07-24T14:29:00.000-07:00

NICU
Family Visitation

The moment your baby is born, you have the overwhelming feeling to be surrounded by your family to share the experience with. This feeling stays true the entire time the infant is in the hospital.

When a baby is admitted to the neonatal intensive care unit, chances are the baby will stay longer than the mother. This allows the opportunity for parents to bring in visitors to see their baby.

Every NICU has a visitation policy that must be followed. Each one is unique to its respective unit.

Most neonatal units will allow visitors to only visit while accompanied by the parents of the baby. And further, to reduce exposure, they may limit the number of visitors physically at the bedside, as well as limiting the amount of visitors per day. This can include immediate and/or extended family.

Grandparents, aunts, uncles, cousins, etc will more than likely have visitaton limited. Siblings of the baby may or may not have limited visitation. Some units allow the other children of the parents to come in without restriction due to the value of being together as a family, as well as to keep moms and dads from having to avoid forced split time with the baby so the other can watch the other children.

There are some units that will allow grandparents to visit without the parents supervision.

Overall, expect there to be some guidelines on who can and cannot visit. This can include family members, so make sure to talk to your baby's nurse or the charge nurse if you have any questions.

NICU - Sibling Visitation

2009-07-24T14:12:00.000-07:00

NICU
Sibling Visitation

Every big brother and big sister cannot wait to see their new little brother or sister. It's a very special moment for all parents to have their families together for the first time with the newest member of the family.

In the NICU, there may or may not be restrictions on sibling visitation. Often, since babies, especially neonatal infants, have very low immune systems, visitation by children can be restricted. This can include siblings.

Since children are much more likely to be around other children, and have a much higher tendancy to pass along bacteria and viruses, there may be a limitation to how often a big brother or sister may visit.

This is purely in the best interest of not only your baby, but every baby in the neonatal unit. Just bumping into a chair or crib, or accidentally sneezing or coughing, risks infecting a baby.

Some units may not let siblings under a certain age visit. For instance, there are some neonatal units that will not let a sibling under four years of age into their area. Again, this is a precautionary measure to protect the babies in the unit.

Most NICUs will provide a visitation policy for you to sign. Remember, every NICU is different, so each is bound to have their own unique visitation rules. If you have any further questions regarding specific guidelines, be sure to ask the nurse of your child, or the charge nurse if your nurse is not available.

NICU - What is HIPPA?

2009-07-24T13:59:00.000-07:00

NICU
What is HIPPA?
From the U.S. Department of Health & Human Services [Source]

HIPPA stands for the Health Insurance Portability and Accountability Act of 1996.

Your Health Information Is Protected By Federal Law

Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information.

Who Must Follow This Law

We call the entities that must follow the Privacy Rule covered entities.

Covered entities include:

Health Plans - including health insurance companies, HMOs, company health plans, and certain government programs that pay for health care, such as Medicare and Medicaid.
Most Health Care Providers - those that conduct certain business electronically, such as electronically billing your health insurance—including most doctors, clinics, hospitals, psychologists, chiropractors, nursing homes, pharmacies, and dentists.
Health Care Clearinghouses - entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

Who Is Not Required to Follow This Law

Many organizations that have health information about you do not have to follow this law.

Examples of organizations that do not have to follow the Privacy Rule include:

life insurers,
employers,
workers compensation carriers,
many schools and school districts,
many state agencies like child protective service agencies,
many law enforcement agencies,
many municipal offices.

Your Health Information Is Protected By Federal Law

Examples of organizations that do not have to follow the Privacy Rule include:

life insurers,
employers,
workers compensation carriers,
many schools and school districts,
many state agencies like child protective service agencies,
many law enforcement agencies,
many municipal offices.

What Information Is Protected

Information your doctors, nurses, and other health care providers put in your medical record
Conversations your doctor has about your care or treatment with nurses and others
Information about you in your health insurer’s computer system
Billing information about you at your clinic
Most other health information about you held by those who must follow this law

How Is This Information Protected

Covered entities must put in place safeguards to protect your health information.
Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.
Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.
Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information.

What Rights Does This Law Give Me Over My Health Information

Health Insurers and Providers who are covered entities must comply with your right to:

Ask to see and get a copy of your health records
Have corrections added to your health information
Receive a notice that tells you how your health information may be used and shared
Decide if you want to give your permission before your health information can be used or shared for certain purposes, such as for marketing
Get a report on when and why your health information was shared for certain purposes
If you believe your rights are being denied or your health information isn’t being protected, you can
- File a complaint with your provider or health insurer
- File a complaint with the U.S. Government

You should get to know these important rights, which help you protect your health information.

You can ask your provider or health insurer questions about your rights.

Learn more about your health information privacy rights.

Who Can Look at and Receive Your Health Information

The law sets rules and limits on who can look at and receive your health information

To make sure that your health information is protected in a way that does not interfere with your health care, your information can be used and shared:

For your treatment and care coordination
To pay doctors and hospitals for your health care and to help run their businesses
With your family, relatives, friends, or others you identify who are involved with your health care or your health care bills, unless you object
To make sure doctors give good care and nursing homes are clean and safe
To protect the public's health, such as by reporting when the flu is in your area
To make required reports to the police, such as reporting gunshot wounds

Your health information cannot be used or shared without your written permission unless this law allows it. For example, without your authorization, your provider generally cannot:

Give your information to your employer
Use or share your information for marketing or advertising purposes
Share private notes about your health care

NICU - Cystic Fibrosis

2009-07-23T21:58:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie

Cystic Fibrosis

What is Cystic Fibrosis?

Cystic Fibrosis is a genetic disease that causes the body to produce extra mucus, leading to potentially life-threatening complications. There is a gene that controls the movement of salt throughout the body, and with cystic fibrosis, there is a flaw with this particular gene that results in the thick secretions.

Potential complications from the thick mucus can lead to difficulty breathing, as well as building up harmful bacteria, leading to lung infection. These factors can eventually contribute to damaging the lungs themselves, and even death.

Cystic Fibrosis is considered one of the leading genetic diseases that ultimately leads to a shorter life.

The following is courtesy of Genetics Home Reference: [Source]

"Cystic fibrosis is an inherited disease of the mucus glands that affects many body systems. The disorder's most common signs and symptoms include progressive damage to the respiratory system and chronic digestive system problems.

Mucus is a slippery substance that lubricates and protects the linings of the airways, digestive system, reproductive system, and other organs and tissues. In people with cystic fibrosis, the body produces mucus that is abnormally thick and sticky. This abnormal mucus can obstruct the airways, leading to severe problems with breathing and bacterial infections in the lungs. These infections cause chronic coughing, wheezing, and inflammation. Over time, mucus buildup and infections result in permanent lung damage, including the formation of scar tissue (fibrosis) and cysts in the lungs.

Most people with cystic fibrosis also have digestive problems because thick, sticky mucus interferes with the function of the pancreas. The pancreas is an organ that produces insulin (a hormone that helps control blood sugar levels). It also makes enzymes that help digest food. In people with cystic fibrosis, mucus blocks the ducts of the pancreas, preventing these enzymes from reaching the intestines to aid digestion. Problems with digestion can lead to diarrhea, malnutrition, poor growth, and weight loss. Some babies with cystic fibrosis have meconium ileus, a blockage of the intestine that occurs shortly after birth.

Cystic fibrosis used to be considered a fatal disease of childhood. With improved treatments and better ways to manage the disease, many people with cystic fibrosis now live well into adulthood. Adults with cystic fibrosis experience medical problems affecting the respiratory, digestive, and reproductive systems. For example, most men with cystic fibrosis are unable to father children (infertile) because the tubes that carry sperm (the vas deferens) are blocked by mucus and do not develop properly. This condition is known as congenital bilateral absence of the vas deferens (CBAVD). Infertility is also possible, though less common, in women with cystic fibrosis."

Treatment

There is no known cure, but there are many treatments and medications available to help with CF complications. Babies with Cystic Fibrosis will need antibiotics to fight potential infections, as well as medications to help break up mucus.

Parents need to be consistent with helping keep their baby's chest clear by administering medications as well as manually loosening mucus if necessary. This can be done by gently tapping on your baby's chest with a cupped hand. Have a pediatrician demonstrate this method before using it.

Survivability has increased vastly over the years, with many childrne born with CF living well into their 30s, and sometimes longer.

See Also:

• BabyCenter - Cystic Fibrosis
• Cystic Fibrosis Foundation
• Livestrong - Infant Cystic Fibrosis

NICU - Coarctation of the Aorta

2009-07-23T10:58:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Coarctation of the Aorta

Coarctation of the Aorta is a narrowing of the aorta, the largest artery in the body. The aorta carries blood to be distributed throughout the upper and lower body regions. If the narrowing is severe enough, it may restrict blood flow from the aorta to the lower parts of the body, making the heart work harder, which can lead to congestive heart failure. It also could decrease blood flow to other organs.

Treatment

Surgery is almost always necessary in NICU infants. Often, the narrowed section is removed, and the two ends of the aorta are reattached.

If the neonate is critically ill, intravenous (IV) medication may be given to help keep the aorta open and to increase blood flow to the lower regions of the body.

See Also:

• Cincinnati Children's - Coarc of the Aorta
• Mayo Clinic - Coarc of the Aorta
• American Heart Association

NICU - Cytomegalovirus (CMV)

2009-07-23T10:37:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Cytomegalovirus (CMV)

CMV is a virus in the herpes family. Though it does not present visible symptoms such as blistering or scarring, it does present itself in the form of mono-like symptoms, including fever, swollen glands, and feeling lethargic.

Infants in and out of the Neonatal Intensive Care Unit usually obtain CMV from their mothers while in utero, or it is given to them by their mothers after birth.

Here are a couple key facts about CMV to remember:

Almost everyone has been exposed to CMV by adulthood.
Most infected infants, children, and adults do not show symptoms of CMV.
Like herpes, the virus stays in your system forever, lying dormant.
CMV is of higher risk to infants and people with auto-immune deficiencies
Only 1:1000 babies may develop serious serious nervous system damage or developmental disabilities [Source]

Treatment

There is no current treatment for CMV, as there are no vaccinations for the virus. Infants in the NICU may be treated for CMV by intravenous (IV) drugs.

See also:
• New York State Department of Health - CMV
• Kid's Health - CMV

NICU - Clubfoot

2009-07-23T10:10:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Clubfoot

Clubfoot refers to a condition where the foot is visibly bending inwards from the ankle. Clubfoot is unmistakable and can happen in one or both feet. It is even possible to detect a baby's clubfoot with an ultrasound while in utero (latin for in the uterus).

While painless, clubfoot should be treated from birth so as to prevent a child to learn to walk on his or her ankles.

Treatment

Treatment for clubfoot has been quite successful over the years, often not requiring surgery. A method of realigning the foot by stretching and casting is called the Ponseti Method. It has been quite successful, but requires parents to actively maintain the casts themselves.

If clubfoot is severe enough, surgery may be required to readjust the tendons and ligaments.

See also:

• Mayo Clinic Clubfoot
• Southern California Orthopedic Institute Clubfoot

NICU - Cerebral Palsy

2009-07-23T09:27:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Cerebral Palsy (CP)

What is Cerebral Palsy?

Cerebral Palsy is a disorder for which there is no know cure to date. It affects a variety of body functions, including muscle control, movement, and other neurological aspects.

CP is also a congential disorder, meaning that it happens during pregnancy or after birth. The brain is damaged in some way or form or has developed in an abnormal way. The cause of this is generally unknown. This damage prohibits the body from being able to control a variety of movements, potentially standing up, balancing, or even bladder and bowel movement control.

Learning disablilties later on in life are also common.

Remember, the severity of Cerebral Palsy differs, ranging from mild to quite severe. However, it is not a condition that worsens with age.

Types of Cerebral Palsy

Athetoid Cerebral Palsy - Causes uncontrolled movements, sometimes inability to stand
Ataxic Cerebral Palsy - Causes a lack of balance and vision issues
Spastic Cerebral Palsy - Causes muscle and joint stiffness, as well as movement difficulty

Treatment

While there is no known cure to date for CP, there are several options to help lessen the affects it has over the body. Occupational and physical therapy could help, as well as some medications and possibly even surgery.

Ask your neonatologist or pediatrician about groups and resources in your area that can offer assistance if your infant or child has CP.

See also:

• Kid's Health CP
• National Institute of Neurological Disorders and Stroke
• Cerebral Palsy Source

NICU - Atrial Septal Defect (ASD)

2009-07-23T07:06:00.000-07:00

NICU
Neonates, Infant, Newborn, Baby, Preemie
Atrial Septal Defect (ASD)

What is ASD?

ASD is where there is a 'hole' between the upper champers of the heart. These upper chambers are called the atria. Blood is oxygenated in the body by the heart passing oxygen deficient blood to the lungs. ASD is a defect that allows already oxygen-rich blood to pass back into the lungs. By doing so, it replaces blood needing oxygen.

Treatment

Often, if the ASD is severe enough in NICU patients, surgery may be an option to close the defect. If it is not severe, a cardiologist may just require regular checkups to make sure the ASD does not pose any current problems.

See also:

• Kid's Health ASD
• American Heart Association ASD