NICU 101

The other day I was sitting with my little muppets while I spoke with the nurses about their development. I ask them about breathing, heart rates, feeding, weight and general attitude on a daily basis.

Linguo: Not a NICU term.

But as you’ve seen, the boys were also both born with full heads of dark hair. This may be due to generally fabulous genes, but some of their hair could also be the result of their prematurity. According to my research, this hair will disappear as they get bigger. (Doesn’t it seem like everything happens “as they get bigger”? I guess that’s the whole “premature” concept…) Out of curiosity, I asked how long we could expect the linguo to last.

Jon later pointed out that Linguo was the name of Lisa Simpson’s grammar correcting robot in a Simpson’s episode. I was trying to find out how long the lanugo – a fine downy hair on developing babies – would last (33-34 weeks gestation).

Since I am still getting confused even though we visit the NICU twice a day, talk to the doctors and nurses as much as possible before coming home and researching things further, I thought I’d share some of the common NICU terms and concepts surrounding Search and Destroy’s development.

Please add your own in the comments or let me know what you’re interested in and I’ll add the definition to this post. (Definitions below pulled from preemiecare.org.)

Adjusted Age: Also known as corrected age, is a term used most appropriately to describe children up to 3 years of age who were born preterm, “corrected age” or “adjusted age” is calculated by subtracting the number of weeks born before 40 weeks of gestation from the chronological age.
(Search and Destroy were 12 weeks premature.)

Apgar Score: A scoring system that helps the physician estimate a baby’s general condition at birth. An acronym for A- activity, P-pulse, G-grimace, A- appearance, R-respiration. The test measures a baby’s heart rate, breathing, muscle tone, reflex response and color at 1 minute, 5 minutes and 10 minutes of life. Named after its creator, Virginia Apgar, in 1952.
(Search and Destroy both got a 5/8.)

Apnea: A pause in breathing that lasts longer than 15- 20 seconds. Apnea of Prematurity occurs in infants born before 34 weeks gestation. Because the brain or respiratory system may be immature or underdeveloped, the baby may not be able to regulate his or her own breathing normally.
(This may be normal/typical – but it’s scary as all get out. Destroy is struggling with this right now.)

Beta-methasone: Corticosteroid medication given to the mother before the baby is born to stimulate fetal lung maturation and to decrease the frequency and damage from intracranial hemorrhage in premature infants.
(These are the aforementioned steroids Search and Destroy received.)

Bilirubin: Bilirubin is a breakdown product of hemoglobin, the substance in blood that carries oxygen. Normally bilirubin passes through the liver and is excreted as bile through the intestines. Jaundice occurs when bilirubin builds up faster than a newborn’s liver can break it down and pass it from the body.
(Preventative treatment for Jaundice is why the boys look like they’re at a rave in some of their earlier pictures.)

Bradycardia: A heart rate less than 100, slower than normal for an infant.
(This seems to go hand-in-hand with the apnea episodes.)

Breast Pump: A machine to collect breast milk without the baby present. A hospital- grade breast pump is often more powerful than those for home use, and may be available for rental.
(I am the Dairy Queen!)

Cannula: A slender tube that can be inserted into a body cavity or duct.
(The boys have thus far been consistently on and off a cannula of the nasal variety.)

Complete Blood Count (CBC): Blood test that looks at the number and type of white blood cells, the concentration of hemoglobin, the percentage of blood volume consisting of red blood cells (hematocrit), and the number of platelets.
(Search and Destroy have both had several of these. Doctors order them to rule out infections or other issues. Typical diagnosis: “They’re tiny.”)

Continuous Positive Airway Pressure (CPAP): Through small tubes that fit into the baby’s nostrils, called nasal CPAP, this machine pushes a continuous flow of air or oxygen to the airways to help keep tiny air passages in the lungs open.
(Search and Destroy have been on and off of this machine as well. It encourages them to remember to breathe.)

Electro- cardiogram (EKG): An adhesive patch placed anywhere on the body, and connected by a wire to a monitor, used to detect heart rate, respirations, or blood oxygen levels.
(Destroy had one of these yesterday because of his bradycardia episodes. It was positively terrifying to see all the little patches on his tiny body. Diagnosis: “He’s tiny.”)

Gavage Feeding: A method of feeding a baby with breast milk or formula before he has learned how to swallow. A small flexible tube is placed into a baby’s nostril or mouth and passed down into the stomach.
(The boys are big fans of food – regardless of how they get it at this point.)

Incubator/ Isolette: A heat-controlled crib used to maintain a baby’s body temperature.
(Baby jail.)

Kangaroo Care: Holding a baby against one’s naked chest, so there is skin-to-skin contact.
(See Kangaroo Kare post.)

Lanugo: Fine, downy hair that covers the fetus until shortly before or after birth.

Monitor: A machine that records information such as heartbeat, body temperature, respiration rate, and blood pressure.
(They beep. A lot.)

Nasal Cannula: The “oxygen tubes” that give extra oxygen by blowing moisturized oxygen, possibly mixed with air, into the nose.
(See “cannula.” Both Search and Destroy receive standard room air through this “oxygen tube.”)

Neonatal Intensive Care Unit (NICU): There are three levels of NICUs: Level 3: Cares for any infant (at any age of gestation) that may have or could have severe or life threatening conditions. Level 2: Any newborn that may require monitoring after birth and requires more than routine newborn care. Level 1: Routine newborn care. Usually for full term infants, there may not be specialized equipment or physicians for problems.
(Kaiser Santa Clara is a Level 3 care center. Thank goodness.)

Neonatologist: Physician with 10 years of training specialized in dealing with the diseases and care of newborn infants.
(A big thank you to Drs. Lawrence Dong, Yuri Knauer, Preeti Patel, Anupama Shetty, Richard Vanwoerkom and Carlene Wong for taking such great care of our little ones.)

Percutaneous Line (PICC): Also called percutaneously inserted central catheter or PICC line, this is a long catheter placed into a surface vein, with the catheter tip extending farther into the body into a large central vein. Doesn’t have to be replaced as often as a regular IV line.
(Once the boys got their PICC lines, we got to start Kangaroo Kare. Now that they’re eating so well, the lines are already gone.)

Severe Prematurity: Also known as very premature, refers to babies born from 28 weeks through 31 weeks gestation.
(The twins were technically born at 27.5 weeks, but we’ve upgraded them to 28 since they were only two days short of the coveted third trimester.)

Very Low Birth Weight (VLBW): Very low birth weight infants weigh less than 1500 grams or 3lbs 5 oz.
(Search weighed in at 970 grams and Destroy was born at 1005 grams.)