children s health issues
Overview of General Problems in Newborns
Treatment
Medical treatment of specific disorders in newborns is discussed elsewhere. Many health issues in newborns are minor and resolve on their own or need follow-up care at a doctor's office in the weeks after birth. Some newborns have more severe issues. Newborns (neonates) that are preterm or have serious health issues are cared for in a neonatal intensive care unit (NICU), where this level of care is available. The NICU is a specialized facility that brings together the medical team and technology needed to care for newborns with various disorders. Newborns may need such specialized care because of Preterm (Premature) Newborns None Respiratory disorders Low blood sugar (glucose) Severe infections (for example, Sepsis in Newborns ) Overview of Heart Defects None Overview of Hereditary Metabolic Disorders None Overview of Birth Defects that require specialized care or surgery The NICU team is usually directed by neonatologists (pediatricians specially trained to manage the problems of newborns). Much of the care is delivered by specialized neonatal nurses. Other team members may include pediatricians, respiratory therapists, social workers, pharmacists, physical and occupational therapists, speech-language pathologists, and other specialized personnel. Many NICUs also have doctors and students in training. Depending on the care required for the newborn, medical and surgical subspecialist physicians are also often involved. In the NICU, newborns are cared for in incubators or radiant warmers, which keep them warm while allowing staff to observe and treat them. Newborns are usually connected to monitors that continuously measure their heart rate, breathing, blood pressure, and oxygen levels in the blood. They may have catheters placed inside an artery or in the vein running inside the umbilical cord to permit continuous blood pressure monitoring, to allow repeated blood sampling, and to give fluids and medications. NICU facilities vary widely. Some NICUs have wards in which many babies share a large space, some have modules with a few babies in a space, and some have private rooms for a family and their baby. Regardless of the layout, NICU personnel are focused on meeting the parents’ need for time and privacy to become acquainted with their newborn; to learn the newborn’s personality, likes, and dislikes; and ultimately to learn any special care that they will need to provide at home. Visiting hours vary but are usually flexible so that families can spend as much time with their newborn as they wish. Some hospitals have sleeping facilities for parents on-site or nearby. Many NICUs have cameras, which allows parents to see their baby even when they cannot be present in the NICU. Sometimes, parents feel that they have little to offer their newborn in a NICU. However, their presence, including physical contact, speaking, and singing to their newborn, is very important. Newborns hear their parents' voices even before birth and are accustomed to them so they often respond better to their own parents’ attempts to calm them. Skin-to-skin contact (also called kangaroo care), in which the newborn is allowed to lie directly on a parent’s chest, is comforting to the newborn and enhances bonding. Breast milk significantly reduces the risks of Necrotizing Enterocolitis (NEC) (a serious intestinal disorder that can occur in preterm infants) and infections in preterm infants, and has a wide range of health benefits for all infants (see NICU personnel understand that parents need to be kept up to date on their baby's condition and expected course, the care plan, and the estimated time of discharge. Regular discussions with the nurses and medical team are beneficial. Many NICUs also have social workers who help communicate with the parents and assist in arranging family and medical services. 