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Narrator: Birth is an exciting time for most families, but for the one in eight who deliver their babies prematurely, it can be a frightening experience.
Few are prepared for the days, weeks, and even months of round-the-clock care their babies will need in the hospital NICU.
Dr. Jacqueline Evans: NICU stands for neonatal intensive care unit, and it's a specialized unit for babies who have some problems after birth – anywhere from mild problems to severe problems.
Dr. Jacqueline Evans is a neonatologist, caring for preemies like Alex, Ciro, Dori, and her twin, Ayden, at the Children's Hospital of Philadelphia.
Doctor: Parents are often very overwhelmed by all this equipment around this little tiny baby.
Narrator: Getting a basic understanding of the NICU's equipment and the procedures your preemie may undergo can ease your fears.
Everything in the NICU has a purpose.
The first thing you'll notice is the different types of bed. The isolette or incubator has several portholes for hands to reach in. Generally it's used for the smallest babies. It's totally enclosed, warm, and nearly soundproof.
Doctor: The major benefit is that it's the best way to maintain the temperature of a tiny baby. Babies have a real tendency to lose a lot of heat by evaporation.
Narrator: Other preemies, like Ciro, may start out on a radiant warmer.
Doctor: It's our first choice to put a very sick baby on this type of a bed. As you can see we can have easy access to do procedures on him, put a breathing tube in, put lines in, so on.
Narrator: As your preemie grows stronger and is able to maintain her own heat, like Dori, she'll be moved to an open crib.
Doctor: Premature babies especially, but all babies that are sick, tend to be bothered a lot by external stimuli. What they really want is for it to be quiet and warm and dark.
Narrator: While babies do need some exposure to light for healthy development, for the most part, the NICU will be kept dim. It's also a good idea to move slowly and speak softly around your baby.
Doctor: We like to keep these babies very snuggled. Make him feel like he's nestled and secure.
So I'm just going to show you some of the very common lines and tubes that a baby might have. Here we have the tube that's for the ventilator. It goes into his windpipe and helps him with the breathing.
This little probe that goes on the foot, it can go on the hand, and it gives a continuous readout of oxygen saturation.
Narrator: Breathing problems are the most common issue Dr. Evans sees with preemies, because lungs are one of the last organs to develop.
Doctor: The baby may need anywhere from a little bit of extra monitoring to extra oxygen.
Narrator: Extra oxygen given through a nasal tube is often enough for mild problems.
Very young preemies, like Alex, need a ventilator to breathe for them.
For severe ongoing respiratory problems, a surgical opening in the neck, called a tracheostomy, may be necessary.
Doctor: On this hand, we have an intravenous line, and this would be used for giving intravenous nutrition.
Narrator: Another common problem among preemies is the inability to nurse or bottle-feed, because they haven't developed the coordination to suck, breathe, and swallow at the same time.
Until they master these skills, they're fed through tubes attached through the umbilical cord, nose, mouth, or directly into the stomach.
Narrator: With lots of patience and practice, many preemies like Dori and her brother Ayden, born at 27 weeks, learn to eat from a bottle.
In addition to feeding and breathing tubes, you may see other equipment attached to your baby.
Doctor: These wires are hooked up to the chest. And they give a readout of heart rate and also the breathing rate. There's another intravenous line here and that one might be for medications. These intravenous catheters just go through small veins on the hand, could be on the foot, sometimes the head.
Narrator: With all this high-tech monitoring equipment, warnings go off constantly, making the experience even more frightening for parents.
Doctor: We do have to warn parents that most alarms are nothing serious going on.
Narrator: Daily care for a preemie usually includes multiple blood tests, IV medications, X-rays or ultrasounds, and light therapy for jaundice.
As hard as it is to believe in those first few days, your baby's daily triumphs will soon outweigh her struggles.
But the million-dollar question is: When will she go home?
Doctor: If a baby is born like a month or six weeks early, lots of those babies have a very short stay in the NICU. A rough guesstimate is often around the time that the baby should have been born. If your baby is born 16 weeks early, you should be thinking in terms of a three- to four-month hospital stay.
Narrator: For twins Dori and Ayden, the happy day has finally come. After 128 days in the NICU, they're going home.