Common Diagnoses in the NICU

All expectant parents hope that their babies will be healthy. Yet sometimes problems arise that require a newborn to be hospitalized. When this happens, the baby may be admitted to the neonatal intensive care unit (also called the NICU) for treatment.
It's almost always stressful when a baby is unexpectedly admitted to the NICU. But the doctors, nurses, and other caregivers in the unit will do their best to provide emotional support for you while caring for your infant's medical needs.
What Is the NICU?With equipment designed for infants and a hospital staff who have special training in newborn care, the NICU is an intensive care unit created for sick newborns who need specialized treatment because they're still developing rapidly.
Sometimes the NICU is also called:
a special care nursery
an intensive care nursery
newborn intensive care
Babies may be sent to the NICU if:
they're born prematurely
difficulties occur during their deliveries
they show signs of a problem in the first few days of life
Only very young babies (or babies with a condition linked to being born prematurely) are treated in the NICU - they're usually infants who haven't gone home from the hospital yet after being born. How long these infants remain in the unit depends on the severity of their illness.
Although not all babies in the NICU have the same illness or condition, there are some diagnoses that are common to newborns who need intensive care. Here's a brief look at what these conditions are, what causes them, how they're diagnosed, how they're treated, and how long infants usually stay in the unit after they've been diagnosed.
Anemia
What is it?One of the more common blood disorders, anemia is a low number of red blood cells in the blood. Babies who are anemic may:
have apnea (stop breathing for 20 seconds or more)
have low blood pressure
have a high heart rate
seem sleepy
What causes it?Premature infants may develop anemia for a number of reasons. In the first few weeks of life, infants don't make many new red blood cells. Also, an infant's red blood cells have a shorter life than an adult's. And the frequent blood samples that must be taken for laboratory testing make it difficult for red blood cells to replenish.
In full-term or preterm infants there are also conditions that can cause the destruction of red blood cells that then lead to anemia. These conditions are referred to as the hemolytic disease of the newborn and are typically due to differences in the blood types of the mother and the infant.
How is it diagnosed?A doctor can diagnose anemia with a blood test.
How is it treated?Minor cases are monitored closely, whereas severe cases (especially in those premature babies who weigh less than 2.2 pounds [1,000 grams]) may require red blood cell transfusions. Doctors also try to treat the underlying cause of the anemia.
How long will my baby be in the NICU?By the time the underlying problem has been treated, the number of red blood cells in the infant's circulation stabilizes. As long as the baby is doing well and no longer has symptoms, then the doctors usually let the infant go home with close follow-up with the child's doctor.
Apnea
What is it?Although it's perfectly normal for everyone to experience occasional pauses in breathing, newborns who don't take at least one breath in 20 seconds or more have a condition called apnea. During an apnea spell:
the baby stops breathing
the heart rate may decrease
the skin may turn pale, purplish, or blue from lack of oxygen
What causes it?Apnea is usually caused by immaturity in the area of the brain that controls the drive to breathe (the brain doesn't "remember" to take a breath), although illness can also be responsible. Almost all babies born at 30 weeks or less will experience apnea, but apnea spells become less frequent with age.
How is it diagnosed?To accurately diagnose apnea, doctors monitor a baby's breathing rate in the NICU and may order a pneumogram, which involves attaching the baby to several monitors and observing the infant for about 8 to 12 hours. The pneumogram provides information about the baby's heart rate, breathing, and oxygen saturation in the blood.
How is it treated?In the NICU, all premature babies are monitored for apnea spells. The first line of treatment for apnea is simply stimulating the baby to help him or her remember to breathe. This can mean rubbing the infant's back or tapping the feet. However, when apnea occurs frequently, the infant may require medication (most commonly caffeine or theophylline) and/or a special nasal device that blows a steady stream of air into the airways to keep them open. more...

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