Nurturing in neonatal intensive care unit

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