Millions of families around the world begin their parenting journey with their newborn receiving specialized care in a Neonatal Intensive Care Unit (NICU). Babies born prematurely with a low birth weight, or with medical conditions that need specialized attention require an admission to the NICU, where advanced medical support and a carefully controlled environment help support their recovery and growth.
“NICU is more than just a hospital unit. Consider it a place that mimics the environment of the womb, helping premature or medically fragile babies who are not yet ready for the outside world thrive,” says Dr Jafar Khan, Head of Neonatology and Senior Consultant Neonatologist at Ankura Hospital for Women and Children, Indore. He adds that such babies may have organs that are not yet fully developed, may not have the ability to feed independently or regulate their body temperature, unlike healthy, full-term newborns. The specialized equipment, controlled temperatures, and limited stimulation of the NICU help such babies conserve energy and support their growth and development. “Moreover, they are monitored round the clock by neonatologists and trained nursing staff,” he says.
Dr Jafar, who cares for many such newborns on a daily basis, and has treated babies with birth weight as low as 450 gms, says that while the journey of a baby inside the NICU can be challenging for families, equally challenging is the time when the baby is finally discharged. “The relief is that the baby is now ready to enter the outside world, but the challenge parents often face is that the shield of the NICU is no longer there, and they now have to care for their baby on their own.”
He encourages parents to participate in caregiving activities such as diaper changing and, feeding when required, once the baby is stable. This helps parents build confidence in caring for their baby. He further advises parents not to be in a hurry to take the baby home, and to use the time before discharge to understand all aspects of the baby’s care that they will need to manage at home, as he elaborates below.
Feeding at Home
While breastfeeding is the preferred form of nutrition for newborns, not all babies discharged from the NICU may be able to breastfeed completely, depending on their suckling and swallowing capacity. If a specific feeding method or equipment is to be continued at home, parents should use it in the same manner as practised in the NICU. They should also understand the baby’s feeding schedule, hunger cues, and signs of adequate feeding. “What’s foremost is maintaining good hygiene and ensuring appropriate storage of powdered or expressed milk,” Dr Jafar emphasizes. He also advises Kangaroo care, or skin-to-skin contact of the baby and parent, to help promote bonding and support the baby’s development and well-being.
The Home Environment and Infection Control
“Babies stay in a strictly controlled environment inside the NICU and should not be overwhelmed with excessive light and sound at home,” Dr Jafar advises. He recommends creating a calm, comfortable, and uncluttered space for the newborn. Moreover, maintaining a hygienic, sanitized environment and limiting visitors can help reduce the risk of infections, particularly during the early period after discharge. Sanitizing hands before touching the baby, particularly for caregivers and visitors, is essential, while anyone unwell should avoid close contact with the newborn. “Crowded places like malls or large indoor gatherings should also be avoided to prevent unwanted infections,” he adds.
Sleeping at Home
Newborns should preferably sleep in a comfortable crib, free of loose blankets, pillows and toys. “Premature babies and NICU graduates typically need more sleep,” says Dr Jafar. He therefore advises parents to avoid keeping these babies awake for long periods between naps.
Understanding Medical Needs
“Medical care for NICU babies does not end at discharge. They require follow-up appointments to ensure they are thriving well and their healthcare needs are met,” Dr Jafar says. Parents should thus ensure they continue the visits as advised. “Learning to identify the signs of an emergency and being trained to perform CPR, a crucial lifesaving procedure for babies, is also very important,” he stresses. He further advises caregivers to seek immediate medical attention if the baby develops breathing difficulty, turns bluish, refuses feeds, becomes unusually drowsy or shows any other sudden change in condition.
Dr Jafar assures parents that the baby’s medical and developmental readiness is carefully assessed before discharge, so caregivers need not be anxious about their baby’s health.
“What’s important is staying aware. Parents should ask questions, seek clarification from the medical team, and reach out to the hospital whenever they are unsure about something. That’s the best way to help their little fighter grow and thrive,” concludes Dr Jafar.
