Transitioning Newborns from NICU to Home
Appendix A: Family Information Packet (continued)
How Can I Manage My Child's Breathing Problems at Home?
- Visit the NICU often, and help care for your baby as much as possible in the hospital.
- Learn how to use equipment: pulse oximeter, oxygen tank, nasal canula.
- Know the signs of difficulty breathing.
- Learn CPR.
- Learn how to give your child's medicines.
- Plan ahead for extra help at home.
- Schedule routine followup doctor visits.
- Wash your hands frequently.
- Avoid crowds.
- Have your child immunized.
What is SIDS?
- "SIDS" stands for Sudden Infant Death Syndrome.
- Sudden, unexplained death of an infant less than 1 year old.
What should I know about SIDS?
- Babies sleep safer on their backs.
- Babies should be placed on a firm sleep surface.
What can I do to lower my baby's risk of SIDS?
- Babies should be put on their backs to sleep for nap and at night.
- Keep toys, objects, and loose bedding out of your baby's sleep area.
- Do not allow smoking around your baby.
- Do not allow your baby to overheat during sleeping.
What about "tummy time"?
- Daily tummy time is necessary for normal development.
- Make sure your baby spends several hours on their tummy when they are awake and someone is watching.
What is Bronchopulmonary Dysplasia (BPD)?
- Type of chronic lung disease.
- Common in babies born early.
- Damaged lung tissue causes breathing and health problems.
- Lungs trap air, fill with fluid, and produce extra mucus.
What Causes BPD?
- Being born early.
- Having a virus called RSV (ask your Health Coach for a fact sheet about RSV).
- Having a heart condition.
- Being on a ventilator.
- Lack of nourishment.
- Fluid in the lungs.
What are the Symptoms of BPD?
- Breathing heavily.
- Flaring nostrils.
- Sucking in air.
- Tiring easily.
- Pale or grey skin.
How is BPD Diagnosed?
- If your baby still needs oxygen at 36 weeks old.
- If your baby has been on a ventilator.
How is BPD Treated?
- BPD is treated with oxygen to control fluid in the body and medicine to relax the airway.
- Treatment does not cure BPD.
- Treatment helps your baby breathe better.
- Lungs will eventually heal.
- Your baby needs nutrients for healthy growth.
What is Respiratory Syncytial Virus (RSV)?
- A common virus that affects babies and infants.
- Leading cause of two lung infections: pneumonia and bronchitis.
Symptoms of RSV
- Starts out like a cold with fever or runny nose.
- Can also include:
- Problems breathing.
- Fast breathing.
- Not eating well.
How is RSV Spread?
- Contact with someone who is coughing or sneezing.
- Enters the body through the eyes, nose, or mouth.
How to Prevent the Spread of RSV?
- Wash your hands before and after handling a baby.
- Avoid exposing your baby to others with cold symptoms.
- Cover coughs/sneezes and throw away used tissues.
- Keep your baby away from crowded areas.
- If your baby is at high risk for RSV, talk to your doctor about a monthly shot that can help lower the risk of a baby getting severe RSV.
- Your baby may be eligible for palivizumab (brand name: Synagis®), a treatment given to prevent and reduce RSV.
- The shot, given monthly during RSV season, reduces the chance of your baby getting pneumonia and bronchitis.
- Babies may still get RSV but will be less sick.
- Feed your baby ONLY infant formula and breast milk for their first 4 to 6 months.
- Feed your baby at least every 3 hours, day and night.
- Before each feeding, warm the breast milk or formula to room temperature by placing the bottle in warm water; do not leave cold bottles on the counter to warm up.
- Never heat breast milk or formula in a microwave oven.
- Throw away any remaining breast milk or formula after each feeding.
- When traveling, keep the breast milk or formula cold in a cooler.
Infant formulas are available in 3 ways:
- Ready to Feed
- Do not add water.
- Liquid Concentrate
- Add sterile water.
- Add sterile water.
To make Sterile Water:
- Boil water for 2 minutes.
- Cover the pot.
- Let water cool to room temperature.
Formula Storage and Use
- Store prepared formula in a refrigerator.
- Use formula in 24 to 48 hours.
- Clean bottles and nipples by washing with hot, soapy water or on top rack of dishwasher.
- Allow bottles and nipples to air dry.
Breastfed babies have:
- Fewer ear infections.
- Lower chance of asthma, food allergies, and dental cavities.
- Protection against diarrhea, stomach, and lung infections.
- Better nervous system development and higher IQ levels.
- Lower risk of some childhood cancers.
- Lower chance of becoming over weight.
Mothers who breastfeed have:
- Lower risk of pre-menopausal breast cancer.
- Lower chance of osteoporosis later in life.
- Quicker return to pre-pregnancy weight.
- Food source for their babies even during emergencies.
- Lower chance of becoming pregnant before menstruation returns.
Giving medicines and feeding if your baby has a gastrostomy tube
- Clear the G tube or button as your health care provider showed you.
- Check for placement of the G tube or button.
- Slowly push in liquid medicine or feeding with a syringe.
- If the pharmacist says it is ok, pills and capsules may be dissolved in 10 to 20 cc of warm tap water.
- All medicines and feedings should be flushed in with 5 to 10 cc of warm tap water.
- Ask your baby’s doctor, nurse, or pharmacist how to measure the tap water.
It is important to use the specific tube adapter made by the manufacturer of your button.
- In fluid restricted babies flush medicines with ONLY 1 to 5 cc of warm tap water.
- Vent the tube after feeding to remove excess air or fluid and reduce leaking.
Protecting the G Tube or Button
- Snap t-shirts and onsies work best to prevent babies from pulling on the tube or button.
- You may also use a sticky wrap or stretchy dressing.