For most expectant parents, the NICU (Neonatal Intensive Care Unit) is a place where their babies will not visit but for a few of us it is a place of miracles or a place of unspoken tragedy. A typical NICU is a desperate, yet hopeful place, a quiet setting where babies lie nestled in dim quarters with their limbs nestled close to their bodies. They rest to grow and find strength to fight for another day. Hooked up to every monitor and machine you can think of, with tubes running every kind of medication to their heart and lungs, many parents are unprepared for the emotional journey that lies ahead. Neonatal units take the sickest of babies, either born too soon or who have complications from their birth experience. A friend of mine who is an NICU nurse, refers to the babies as potted plants, precious and perfectly formed little babies given a place to feed and grow. No expectant mother envisions having a premature or sick baby. Most mothers aren't prepared to watch helplessly as her newborn struggles while she counts each breath taken by fragile lungs, clinging to life. They want to take every poke and prod these babies get. They want to take the pain for them. They learn, sadly, that they can't protect them anymore having them nestled outside the womb. A child so small but can hold the power to hurt you more than anyone else in the world if they pass away. Many parents don't even know what to think. Parents haven't even imagined a place like this existed until they need it's services.

Each one of these parents will tell you, you have to take having a baby in NICU one day at a time or you'll go crazy. While as a parent of a sick baby, you may be given hope, you are also given the realistic expectations. Some hear the worst. Other's will deal with the immediate crisis. It's phenomenal how parents forced into this situation cope. Parents are free to reach into the incubators to comfort their child with a caress, others may be lucky enough to give "kangaroo care", giving the newborn skin to skin contact. Other times reality isn't so kind. The first and last chance parents might have to hold their son or daughter is moments before the child takes it's last breath. If the unthinkable does occur, hospital staff have come to recognise the value of these little miracles. Today, babies who don't survive aren't whisked away as if they never existed. Parents can give them a final bath, hold them and say goodbye. Hospital staff have been known to attend baptisms and funerals, write cards, send photos or save hair clippings. Little things that may not seem like a lot in a time of overwhelming grief but come to mean a great deal later.

Of the ones who do make the precarious journey through the NICU, the NICU staff look after not only the newborn but also the entire family. Those doctors and nurses do their best in an unfair situation and more and more they are winning the premature birth battle. About 80% of babies born at 25 weeks and on survive, with about 20% disabled with cerebral palsy, blindness, deafness or mental handicaps. Premature infant's vital systems are fragile and underdeveloped. Ventilator's help them breathe but often do damage. Surfactant, a natural substance in mature lungs, is given to keep the baby's lungs expanded. Many babies are given morphine to help them relax. In the last 20 years great strides have been made in saving these tiniest of soldiers. Whether medical science will be able to expand those odds of helping premature babies younger than 25 weeks life full lives, who knows. All is known is that life in the NICU is stressful but for a happy outcome and a baby going home, it's part of the process parents will cherish. If not and it's the only time parents have with their child, it's precious. Sometimes a baby is not made for this world. A harsh reality.

Many professionals work together to care for preemie babies. You may meet some or all of the following:


Neonatologist - a pediatrician who has had special training in newborn intensive care

Neonatal Fellow - a pediatrician who is currently getting special training in newborn intensive care, a future neonatologist

Resident - a doctor who is receiving additional training to be a pediatrician or some other specialist

Physician Assistant or Nurse Practitioner - a trained professional (non-MD) who has received additional training in newborn intensive care so s/he can perform many of the same tasks as doctors

Clinical Nurse Specialist - a nurse with additional training and responsibilities for patient and nurse education

Primary Nurse - the nurse who will most frequently take care of your baby, develop your baby's nursing care plan, and teach you to care for him/her.

Social Worker - the person who will help you with non-medical issues, such as where to stay, insurance, transportation, etc.

Perinatal Pharmacist - a pharmacist with special expertise in drugs for babies.

Respiratory Therapist - a person with special training for care and management of oxygen, breathing machines, etc.

Occupational Therapist - a person with special training in infant development. You may come across this person either in the nursery or in a follow-up clinic.

Physical Therapist - a person with special training in assessing and helping muscle tone and movement problems in babies. You may come across this person either in the nursery or in a follow-up clinic.

Speech and Language Specialist - a person with special training in feeding problems like sucking and swallowing

Home Health Care Specialist - a person who helps co-ordinate any equipment or monitoring needs after discharge, such as home oxygen or home phototherapy.

Unit clerk or Ward Clerk - individuals who transcribe orders, send blood tests to the laboratories, answer phones, etc.

Hospital Chaplain - a hospital-based religious support person.

Others - people who stock shelves, clean the nursery, obtain laboratory tests, take x-rays, and provide maintenance

Your baby probably has one or two doctors and one or two nurses who are primarily responsible for his/her care. You may want to write down their names as they are the people with whom you will interact most frequently.

In addition, if your baby has a particular problem, another physician specialist may be called in. Common sub-specialists and their area of expertise include:

Cardiologist -- Heart problems
Neurologist -- Brain and nervous system problems
Nephrologist -- Kidney (urine) problems
Gastroenterologist -- Intestinal problems and nutrition
Endocrinologist -- Glands and hormone problems
Hematologist -- Blood problems
Ophthalmologist -- Eye problems

If your baby has a surgical problem, your baby may need a surgeon and an anesthesiologist.

About the Author:

Loree Siermachesky is a mother of three boys, one with a developmental speech delay and has been introducing ASL as a method of communication and a certified doula. She is the webmistress of All About Moms and Empty Cradles.

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Copyright © 2001 Loree Siermachesky, All Rights Reserved Reprinted with Permission