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.