Most NICU graduates need no special medical equipment when they leave the hospital. Some babies are strong enough to go home but still need some help. If your baby is discharged with medical equipment, you should learn how to use it and practice using it with your baby, before he leaves the hospital. Usually the company that provides the equipment will send someone to the NICU or to your home to show you how to use it properly.
The three most common types of equipment that babies are sent home using are an apnea monitor, a feeding tube and oxygen.
Many babies have episodes of apnea (a periodic interruption in breathing). If a baby has not completely outgrown this problem in the hospital, she may temporarily need an apnea monitor at home. The monitor is connected to the baby by soft, sticky patches or by a soft belt that goes around her chest. The monitor sounds an alarm if the baby stops breathing or if her heartbeat is too fast or too slow. Parents use the monitor when the baby is sleeping or when they are not watching the baby. A health care provider will teach you what to do when the alarm goes off and when you should call your baby’s provider. As you probably saw in the hospital, sometimes the alarm goes off when there is nothing wrong with your baby. You will learn how to recognize these false alarms and what to do to help avoid them.
Some babies can’t suck or swallow well enough to take in enough nutrients for healthy growth. These include babies with problems involving the heart, lungs, mouth, esophagus, airways or central nervous system. When these babies go home, they may need to continue to be fed breast milk or formula through a tube (called gavage feeding). The tube is inserted through the baby’s nose or mouth, down the back of the throat, through the esophagus and into the stomach. This tube usually stays in place between feedings and doesn’t bother your baby. You feed your baby by pouring breast milk or formula into a syringe and inserting it into your baby’s feeding tube. If your baby is not able to take in enough food by mouth for an extended period, she may need to be fed in a similar way through an opening (gastrostomy) in her stomach, which has a small plastic feeding tube attached to it.
Most babies are breathing on their own before they go home. But a few babies need additional oxygen for a while. The most common reason babies need oxygen at home is a lung disorder called bronchopulmonary dysplasia (BPD). Babies who have had severe respiratory distress syndrome (RDS) and have required prolonged treatment with mechanical ventilation and oxygen are at risk for BPD. The lungs often heal over the first two years of life.
If your baby needs oxygen, you will need stationary and portable oxygen tanks (there are several different types, depending on your baby’s needs) and nasal cannula (soft plastic tubing that goes around the baby’s head) at home. The cannula has openings (prongs) that go slightly into a baby’s nose.
The hospital may arrange for a home health nurse to visit your home to check on the baby and to be on call to answer your questions or concerns. If this isn’t arranged, speak to the NICU social worker or your baby’s health care provider to see if this is possible. As the baby’s lungs heal, and breathing becomes easier, the amount of oxygen will be gradually decreased, then discontinued.
If your baby does go home on oxygen, it is important that you observe several safety measures. Oxygen is very flammable, meaning that even a small spark can start a big fire. No smoking, burning fire or sparks, including gas stoves, should ever be in the same room as the oxygen tank.
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