Although your baby may be unable to begin breastfeeding shortly after birth, it is important to establish and maintain a good milk supply. Our breastfeeding support program offers a number of helpful tips, resources and guides that you may find useful.

We also offer a team of lactation consultants and breastfeeding support specialists to assist you while you are here at the hospital. After you leave the hospital, our outpatient breastfeeding clinic can support you with any difficulties you and your baby are having with breastfeeding. Visit our breastfeeding page to learn more about our breastfeeding resources.

Kangaroo care is the practice of holding your baby skin-to-skin. In addition to the emotional benefits, this nurturing contact can help maintain your child's body warmth, regulate heart and breathing rates, encourage them to spend more time in deep sleep, and improve breast-feeding. 

One of the most frequently asked question that parents of preterm or sick infants ask is "When will my baby catch up?"

Preterm and sick newborns generally follow the same developmental patterns as babies who are full term and not sick. However, full term babies will often reach developmental milestones sooner than babies who are preterm, or who have been sick. It is important to remember that even full term and healthy babies develop at different rates. No two babies are alike. Just because your baby is not doing all the things the neighbor's baby is doing does not mean that your baby is slow; rather, since your baby was either ill or preterm he or she needs a little extra catching up time. For example, most full term babies begin to sit up at six months of age. A baby born two months early may not do this until eight months of age.

Knowing that your baby is making progress, doing something this week that he or she could not do last week is a very good indicator that they are developing properly. For many NICU babies, it may take several years to fully catch up with their peers.

As babies grow bigger and stronger, they develop many new and different skills. These new abilities include mental, motor or movement skills, and eventually, social, communication and language skills.

Babies develop properly when their parents and other caregivers play with them frequently and provide them with a variety of interesting things to see and do.

• Mental development occurs with a child's increasing ability to use their senses to absorb information about his or her surroundings and take an active interest in solving problems. The greater the range of experiences that babies are exposed to, the more interested they become in their new world.
• Motor development includes the development of skills such as rolling over, sitting, standing and walking, and the fine motor skills required in reaching for and exploring objects. Smiling and talking to babies when they do something new, helps them feel good about themselves and encourages them to practice their new abilities.
• Social Development occurs as a child interacts with parents, siblings, family and eventually with friends. Babies gradually learn to recognize familiar and unfamiliar people. It is special for parents to watch their babies begin to smile. At first, babies share their smiles with anyone who smiles at them. With time, a baby often becomes more selective with smiles and may even become fearful of strangers. This is a perfectly normal stage of development.
• Language development takes place as a child listens to, imitates and understands words, and eventually speaks. This is why it is so important for parents, family and other caregivers to speak and interact often with their babies.

The Giraffe Omnibed can work either as an open bed with a warming device above the baby or as an incubator (closed bed) that heats up the air and surfaces around the baby to keep him or her warm. Most babies are admitted to this type of bed and remain on it for most of their time in the NICU. There are portholes in the sides of the incubator to provide access for you and NICU personnel to care for your baby. 

The top of the Omnibed can be raised quickly to make your baby more accessible but still keep them warm. The bed has a probe that is placed on your baby's skin to help monitor temperature. The bed will be kept in the closed position most of the time to provide the best temperature regulation for your baby.

Babies in the Brandon NICU are monitored by attaching leads which are taped to their chest and limbs to keep track of their vital signs (heart rate, breathing rate, blood pressure, oxygen saturation). These monitors are set to alarm if any of the baby's vital signs are outside of the normal range. Sometimes the baby's normal movement or other factors can cause a false alarm. Your baby's nurses are prepared to look at the baby as well as the monitor to determine if something is truly wrong.

Premature and sick babies who are not able to take regular feedings for a period of time will need to receive fluids and nutrition by IV. Some medications must also be given through an IV. This may be done using the following:

• Peripheral IV - A short, thin line (tube) that is placed into one of the baby's veins, usually in the arms or legs. It can be used to give IV fluids, nutrition and medications.
• Percutaneous Intravenous Central Catheter (PICC) - A long thin flexible line passed through the baby's skin, usually in an arm or leg, into a blood vessel that leads deep into the baby's body. They are used to give IV fluids, nutrition and medications. They usually last longer than a regular peripheral IV.
• Peripheral Artery Catheter (PAC) – a short thin tube like a peripheral IV but placed in an artery near the wrist or ankle, used for blood pressure monitoring and blood sampling.
• Umbilical Venous Catheter (UVC) - A small flexible line put into the umbilical vein through the umbilicus or "belly button". This tube is also sometimes used for blood samples, but is mainly used to give IV fluid and medicine to the baby. Umbilical catheters are not painful to the baby. The main complications that can occur involve infection and bleeding. These occur rarely and your baby's doctor or nurse can answer questions you may have about them.
• Umbilical Artery Catheter (UAC) - A small flexible line put into one of the two arteries in the baby's umbilicus or "belly button". Blood samples can be taken from the line and tested to check the oxygen in the baby's blood. This helps to tell the doctors and nurses how well the baby's lungs are working to supply oxygen to the baby. Blood pressure can be monitored, to tell how well the baby’s heart is working.  Fluids are also given to the baby through the UAC.

Many premature and sick full term babies need help with breathing. This is provided by the following:

Ventilator 

A machine that gives extra breaths of air and/or oxygen under pressure to the baby. The machine breathes for a baby who can't breathe on their own or who is very sick and working hard to breathe. The ventilator is set to give a certain number of breaths to the baby each minute. Even when the baby can breathe a little on their own, the ventilator can give extra support to the baby.

The ventilator is attached to a plastic tube (endotracheal or ET tube). The ET tube is placed through the baby's nose or mouth. It goes through the voice box and into the baby's windpipe. Air from the ventilator entering the windpipe then travels into the baby's lungs. This tube is taped in place. Then the ventilator begins the work of pushing air in and out of the baby's lungs. Extra oxygen is also given through the ventilator.

Since the ET tube goes through the voice box, you will not hear your baby cry or make sounds. Once the tube is removed, the baby will be able to make sounds again.

Most ventilators give babies breaths at the rate they would normally breathe (40-60 times a minute). Some babies have conditions that require a much faster respiratory rate. This is accomplished by using a high frequency jet ventilator or oscillator. It will give the baby oxygen without using a lot of pressure. In order to do this, it gives hundreds of short little "breaths" every minute. The baby's chest will look like it is shaking very fast instead of rising and falling slowly. Some babies only need the high frequency ventilator for a few days. Other babies may need it for weeks. As your baby gets better, it will slowly be removed and the regular ventilator will take over again.

Nasal CPAP (Continuous Positive Airway Pressure) 

A mixture of air and oxygen is given through a special device placed on the nose to maintain some extra air pressure in the breathing passages and keep the lungs from collapsing when the baby exhales.

Nasal cannula

Small prongs that go into the baby's nose through which air mixed with oxygen is administered.

Newborn infants may be treated with antibiotics (drugs that fight infection) when we think that a serious infection may be the reason why they are sick, either at the time they are admitted to the NICU, or later during their time in the newborn ICU.

Small line placed into an artery (at the wrist or ankle) that allows continuous monitoring of blood pressure and drawing blood for lab tests.

Infants in the NICU sometimes need blood transfusions to correct anemia (too few red blood cells in the circulation) or low blood pressure that results from blood loss. This is done when the physicians think that the baby’s health or survival is in danger. Sometimes babies need transfusion of other blood products, called “platelets” or “plasma” to correct potentially dangerous bleeding problems. 

A device that provides extra pressure to the breathing passages via a rubbery mask or prong set on the nose. The baby is breathing on their own but this machine gives some extra pressure even as the baby exhales, to help keep the lungs from collapsing.

U-M Health provides extracorporeal life support for newborns who are experiencing life threatening heart or lung illness. ECMO, which stands for Extracorporeal Membrane Oxygenation, is basically heart/lung bypass performed outside of the operating room. U- M’s ECMO Program is the oldest and one of the largest ECMO programs in the nation. 

Our ECMO team cares for newborns in the NICU along with the neonatal nurses and physicians. Each patient on ECMO is cared for both by an ECMO specialist as well as a NICU nurse. The ECMO specialists are highly skilled nurses and respiratory therapists who are trained in operation of the ECMO circuit and provide complete, patient centered care during a critical time in their hospital stay.

A breathing tube is passed through the mouth or nose, into the trachea (windpipe) and connected to the ventilator. It is taped in place to the upper lip and cheeks.

Many babies born prematurely will have one or more examinations of the retina, which is the back of the eye, by an eye doctor (Ophthalmologist) after they have been in the NICU for a while. Babies who have this eye examination are being checked for evidence of a common complication of prematurity called “Retinopathy of Prematurity” (ROP), which may cause visual impairment or even blindness. Early detection through these eye examinations and treatment (if necessary) is very important. 

Use of fatty part of the heel to draw small amounts of blood for tests. (Larger amounts are drawn from indwelling IV lines or from a larger vein in the arm.)

This is another type of breathing machine that delivers very small breaths at a very high rate. The Oscillator is used for babies who are either not responding well to conventional ventilation or who have lung problems that respond better to this type of ventilator.

Small line placed into the vein, on the hand, foot, forearm or lower leg for delivery of fluid, usually sugar water, medications, and sometimes IV nutrition.

A procedure used to put a tube through the baby's mouth or nose into the windpipe. This tube is then attached to the equipment that assists breathing (the ventilator).

A flexible tube that goes through baby's nose into the stomach. Used to keep the stomach empty at first and can also be used to feed baby when appropriate. It is taped in place on the cheek.  Sometimes it is placed through the mouth instead of the nose.

A small sticky probe placed on the baby's hand or foot that allows the oxygen level to be viewed on the bedside monitor.

Treatment with special blue-tinted lights to help break down bilirubin, the yellow pigment that causes newborn jaundice, so it can leave the body in the stool or urine. Babies wear protective eye patches while they are receiving phototherapy.

A long thin line inserted through the baby's skin, usually into a vein in an arm or leg. It is passed through a blood vessel that goes deep into the baby's body. They are used to give IV fluids, IV nutrition and medications. They usually last longer than a regular peripheral IV.

Therapeutic hypothermia, or “cooling”, is a treatment for babies who are born at or near their due date that we think might have had a brain injury caused by interruption of blood flow or oxygen delivery. Many people have heard of icing a joint that is hurt. Even though the brain is more complicated than a joint, cooling can still help reduce the effects of brain injury in some babies. The baby is placed on a mattress with circulating water inside it, for 72 hours. 

The water is cool to begin with, and then the machine pumping the water automatically adjusts the water temperature to keep the baby's body temperature slightly cool, between 33° and 34° C (91.4° - 93.2° F). Cooling the entire body is the most commonly used way to ensure that the brain is cooled into a therapeutic temperature range. Our NICU participated in one of the pioneering clinical trials that showed “cooling” helped babies with brain injury.

Your baby may have ultrasound pictures of the head, heart or belly, or other locations. The machines used are like those used to look at a baby inside the womb. Common reasons to do an ultrasound in a baby in the NICU include checking for problems in the brain, heart, or urinary system, and checking the position of lines or tubes.

Treatment using a breathing machine. The most common type of ventilator is called a conventional ventilator. A conventional ventilator provides positive pressure breaths through a breathing tube at a rate similar to what the baby would breathe on their own. The volume of air delivered is approximately the amount that the baby would breathe on their own, but sometimes extra pressure is needed to deliver each breath when the baby has lung problems, for example from prematurity or an infection. 

The ventilator not only provides positive pressure breaths but it may also provide additional oxygen. The ventilator is continuously adjusted to give babies the additional support that is needed. Respiratory Therapists are the members of our team that adjust and maintain the ventilators.

Your baby may have X-ray pictures of the chest or the abdomen (belly), or other locations. Common reasons to take an X-ray in the NICU include checking for correct position of lines or tubes that we place, determining the cause of a lung, heart or intestinal problem, or detecting a suspected complication.