The movement of an arm or leg away from the midline of the body. Abduction of both legs spreads the legs. The opposite of abduction is adduction; adduction of the legs brings them together.
A condition caused by the accumulation of waste acids in the body. These acid products may result from breathing problems – respiratory acidosis; or poor function in other systems – metabolic acidosis.
Also known as “corrected age.” This is your child’s chronological age minus the number of weeks he or she was born early. For example, if your 9-month-old was born 2 months early, you can expect him or her to look and act like a 7-month old. Usually you can stop age-adjusting by the age of 2 or 3.
A medication used to stimulate an infant’s central nervous system. It is prescribed to reduce the incidence of apneic episodes. This is the intravenous form; the oral form is known as Theophylline.
A condition in which the red blood cells in the blood—measured by a hematocrit, or “crit”—are lower than normal. Red blood cells carry oxygen and carbon dioxide to and from tissue
A numerical summary of a newborn’s condition at birth based on five different scores, measured at 1 minute and 5 minutes. (Additional measurements are made every five minutes thereafter if the score is less than 7 at five minutes, until the score reaches 7 or greater.) Premature infants generally have lower scores than full-term infants, but the Apgar score does not accurately predict future development.
A baby whose birth weight falls within the normal range for his or her gestational age.
A steroid medication given to the mother before birth to help the baby’s lungs mature more quickly. It is most effective if it is given more than 24 hours before delivery. Betamethasone also helps intestines, kidneys and other systems to mature.
Yellow chemical that is a normal waste product from the breakdown of hemoglobin and other similar body components. The placenta clears bilirubin from the fetus’s blood, but after delivery this task belongs to the infant. It usually takes a week or more for the newborn’s liver to adjust to its new workload. When bilirubin accumulates, it makes the skin and eyes look yellow, a condition called jaundice.
A blood test used to evaluate an infant’s level of oxygen, carbon dioxide and acid. This test is significant because it helps to evaluate an infant’s respiratory status.
A blood test that measures how well the kidneys are functioning.
An abnormally low heart rate. Bradys are usually associated with apnea in premature infants. During these spells the infant will stop breathing for at least 15 seconds and the heart rate will start to slow, also referred to as an “A&B spell.” Gentle touching or other stimulation almost always restarts the breathing and increases the heart rate. Medications (theophylline or caffeine) are often used to treat these spells in newborn babies.
A hearing test where a tiny earphone is placed in the baby’s ear to deliver sound. Small sensors, taped to the baby’s head, send information to a machine that measures the electrical activity in her brain in response to the sound. Premature babies are at increased risk of hearing problems, but early detection can prevent speech and language problems.
Type of intravenous tube used to give fluids and medications to infants or children. The catheter is placed in a major vein of the body during surgery. The BROVIAC® catheter is designed to stay in place over many months, if needed. There are other types of catheters with different names, all of which serve the same function.
A central nervous system stimulant that’s used to treat certain breathing problems in some preemies. This medication is given intravenously.
A patient advocate who coordinates health services and home care with the insurance company during hospitalization.
The central venous line (CVL), also called the central venous catheter (CVD), is a type of intravenous tube used to give fluids and medications. The catheter is placed in a major vein of the body during surgery or by insertion through a vein in the arm, leg or head.
Fluid (produced by the ventricles of the brain) that circulates around the spinal column and brain.
The registered nurse who has general responsibility for coordinating the nursing care of all babies in a unit for a particular shift. Nursing shifts may be either 8 or 12 hours.
Supplemental oxygen or room air delivered under pressure though either an endotracheal tube (tube that goes directly into the infant’s lungs) or small tubes or prongs that sit in the nostrils. Delivering oxygen under pressure helps keep air sacs in the lungs open and also helps maintain a clear airway to the lungs. Nasal CPAP (NCPAP) is commonly used immediately after removing the endotracheal tube to treat apnea and/or prevent the need for an endotracheal tube and ventilator.
Slang for hematocrit, this is a test used to determine the percentage of red blood cells compared to total blood volume. It is commonly used to test for anemia. It is significant in that is helps show a baby’s ability to supply oxygen to his or her organs and tissues.
Major and minor social, emotional, physical, and cognitive skills acquired by children as they grow up.
A term used to describe infants and toddlers who have not achieved skills and abilities which are expected to be mastered by children of the same age. Delays can be in any of the following areas: physical, social, emotional, intellectual, speech and language and/or adaptive development, sometimes called self-help skills, which include dressing, toileting, and feeding. Many developmental delays can be overcome with early intervention programs.
Planned use of physical therapy and other interventions in the first few years of a child’s life to enhance the child’s development.
Ultrasound picture of the heart. This is a painless, non-invasive procedure that takes accurate pictures of almost all parts of the heart. Many preemies have a cardiac ultrasound if the doctor is looking for evidence of a patent ductus arteriosus.
Puffiness or swelling, usually because of fluid retention in the body tissues.
A test that records the electrical activity of the heart. It can show abnormal rhythms (arrhythmias or dysrhythmias) or detect heart muscle damage.
Tube placed through the mouth or nose into the throat and the child’s trachea (windpipe). This tube provides a secure pathway through which air can be circulated to the lungs.
This long name means “oxygenation outside the body.” It’s used for babies whose lungs are not working properly (i.e., transferring oxygen into the blood and removing carbon dioxide) despite other treatments. The ECMO takes over the work of the lungs so they can rest and heal. It’s similar to the heart-lung bypass used during some types of surgeries.
A baby born weighing less than 2 pounds, 3 ounces (1,000 grams). Also known as a “micropreemie.” See also Very Low Birth Weight and Low Birth Weight.
Removing the Endotracheal Tube (ET Tube) from the baby’s windpipe.
The soft spot on the top of the head. At birth the skull is made of up of several plates of bone; it is not a single, solid bone. The spaces between the bone plates allow the skull to expand as the brain grows. Where four of these bony skull plates come together it forms a soft spot in the skull called a fontanelle. There is no bone in these soft spots, making these areas softer than the surrounding areas. There are usually two soft spots in the skull of a newborn, the anterior and the posterior fontanelle; both usually close by about 18 months of age.
Feeding a baby through a nasogastric (NG) tube. Also called tube feeding.
The period of development from the time of fertilization of the egg, until birth. Normal gestation is 40 weeks; a premature baby is one born at or before the 37th week of pregnancy.
The basic unit of weight in the metric system (28 grams = one ounce).
A newborn’s reflexive grab at an object, such as a finger, when it touches her hand. This grasp may be strong enough to support the infant’s own weight, but doesn’t last very long. This reflex lasts until a baby is 3 or 4 months old. Newborns have many naturally occurring reflexes.
Test to examine the hearing of a newborn infant.
A noise heard between beats of the heart. Innocent, functional heart murmurs are common and often heard in infants and toddlers.
Pricking the baby’s heel to obtain small amounts of blood for testing.
A material in red blood cells that carries oxygen and contains iron.
A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator (420 BPM, or Breaths Per Minute).
A special ventilator capable of breathing for a baby at rates exceeding those of a normal ventilator (for example, 120 - 1,320 BPM, or Breaths Per Minute).
A special form of mechanical ventilation, designed to help reduce complications to preemies’ delicate lungs.
Another name for respiratory distress syndrome (RDS).
Abnormal accumulation of cerebrospinal fluid within the ventricles of the brain. It is sometimes known as “water on the brain.” Within the center of our brains each of us has two fluid-filled areas called cerebral ventricles. Cerebrospinal fluid is made within these ventricles and distributed over the surface of the brain and spinal cord. When the normal circulation of cerebrospinal fluid is interrupted, fluid can accumulate within the ventricles. This fluid puts pressure on the brain, forcing it against the skull and enlarging the ventricles. In infants, this fluid accumulation often results in bulging of the fontanelle (soft spot) and abnormally rapid head growth. The head enlarges because the bony plates making up the skull have not yet fused together. In preemies the most common cause of hydrocephalus is intraventricular hemorrhage.
Another name for jaundice.
Refers to the amount of fluids given by oral feedings and/ or by IV, and the amount of fluid excreted in the urine or stools.
An acronym for the Individuals with Disabilities Education Act, which provides grants to states to support services, including evaluation and assessment, for young children who have or are at risk of developmental delays/disabilities.
Something which happens spontaneously or from an unknown cause.
Puncture or hole in the last part of the small bowel (ileum). This usually occurs spontaneously in extremely premature babies. Its cause is unknown. Often an ileal perforation requires surgery to form an ileostomy and to repair the hole in the bowel. Some NICUs have reported success simply by putting a piece of drainage tubing into the abdomen to drain out the infection and let the perforation seal on its own.
Another name for an isolette.
A written statement for an infant or toddler developed by a team of people who have worked with the child and the family. The IFSP describes the child’s development levels, family information, major outcomes expected to be achieved for the child and family, the services the child will be receiving, when and where the child will receive these services, and the steps to be taken to support the transition of the child to another program.
A drug sometimes given to close a patent ductus arteriosus.
Bleeding within the skull. Bleeding most often occurs within the ventricles of premature infants, but it can occur anywhere within or on the outside of the brain.
A condition in which the fetus doesn’t grow as big as it should while in the uterus. These babies are small for their gestational age, and their birth weight is below the 10th percentile. IUGR can be caused by decreased blood flow to the placenta, maternal hypertension, drug use, smoking, poor weight gain, dieting during pregnancy, pre-eclampsia, alcoholism, multiple fetuses, abnormalities of the cord or placenta, prolonged pregnancy, chromosomal abnormalities, or a small placenta.
A catheter (small tube) placed directly through the skin into the vein in a baby’s hand, arm, foot, leg or scalp. Nutrients, fluids and medications can flow through this tube. Using an IV is a common route for delivering fluids to newborns and other patients. Babies’ veins are very fragile, so the location of the IV may need to be changed frequently.
Inserting a tube into the trachea (windpipe) through the nose or mouth to allow air to reach the lungs.
Also known as an incubator, an isolette is a clear plastic, enclosed bassinet used to keep prematurely born infants warm. Preemies often loose heat very quickly unless they are put in a protected thermal environment. The temperature of the isolette can be adjusted to keep the infant warm regardless of the infant’s size or room temperature.
Skin-to-skin contact between parent and baby. During kangaroo care, the baby is placed on the parent’s chest, dressed only in a diaper and sometimes a hat. The baby’s head is turned to the side so the baby can hear the parent’s heartbeat and feel the parent’s warmth. Kangaroo care is effective, but it’s limited to babies whose condition is not critical.
The fine, downy hair that often covers the shoulders, back, forehead, and cheeks of a prematurely born newborn. Lanugo is replaced by more normal appearing hair toward the end of gestation.
A baby whose birth weight exceeds the normal range for the gestational age.
Wires connecting the sensors on the baby’s chest to the vital signs monitor.
A marker of the level of infant care a NICU can provide, usually expressed as I, IIa/IIb, or IIIa/IIIb/IIIc. Click here for an explanation of the different levels.
A baby born weighing less than 5 1/2 pounds (2,500 grams) and more than 3 pounds, 5 ounces (1,500 grams). See Very Low Birth Weight.
Also known as a “spinal tap,” this test involves inserting a hollow needle in between the vertebrae of the lower back to collect a sample of cerebrospinal fluid.
Imaging technique that uses powerful magnets and computers to produce a detailed picture of tissue.
A dark green, sticky mucus, a mixture of amniotic fluid and secretions from the intestinal glands, normally found in infants’ intestines. It is the first stool passed by the newborn. Passage of meconium within the uterus before birth can be a sign of fetal distress. The meconium is very irritating to the lungs.
Respiratory disease caused when babies inhale meconium or meconium-stained amniotic fluid into their lungs; characterized by mild to severe respiratory distress.
Machine that displays and often records the heart rate, respiratory rate, blood pressure and blood oxygen saturation of the baby. An alarm may sound if one or a number of these vital signs are abnormal. For example, in a normal infant the heart rate is usually between 120 and 180 beats per minute and oxygen saturation should be above 90%. False alarms are common, as abrupt movements can cause the monitor to register inaccurate readings—a good general rule of thumb is “Look at the baby, not the monitor.”
A newborn reflex. The automatic response to loud noises or sudden movements in which a newborn will extend his arms and legs, arch his back, and sometimes cry out. Newborns can have this reaction even during sleep, but lose it after a few months.
Gross motor skills are the movements that use the large muscles in the arms, legs, and torso, such as running and jumping. Fine motor skills are the small muscle movements used to grasp and manipulate objects, like picking up a Cheerio or using a crayon.
Many different areas of expertise or specialization coming together to provide comprehensive care. Examples include medicine, nursing, pharmacy, social work, physical therapy and respiratory therapy.
Light, flexible tube used to give supplemental oxygen to a child. Oxygen flows through two prongs extending into the nostrils.
Narrow, flexible tube inserted through the nostril, down the esophagus, and into the stomach. It is used to give food or to remove air or fluid from the stomach.
A nebulizer humidifies air and/or oxygen that is passed to the infant. At home, a nebulizer is a way of delivering medication—it transforms medicine into droplet form for inhalation. Used for a variety of lung problems.
Swelling, tenderness and redness of the intestine caused by an infection or decreased blood supply to the intestine. The seriousness of NEC varies: it may injure or destroy parts of the bowel, or it may affect only the innermost lining or the entire thickness of the bowel.
A special care nursery for preemies and newborn infants with severe medical complications. They are cared for by neonatologists and nurses with specialty training.
A term used to describe an infant during the first 30 days of life.
A pediatrician who has received 4-6 years of training after medical school in preparation for treating premature or sick newborns. This is the person who usually directs your baby’s care if hospitalization in an NICU is required.
An abbreviation for a Latin term that means “nothing by mouth”—i.e., no food or water.
A birth defect in which the intestines (and sometimes other abdominal organs such as the liver) come through an opening in the navel.
Machine monitoring the amount of oxygen in the blood. A tape-like cuff is wrapped around the baby’s toe, foot, hand or finger. This machine allows the NICU staff to monitor the amount of oxygen in the baby’s blood without having to obtain blood for laboratory testing.
A clear plastic box that fits over a baby’s head and supplies him or her with oxygen. This is used for babies who can breathe on their own, but still need some extra oxygen.
Solution put directly into the bloodstream, giving necessary nutrients, such as protein, carbohydrates, vitamins, minerals, salts, and fat. Other names for this are hyperal, total parenteral nutrition (TPN) and intravenous feedings.
The ductus arteriosus is a blood vessel connecting the pulmonary artery and the aorta. Before birth, this vessel allows the baby’s blood to bypass the lungs because oxygen is supplied by the mother through the placenta. The ductus arteriosus should close soon after birth. If it does not, it is called a patent (open) ductus arteriosus, or PDA. A PDA may be treated either with medication or surgery.
Irregular breathing pattern marked by pauses for as long as 10 to 20 seconds. This is common in both premature and full-term babies and does not usually mean there is a problem.
High blood pressure in the lungs, which causes the small blood vessels in the lungs to become progressively narrower. It can lead to breathing problems and reduced levels of oxygen in the blood. Sometimes treated with nitric oxide, a gas naturally produced by the body that can help expand blood vessels.
Light therapy to treat jaundice. Bright blue fluorescent lights, called bililights, are placed over the baby’s incubator. Treatment usually lasts between 3-7 days.
A special IV line used to provide fluids into a vein. A PICC line is usually very stable and lasts longer than a typical IV.
A sleep study, monitoring the baby’s breathing and heart rate during sleep to detect any abnormal breathing patterns.
When air from the baby’s lungs leaks out into the space between the baby’s lungs and chest wall. While small leaks may cause no problems and require no treatment, larger leaks may cause serious complications such as lung collapse and may need to be repaired with surgery.
A baby born three or more weeks before the due date.
A condition occurring in infants on ventilators that results in the formation of “bubbles” around the tiny air sacs (the alveoli) of the lungs. These “bubbles” may interfere with normal lung function.
Respiratory problems due to lung immaturity. Respiratory distress is a much more inclusive term meaning simply that the child is having problems breathing. Respiratory distress syndrome is a specific condition that causes respiratory distress in newborn babies due to the absence of surfactant in the lungs. Without surfactant, the alveoli (air sacs) collapse when the baby breathes out. These collapsed air sacs can only be reopened with increased work at breathing. Most newborn babies do not have a normal amount of surfactant in their air sacs until 34 to 36 weeks’ gestation. However, some very premature infants (27 to 30 weeks’ gestation) will have adequate surfactant production and function and some full-term infants (37 to 40 weeks’ gestation) will not.
An abnormal sucking in of the chest during breathing, indicating that the baby is working too hard to breathe.
An old name for retinopathy of prematurity.
The air we normally breathe, which contains 21% oxygen. When supplemental oxygen is given for respiratory problems, it is in concentrations higher than 21%.
An instinctive reflex in newborn infants that causes them to turn their head to the side when their cheek is stroked. This reflex helps infants learn how to eat. By gently stroking the cheek, your baby will turn his or her head toward you with an open mouth ready to feed.
Term for blood oxygen saturation.
A “short-circuiting” of electrical impulses in the brain, resulting from a variety of causes. Seizures can generally be classified as either “simple” (no change in level of consciousness) or “complex” (when there is a change in consciousness). Seizures may also be classified as “generalized” (the baby’s whole body is affected) or “focal” (only one part or side of the body is affected).
A baby whose birth weight is less than the normal range for the gestational age.
Trained professional who helps coordinate social services available to families and also helps families understand and use their insurance coverage. They can help families access services available through governmental and private agencies. Some social workers also act as counselors for parents undergoing personal or family stress while their baby in a NICU.
Another name for an ultrasound.