What To Expect From Your NICU Care Team

Nobody envisions their pregnancy will end with a stay in the neonatal intensive care unit or NICU. When it happens, the NICU teams at Yale New Haven Health are there to meet the needs of both the baby and their family members.

Medical care in the NICU

The clinical team includes attending physicians who received special training in neonatology, pediatric residents, physician assistants, neonatal nurse practitioners and registered nurses with specialized training related to neonatal care. These providers have the expertise to care for patients in a variety of scenarios. Some babies need a little extra monitoring after delivery while others have pre-existing medical conditions. Many babies in the NICU were born prematurely.

“Parents are often dismayed to find out how long their baby will have to be in the NICU. Although people understand that a baby spends 40 weeks or 9 months inside his or her mom growing, when a baby is born prematurely, I think parents are very disappointed to learn that the baby will need to finish growing for nearly the same amount of time in the NICU,” said Eliza Myers, MD, medical director of the Yale New Haven Children’s Hospital NICU, Bridgeport Campus and associate professor of pediatrics at Yale School of Medicine.

During that time, premature babies are kept in an incubator called an isolette which provides a warm and safe environment. They are also attached to monitors and may require a special tube for feeding.

“When families see how small the baby is, and how much we are doing to help with feeding and growing it makes more sense. There are some physical limitations. The smallest you can be to ride in a car seat is four pounds so that’s a concrete goal that parents understand,” said Dr. Myers.

While most medical attention is focused on the baby, postpartum patients need care too. For example, Bridgeport Hospital has a postpartum blood pressure screening kiosk. Many patients believe pre-eclampsia can only happen during pregnancy, but it can be common after delivery and parents focused on their baby in the NICU may miss crucial signs or symptoms.

There are also earlier and more frequent screenings to identify signs of postpartum depression, which can be more common in parents who have a baby in the NICU. Those parents are then connected with the appropriate referrals for help.

Supporting NICU families

In addition to the specialized clinical care, NICU families get support from lactation specialists, social workers, physical therapists, occupational therapists, speech language pathologists, child life specialists and even a music therapist who writes and plays music for babies at the bedside.

“When you think of it, doctors and nurses are there to care for the patient. So, who helps to care for the parents? That’s where those ancillary services come into play,” said Michelle Gray, NICU family support specialist at Yale New Haven Children’s Hospital, New Haven Campus.

Gray, who is a former NICU parent herself, puts together a calendar of activities that allow parents to step away from the bedside and take a break. That may include education classes, time for music and reading, or a coffee hour where parents can meet each other and talk about their experiences. A collaboration with The Tiny Miracles Foundation connects families with peer counselors who have had a hospitalized NICU baby themselves.

“Whether you're here for two days or six months, it's not what you planned for and to connect with families who are experiencing the unexpected can be exactly what you didn't know you needed,” said Gray.

That support is key as parents learn to care for their baby in a new way. For example, it can take time to learn how to properly hold a premature baby to reap the benefits of skin-to-skin contact. When breastfeeding isn’t an option, pumping milk can give parents a ‘task,’ and help them feel like they are doing something concrete.

If at any point parents aren’t sure what to do in a certain scenario, the NICU team will be right there to guide them.

“It’s ok to ask the same questions over and over again, particularly if it helps you advocate for your baby,” said Dr. Myers. “We really value being a team with parents, with families. We are ready to hear the same question and offer answers that make sense. Our goal is the same as the parents’ goal, which is to send home a healthy baby.”

Learn more about NICU services at Yale New Haven Health.