Neonatal care unit – Glossary of terms

Learning the language of the NICU (neonatal intensive care unit)  not only helps your understand the progress that your baby is making as you journey through the NICU together, it also gives you the tools to parent your precious baby as his/her primary caregiver.  I was never without my journal and pen while I was in the NICU with my daughter Amelia and every time I heard a word I didn’t understand I would either ask a staff member to explain the word to me if they were free to talk or I would jot down the word in my journal and ask for an explanation later.  Here’s a glossary of terms that I compiled during my time in the NICU:-

A

adjusted age (or corrected age): the age your baby would be if she had been born on her due date.

air sacs: small structures in the lungs where oxygen is delivered to the blood and carbon dioxide is removed.

anaemia: abnormally low concentrations of red blood cells or haemoglobin in your baby’s blood.

antibodies: protein substances in the blood which attack any foreign substances, such as bacteria, viruses or transplanted organs.

aorta: the main artery leaving the heart.

apgar score: an evaluation of your newborn baby based on five criteria: heart rate, respiratory effort, muscle tone, response to stimulation and skin color. Each criteria is scored 0-2, for a best possible score of 10.

apnoea: a pause in breathing that lasts 20 seconds or longer.

asphyxia: decreased oxygen in the body, accompanied by rising carbon dioxide levels. This condition can cause serious injury to your baby.

aspiration: breathing any foreign substance into the lungs usually milk or meconium. Aspiration is also used to describe when milk is deliberately drawn up from the stomach by the NICU staff-this can be done to test if a feeding tube is in the correct position.

audiologist: a medical professional who diagnoses and treats hearing problems.

B

bagging: a type of respiratory support in which a bag attached to a mask that covers your baby’s nose and mouth is used to pump air and/or oxygen into the lungs.

bayley scales of infant and toddler development: Developmental assessment scale measuring cognitive, language, motor and behavioural/emotional development

bethmethasone: corticosteroid administered to you before your baby is born to stimulate their lungs to mature and decrease the frequency of intracranial haemorrhage  (brain bleed) in your baby.

bililights (phototherapy): special light treatment if your baby is suffering from jaundice : your baby  is placed under special fluorescent lights that break down the bilirubin ( a blood component responsible for the jaundice) so it can be eliminated from the body.

bilirubin: a breakdown product of red blood cells. Excessive amounts may cause yellowing of the skin, or jaundice.

blood gas analysis: a blood test to determine the levels of oxygen, carbon dioxide, and acidity in your baby’s blood.

blood pressure: the pressure the blood exerts against the walls of the blood vessels. This pressure allows the blood to flow through the vessels.

blood sugar: the concentration of glucose in your baby’s blood.

blood transfusion: administration of blood from a healthy donor to a patient.

bonding: the process of a parent and child becoming emotionally attached.

BPD: see “bronchopulmonary dysplasia”.

bradycardia: a slower-than-normal heart rate rate for that individual.

brain bleed: see “intraventricular haemorrhage”.

breastmilk fortifier (BMF): a powder that can be added to breastmilk for your premature baby. BMF contains energy, protein, vitamins and minerals to help growth.

breastpump: a machine to collect breastmilk . Hospital grade pumps are more powerful than those for home use and are available for rent.

bronchioli: the passageways by which the air passes through the nose or mouth to the air sacs of your baby’s lungs.

bronchiolitis: inflammation of the small airways in the lungs.

bronchopulmonary dysplasia (BPD): chronic breathing problems arising from lung tissue damage due to artificial pulmonary ventilation. Children who require respirator support and/or supplemental oxygen for more than 28 days are at increased risk of developing BPD.. Also known as chronic lung disease (CLD).

C

cannula: a narrow, flexible tube with prongs used to deliver oxygen into your baby’s nose.

cardiopulmonary resuscitation (CPR): a method of reviving a person whose breathing and heartbeat have stopped or slowed abnormally.

catheter: a narrow, flexible tube used to either administer fluids to the body or to drain fluids from your baby’s body.

central line: A small plastic tube that is placed in a large blood vessel near the heart, to deliver intravenous feedings and medications. A central line can avoid many needle sticks for your baby, when long-term care is needed.

chronic lung disease (CLD): chronic breathing problems arising from lung tissue damage due to artificial pulmonary ventilation. Children who require respirator support and/or supplemental oxygen for more than 28 days are at increased risk of developing BPD.Also known as bronchopulmonary dysplasia (BPD).

chronological age: age based on date of birth.

congenital: present at and existing from the time of birth.

congenital diaphragmatic hernia: birth defect involving an opening in the diaphragm, the large muscle that separates the chest from the abdomen. Abdominal organs such as the stomach, liver and intestines can move through the opening into the chest where they interfere with lung development.

colostomy: a opening in the abdominal wall (surgically-created) that permits the colon (the lower section of the large intestines) to empty directly into a waste bag outside the body.

colostrum: the thin, yellowish fluid secreted from the breasts before the mother’s milk comes in. This fluid is rich in antibodies, which provide protection against infection to the newborn.

computed tomography (CT or CAT scan): Imaging technique that produces precise pictures of tissue using a narrow beam of radiation and computers.

contagious: ability to transmit infection from one person to another.

continuous positive airway pressure (CPAP): a respiratory support method that delivers a constant flow of air into your baby’s lungs to keep the air sacs open after each breath.

corrected age: the age your baby would be if she had been born on her due date.

CPR: see “cardiopulmonary resuscitation”.

cyanosis: blueish colour for the skin usually caused by reduced oxygen levels.

cytomegalovirus (CMV): a viral infection that when contracted by a pregnant woman can result in  newborn illness and can sometimes lead to chronic disabilities such as intellectual disability or vision and hearing loss. CMV can also be acquired after birth and lead to hearing loss.

D

developmental milestones: important points in your baby’s development, such as crawling, walking and talking.

developmental problems: failure to meet expected capabilities associated with age. May include gross and fine motor coordination (such as rolling over, sitting or picking up small objects with thumb and finger), social, communication, and learning disabilities.

diabetes: disorder of sugar metabolism. Early intervention: programs and services for children with developmental delays.

E

early intervention: programs and services for children with developmental delays.

echocardiogram: the use of ultrasound to evaluate the structure and function of your baby’s heart and great vessels.

electrocardiogram (ECG): a graphic recording of the electrical activity of your baby’s heart.

electroencephalogram (EEG): a graphic recording of the electrical activity of your baby’s brain.

endotracheal tube (ETT): a small tube placed into your baby’s trachea (windpipe) to allow air and/or oxygen to flow into the lungs, bypassing the nose.

enteral feeding: feeding into the gut. Can be given through the mouth as oral feeds, or through a tube as “tube-feeds”.

exchange transfusion: Special type of blood transfusion in which some of your baby’s blood is removed and replaced with blood from a donor; sometimes used to treat severe jaundice.

expressed breastmilk (EBM): breastmilk which has been expressed (pumped) either by hand or by pump.

extracorporeal  membrane oxygenation (ECMO): in babies this machine is used to allow the lungs to rest and recover from disease and medical conditions. ECMO is similar to the heart-lung bypass that is used in operating theatres for heart surgery but in newborns it is used for longer periods of time.

extubate:  removal of an endotracheal tube from your baby’s widepipe.

F

failure to thrive: the failure to gain weight as expected, which is often accompanied by poor height growth.

fever: a rise in body temperature.

fine motor skills: precise use of the hands and fingers.

foetal lung fluid: fluid made in the lungs before birth.

fontanelle: the soft spots between the bones of the skull of your baby.

full-term: a baby born after 37 completed weeks gestation.

G

Gastro oesophageal reflux disease (GORD): the flow of stomach contents up into the oesophagus, occasionally resulting in vomiting.

gavage feeding: see “nasogastric tube”.

gestation: the time spent in the womb between conception and delivery. Average gestation/pregnancy in humans is 40 weeks.

gestational age: the number of weeks from the first day of the last menstrual period and the date of birth.

glucose: a simple sugar that supplies the body with energy.

gram-negative organisms: a type of bacteria that may cause infection after entering your baby’s body through a respirator tube or during the process of delivery.

Group B Strep Infections (GBS): a type of bacterial infection that your may get from you during the birthing process.

gross motor skills: use of the large muscles of the body.

H

haematocrit: the percentage of blood volume consisting of red blood cells. Used as a measure of anaemia.

haemoglobin: the component of red blood cells that carries oxygen. Used to measure anaemia.

heel prick: procedure in which a tiny prick is made on the heel in order to get a sample of blood for laboratory analysis.

heel prick test: newborn bloodspot screening test that your babies have at 5 days of age to screen for certain metabolic/genetic medical conditions. This test is also called a Guthrie Test or PKU.

high-risk: a term used to describe persons or situations that require special attention and/or intervention to prevent a problem from worsening.

high-frequency ventilation: Special form of mechanical ventilation, designed to help reduce complications to delicate lungs.

humidification: this is when humidity inside the incubator is used to reduce water loss from the delicate skin of your baby.

hyaline membrane disease: see “respiratory distress syndrome”.

hydrocephalus: an abnormal accumulation of fluid in the chambers of the brain, characterized by an abnormal increase in head size hyperbilirubinemia: see “jaundice”.

hyperglycemia: High blood sugar levels.

hypertension: high blood pressure.

hypertonia: increased muscle tone.

hypoglycemia: Low blood sugar levels.

hypotonia: deficient muscle tone.

hypoxia: a lack of sufficient oxygen in the body.

I

ileostomy: a surgically-created opening in the abdominal wall that allows for a diversion of the intestine to drain stools into a waste receptacle bag. This procedure may be necessary with problems such as intestinal obstruction or necrotizing enterocolitis.

immunization: administration of a vaccine to induce the production of antibodies to protect against infection.

incubator: cot for keeping your premature baby in controlled conditions and protecting him/her from infection.

inflammation: the body’s response to injury; it may include pain, heat, redness and swelling.

infusion pump: a device attached to an intravenous line that carefully regulates the amount of fluid going into your baby’s bloodstream.

intracranial haemorrhage: abnormal bleeding into the chambers and possibly the surrounding tissue of your baby’s brain.

intrauterine growth retardation (IUGR): describes babies who are lighter in weight than would be expected for their age/gestation.

intravenous (IV): delivery of fluids, nutrition and/or medication directly into a vein.

intraventricular haemorrhage (intracranial haemorrhage or brain bleed): abnormal bleeding into the chambers and possibly the surrounding tissue of your baby’s brain.

intubation: the insertion of a tube into your baby’s trachea (windpipe) through the nose or mouth to assist with breathing.

J

jaundice: a yellow colouration of the skin caused by an elevation of bilirubin ( a breakdown product of red blood cells) in your baby’s blood.

K

kangaroo care: a technique of placing your baby on your chest to enable skin-to-skin contact.

L

lactation consultant: a healthcare professional who can provide practical tips about expressing and breast-feeding.

lanugo: fine, soft, lightly-colored hair covering the body of your baby in the womb and and some premature babies at birth.

level 1, 2, 3: levels of neonatal care in the hospital include Level 1, Level 2 and Level 3 : Level 3 being for the care of those babies who require a high level of specialized care.

lower oesophageal sphincter: the muscle at the junction of the oesophagus and stomach. It is normally closed except during swallowing, vomiting, and burping.

lower respiratory tract (lower airway): the parts of the breathing system referring to the trachea (wind pipe), the two bronchial tubes (one to each lung), the bronchioles and the lungs. In essence the tracts for breathing above the shoulders.

lumbar puncture: a diagnostic procedure in which spinal fluid is withdrawn with a needle, inserted between two lumbar vertebrae into the area containing spinal fluid.

M

magnetic resonance imaging (MRI): Imaging technique that uses powerful magnets and computers to produce a detailed picture of tissue.

mechanical ventilation: Using a mechanical ventilator to breathe for your baby while his/her lungs recover.

meconium aspiration syndrome: Breathing problems that occur when your baby inhales meconium (fetal stool) during labor and delivery. The stool usually is released shortly before or after birth.

meconium: dark green fecal material in your baby’s first bowel movement, excreted at or near delivery.

monitor: a machine that records information such as heartbeat, body temperature, respiration rate, and blood pressure.

monoamniotic twins: Monoamniotic twins are the result of the egg splitting after the placenta and amniotic sac have formed, resulting in the embryos sharing both.  This type of pregnancy will be closely monitored as the babies are at increased risk of premature delivery and cord complications.

moro reflex: a normal reflex of young babies: a loud noise causes your baby to stretch out the arms and flex the legs.

N

nasal canula: Soft plastic tubing that goes around your baby’s head and under his/her nose, where there are openings (prongs) to deliver oxygen.

nasal prongs: Small plastic tubes that fit into or under your baby’s nose to deliver oxygen.

nasogastric tube (NG tube): a narrow, flexible tube that is inserted through the nostrils, down the oesophagus, and into the stomach, used to deliver nourishment to or to remove air or fluid from the stomach.

nebulizer treatment: a method of delivering medication by transforming medicine into droplets for inhalation.

necrotizing enterocolitis (NEC): a disease of the intestinal tract, caused by inflammation of the intestinal tract or decreased blood supply to the bowel. This complication in premature babies generally improves, but can lead to serious complications.

neonatal abstinence syndrome (NAS): a condition in which your baby exhibits withdrawal features- irritability, unsettled , restless, crying and feeding issues.  It occurs when a mother has a history of drug abuse during pregnancy.  These features can last for up to 6 weeks or more.

neonatal intensive care unit (NICU): a special section of a hospital (usually a large regional hospital) that provides intensive care for newborn babies.

neonatal period: the first 28 days of life.

neonatologist: a doctor who specializes in the medical care and development of premature babies and sick newborns.

neonatology: branch of paediatric medicine which deals with newborn babies.

neurologist: a doctor  specializing in the diagnosis and treatment of diseases of the nervous system.

NICU: neonatal intensive care unit.

nitric oxide: gas delivered into your baby’s lungs to improve oxygenation in extremely sick babies.

noninvasive: description of a procedure that does not require injection, incision, or insertion into a part of the body.

nosocomial infections: hospital-acquired infectious diseases.

O

occupational therapist: a medical professional who specializes in helping with developmental tasks involving the use of the arms, hands, mouth and tongue.

ophthalmologist: a medical doctor who can diagnose and treat injuries or defects of the eyes, including prescribing glasses and medications, and performing surgery.

orogastric tube (OG tube): a narrow, flexible tube that is inserted through  your baby’s mouth, down the oesophagus, and into the stomach, used to deliver nourishment or to remove air or fluid from the stomach.

ototoxic antibiotics: drugs used to fight infections that have the potential to cause hearing problems.

oxygen hood: a plastic box placed over your baby’s head to allow accurate control of oxygen.

oxygen therapy: any method of delivering supplemental oxygen to your baby.

P

parenteral nutrition (hyperalimentation): delivering nutrition directly into your baby’s bloodstream, providing necessary nutrients such as carbohydrates, electrolytes, protein, minerals, vitamins, and fat without using the digestive tract.

patent ductus arteriosus (PDA): a condition in which the blood vessel that connects the aorta (the main artery of the body) and the pulmonary artery (the artery that brings blood to the lungs) does not close as it should shortly after birth.

percutaneous line/percutaneous central catheter: a long catheter placed into a central vein, with the catheter tip extending further into the body into a large central vein. A PICC does not have to be replaced as often as an IV line.

perforated bowel: a hole in the intestine.

perinatal period: the time immediately preceding, during, and after birth, typically from the 28th week of pregnancy through 7 days following delivery.

persistent pulmonary hypertension of the newborn (PPHN): High blood pressure in the lungs, leading to breathing problems, and reduced levels of oxygen in the blood.

periventricular leukomalacia: changes, usually small cysts in brain tissue around the ventricles or fluid spaces of the brain.This cystic change is linked with an increased future risk of learning, vision or movement.

phototherapy (bililights): special light treatment for your baby with jaundice where he/she is placed under special fluorescent lights that break down the bilirubin so it can be eliminated from the body.

physical therapists: medical professionals who work with premature babies to help with their neuromuscular development. They are also often involved in follow-up developmental care.

plain film of abdomen (PFA): a PFA is an x-ray of the abdomen.

pneumonia: an infection of the lungs leading to breathing difficulty, coughing, chest pain and fever.

pneumothorax: When air from your baby’s lungs leaks out into the space between the lungs and chest wall. While small leaks may cause no problems and require no treatment, larger leaks may cause lung collapse and may need surgical repair.

premature (preterm): born before the 37th completed week of pregnancy.

prognosis: a forecast of the probable course and end of a disease.

pulmonary artery: the artery that carries blood from your babys heart to his/her lungs.

pulse oximeter: Small device that uses a light sensor to help determine your baby’s blood oxygen levels.

R

radiant warmer: a heat source for an open bed that warms your baby yet allows easy access.

red blood cells: the cells in your baby’s blood that carry oxygen.

respirator: a machine that assists your baby with breathing assistance by supplying and regulating a flow of air, oxygen, and air pressure introduced through a tube threaded through the nose or mouth, down the back of the throat, and into the trachea (windpipe).

respiratory distress syndrome (RDS): a breathing disorder in immature lungs caused by the lack of surfactant.

respiratory syncytial virus (RSV) disease: a respiratory infection caused by a virus that is very common and can have serious implications in babies born prematurely, with or without chronic lung disease, and infants with congenital heart disease.

retina: Lining at the rear of your baby’s eye that relays messages to the brain.

retinopathy of prematurity (ROP): a disease of the retina of the eye found primarily in premature babies.

Rh disease: Blood  incompatibility between the mother and baby in the womb that causes destruction of baby’s red blood cells.

S

sepsis: the presence of bacteria and/or their toxins in your baby’s bloodstream.

septic shock: a drop in the vital signs due to an infection throughout your baby’s body, due to a decrease in the function of the heart and other major organs.

small for gestational age/small for dates (SGA): SGA describes a baby who is born smaller than expected for their gestation.

shunt: a surgically implanted passage between two areas of the body, such as the ventriculoperitoneal shunt that drains fluid from the brain ventricles into the abdominal cavity of a child with hydrocephalus.

special care baby unit (SCBU): an alternative name for a neonatal unit.

spina bifida: Birth defect involving the spinal cord, resulting in varying degrees of paralysis, bladder and bowel problems. Affected babies may require surgery during the newborn period to close the back and prevent further nerve damage and infection; however, surgery cannot reverse nerve damage that already has occurred.

spinal tap (lumbar puncture): a diagnostic procedure in which spinal fluid is withdrawn with a needle, inserted between two lumbar vertebrae into the area containing spinal fluid.

stiffness: very tight muscles.

subarachnoid haemorrhage: bleeding in the area around the outside of your baby’s brain.

surfactant: a substance formed in your babys lungs that helps keep the small air sacs expanded and prevents them from collapsing.

syndrome: A combination of signs and symptoms that, when present together, are associated with a specific medical condition.

synthetic surfactant: a liquid administered directly into your baby’s lungs to correct a deficiency of natural surfactant, thereby avoiding significant respiratory problems.

T

tachycardia: Rapid heart rate.

therapeutic cooling (TC): TC is the cooling of your babys body temperature down to 33.5C. TC is an effective treatment in babys’ who have had an oxygen deficiency in or around the time of birth. The treatment is instituted for a total of 72 hours at the end of which your  baby is rewarmed and the body temperature brought back to 37C.

tonic neck reflex: one of the reflexes present at birth, also called the fencing reflex. Your newborn baby  will bend one arm while the other is extended away from the body, in the direction your baby is facing.

transfusion: administration of blood or blood products from a donor to a recipient.

transient tachypnea of the newborn (TTNB): rapid breathing that gradually improves in the first few hours or days after birth.

trophic feedings: breast-milk feedings given just a few drops a day to your baby until he/she is stable enough for a full breast-milk schedule. This helps the Gastro-intestinal tract to mature and produce enzymes for later feedings.

twin-to-twin transfusion syndrome (TTTS): a disease of the placenta that affects identical twin pregnancies. The shared placenta contains abnormal blood vessels that can convey blood from one twin to another resulting in a higher red blood cell count and sometimes better growth in one twin than another.

U

ultrasound (sonogram): a noninvasive diagnostic technique that produces images of organs by use of high-frequency sound waves.

umbilical catheter: a narrow, flexible tube inserted through a blood vessel in your baby’s belly button (umbilical cord).

upper respiratory tract (upper airway): the parts of the breathing system consisting of the nose, the nasal cavity and the throat. In essence the tracts for breathing above the shoulders.

V

ventilator: a machine to maintain a normal flow of air in and out of the lungs.

X

X-ray: a diagnostic technique that uses radiation to view internal body structures.

 

If you would like more information on premature baby’s please visit The Irish Neonatal Health Alliance  – www.inha.ie