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Here are some medical words you may hear doctors and nurses use while they care for your baby in the NICU
NICU jargon can be confusing! Below is a list of come commonly used NICU words and terms. It can help being familiar with what these words mean to understand, and be part of, your baby’s care.
A short time when a baby does not breathe. Apnoeas are common when babies are immature (not completely ready for the outside world) and will happen less as your baby develops and becomes older. When a baby has an apnoea we may notice their skin colour change (skin/lips becomes slightly blue or dusky) and sometimes their heart rate will slow down, which we call a bradycardia.
Anaemia is a low number of red cells (RBCs) in the blood; these are cells which carry oxygen around the body. Babies with anaemia may need treatment with a blood transfusion of ‘packed red cells’ (high concentration of RBCs). Extra iron in the form of drops may also be given to premature babies after 6 weeks of age to help them make enough RBCs.
A condition where there has been not enough oxygen to some parts (tissues and organs) of the body. The brain and kidneys are the organs most likely to be damaged by a lack of oxygen. The problems caused by asphyxia may be temporary (not last for ever) or may cause long term issues..
Our lungs should only breathe gases like air; if liquid gets into the lungs we call it aspiration. Examples of liquids that may affect babies’ lungs include expressed breast milk, stomach fluids or meconium.
Special blue coloured lights used in the treatment of jaundice.
A yellow pigment (coloured substance) formed by the breakdown of red blood cells. – see jaundice
A blood test used to check the levels of gases like oxygen, carbon dioxide, and the amount of acidity (balance of chemicals) in the blood. This test can be checked by taking a small amount of blood from baby’s heel or a blood vessel.
Where blood is given by one person, called the blood donor, and placed into the circulation (blood flowing around the body) of another person (called the recipient or receiver).
This is a baby who is well, but needs to be cared for in the nursery while his/her mother has treatment in the hospital or is too unwell to care for her newborn.
A brain wave monitor (also called an EEG) which is placed on the baby’s head to check for possible seizures (fits) which she/he may be having.
A slow heart rate – for babies this is when the heart beats at less than 100 beats per minute. In premature babies, bradycardias often happen at the same time as an apnoea.
A fine catheter (tube) placed into a vein that can be used for a long time to give feeding (called intravenous nutrition), fluids, and medicines to babies. The line is put in a more central vein than those of the hands and feet so that it need not be replaced as frequently.
A small, hollow plastic tube put through the skin and muscle of the chest wall into the space between the lung and chest wall to remove air or fluids from this space. If air is trapped in this space it is called a pneumothorax. – see pneumothorax in the NICU Glossary of Medical Conditions
Means to be born with, or be present at birth.
A special way to give oxygen or air to babies with breathing difficulties. CPAP works by giving the baby air/oxygen at a slightly higher pressure than normal; this helps keeps the baby’s airways (breathing tubes) open and helps baby get enough oxygen. CPAP is usually given by a mask or nose prongs
Special x-rays which use a computer to make a clear picture of parts of the body. In NICU, CT scans are often used to get a detailed picture of a baby’s brain. If your baby needs a CT scan, they will be taken to Westmead Children’s Hospital Radiology Department to have the scan done.
A sample of blood, urine or other body fluid is collected and taken to the laboratory where it is checked for germs (bacteria or viruses) by growing it in a substance called a culture medium. This test tells us which bacteria or virus is causing an infection and the best antibiotic medicine needed to fight the infection.
Blueish, or dusky, colour of the skin, lips and nail beds which we see when there is not enough oxygen in the blood such as during an apnoea.
An ultrasound of the heart done by using a probe on the skin of the chest wall. This test does not cause pain and gives very good pictures of the shape and movement of the heart as well as the blood flowing through the heart and blood vessels.
“Puffy” skin from fluid collecting in body tissues.
A plastic tube which is placed through the baby’s nose or mouth, past the voice box and into the upper windpipe (trachea). An ET tube helps the baby to breath.
– When the tube is put in we call it intubation.
– When the tube is taken out we call it extubation.
A treatment which removes small amounts of the baby’s blood and then gives back blood from another person (called donor blood). In the NICU this procedure is most often used to lower the level of bilirubin (jaundice) in the baby’s blood. It may also be used to raise or lower the number of red blood cells and sometimes to help the baby’s blood to clot.
Full Blood Count (FBC)
A test which counts the different types of cells found in the blood. These cells are:
– red cells (for carrying oxygen)
– white cells (for fighting infection)
– platelets (for preventing bleeding by helping
blood to form clots)
This is the name given to premature babies that are getting ready to be discharged home. They are growing and learning to feed by sucking rather than being tube fed.
Feeding intolerance means that the baby is not coping with milk being fed through the gut (intestines). In premature babies the following problems tell us the baby is not managing feeds:
– increased gastric residuals (amount of fluid left in the stomach after feeding)
– vomiting
– reflux (fluid running back up the swallowing tube/ oesophagus)
– abdominal distension
– tummy looking bloated
– diarrhoea
– poor growth
Gavage Feeding
Feeding which is given by a small plastic tube placed through the nose or mouth down into the stomach. This type of feeding is used when the baby is too weak, or too premature, to suck and swallow.
A rushing sound made by blood flowing in the heart, it is usually heard with a stethoscope. Sometimes a heart murmur tells us the baby has a problem with his/her heart
Where a tiny needle is used to collect a small blood sample from the baby’s heel.
Hyperbilirubinemia
An elevated level of bilirubin (yellow substance or pigment) in the blood. – see jaundice
A low amount of sugar (glucose) in the blood. There are many causes for low blood glucose in newborns including:
– being premature
– mum having diabetes during her pregnancy
– infection
– low body temperature
Lower temperature than normal body temperature (Normal is 36.5oC – 37.5oC). Babies with low temperature may be restless (irritable) or they can become less active (lethargic). Hypothermia can cause babies’ blood sugar to be too low (hypoglycaemia).
Infant of a Diabetic mother
A mother may have diabetes during pregnancy either because she was diabetic before pregnancy, or because she developed diabetes during her pregnancy (gestational diabetes). The most common problem for babies of diabetic mothers is low blood sugar (hypoglycaemia), so we watch these babies for signs of low blood sugar levels and we check their blood glucose levels regularly.
A thin tube inserted into a vein to give medicines or fluid.
The brain has hollow areas, called the ventricles, which are filled with fluid (cerebrospinal fluid / CSF) that normally protects and flows around the brain and spinal cord. When blood collects in the ventricles we call it an intraventricular haemorrhage (IVH).
Jaundice
Jaundice is a yellow colour of the skin and eyes caused by increased amounts of bilirubin in the bloodstream. Bilirubin is formed when the red blood cells break down. It is very common for newborns to develop jaundice. Newborn jaundice is usually mild, but can be serious and may need treatment, which is why we check all babies with jaundice regularly and carefully. Treatments for jaundice include light therapy (phototherapy) and exchange transfusion.
Kangaroo care is also called skin to skin care. This is good way of providing warmth, sleep and comfort to premature infants. This also gives an opportunity for closer parent-baby interaction especially for premature babies in NICU.
These are infants born after 34 weeks of pregnancy but before 37 weeks. Although they may look like term babies, they may still have the same problems as premature infants such as:
– difficulty breathing
– not being able to control their body temperature
(hypothermia)
– low blood sugar levels (hypoglycaemia)
– jaundice
– difficulty with feeding
Lumbar Puncture (Spinal Tap)
A procedure by which a small needle is placed through the skin and between the bones (vertebrae) of the lower back into the space around the spinal cord. The needle is used to collect fluid to check for infection or other tests.
The first poo that a baby does. Meconium is thick, sticky, and dark green to black in colour. Sometimes babies pass meconium while still inside the womb.
Meconium aspiration happens when a baby breathes meconium into his/her lungs during, or before birth. Meconium in the lungs can cause problems with breathing after the baby is born. This condition is called meconium aspiration syndrome (MAS).
Meningitis
Infection of membranes around the brain and the fluid (cerebrospinal fluid – CSF) that flows around and protects the brain and spinal cord.
A way of getting clear pictures of the organs inside the body, for example, pictures of the brain. MRI uses magnets instead of x-rays to make the pictures. Because the magnets are very strong there must be no metal on, or near, the baby when the test is done. If your baby needs an MRI scan, they will be taken to the radiology department of Westmead Children’s Hospital to have the scan done.
Clear plastic tubes that are placed just under baby’s nose, into the nostrils, to give extra oxygen if your baby needs it.
Newborn Bloodspot Screening Test (NBST)
The NBST is done on all babies in NSW on day 2-3 after birth. A small amount of blood is collected from your baby’s heel with a tiny needle. The blood is checked for a number of rare medical problems, some of which need early treatment to protect affected babies from harm. Examples of what is checked for include:
– Phenylketonuria (PKU)
– Hypothyroidism
– Cystic Fibrosis
– Galactosemia
– Medium Chain Acyl CoA Dehydrogenase (MCAD) Deficiency
– Other rare metabolic disorders
Non-nutritive sucking means that the baby sucks on a pacifier (dummy) during a tube feed. NNS is often used in neonatal nurseries because it helps babies learn sucking behaviour and soothes them while they are changing from tube to sucking feeds.
The baby must not be given milk, or any other liquid, by mouth or through the intestinal tract (by tube).
Ophthalmologist
A medical doctor who is specially trained to look after problems or illness of the eyes.
Oxygen is one of the gases in the air that we breathe. Normal air has 21% oxygen. Oxygen has no colour or smell and we cannot survive without it. Often premature and newborn babies who are having problems breathing are given extra oxygen.
Phototherapy is blue light used to treat jaundice. Phototherapy can be given by lights above the baby’s bed or by a blanket the baby lies on. Eye shields are placed over the baby’s eyes to protect them from the light.
Reflux
Reflux is when milk or fluid flows from the baby’s stomach into the swallowing tube (oesophagus). Reflux may cause babies to spit up or vomit.
Respiratory distress syndrome is a condition which often happens to premature babies. The lungs of premature babies are not yet ready for the outside world and so babies may have problems breathing for some time after they are born. Premature babies may be given a medicine called surfactant directly into their lungs to help treat this problem.
Seizure is the medical name for ‘fit’, which is when the baby’s muscles twitch or stiffen without the baby being in control of them (called involuntary movement). Seizures are usually caused by abnormal electrical activity in the brain. There are many causes of seizures and it may take time to find out what the reasons are in each case. Your treating doctors and nurses will discuss this with you.
Sepsis
Infection in the bloodstream.
The tests done when a baby might have an infection. These tests may include all or some of the following:
– chest or abdominal x-ray
– blood culture (blood taken to lab to look for and grow germs)
– urine culture (urine taken to lab to look for and grow germs)
– spinal fluid culture (fluid taken to lab to look for and grow germs)
Because infections in babies can worsen very rapidly, they are often started on antibiotics before the results of the tests are known.
Small for gestational age babies are infants that are in the smallest 10% of babies born at that number of weeks of pregnancy. Causes of small for gestational infants include:
– baby is small because the parents are small
– healthy small baby
– baby did not grow well in the uterus because the placenta was not feeding the baby adequately
– baby did not grow well in the uterus because mum had a medical illness
– some medical problems of babies may cause them to be small
A supra pubic tap is done when clean urine is needed for culture in the laboratory to check for infection. The lower part of the abdominal (tummy) wall is cleaned with antiseptic and a small needle is passed through the skin directly into the bladder to collect the urine.
A substance made by cells in the air sacs of the lungs, this substance helps to keep the lungs flexible and stops the small air sacs, called alveoli, from collapsing. Surfactant is important for normal breathing and keeping oxygen and other gases flowing in and out of the lungs. The lungs of premature babies do not make enough surfactant which causes Respiratory Distress Syndrome (RDS).
Tissuing of an intravenous infusion
When an intravenous (IV) needle slips out of the vein it may allow the IV fluid to collect in the surrounding tissues.
An ultrasound is when very fast moving sound waves are used to take images (pictures) of organs in the body such as the brain, kidney and heart. Ultrasound is safe and not painful. Ultrasounds are usually done in the NICU at the baby’s bedside.
A small plastic tube placed into one of the umbilical cord (belly button) blood vessels to give fluid and or medicines to the baby.
ASKING QUESTIONS
Medical terminology and abbreviations can be overwhelming and confusing
If you would like more information, ask the NICU staff to explain terms in plain language.
NICU Glossary of Medical Terminology | April 2023 Adapted from NSW Health Fact Sheet
Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.
“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.
In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.
Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.
Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.
“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people. They may never get the chance to say to anyone, look I’m really stressed,” he points out.
“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.
Richard credits a varied career, a talented and innovative team, and much life experience for affording him the insight needed to address the challenges related to actively engaging dads.
After completing his masters in Medical Science, studying epidemiology, Richard earned his PhD focusing on fathers and attachment.
“Fathers are invisible in many places, and that is endemic. Not because people dislike fathers, but because the system is set up to be focused on mothers.”
Some services and organisations are aware of the need to engage dads, but have been unsuccessful in their attempts.
“When people are challenged about this, they generally want dads involved,” Richard affirms.
“Often, however, they just don’t know how to do it.”
Richard works with health professionals on issues related to fathers, and has delivered many antenatal programs for expectant dads.
He credits his own family with giving him an understanding of the role of fathers needed to make his work relevant.
“I have three daughters and two stepdaughters,”
“My kids would say they taught me just about everything I know and they’d be right. They’ve taught me a lot, and still do.”
Richard’s research revealed possible long-term negative impacts on the children of dads with mental health issues. Fathers’ depressive symptoms in the first year after the birth predicted behaviour problems in their children years later.
“If dads’ mental health has such a dramatic impact then we need to be screening dads for depression, not just mums,” Richard explains.
In response to these limitations, Richard and his team have designed a smart-phone based program that allows mobile connection for new and expectant dads.
Participants receive texts containing information and links, and self-report their mood. If the mood tracker identifies dads as needing extra support, they will be offered a phone call from a counsellor trained in this area.
Following the success of the pilot of the SMS4dads program, Funding was received to enable a National roll-out.
“When dad’s miss antenatal classes or activities, they also miss out on contact and links to other people. They may never get the chance to say to anyone, look I’m really stressed,” he points out.
“SMS4dads is a way of bringing dads into the health system and keeping them linked in with services and support,” explains Richard.