Babies admitted to the Neonatal Intensive Care Unit (NICU) are cared for by a large health-care team.
How do you tell who's who at the hospital?
It can be very difficult to tell by the clothes health-care professionals wear what they do at the hospital. However, all hospital staff are required to wear identification badges that include their name and their area of specialty. If you are not sure what somebody does, do not be afraid to ask them.
Dietitian
This is a health professional with expertise in healthy eating and nutrition. Dietitians help to prevent and treat illness through dietary modification. In premature babies and babies who are ill, dietitians assess whether their nutrition and feeding are adequate. They can help ensure babies receive adequate nutrition either intravenously or with breastmilk or formula.
Lactation consultant
A lactation consultant is an expert in breastfeeding. When babies are admitted to the NICU, breastfeeding is often delayed due to prematurity or due to the medical condition that required intensive care. Lactation consultants can help parents produce breastmilk while their baby is in the NICU and establish breastfeeding when the baby is ready to do so.
Neonatal transport teams
Some babies are born in community hospitals that cannot provide the required level of care for them. They are transferred to a hospital with the appropriate facilities by a transport team. The transport team generally includes at least two of the following people:
- A transport physician: a physician with expertise in the emergency transport of premature babies
- A transport nurse: a nurse with expertise in the emergency transport of premature babies
- A respiratory therapist with expertise in the emergency transport of premature babies
The transport team stabilizes the baby for transport and delivers neonatal intensive care to the baby during the transfer from the birth hospital to the NICU that can provide the appropriate level of care for the baby.
Neonatologists and neonatal fellows
A neonatologist is a paediatrician who specializes in the care of newborn babies who have problems such as prematurity, breathing problems, infection, jaundice, feeding problems or genetic disorders. Neonatologists take care of newborn babies in the NICU of the hospital. Neonatal fellows are paediatricians who are training to be neonatologists.
Nurse practitioner
A nurse practitioner is a registered nurse with additional training. They have advanced knowledge and decision-making skills, can assess and treat babies and are members of the health-care team providing daily care to babies in the NICU.
Nursing team
- Registered nurse: a nurse who provides direct care to your premature baby at the bedside
- Clinical nurse specialist (CNS): a registered nurse who specializes in caring for premature and other newborn babies and their families
- Clinical support nurse: a registered nurse who assists nurses in caring for babies in the NICU
- Team leader: a registered nurse who leads the team of nurses caring for premature babies
- Child health services director: a professional responsible for the management of the NICU within the organizational structure of the hospital
Occupational therapist
Paediatric occupational therapists (OTs) are health-care professionals who work with premature babies, young babies and children to help them overcome physical problems caused by prematurity, illness and hospitalization. While your baby is in the NICU, the OT can show you and the health-care team ways to position, handle and interact with your baby in order to promote appropriate development. The OT can also help you learn to read your baby’s cues and responses to the environment so that you can help to reduce the stress they may experience and help them learn to organize themselves. Occupational therapists play an important role in helping some babies learn to feed. Depending upon the specific feeding issue, the OT will recommend feeding strategies such as changing the feeding equipment or method, altering the feeding position or providing techniques to change the flow rate of liquid. All interventions are specific to the individual needs of each baby.
Paediatric surgeon and paediatric surgical fellows
A paediatric surgeon is a surgeon who has specialized training to perform surgery on newborn babies, older infants and children. Before surgery, a paediatric surgeon evaluates the child’s medical condition. After surgery, they play an active role during the child’s recovery in the NICU or intensive care unit. Your newborn baby might be referred to a paediatric surgeon if your baby requires surgery. A paediatric surgical fellow is a surgeon who is training to be a paediatric surgeon.
Pharmacist
A pharmacist is a health-care professional who is a medication expert. Pharmacists work closely with the rest of your child's health-care team to make sure your child receives the most appropriate medications.
Respiratory therapist
This is a health-care professional specially trained to help with breathing. Respiratory therapists provide breathing and oxygen support to newborn babies who have trouble getting enough oxygen into their blood because of respiratory problems or a heart condition. The most commonly used treatment is mechanical ventilation and other forms of respiratory support, which includes machines to help the newborn baby breathe.
The family support team at the hospital
If your newborn baby requires treatment in the NICU, you may feel stress. You might also need to make difficult decisions for your newborn baby. Below is a list of the hospital staff who can help you through this challenging time.
Chaplain or spiritual advisor
Chaplains or spiritual advisors of different faiths offer pastoral care to newborn babies and their families. They perform religious services at hospitals. Most hospitals offer chapels, meditation rooms or prayer rooms.
Bioethics consultant
These are professionals who can help parents who have concerns about ethical or moral issues having to do with their newborn baby’s care. They also work with members of the medical team to resolve any issues with the family that may be interfering with delivery of care. Bioethics consultants will not provide you with the "right answer" but may help you think through difficult decisions.
Medical interpreter
Medical interpreters are trained to translate medical information. They help families talk with health-care professionals about the baby’s medical condition in their first language.
Social worker
This is a person who offers supportive services, including individual, family or group counselling, patient and family education, information regarding community resources and referral to community-based services. You may want to talk to a social worker if you are worried about your newborn baby’s diagnosis, if you have trouble adjusting to your baby’s treatment or if you are experiencing stress, family conflict or grief.
Volunteers
These are individuals who can come and help you, hold your baby, talk to you and do other things such as knitting baby clothes.
Other specialists
If your newborn baby needs specific treatment for a particular condition, they may need to see other specialists. Below is a list of some of the specialists that are available, along with a very brief description of what they focus on.
- Cardiologist and cardiac surgeon: the heart
- Craniofacial surgeon: the skull or face; for example, a craniofacial surgeon can repair abnormalities such as cleft lip
- Dermatologist: the skin
- Ear, nose and throat (ENT) specialist or otolaryngologist: the ears, nose and throat
- Endocrinologist: hormones and glands that produce hormones
- Geneticist: genes, inherited conditions and conditions affected by genes
- Haematologist: the blood and blood-forming tissues such as bone marrow
- Nephrologist: the kidneys
- vNeurologist: the nervous system (the brain, spinal cord and nerves)
- Ophthalmologist: the eyes
- Orthopaedic surgeon: the bones, joints, muscles, ligaments and tendons
- Radiologist: imaging techniques such as X-rays and ultrasound
- Respirologist: the lungs and respiratory tract
- Urologist: the urinary tract in males and females, and the reproductive tract in males
What is your role on the team?
It is important for families to understand and participate in the care of their baby. If you have questions or concerns about your baby, please feel free to ask any member of the team. They will make sure you get an update or will arrange for you to speak with a health-care team member who has the information you seek.