Medical equipment at home after the NICU
Most babies who leave the neonatal intensive care unit (NICU) don’t need special medical equipment, like monitors or feeding tubes, when they leave the hospital. However, some babies are strong enough to go home but still may need these kinds of things to help them eat and breathe.
If your baby needs this kind of equipment, your hospital discharge team can help you order it before she’s discharged. If possible, try to "room in" with your baby before she leaves the hospital. Rooming in means you stay overnight in your baby’s room so you can learn how to use the equipment and practice the steps you need to take to care for your baby.
Talk to your baby’s provider if you have any questions about the equipment you take home with your baby. Here are three pieces of equipment that NICU babies may need:
- Apnea monitor: Apnea is an interruption in a baby’s breathing for a short period of time. Many NICU or premature babies have apnea episodes. If your baby has not completely outgrown this problem before discharge, he may need an apnea monitor at home.
The monitor is connected to your baby by a soft belt that goes around his chest. You use the monitor when your baby is sleeping or when you’re not watching him. The monitor sounds an alarm if your baby stops breathing or if his heartbeat is too fast or too slow. Before you leave the hospital, your baby's health care provider tells you what to do when the alarm goes off and when to call for help.
Don't be too frightened if the alarm goes off. It could be a false alarm. This can happen when the belt is placed incorrectly or if it becomes loose when the baby moves around. Sometimes a baby can have a short period of apnea and needs some stimulation to wake up. You can learn how to recognize these false alarms and what to do to help avoid them.
Your baby’s health provider can tell you when it’s safe to stop using an apnea monitor.
- Feeding tubes and syringe: When they go home, some babies need to continue gavage feeding. Gavage feeding is when a baby is fed breastmilk or formula through a tube placed through his nose or mouth into the stomach or intestines. Gavage feeding helps babies get enough food when they can’t get enough food by mouth through breastfeeding or a bottle.
For gavage feeding, you need feeding tubes and a syringe. A syringe is a needle-like tool that you use to put liquid (breastmilk or formula) into the feeding tube. If your baby has feeding trouble for a long time, she may need to be fed through an opening, called a gastrostomy, in her stomach. The opening has a small plastic feeding tube attached to it.
- Oxygen: Babies usually are breathing on their own before they’re discharged from the hospital. But some need additional oxygen at home for a while.
The most common reason babies may need oxygen at home is a lung disorder called bronchopulmonary dysplasia (BPD). BPD can cause lung damage and scarring. Babies at risk for BPD include those who had severe respiratory distress syndrome (RDS) and needed long treatment with breathing equipment and oxygen. The lungs often heal over the first 2 years of life. Sometimes BPD can continue and become an asthma-like condition.
If your baby needs oxygen, you need an oxygen tank and a nasal cannula. A nasal cannula is the soft plastic tubing that goes around your baby's head and into your baby’s nose. Oxygen from the tank passes through the cannula to your baby to help him breathe. A home health nurse may visit on a regular basis to check on your baby and answer your questions.
Oxygen can catch fire easily. Be sure to be careful with the tanks and follow the instructions on how to use them. Don’t keep the tank in a room with a burning fire, sparks or gas stoves. And don’t let anyone smoke near the tank.
When your baby’s health care provider decides that your baby is breathing better, the amount of oxygen that she gets is slowly lowered, then stopped. Most babies need oxygen at home for less than 6 months.
Last reviewed June 2011
Frequently Asked Questions
How do I calculate adjusted age for preemies?
Chronological age is the age of a baby from the day of birth. Adjusted age is the age of the baby based on his due date. To calculate adjusted age, take your baby's chronological age (for example, 20 weeks) and subtract the number of weeks premature the baby was (6 weeks). This baby's adjusted age (20 - 6) is 14 weeks. Health care providers may use this age when they evaluate the baby's growth and development. Most premature babies catch up to their peers developmentally in 2 to 3 years. After that, differences in size or development are most likely due to individual differences, rather than to premature birth. Some very small babies take longer to catch up.
Is it OK to invite people over after leaving the NICU?
Babies who've been in the newborn intensive care unit (NICU) are often at higher risk of getting an infection than other babies. Be careful where you take the baby and who comes to visit her. But you don't need to stay in your house alone for the first months after your baby comes home.
If you do have visitors, make sure they wash their hands before touching the baby. Also, don't let adults or children who are sick, have a fever or have been exposed to an illness near her. Lastly, ask visitors not to smoke in your house.
My baby has developmental delays. Where can I find help?
Some babies leave the newborn intensive care unit (NICU) just fine while others may have developmental delays. The earlier these delays are identified and treated, the more likely your baby will be able to reach his potential later in life. Most NICU babies will be evaluated before leaving the NICU to see their strengths and any areas that can be improved. If you think your baby has developmental delays, talk to his health care provider about where to find early intervention services. Contact state and local programs for help.