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If your baby is born prematurely or needs additional medical care immediately after birth, he or she will be transferred to our Neonatal Intensive Care Unit (NICU). You may sometimes hear the NICU referred to as a “Level III Nursery.”
Level III is the formal designation given to hospitals that have the staff and equipment to handle the most complicated births, including babies born before 32 weeks of pregnancy or who are born with an illness that requires intensive care. UC San Diego Health offers both a Level III NICU and a Labor and Delivery Unit in the same hospital to better serve women with high-risk pregnancies. The co-location of services can greatly minimize transport time in case of an emergency.
Your baby’s NICU team will include team members from many disciplines based on the needs of your baby. This includes an attending neonatologist, a neonatal nurse practitioner, a registered nurse who specializes in newborn care, a nutritionist, a respiratory therapist and a therapist who specializes in occupational or physical therapy.
Since our hospital is a teaching facility, a fellow and a resident physician are also part of the team. If your child has special medical needs, they will be attended to by a pediatric specialist. Your family will also meet regularly with a social worker and you will have access to a lactation consultant. Discharge planning staff will assist with discharge and scheduling post-discharge doctor visits.
Neonatologists are pediatricians who have three years of additional training focused on the care of critically ill newborns.
An NNP is a registered nurse (RN) with an advanced degree in neonatal nursing, medicine and health care. NNPs work in collaboration with a neonatologist to provide comprehensive health care to meet the needs of infants and families.
Medical rounds typically occur in the early morning hours between 7 a.m. and 10 a.m. During rounds, members of the medical team, which is led by the attending neonatologist, discuss each infant’s case individually.
Once the medical plan for the day is determined, the physician and/or nurse practitioner will update the parents at the bedside when they come to visit. The doctors will also review the infant’s care in the evening with the “on call” doctor and the nurse that is in charge.
Your family is considered part of your infant’s care team. Family members are welcome in the NICU at all hours except between the hours of 6 a.m. and 8 a.m., and 6 p.m. to 8 p.m. The NICU is closed to visitors during these hours while the nurses change shifts.
When your baby is stable, parents and guardians will be encouraged to hold their infant against their bare chest. This is referred to as kangaroo care. Research shows this can help your baby. Help is also available for mothers who want to breastfeed.
Our NICU concierge is a parent who has been through the NICU experience and is here to help parents better understand what to expect. Dinners are held regularly for parents of infants in our NICU. We want to provide as much help as possible for parents and guardians who have babies in our NICU. Our UC San Diego chaplain is available to meet with families. We can also schedule in-hospital visits with your clergy person.
Family and friends are welcome, with permission from the baby’s parents. However, only two visitors are permitted at a time at the baby’s bedside and one of the visitors must be a parent. Siblings over the age of 12 may visit the baby if they are healthy. No visitors under the age of 12 are permitted.
You will be given a business card with the phone number for the NICU. You will establish a password and notify the nurse caring for your baby of your password choice. This will be written on a private record kept at your baby’s bedside. When parents or guardians call to ask for information, the nurse caring for the baby will ask for the password before giving out any information.
If your preterm infant is mature enough to breastfeed, you will be encouraged to do so. There is a lactation consultant on staff each day that can work with mothers and their babies to help with breastfeeding, as part of the Supporting Premature Infant Nutrition (SPIN) program.
If an infant is not strong enough to breastfeed, the mother will be provided with a breast pump in order to express breast milk. Mom will also have access to a breast pump at the baby’s bedside that she can use while visiting the NICU. Expressed breast milk will then be given to your infant through a feeding tube or bottle. In some cases, your breast milk will be fortified with additional supplements by a milk technician.
UC San Diego pioneered the Premature Infant Nutrition Clinic (PINC), which offers support to breastfeeding mothers after their premature baby leaves the NICU.
If your baby is a full-term infant and is admitted to our NICU, he or she may be returned to the mother’s hospital bedside or go directly home after any health complications have been stabilized.
If your baby was born prematurely or needs medical care, he or she will stay in the NICU until ready to go home. When a baby is ready to go home depends on the severity of the baby’s circumstances. Generally speaking, infants are ready to go home when they are the equivalent of 35 to 37 weeks term (nearly nine months from conception). However, some may be ready a little earlier, while others may need to stay longer.
There are no specific weight and age requirements that determine whether a baby is ready to go home. When the medical issues for which a baby was admitted to the NICU have been addressed, we also make sure babies can do the following before sending them home:
- Keep their body temperature in the normal range without an incubator
- Eat by mouth without a feeding tube
- Maintain stable respiratory patterns
Before leaving, we’ll prepare you so that you feel comfortable taking care of your little one(s) at home.
After You Go Home
You will have appointments with your baby’s primary care provider and possibly, appointments with other specialists. You will be given a list of upcoming appointments and/or phone numbers to call to schedule appointments, if needed.
Many infants cared for in the NICU will continue being seen through our High-Risk Infant Follow-up Program until they are six months old, according to their due date (their “corrected” or “adjusted” age). This program will evaluate their development and muscle strength, and help teach families how to help their child grow and develop.
If you think there is an emergency, call 911 immediately. For most questions, you can call the office of your child’s primary care provider. There is almost always an answering service that can help answer your questions if it is after hours or on a weekend.
Feeding Your Baby
Remember, now that you and your baby are home from the hospital, your baby’s primary care provider will be able to answer most questions and provide help and guidance.
No. You may boil tap water or use bottled water.
You only need to boil water if it is tap water. Bottles do not need to be boiled, but some nipples do. Always check the directions on the package.
Call and ask to speak with the pediatrician or a nurse, or make an appointment with whoever is available. You may also try bringing you baby’s thighs up to his or her belly. Giving your baby a warm bath may also help.
Any dish soap is fine. Make sure to use warm water and rinse well.
NICU Little Grad Picnic
Every year, we invite our NICU “graduates” and their families to join our physicians, nurses and staff to join us for a celebration. See more information.