When babies arrive early
The majority of premature babies admitted to the NICU are born between 34 and 37 weeks. However, a level IV NICU can care for infants born as early as 22 weeks, some weighing less than a pound. The earlier a baby is born, the more medical support they need.
“One of the first things somebody has to do when they are born is start breathing,” Mujsce said. “A very preterm baby's lungs are underdeveloped and usually not ready to do the work of breathing.”
The NICU team helps babies breathe with breathing tubes, ventilators or medication. Care may also include an incubator to maintain body temperature or intravenous (IV) nutrition when an infant can’t safely eat or digest food.
NICUs treat critically ill infants with conditions such as intestinal abnormalities, urinary tract problems, narrowed airways, heart defects, fluid buildup in the brain, problems breaking down nutrients, birth injuries and infections.
Levels of NICU care
NICUs provide four different levels of newborn care:
- Level I, Newborn nursery: Basic care for healthy infants
- Level II NICU or Special Care Nursery: Care for stable or moderately ill newborns, often born between 32 and 40 weeks
- Level III NICU: Advancedcare for smaller babies born under 32 weeks and newborns with medical conditions
- Level IV NICU: Highest level of care for the most critically ill newborns, including advanced specialists and surgical care
What parents can expect in the NICU
Having a baby in the NICU can be a roller coaster of emotions and uncertainty. Many NICUs offer psychologists, social workers and care coordinators who help parents navigate the experience.
Gardner and Maximus’s father, Nate Coelho, spent as much time as they could each day with their son in the NICU, while balancing responsibilities at work and home.
“We definitely felt the push and pull of having three kids at home who needed us and a premature infant who needed us,” Gardner said.
When doctors manage a condition that requires NICU care, they meet with the parents to answer common questions, such as:
How long will my baby need to stay in the NICU?
The average stay is about three weeks, Mujsce said, though some infants need care for three to six months. Before going home, babies must be able to maintain their body temperature, breathe with little or no support and feed well enough to keep growing.
Can I breastfeed my baby during a NICU stay?
“The baby's mother's milk is one of the best sources of food and nutrients for the baby,” Mujsce said.
If an infant can’t suck or swallow to breastfeed normally, the mother can pump her milk for feeding through a tube. Lactation consultants offer help with feeding questions. The NICU at Penn State Health Golisano Children’s Hospital has a Milk Lab where parents can drop off pumped breast milk to be safely stored for their babies.
How can I bond with my baby in the NICU?
“We encourage parents to be involved in the care of their infant,” Mujsce said. “A lot of parents are afraid to touch their babies if they're in incubators or have IVs, so we guide them toward the best way to interact with their child for their development.”
Skin-to-skin snuggle time, reading, talking or singing to their baby and participating in feedings and daily care helps strengthen the parent-child bond.
“The Child Life team at the hospital not only supported us, but they embraced our three older children and helped them read to Maximus, bathe him and make crafts for him,” Gardner said. “They made it special and helped our bigger kids bond with their brother.”
How do we prepare to go home?
Many hospitals offer transition rooms where parents and babies can stay together before discharge. Care coordinators help schedule follow-up appointments and provide instructions for how to care for the baby at home, including who to call for questions or concerns.