When Baby Needs Special Care

The NICU

Newborn Warning Signs
Warning signs that may indicate a possible problem in your newborn include no urine in the first 24 hours at home; a rectal temperature of 100.4 degrees or higher; or a rapid breathing rate.
When a Baby Has Difficulty After Birth
Babies who may have difficulty at birth are those born prematurely, those who experienced a difficult delivery, maternal illness, or those with birth defects.
The Neonatal Intensive Care Unit (NICU)
NICUs provide specialized care for the tiniest patients. NICUs may also have intermediate or continuing care areas for babies who are not as sick but do need specialized nursing care.
Warmth and Temperature Regulation
Premature and low birthweight babies may be too immature to regulate their own temperature, even in a warm environment. Even full-term and healthy newborns may not be able to maintain their body temperature if the environment is too cold.
Nutrition and Fluids
When your baby is in the neonatal intensive care unit, your main concern is getting her healthy and home. Taking food by the mouth and gaining weight are two important steps toward that goal. Find out what happens to help your baby get there, including the role you play.
Testing and Lab Procedures for the Newborn in Intensive Care
It’s important that babies in intensive care undergo regular testing so they get the important care they need. Here are common seven lab tests used in the newborn intensive care unit. Make sure to ask your baby’s doctor about them.
Intravenous Line and Tubes
Because most babies in the NICU are too small or sick to take milk feedings, medications and fluids are often given through their veins or arteries.
Procedures and Equipment in NICU
NICUs are equipped with complex machines and devices to monitor nearly every system of a baby's body—temperature, heart rate, breathing, oxygen and carbon dioxide levels, and blood pressure.
Special Care
Premature babies especially need a supportive environment to help them continue to mature and develop as they would in their mother's womb.
Parenting in the Neonatal Intensive Care Unit (NICU)
In most cases, you can be with your baby in the NICU at any time. The staff of the NICU will give you instructions on special handwashing techniques before entering the area.
Taking Your Baby Home
Your baby is finally ready to come home. Turn your nervous energy into positive action. Make a checklist for what you and she needs before leaving the hospital so that you can create a safe home environment. Here’s a list of items to get you started.

Problems and Conditions

Weight and Growth Problems

Prematurity
Other terms often used for prematurity are preterm and "preemie." Many premature babies also weigh less than 5.5 pounds and may be referred to as low birthweight.
Know How Your Preemie Will Grow
Premature babies may grow at a slower rate than full-term babies, but usually catch up in height and weight by 2 years of age. But premature babies are more likely to have trouble with speech, motor skills, hearing or vision.
Very Low Birthweight
Very low birthweight is a term used to describe babies who are born weighing less than 3 pounds, 4 ounces. Only a few babies are born this tiny.
Low Birthweight
If your baby’s birthweight was lower than normal due to premature birth or some other factor, don’t worry. With proper medical attention and your loving care, your baby will soon catch up with the other children in the nursery.
Small for Gestational Age
Although some babies are small because of genetics (their parents are small), most SGA babies are small because of fetal growth problems that occur during pregnancy.
Large for Gestational Age (LGA)
The average baby weighs about 7 pounds at birth. About 10 percent of all babies weigh more than 8 pounds, 13 ounces. Rarely do babies weigh over 10 pounds.
Postmaturity
The most common symptoms of postmaturity in a baby are dry, peeling skin; overgrown nails; and abundant scalp hair.

Respiratory Disorders

Sex During Pregnancy
In most cases, sex during pregnancy is safe. In fact, with your doctor's approval, sexual relations can continue until delivery.
Chronic Lung Disease
If your baby was born premature and needed to be on a respirator, her lungs may have been damaged. This can cause a condition called chronic lung disease (CLD). But CLD can be treated, and as lungs mature the condition can improve. Learn about the symptoms and treatments for CLD.
Respiratory Distress Syndrome
This disease is one of the most common problems of premature babies. It can cause babies to need extra oxygen and help in breathing.
Meconium Aspiration
Meconium aspiration occurs when a baby breathes in amniotic fluid containing meconium (the baby's first stools).
Pneumothorax
Pneumothorax is a lung disorder in which air in the lungs leaks out through holes in the lung tissue into the spaces outside the lung airways.
Persistent Pulmonary Hypertension
In this condition, a newborn's circulation changes back to the circulation of a fetus, where much of the blood flow bypasses the lungs.
The Respiratory System in Babies
By about 35 weeks gestation, most babies have developed adequate amounts of surfactant, a substance normally released into the lung tissues to lower surface tension in the airways. This helps keep the air sacs in the lung open.
Transient Tachypnea of the Newborn
Transient tachypnea of the newborn is a term for a mild respiratory problem of babies that begins after birth and lasts about three days.
Apnea of Prematurity
It’s a cliché that many new parents need to reassure themselves that the baby is still breathing. But what if your baby really is having breathing problems? A breathing condition called apnea of prematurity affects some babies, especially if they’re born early. But you can learn what symptoms to look for.

Blood Disorders

Blood Types in Pregnancy
A baby may have the blood type and Rh factor of either parent, or a combination of both parents.
Hemolytic Disease of the Newborn
This condition occurs when an incompatibility exists between the blood types of the mother and baby.
Vitamin K Deficiency Bleeding (Hemorrhagic Disease of the Newborn)
Hemorrhagic disease of the newborn is a bleeding problem that occurs during the first few days of life.
Hydrops Fetalis
This is a life-threatening problem of severe swelling in the fetus and newborn. It develops when too much fluid leaves the bloodstream and goes into the tissues.
Hyperbilirubinemia and Jaundice
A newborn with this condition has too much bilirubin in the blood. Bilirubin causes a yellowing of the baby's skin and tissues. This is called jaundice.
Hypocalcemia
A baby with this condition has too little calcium in the blood. Hypocalcemia is more common in premature and low birthweight babies.
Hypoglycemia in the Newborn
Babies who are more likely to develop hypoglycemia include those born to women who have diabetes.
Overview of Blood and Blood Components
Human blood consists of about 22 percent solids and 78 percent water. The components of blood are plasma, fat globules, chemicals, and gases.
Polycythemia
Mild polycythemia may not cause problems, but too many red blood cells can increase the blood volume or thicken the blood, making it harder to circulate through the blood system and to the organs.
Thrombocytopenia
Thrombocytopenia is a condition in which a baby has too few platelets—the blood cells needed for clotting.

Heart Disorders

Blood Circulation in the Fetus and Newborn
During pregnancy, the fetal lungs are not used for breathing—the placenta does the work of exchanging oxygen and carbon dioxide through the mother's circulation. With the first breaths of air the baby takes at birth, the fetal circulation changes.
Patent Ductus Arteriosus (PDA)
PDA is a heart problem in which the connection between the aorta and pulmonary artery remains open after birth, instead of closing as it should.
Congenital Heart Disease
Heart problems are the most common kind of birth defects. While children with some heart defects can be monitored by a doctor and treated with medicine, others will need to have surgery.

Fever and Infections

Cytomegalovirus (CMV)
CMV may be passed from a mother to her baby during pregnancy and is the most common congenital viral infection.
Group B Streptococcus
You’ve probably never heard of group B streptococcus. That’s because you didn’t need to before you were pregnant. This bacterium generally doesn’t cause problems for healthy nonpregnant women. But it can cause illness in pregnant women and their babies. Here’s what you need to know.
Human Immunodeficiency Virus (HIV)
Most babies with HIV contract the infection from their HIV-infected mother during pregnancy, or during labor and delivery.
Respiratory Syncytial Virus (RSV)
RSV is the most common cause of bronchiolitis—inflammation of the lower airways—and pneumonia in babies.
Sepsis
Sepsis is a term for severe infection that spreads throughout the body. Sepsis in a newborn is more likely to develop when the mother has had pregnancy complications that increase the likelihood of infection.
Thrush or Candidiasis
Candidiasis is an infection caused by yeast on the skin and mucous membranes. When the infection occurs in the mouth, it is called thrush.
Fever in A Newborn
Detailed information on fevers in children

Other Conditions

Sudden Infant Death Syndrome (SIDS)
SIDS stands for sudden infant death syndrome. It is a leading cause of infant death in the U.S. The causes of SIDS are unknown, but researchers have learned more about factors that can put your baby at risk. Learn which ones parents can prevent.
Birth Injuries
For various reasons, some babies have a more difficult trip through the birth canal than others, resulting in physical injuries. Such injuries usually are not serious and clear up or improve within a few days or weeks following the birth.

Blood Sugar Disorders

Hypoglycemia in the Newborn
Babies who are more likely to develop hypoglycemia include those born to women who have diabetes.
Infant of Diabetic Mother
A baby born to a diabetic mother may need glucose orally or intravenously. The baby's blood glucose levels will be closely monitored after treatment.

Digestive Disorders

Necrotizing Enterocolitis
This condition appears to develop when the intestines are weakened by too little oxygen or blood. The weakened tissues can become severely damaged and die, which causes a hole in the intestinal wall.
Gastroesophageal Reflux (GER)
Hiccups. Belching. Stomachache. Sound like a case of heartburn? It isn’t an adults-only condition. If your baby has some of these symptoms, she may have gastroesophageal reflux. If feeding changes don’t bring relief, your doctor may prescribe medications to help.

Babies, Drugs, and Alcohol

Neonatal Abstinence Syndrome
Neonatal abstinence syndrome is a term for a group of problems a baby experiences when withdrawing from exposure to narcotics.
Fetal Alcohol Syndrome
Fetal alcohol syndrome refers to a group of abnormalities in babies born to mothers who drink during pregnancy. The problems include small head and brain, facial abnormalities, and defects of other organs.

Vision and Hearing Disorders

Retinopathy of Prematurity
A premature baby comes with many special concerns, and eye health is an important one. Some premature babies develop retinopathy of prematurity, or abnormal blood vessel development in the retina of the eye. Learn about this complication and find out why screenings are so important.
Hearing Loss in Babies
Hearing loss in babies is rare in this country, but when it does occur, it's important to diagnose it early. Undetected hearing loss can delay speech and language development.

Brain Disorders

Intraventricular Hemorrhage
If your baby is born prematurely, there are many worries that likely go through your mind. One of the things that can happen is bleeding on the brain. Read on to learn about this and what doctors can do help your baby.
Periventricular Leukomalacia (PVL)
The head is one of the most fragile parts on your baby, especially after birth. Sometimes, damage can occur, particularly if your baby is born prematurely. One type of brain damage is called periventricular leukomalacia. Read on to better understand what this diagnosis means for you and your baby, and what doctors can do to help.

Birth Defects and Genetic Disorders

Anorectal Malformation
An anorectal malformation is a birth defect in which the anus and rectum do not develop properly.
Overview of Birth Defects
A "birth defect" is a health problem or physical change that is present in a baby at the time he/she is born.
Down Syndrome (Trisomy 21)
Down syndrome is a genetic disorder that includes a combination of birth defects, including some degree of mental retardation, characteristic facial features and, often, heart defects.
Diaphragmatic Hernia
A diaphragmatic hernia is a birth defect in which an opening is present in the diaphragm. Some of the organs that are normally found in the abdomen move up into the chest cavity through this abnormal opening.
Hydrocephalus
Hydrocephalus is a condition in which a buildup of fluid in the brain causes the pressure inside of the head to increase and the skull bones to expand to a larger-than-normal appearance.
Hypospadias
Hypospadias is a disorder in newborn boys in which the opening of the urethra is not located at the tip of the penis.
Omphalocele
An infant with an omphalocele has a portion of the abdominal organs protruding through an opening in the muscles near the umbilical cord.
Pyloric Stenosis
Pyloric stenosis is a problem that affects babies between 2 and 8 weeks of age and causes forceful vomiting that can lead to dehydration.
Spina Bifida
Spina bifida can occur in the early weeks of pregnancy, before you even know you are expecting. That’s why your baby is depending on you to have healthy habits in place from the start. Learn more about the prevention and treatment of this birth defect.
Trisomy 18 and 13
Trisomy 18 and trisomy 13 are genetic disorders that present a combination of birth defects including severe mental retardation, as well as health problems involving nearly every organ system in the body.
Turner Syndrome
Turner syndrome is a genetic disorder seen in girls that causes them to be shorter than others and to not mature sexually as they grow into adulthood.
Hernia (Umbilical/Inguinal)
A hernia occurs when a section of intestine protrudes through a weakness in the abdominal muscles. In babies, this usually occurs around the navel or in the groin area.
Cleft Lip/Cleft Palate
Detailed information on craniofacial anomalies, including cleft lip and cleft palate
Developmental Dysplasia of the Hip (DDH)
Detailed information on developmental dysplasia of the hip, including causes, symptoms, risk factors, diagnosis, treatment, and cast care
Clubfoot
Detailed information on clubfoot, including causes, risk factors, diagnosis, treatment, and cast care