The NICU team

Different professionals are working together in a neonatal intensive care unit (NICU) to provide the best possible care and support to a preterm born or ill newborn baby and the parents. They received a special training in neonatology and other related fields to best fit to the individual needs of the baby.

Typically, most of the doctors at a NICU are neonatologists. They have completed a fellowship training in neonatology and residency training in paediatrics. Therefore, neonatologists are specialised in the care of ill and preterm babies. There may also be fellows (who completed a residency in general paediatrics and receive training in neonatology) or residents and medical students in different stages of their training. Parents can contact the neonatologist in charge of their baby for specific questions about the therapy, the health status and the progress made by their baby.

The neonatal team sometimes involves other physicians for specific medical questions, e.g., paediatric surgeons, who are specialised in the diagnosis and care of conditions that require children’s surgery.

Again, paediatric surgery fellows or residents, who are in training, can also be part of the team.

A medical doctor, who is called radiographer takes x-rays or uses ultrasound, also called sonography, to see internal body structures, e.g., organs or vessels.

An ophthalmologist is a medical doctor, specialised in the diagnosis and treatment of eye conditions. All newborn babies receive routine eye examinations. Because preterm born children have a higher risk to develop retinopathy of prematurity (ROP), which is a disease of the retina of the eye, they are routinely tested for this condition.

 

Nurses and midwives at the neonatal intensive care unit (NICU) have received special training in caring for ill and preterm born babies. Their day-to-day work includes monitoring the baby, administering infusions and drugs, and taking over the daily care of the child until the parents are ready for it. They are responsible for educating the parents in taking care for their baby. They spend a lot of time at a baby’s bedside and with the families. Nurses and midwives at the NICU may be at different stages of their training.

While students undertake their education and training at the moment, a registered nurse or midwife specialist has already received advanced training. There are usually nurse or midwife managers with overall responsibility for the nursing team. The different educational levels and job titles differ between countries.

A nurse assistant may help and support nurses and midwives, e.g., by changing bed sheets, equipping the child care unit, and preparing food.

 

Lactation specialists are allied healthcare professionals who are trained in the clinical management of breastfeeding. They can support parents to breastfeed by giving information and teaching suitable techniques. Lactation specialists help parents to find the optimal solution to provide breastmilk to the baby.

A dietitian, also called nutrition specialist or nutritionist, is a professional who is educated and trained in nutrition. He or she has special knowledge about human milk, nutritional supplements, and formulas which are used in the NICU. Additionally, their day-to-day work includes the monitoring of what babies are fed, how their bodies respond to the food, and how they grow.

 

In some units, nurses or midwives with advanced training offer their help to families who need to prepare for discharge from hospital to home. When the time for discharge is approaching they inform the healthcare team and the parents about what is left to do, e.g., train parents how to bath their child.

They provide counselling to the parents and support to strengthen their self-confidence. Additionally, they help to coordinate equipment needed after discharge, e.g., tools for oxygen therapy or home monitors.

 

Parents may experience many different feelings when they have a baby in the NICU. They may have trouble dealing with the difficult situation of their baby as well as with the complex hospital system. There are different options for parents and family members to receive support at the NICU from different professionals.

A psychologist is a professional who provides mental health care to parents and other family members. Psychologists can help families to cope with the difficult situation of having a preterm born or ill newborn child. They help to get in contact with the baby and support parents to understand and deal with their feelings.

Sometimes they also offer to stay in contact with the family after discharge or recommend an established psychologist.

Social workers are specialised in individual, family, or group counselling and family education.

They can provide parents with regional or hospital based support groups. Additionally, they can recommend community resources and services if they need financial support, home healthcare, or home support.

Members of the chaplaincy, or spiritual care department, can offer spiritual support to patients, families, and the NICU team if they wish to.

Consultants on ethics can help parents who have questions or concerns about ethical or moral issues with regard to their baby’s therapy.

Sometimes hospitals provide patient representatives who can act as advocates on behalf of the patient, the parents, and the family.

 

Various therapists may be part of the NICU team caring for a preterm born or ill newborn baby. They provide direct patient care and consultative services to support optimal development.

Physiotherapists are sometimes involved in assessing the infant’s activity level and the risk of developmental problems. They may also provide respiratory care, counselling for parents and the NICU team regarding positioning and handling, and neurodevelopmental therapy or rehabilitation if needed.

Speech and language therapists are trained and educated in human communication and swallowing disorders. They can be involved in the assessment and interventions for breastfeeding and nutrition of the baby.

An occupational therapist can support the baby and the parents in their daily activities including bonding, care, and exploring the environment. They train the parents how they can help their baby be comfortable and support his or her development.

Some units also offer music therapy to babies in the NICU. A music therapist can support parents to sing or make music for their child. This intervention can for example help to reduce stress, promote the bonding process, and facilitate communication between parents and their baby.

If a child needs therapy after discharge from hospital, the team of therapists can help to create a plan to continue these services.