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Treatments and drugs

By Mayo Clinic staff

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Illustration of intensive care for a premature baby Intensive care for your premature baby

At the hospital, the neonatal intensive care unit (NICU) provides round-the-clock care for your premature baby.

Supportive care
Specialized supportive care for your baby may include:

  • Being placed in an incubator. Your baby will probably stay in an enclosed plastic bassinet (incubator) that's kept warm to help your baby maintain normal body temperature. Later on, NICU staff may show you a particular way to hold your baby — known as "kangaroo" care — with direct skin-to-skin contact.
  • Monitoring of your baby's vital signs. Sensors may be taped to your baby's body to monitor blood pressure, heart rate, breathing and temperature. Caregivers may also use a ventilator to help your baby breathe.
  • Having a feeding tube. At first your baby may receive fluids and nutrients through an IV tube. Breast milk may be given later through a tube passed through your baby's nose and into his or her stomach (nasogastric or NG tube). When your baby is strong enough to suck, breast-feeding or bottle-feeding is often possible.
  • Replenishing fluids. Your baby needs a certain amount of fluids each day, depending upon his or her age and medical conditions. The NICU team will closely monitor fluid, sodium and potassium levels to make sure that your baby's fluid levels stay on target. If fluids are needed, they'll be delivered through an intravenous (IV) line.
  • Spending time under bilirubin lights. To treat infant jaundice, your baby may be placed under a set of lights — known as bilirubin lights — for a period of time. The lights help your baby's system break down excess bilirubin, which builds up because the liver can't process it all. While under the bilirubin lights, your baby will wear a protective eye mask.
  • Receiving a bood transfusion. Because your preemie may have an underdeveloped ability to make his or her own red blood cells, a blood transfusion may be needed to raise blood volume — especially if your baby has had several blood samples drawn for various tests.

Medications
Medications may be given to your baby to promote maturing and to stimulate normal functioning of the lungs, heart and circulation. Depending on your baby's condition, medication may include:

  • A liquid (surfactant), squirted into the lungs to help them mature
  • Fine-mist (aerosolized) or IV medication to strengthen breathing and heart rate
  • Antibiotics if infection is present or if there's a risk of possible infection
  • Medicines that increase urine output (duretics) to help the lungs and, sometimes, the circulation

Surgery
When specific complications arise, sometimes surgery is necessary to treat:

  • A feeding problem, by placing a central line to deliver IV nutrition
  • Necrotizing enterocolitis, by removing the damaged part of the intestines
  • Patent ductus arteriosus, when medications fail to work, by closing a blood vessel near the heart
  • Retinopathy of prematurity, by using a laser to reverse abnormal blood vessel development and limit further risks to vision
  • Worsening hydrocephalus, by placing a plastic tube, called a shunt, to drain excess fluid in the brain

Taking your baby home
Your baby is ready to go home when he or she:

  • Can breathe without support
  • Can maintain a stable body temperature
  • Can breast- or bottle-feed
  • Is gaining weight steadily

In some cases, a child may be allowed to go home before meeting one of these requirements — as long as the baby's medical team and family create and agree on a plan for home care and monitoring.

Your baby's health care team will help you learn how to care for your baby at home. Before discharge from the hospital, your baby's nurse or a hospital discharge planner may ask you about:

  • Living arrangements
  • Other children in the household
  • Adult relatives and friends to provide help
  • Primary pediatric care
Lifestyle and home remedies Tests and diagnosis
References
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  3. Robinson JN, et al. Risk factors for preterm labor and delivery. http://www.uptodate.com/home/index.html. Accessed Nov. 7, 2011.
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  13. Kingma PS. Care of the high-risk neonate. In: Bope ET, et al. Conn's Current Therapy. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5..C2009-0-38984-9--TOP&isbn=978-1-4377-0986-5&about=true&uniqId=236797353-5. Accessed Nov. 10, 2011.
  14. Matevosyan NR. Periodontal disease and perinatal outcomes. Archives of Gynecology and Obstetrics. 2011;283:675.
  15. Long CM, et al. Discharge planning for the high-risk newborn requiring intensive care. In: McInerny T, et al. American Academy of Pediatrics Textbook of Pediatric Care. Elk Grove Village, Ill.: American Academy of Pediatrics; 2009:709.
  16. In the NICU: Becoming an informed parent. March of Dimes. http://www.marchofdimes.com/printableArticles/inthenicu_informed.html. Accessed Nov. 14, 2011.
  17. In the NICU: Becoming a parent in the NICU. March of Dimes. http://www.marchofdimes.com/baby/inthenicu_confidence.html. Accessed Nov. 14, 2011.
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  19. Martin JA, et al. Births: Final data for 2006. National Vital Statistics Reports. 2009;57:1.
  20. Fenton TR. A new growth chart for preterm babies: Babson and Benda's chart updated with recent data and a new format. BMC Pediatrics. 2003;3:13. http://www.biomedcentral.com/1471-2431/3/13. Accessed Dec. 5, 2011.
  21. Stewart J. Care of the neonatal intensive care unit graduate. http://www.uptodate.com/home/index.html. Accessed Nov. 30, 2011.
  22. Weiner GM. Problems associated with premature birth. Working with the team. In: Zaichkin J. Newborn Intensive Care: What Every Parent Needs to Know. Ann Arbor, Mich.: Sheridan Books; 2009:223.
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DS00137 Dec. 29, 2011

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