In stories about premature birth and premature babies you might have heard the term NICU? But what exactly is a NICU and what goes on there?
To find out, KBIA visited the NICU, or Neonatal Intensive Care Unit, at University of Missouri Women’s and Children’s Hospital here in Columbia.
Dr. John Pardalos is the medical director of the NICU at Women’s and Children’s hospital. He’s been working with premature babies for more than 20 years – seeing the youngest and smallest of infants on a near daily basis.
What is a pre-term or premature infant?
So a normal pregnancy is considered 40 weeks… So babies born at 36 weeks and 6 days or less are called premature.
Another term that’s often thrown out is micro-preemie – What exactly does that mean?
So a micro preemie - I would consider anything less than 1200 grams or 1250, and then less than 750 are the extremely premature.
So a micro-preemie is about 2.7 pounds or half a bag of sugar, and an extremely premature infant is 1.7 pounds or less – about the weight of my full mug of coffee.
Pardalos took KBIA on a tour of the NICU at Women’s and Children’s Hospital, which was renovated within the last few years and now has beds for 48 infants.
We took the opportunity to make more of these critical care rooms, so the rooms were designed so the 1/3 is for the parents, the 1/3 is for the docs and the nurses taking care of the baby and then the middle is the baby. And that way we try to encourage the parents to stay as much as possible with their babies.
All of our babies while they are they're here are on heart rate monitors and respiratory monitors. So the nurse standing outside can see her baby, and then if the nurses have two or three babies, at the beginning of the shift, they would make the alarms all talk to each other. So if they happen to be in one room and their other baby is misbehaving, the alarm will ding on that one so they know, ‘Oh, I need to run to that other room real quick.’ We also have these monitors scattered throughout so, no matter where you're at, you can see multiple babies at the same time. So that if someone starts dinging you can look up and say ‘Oh’ and then run to that room to help out that nurse if you need to.
Then as they get better, they move from the critical care rooms out into the open bay areas. Kind of what we tell the parents it’s one step closer to home. So you're healthy enough now you don’t need the quiet room and you can start interacting with the other babies because again for development they need the interaction - the movement of other people around - instead of just being confined into a private room all the time.
The really sick babies it may be one nurse to one baby. Then the babies that are on ventilators it's usually one nurse to two babies, and then what we call our feeders and growers - those usually do one nurse to three babies. So three is the maximum that the nurses take care of in here. And that's because once you get to three - it takes twenty minutes to feed each one and then it adds time to change the diapers and all of that - so by the time you are finished with the three, then it's time to start all over again.
There's six neonatologists [in the MU Women’s and Children’s NICU]. So it takes three of us to run the unit at any one time. So there's one person on the - what we call the big team - the sicker babies - and so that team has 18 - 20 babies. And then our second doc has the feeder and growers upstairs and that's usually 12 and so anything over 30 babies then the third doctor takes care of them.