When you are pregnant, you look forward to the day that you can bring your precious baby home. For some parents, this day doesn’t come right away – and it may take weeks or even months for their baby to come home. For a variety of reasons, some infants are admitted to the neonatal intensive care unit (NICU) for additional medical treatment and support after labour and delivery.
There are several factors that may lead to a newborn being admitted to the NICU. Premature babies often spend time in the NICU, as well as babies with anemia, apnea, bradycardia, bronchopulmonary dysplasia (BPD), hydrocephalus, cerebral palsy, jaundice, and respiratory distress syndrome. In addition, infants who experience complications during birth – such as birth asphyxia – may spend a period of time in the NICU.
Having a baby admitted to the NICU can be scary for new parents, but it is often the best place for an infant to get the type of specialized medical care that they need. If your baby is in the NICU due to birth injury, the Birth Injury Lawyers Alliance (BILA) is here for you. Reach out today to schedule a free consultation with a birth injury lawyer in your province.
What Is the NICU?
The Neonatal Intensive Care Unit is an intensive care unit for newborns. Just like an ICU for adults, the NICU provides specialized treatment for sick infants. Newborns can be in the NICU from birth to up to 6 months of age, after which time they typically move to the Pediatric Intensive Care Unit (PICU) if they need further care.
There are several levels of care in the NICU, based on the needs of the patient. The higher the NICU level, the greater the medical needs of the infant. The NICU levels include:
- Level I: also referred to as newborn nurseries, Level I NICUs provide basic care for premature infants (born before 37 weeks of pregnancy).
- Level II: also known as special care nurseries, Level II NICUs can provide moderate levels of care for babies born between 32 to 35 weeks gestation.
- Level III: at Level III NICUs, babies who need critical care due to serious medical conditions or being born before 32 weeks gestation are treated.
- Level IV: in Level IV NICUs, newborns and premature babies receive the highest level of medical care.
In the NICU, babies are cared for by teams of specialists. Depending on the level of care that they need, this may include a neonatologist, a respiratory therapist, a physical, occupational, and/or speech therapist, a lactation consultant, and a social worker. NICUs may also have a range of special equipment, such as:
- Infant warmers
- Incubators
- Phototherapy devices
- Monitors, including pulse oximetry (pulse ox), chest leads, temperature probes, and blood pressure monitors
- Feeding tubes and equipment
- IVs
- Ventilators
- Oxygen hoods or nasal cannulas
Seeing this equipment can be overwhelming for parents. However, it is important to remember that these healthcare professionals are working hard to ensure that your baby gets the medical treatment that they need.
Common Conditions Treated in the NICU
Both preterm and full-term infants may be in the NICU for any number of reasons. Some of the more common reasons for a baby to be in the NICU are listed below. We encourage you to talk to your baby’s care team for more information about your baby’s health condition.
Anemia
Anemia, or low red blood cells, is a type of blood disorder. It is often seen in premature babies and is diagnosed with a blood test. Severe cases are treated with blood transfusions, although more minor cases are monitored closely while any underlying causes are treated.
Apnea
Apnea occurs when a baby does not take at least one breath in 20 seconds. It is usually caused by prematurity, as the area of the brain that controls breathing may not be fully developed. It is usually treated by stimulating the baby when monitors alert the healthcare team that a baby is experiencing apnea.
Birth Injuries
Several types of birth injuries, such as hypoxic ischemic encephalopathy (HIE), cerebral palsy, and trauma from the use of forceps and vacuum, can lead to a baby being admitted to the NICU for various treatments, including cooling therapy. In many cases, these birth injuries are caused by medical negligence. They may cause developmental delays, behavioral issues, disability, and even death.
Bradycardia
Bradycardia is an abnormal slowing of the heart rate, which is often caused by other issues like low oxygen levels in the blood or apnea. It is diagnosed through monitoring and taking the baby’s pulse. It is treated by addressing the underlying cause, which may include treating a heart defect.
Bronchopulmonary Dysplasia (BPD)
BPD is one of the most common chronic lung diseases in infants, and it occurs when a baby needs oxygen at 4 weeks before their original due date, which can cause damage to the lungs. It can happen in both full-term and premature babies, although it is more common in preterm infants due to their immature lungs. It is often treated with steroids to decrease scarring in the lungs, diuretics to eliminate excess fluid, and bronchodilators to relax the muscles surrounding the airways. Babies with BPD may also need ventilators to help them breathe.
Hydrocephalus
Also known as water on the brain, hydrocephalus is caused by a buildup of cerebrospinal fluid in the area that surrounds the brain and spinal cord that happens when something blocks the flow of the fluid. Hydrocephalus can create pressure that leads to brain damage. In more serious cases, doctors may need to surgically place a shunt into the brain to drain the fluid.
Hypoglycemia
Hypoglycemia is low blood sugar. It is usually diagnosed shortly after birth by checking glucose (blood sugar) levels. Hypoglycemia is treated with early feeding and an intravenous (IV) glucose solution.
Intrauterine Growth Restriction (IUGR)
Babies with IUGR grow more slowly than usual during pregnancy and are small for their gestational age at birth. It is usually diagnosed during pregnancy through an ultrasound.
Intraventricular Hemorrhage (IVH)
An intraventricular hemorrhage is bleeding in the brain that often occurs in premature babies because of their more fragile vessels in the brain. It is diagnosed through an ultrasound of the head. Treatment usually involves controlling the baby’s blood pressure.
Jaundice
Jaundice is a high level of bilirubin in the blood that is caused when a baby has increased blood cell breakdown and its liver cannot process the extra bilirubin. It is diagnosed through a blood test, and treated with fluids and light therapy.
Necrotizing Enterocolitis (NEC)
NEC is an intestinal condition that involves the death of parts of the intestine. It is most often seen in premature infants and is diagnosed through an x-ray of the abdomen. It is treated with antibiotics, stopping intestinal feeding and using an IV or feeding tube, draining the baby’s stomach, and in some cases, performing surgery to remove the diseased section of the intestines.
Patent Ductus Arteriosus (PDA)
PDA occurs when a blood vessel in the heart – the ductus arteriosus – does not close after birth, which can cause fluid in the lungs and respiratory problems. It is diagnosed through an ultrasound of the heart after doctors notice breathing problems and/or a heart murmur. PDA is usually monitored, and sometimes medicine or surgery is necessary to close the blood vessel.
Periventricular Leukomalacia (PVL)
PVL is a type of brain injury that is often caused by severe intraventricular hemorrhaging. There are often no signs of PVL, but babies at higher risk of this condition may be diagnosed through a head ultrasound or MRI. It is treated through close monitoring and then addressing any developmental delays later in life.
Persistent Pulmonary Hypertension of the Newborn (PPHN)
PPHN is high blood pressure in the lungs, which occurs when the blood vessels in the lungs do not relax after birth and allow blood to flow through them. This condition is often linked to birth defects, heart defects, or complications during labour and delivery. It is treated with a ventilator to help the baby breathe and a gas (nitric oxide) to help the blood vessels relax.
Respiratory Distress Syndrome (RDS)
RDS is difficulty breathing that is due to a lack of surfactant in the lungs. When babies are breathing particularly hard or need extra oxygen, a chest X-ray can confirm an RDS diagnosis. It can be treated by administering steroids right before delivery, giving the baby an artificial surfactant, and/or the use of a breathing machine (ventilator) until they can breathe more easily on their own.
Retinopathy of Prematurity (ROP)
ROP is the abnormal growth of the blood vessels in an infant’s eyes, which can cause damage to the eyes. It is most often seen in premature infants, so these babies usually have an eye exam by a pediatric eye doctor. In more severe cases, laser eye surgery is needed to prevent the damage from getting worse.
Sepsis
Sepsis is an infection that is caused by bacteria growing in the blood. It is diagnosed through a blood culture, and treated with antibiotics.
Transient Tachypnea of Newborn (TTN)
TTN is rapid breathing in a full-term newborn, which may be caused by pneumonia, a blood infection, or another problem with the lungs. It is diagnosed through blood tests and X-rays, and treated with oxygen.
How BILA Can Help
Not all NICU stays are associated with birth injuries. In many cases, a combination of factors – including genetics – leads to a baby being diagnosed with a condition that requires NICU care. However, a failure to properly diagnose and treat a medical condition, address risk factors during pregnancy, or intervene when necessary during labour and delivery, can be a form of medical negligence.
If you believe that your baby may have suffered a preventable birth injury, a birth injury lawyer can advise you of your legal options. For help with a potential birth injury claim, call BILA today at 1-800-300-BILA or fill out our online contact form to schedule a free initial consultation with a lawyer in your province.
If My Baby’s Medical Condition Wasn’t Diagnosed Promptly, Can I File a Birth Injury Lawsuit?
Possibly. Medical negligence comes in many forms, including a failure to diagnose. If a delay in diagnosis and treatment caused your baby to suffer damage or develop a disability, you may be able to file a birth injury lawsuit.
At BILA, we work with parents and families to help them understand their legal options. Reach out to us today to schedule a free consultation with a birth injury lawyer in your province.
How Long Will My Baby Be in the NICU?
It depends. NICU stays can last a few days to several months. Your NICU team should keep you updated on your baby’s progress. In some cases, there will be specific milestones that they must hit in order to be released from the NICU.
During this time, you may have questions about whether your baby’s condition was preventable. BILA can help you determine if you may have a birth injury claim. Reach out today to schedule a consultation with a birth injury lawyer in your province.
Related:
Susanne Raab is a lawyer at Pacific Medical Law, and an advocate for people living with disabilities. She has been selected for inclusion by her peers in Best Lawyers in Canada in the area of Medical Negligence and is recognized as a leading practitioner in the Canadian Legal Lexpert® Directory in medical malpractice. Susanne is also a Fellow of the Litigation Counsel of America, an honorary trial lawyer society whose membership is limited to less than one-half of one percent of North American lawyers, judges and scholars.
