When Baby Needs a NICU
While pregnant with her daughter Hattie, Stephanie LaRue, Olathe, assumed everything would go as smoothly as her previous pregnancy with her son, Jack. When contractions started at 33 weeks along, she first wrote them off as Braxton-Hicks. Instead, LaRue found herself in labor and her baby went straight from delivery to the Neonatal Intensive Care Unit (NICU) at Overland Park Regional Medical Center (OPRMC).
Prior to Hattie’s arrival, LaRue’s pediatrician suggested she check out OPRMC because it was nearby. She did so, but didn’t give the hospital’s large NICU much more than a passing glance.
“I never, ever thought I’d need a NICU because I wasn’t considered high risk,” LaRue says, whose family was a 2011 Ambassador Family for the March of Dimes.
Hattie, now an active 5-year-old, spent 31 days in the hospital’s NICU. “I do honestly believe our life would be very different right now if Hattie had not been born in such a good hospital with an amazing NICU team,” La Rue says.
Infants transferred to neonatal intensive care include premature infants and multiples, as well as very sick and low birth weight babies. According to the March of Dimes, up to 12 percent of babies need NICU services due to preterm birth. Access to an on-site NICU can increase the likelihood that, should you need it, both you and your baby will be at the same hospital rather than two different healthcare facilities.
“If there’s anything that happens to the baby, whether it’s during the delivery process or something that might not have been discovered while you were pregnant, the higher level of care the NICU has, the more likely they can take care of the baby’s needs quickly and safely,” says Margaret Meier, the NICU director at OPRMC, which has a Level 3b NICU, the highest level of care available in Johnson County.
Most area hospitals offer some level of newborn intensive care. Hospitals transfer babies requiring a higher level of care to facilities with the capabilities to evaluate and manage more serious health complications.
For example, clinicians will transfer a baby who needs cardiac surgery or presents with serious lung issues to Children’s Mercy Hospital, Kansas City, MO, which has the Extracorporeal Membrane Oxygenation Program (ECMO) and the highest level of NICU care in the region.
“Our ECMO program can rescue infants from respiratory failure when mechanical ventilation is not sufficient,” says Dr. Howard Kilbride, section chief of neonatology at Children’s Mercy Hospitals and Clinics and co-medical director for the Elizabeth J. Ferrell Fetal Health Center at Children’s Mercy. “Less ill infants may be transferred for diagnostic testing because of specialized pediatric laboratory and radiology services not usually present in general community hospitals.”
What to Expect
Infection control and cleanliness are vital in a unit caring for exceptionally vulnerable patients. Parents and staff scrub in each time before touching their infant. While the medical protocols and seriousness of the facility may seem intimidating, staff members encourage parents to bond with their babies through their touch and presence.
With fewer patient assignments, NICU nurses typically provide more one-on-one attention, and clinicians keep parents informed each step of the way. During their baby’s stay, parents will learn how to care for their tiny charges from changing diapers and taking their baby’s temperature to learning CPR and pumping and storing breast milk.
“We provide lots of different types of discharge classes to prepare parents for when they go home,” Meiers says. Rooming-in rooms also give apprehensive parents 24 to 48 hours to practice caring for their babies and their special needs.
A Circle of Support
A support team around a family in crisis helps new parents manage the emotional highs and lows that come with caring for a premature or sick newborn. Grandparents, relatives or family friends may wonder how they can help. With parental consent, hospitals encourage grandparents to visit the NICU and learn the different stages of development, including what’s normal for a low birth weight baby. Other important ways to support the family include providing childcare to siblings, meals and rides.
Time to Go Home?
Clinicians monitor the baby’s growth and intake of formula or breast milk to determine when the baby is ready for discharge. Babies are released to go home when they are stable and able to breathe without assistance although, occasionally, some babies go home with oxygen. Oftentimes, the hospital will also require a car seat test, particularly if the baby is less than 37 weeks gestation to ensure the baby can breathe on his own.
The Different Levels of NICU Care:
- Level 1: Basic care facility. Provides postpartum care for healthy newborns. Ability to stabilize and transfer an infant to a higher level of care.
- Level 2: Additional personnel, equipment and facilities to care for preterm infants from 32 weeks of gestation, including short-term respiratory assistance, using some forms of mechanical ventilation.
- Level 3: Divided into categories A, B and C, with C providing the most support to its tiny patients, offering a full range of subspecialty and surgical services, including cardiovascular surgery and ECMO support.
- Level 4: The highest designation of care. Facility offers regional educational opportunities for a comprehensive range of neonatal clinicians and professional input to city public health leaders regarding community perinatal care.
Source: Howard Kilbride, M.D., Children’s Mercy Hospitals and Clinics
Area Hospital NICUs:
Check out the Labor & Delivery Guide for more information on local hospitals.
- Centerpoint Medical Center, Level 3
- Children’s Mercy Hospital, Level 3c
- Menorah Medical Center, Level 2b
- Olathe Medical Center, Level 2
- Overland Park Regional Medical Center, Level 3b
- Research Medical Center, Level 3b
- Saint Luke’s Hospital, Level 3b
- Saint Luke’s East, Level 3a
- Saint Luke’s North, Level 2
- Saint Luke’s South, Level 3a
- Shawnee Mission Medical Center, Level 3
- St. Joseph Medical Center, Level 2
- St. Mary’s Medical Center, Level 2
- Truman Medical Center Hospital Hill, Level 3
- University of Kansas Hospital, Level 3
Freelance writer Christa Melnyk Hines resides in Olathe with her husband, two active boys and a pair of exceptionally optimistic golden retrievers.