Special Care Nursery resources

Apgar Score: The results of a test given to your baby to quickly evaluate the physical condition and need for immediate extra care.

Apnea: The condition of not breathing.

Aspiration: Inhalation of material (formula, meconium or stomach juice) into the trachea (windpipe) and lungs.

Attending Physician: The physician in charge of your baby’s care.

Bagging: Pumping oxygen to your baby’s lungs by squeezing a bag that covers your baby’s mouth and nose.

Bilirubin: A yellowish pigment that is produced when red blood cells break down. When the body can’t dispose of bilirubin, jaundice can occur.

Bilevel Positive Airway Pressure (BPAP): A continuous positive airway pressure (CPAP) mode that is used during noninvasive positive pressure ventilation.

Blood Gases: Laboratory test to determine the amount of acid, oxygen, carbon dioxide, and other gases in the blood.

Oxygen Saturation: The percentage of oxygen bound to hemoglobin in the patient’s blood.

Bradycardia: A heart rate less than 100 beasts per minute, slower than normal for an infant.

Catheter: Tubing inserted into the body to allow the passage of fluids.

Central Venous Line: A catheter that is placed into a vein in the neck, chest or groin to administer medications or fluids.

Continuous Positive Airway Pressure (CPAP): A machine that pushes a continuous flow of air or oxygen through the airways to help keep the air passages open.

Culture: A propagation of microorganisms in a growth medium.

Dextostix: A special test strip used to determine how much sugar is present in a sample of blood.

Echo-cardiogram (Echo): The use of ultrasound to view the structure and function of the heart.

Edema: Swelling caused by fluid retention.

Electroencephalogram (EEG): The recording of the electrical activity of the brain.

Endotrachael Tube (ET Tube): A breathing tube.

Extracorporeal Membrane Oxygenation (ECMO): Providing respiratory support through an artificial lung

Fellow: A doctor training to be a physician in a given field of medicine.

Fontanel: An anatomical feature of an infant’s skull referred to as the soft spot.

Gastro-Esophageal Reflux: Where food or liquid leaks backwards from the stomach into the trachea.

Gavage: feeding A feeding tube that is placed in a baby who has not learned to swallow.

Gestational Age: Age of baby in weeks from conception.

Gram: A metric unit for measuring weight. One gram equals 1/28 of an ounce.

Hyperalimenation: Administering nutrients by intravenous feeding 10 Incubator/Isolette A heat-controlled crib used to maintain a baby’s body temperature

Intravenous (IV): A small tube inserted into a vein to deliver medicine, fluids into the blood.

Intubation: Insertion of tube through the nose/mouth into the trachea

Intake and Output (I&O):Total amount of fluid taken in to the body (Input) VS. the fluid lost as urine, stool or perspiration (Output).

Jaundice (hyperbilrubinemia): A yellow discoloration of the skin and whites of the eyes that results from excess bilirubin.

Kangaroo Care: Holding a baby against one’s naked chest, so there is skin-to- skin contact.

Lung Hypoplasia: Failure of one or both lungs to develop fully.

Meconium: A baby’s first stool, which is greenish or black

Nasal Cannula: A special tubing that is used to give oxygen through the nose.

Nasogastric Tube (NG Tube): A plastic tube inserted through the nose into the stomach or intestines to aid in digestion when the patient cannot eat by mouth.

Necrotizing Enterocolitis (NEC): An intestinal infection that causes inflammation of the lining, and in rare cases necrosis (tissue death)

Neonatal Intensive Care Unit (NICU) (3 levels): Intensive Care Unit specializing in the care of ill or premature newborn infants. There are three levels of care based on the complexity of care provided: – –

–          Level 1 – Basic Care Provides routine medical care to healthy babies or those who may have mild illness expected to resolve quickly.

–          Level 2 – Specialty Care Handles babies who need close monitoring or who have moderate illness or condition expected to resolve quickly

–          Level 3 – Advanced Specialty Care Provides intensive care for babies born at all gestational ages. Handles babies who need respiratory support, and/or surgical care.

Neonatologist: A pediatric specialist that cares for newborn infants, especially very ill or premature infants.

Nitric Oxide: A gas that is used as an inhalant in order to try and enhance lung growth and recovery.

Oximeter (Pulse Oximeter): A device worn on the finger, toe or earlobe that can measure levels of oxygen in the blood.

Patent Ductus Arterious (PDA): A condition in which the ductus arteriosus (a blood vessel that allows blood to go around the baby’s lungs before birth) does not close.

Percutaneously Inserted Central Cathetar (PICC Line): Also called a Percutaneous Line. This is a long catheter placed into a surface vein, with the catheter tip extending farther into the body into a large central vein.

Phototherapy: The process of using light to eliminate bilirubin in the blood.

Pneumothrax: The collection of air in the space around the lung.

Pulmonary Hypertension: High blood pressure in the pulmonary artery which conveys blood to and from the right ventricle of the heart, to the lungs.

Respiratory Syncytial Virus (RSV): Infection of the lungs and breathing passages.

Respirator: Also known as a ventilator, is a machine that helps breathing by supplying and regulating a flow of air and oxygen.

Retinopathy of Prematurity (ROP): A potentially blinding eye disorder that effects premature infants.

Rounds: The gathering of doctors, nurses or other health care professionals to discuss the condition and care of patients.

Sepsis: Infection that occurs in, or has spread to, the blood.

Spinal tap: A procedure that is done to collect a sample of spinal fluid for analysis.

Step Down: Decreasing in stages in the amount of care required.

Suctions: Removal of secretions from the nose or throat or from the endometrial tube using a small plastic tube connected to a vacuum outlet.

Tachypnea: Rapid breathing

Total Parenteral Nutrition (TPN): Supplying nutritional needs of the body through an IV, bypassing the digestive system.

Transfusion: The introduction of blood directly into an individual’s blood circulation through a vein.

Umbilical Arterial Catheter: A line placed into the umbilical artery through the umbilical cord.

Vital signs: Temperature, heart rate, respiratory rate, blood pressure and pain level.

Terms Retrieved from Project Sweet Peas’ NICU Guide (2017)

Términos importantes en Espanol (https://es.ranchospringsmedcenter.com/services/maternity/nicu/nicu-glossary)

Kangaroo care, or skin-to-skin contact, is a method of holding your baby. There are many benefits to both the infant and parents when using this method, some of which include: greater bonding, confidence in providing care, and improved immunity system functioning for your infant. As you consider how to best address the needs of your child, make sure to consult with medical professionals. If you are interested in learning more about Kangaroo care, consider clicking on the links below:

1. 1. Baby Steps to Home
   2. March of Dimes: Touching and Holding your Baby
   3. Healthy Children: Information about Skin-to-Skin Contact (En Español también)

For a hard copy booklet of Understanding My Signals by Brenda Hussey-Gardner, check with your care team at FMC or visit https://www.vort.com/product.php?productid=19 .  Below is a summary of tips from the booklet about how to understand your baby’s signals. Be sure to consult your FMC care team for personalized recommendations.

Signals that may say “I am happy and ready”

• I am alert and I coo.
• My face, arms, and legs are relaxed.
• I look at objects or people.
• My eyes are open and I try to smile.

Signals that may say “I am helping myself”

• I hold on. In the beginning I may be too sick to be held. Ask my doctor if it’s okay for me to hold your finger.
• I clasp my hands together – this prevents them from waving around.
• I suck on my fingers or hands – this soothes me. If I hve trouble getting my hand in my mouth, mou may want to help me.
• I go into a light sleep – this allows me to shut out sights and sounds.

Signals that may say “I am not happy and need a change”

• I salute.
• I spread my fingers apart.
• I frown.
• I grimace or grunt.
• I yawn, sneeze, or hiccough.
• I arch my back and neck, and push away.
• I look away.
• I cry.

Changes that may help me

• Your touch can startle me. Try talking to me before you touch me. This will let me know that you are there.
• Before playing with or feeding me, trying laying me quietly on your lap. This doesn’t have to be a nap. It’s just a short break so that I don’t get too excited.
• While playing with me, talk softly and hold me about ten inches from your face – I will be able to see you better.
• Bright lights may bother me. If my eyes are shut, try shading my eyes from the glare with your hand.
• Provide me with a quiet time when I give a “not happy” signal. Try holding me quietly and firmly. This will give me a secure feeling.
• When I am ready, to interact, begin slowly with either a calm face, soft voice, or gentle touch. If this is still too much, let me grab your finger. Hold me quietly until I am ready.
• If I am still not happy, try tucking my arms in close to my chest or firmly wrapping me in a blanket.
• When you are ready to lay me down, put me in the position that my nurse or doctor recommends.

Know FMC rules. FMC guidelines may vary depending on your baby’s condition. Knowing what to expect can help prepare you and your family during you child’s special care nursery stay. Here are some helpful questions to ask during your baby’s special care nursery stay:

1. What are the visiting hours?
2. How many people can visit at a time?
3. Can I bring items from home to support my baby? If so, what is recommended?
4. Are there limitations with how I can interact with my child (for example, holding, feeding, etc.)?
5. How often is my baby checked on?
6. Who checks on my child and what are they looking for?
7. What else should I be considering right now?

You may have more questions later on. Try to make a list of questions as you work with the FMC staff. They are here to support you and your family.

Phone: 928-773-2491
Website: https://nahealth.com/women-infants-center/labor-and-delivery-classes
Location: FMC Education Center, 1000 N. Humphreys Street, Flagstaff 86001

• Offering 15 different education classes. Topics include Labor and Delivery classes, breastfeeding basics, Bootcamp for New Dads/Moms, CPR and safety for infants, Parenting 101, and Tummy Time class,

FMC’s Hospitality House – The Taylor House
Located within walking distance of FMC, The Taylor House offers a supportive, caring atmosphere in a hotel-style setting with affordable guest rooms.
1431 N. San Francisco St., Flagstaff, AZ 86001 (Located on the corner of San Francisco St. and Forest Ave. )
Rate: $60, call for reservations: 928-226-0300

*The below hotels are independently owned and not endorsed by Northern Arizona Healthcare or Northern Arizona University. 

West Flagstaff

DAYS INN
1000 W. Route 66
928-774-5221

HILTON GARDEN INN
350 W. Forest Meadows
928-226-8888

RAMADA INN WEST
2755 S. Woodlands Village
928-773-1111

ECONOLODGE-University
914 S. Milton Rd.
928-774-7326

HOWARD JOHNSON
801 W. Route 66
928-774-3381

RODEWAY INN-DOWNTOWN
122 w. Route 66
928-774-5081

BAYMONT INN
2005 S. Milton Rd.
928-773-1300

QUALITY INN
2000 S. Milton Rd.
928-774-8771

THE L MOTEL
121 S. Milton Road
928-774-8820

HAMPTON INN & Suites
2400 S. Beulah

DRURY INN & Suites
300 S. Milton Rd.

TRAVELODGE-University West
990 W. Route 66
928-913-0900 928-773-4900 928-213-5800

East Flagstaff

QUALITY INN-I 40
2500 E Lucky Lane
928-226-7111

RAMADA INN
2350 E. Lucky Lane
928-779-3614

SONESTA ES SUITES
1400 N Country Club
928-526-5555

TRAVELODGE-Flagstaff East
2918 E. Route 66
928-526-3595

Hand to Hold: https://handtohold.org/

Mission: Hand to Hold helps families before, during, and after NICU stays and infant loss by providing powerful resources for the whole family, and most importantly, one-on-one mentoring from someone who has been there.

This time can be very tough for you and your family. Asking for help, or letting others help you, is such an important consideration when caring for your infant. You can’t take care of others if you can’t take care of yourself. Here are some helpful tips as you maintain your well-being during this time:

• Ask family and close friends to help you with errands, cooking, cleaning, and helping out with the family demands.
• Make sure you are getting enough rest and eating balanced meals.
• If you are able to, get exercise. Going for a walk, stretching your body, and getting some sun can be a nice way to unwind.
• Talking with your friends and family can be a really nice and simple way to relieve stress. Remember, even a nice conversation can help to relax you.
• Practice deep breathing exercises or read a book. These tools are helpful ways to be present with your family, distract your mind in a healthy manner, and keep a more positive outlook.

Here are tips to help maintain your well-being after your baby comes home:

• Get Plenty of Rest – Sleep when your baby does, or at least take time to relax during the nap. Take breaks throughout the day; every few hours unwind and put your feet up.
• Seek Support at Home – Ask your partner to give the baby one or two night feedings. Have a friend/family member run errands with you to watch the baby while you get things done. Have a friend/family member come watch the baby so you can catch up on sleep. Ask someone to help you with laundry once a week. Ask your partner to help with dishes. If you have an older child, put them to work.
• Develop a Social Support Network – Join a support group or mom’s club in the area (see group section). Join playgroups with other mothers, or create your own. Take your baby to the park to meet other parents.
• Make Time for Yourself- Let go of needing to do everything and take time just for you. Spending some time away from your baby is good for you, so do something alone and enjoy it!
• Leave The House – Isolation is the easiest way to make Postpartum Depression worse. Even if it seems difficult, get you and your baby out at least once a day. Take your baby for a stroll, go to a coffee shop, go to the park, or to a friend’s house. Sunlight and fresh air are essential to feeling better.
• Exercise – This is beneficial to you for many reasons such as increasing serotonin and elevating your mood, losing baby weight, and boosting your self-esteem. Take the baby with you on a hike or stroll, use daycare at the gym or take baby to a mom/baby yoga class.
• Eat Nutritiously – Diet is essential to Postpartum Depression symptoms and will affect your mood. Eat a variety of whole grains, plenty of fruits and veggies, choose lean meats and fish and stay away from caffeine, alcohol, processed sugars and salt. Drink a lot of water!
• Keep a Journal – Reflect on your feelings from the day, what went well and how it made you feel. Write down what you accomplished that day.
• Reminders: Have Realistic Expectations of Yourself, Avoid Isolation, and Limit Your Stressors!

Pregnancy and Postpartum Adjustment Group

Who: Open to anyone. Baby and partner are invited to attend. Facilitated by Star Kelly, LCSW & Rachel Josefchuk, RN

When: Wednesday from 1:30pm- 3:00pm

Where: North Country Health Care’s Community Room- 2920 N 4 t h Street Flagstaff, AZ 86004

928-707-0748 or 928-213-6100

Cost: FREE

**Registration is not required. Please note that childcare is not provided.

Pregnancy and Postpartum Wellness Group

Who: Must enroll at the Guidance Center. Facilitated by Alicia Griffing, MS.

When: Thursday from 9:30am- 11:30am

Where: The Guidance Center- 2695 E. Industrial Dr. Flagstaff, AZ 86004

928-527-1899

Postpartum depression is very treatable, and depending on how severe the symptoms, can often be treated with psychotherapy and/or increased self-care alone. However, if symptoms persist or if a person goes untreated, medication is often needed in addition. The two categories of drugs that have proven effective for women with Postpartum Depression are antidepressants and anti-anxiety medications. These can be prescribed by a Physician or Psychiatrist.

Resources:

Postpartum Support International (PSI) Arizona Warmline
(888) 434-MOMS (6667)
Website: www.psiarizona.org
24-hour hotline with trained volunteers who have “been there,” provides the most up-to­ date information regarding area resources and support options for postpartum care.

Postpartum Support International
Website: www.postpartum.net
Phone: 1-800-944-4773
National hotline with 24 hour support in English and Spanish, list of resources in your area, and online support group.

Maternal Mental Health
Website: www.drchristinahibbert.com
Blog, videos, and link to online resources all created by local Psychologist of Flagstaff, Dr. Christina Hibbert.

Online PPD Support Group/ Blog
Website: www.ppdsupportpage.com
Informational and peer support services through discussion forums and resource lists.

The Postpartum Stress Center, LLC
Website: www.postpartumstress.com
Offers a thorough list of educational resources and recommended readings, as well as consultation services and access to clinical treatment plans.

National Suicide Prevention Hotline and Website
Hotline: 1-800-273-8255
Website: www.suicidepreventionlifeline.org

Crisis Text Line
Text HOME to 741741 from anywhere in the USA, anytime, about any type of crisis.

Recommended Reading:

Cowan, K. (2017). When Postpartum Packs a Punch: Fighting Back and Finding Joy,

Smith Brody, L. (2017). The Fifth Trimester: The Working Mom’s Guide to Style, Sanity, and Big Success After Baby.

Moyer, J. (2014). A Mother’s Climb Out of Darkness: A Story About Overcoming Postpartum Psychosis.

Bennett, S. & Indman, P. (2015). Beyond the Blues: A guide to understanding and treating prenatal and postpartum depression. (www.beyondtheblues.com)

Taylor, E. (2014). Becoming Us: 8 Steps to Grow a Family that Thrives.

Kleiman, K.R., & Raskin, V.D. (2003). This isn’t what I expected: Overcoming postpartum depression.

Kleiman, K. (2001). The postpartum husband: Practical solutions for living with postpartum depression.

• Celebrate milestones using photos or scrapbooks.
• Capture the moments in order to share with your providers for updates and your family and friends.
• Remember: all babies are different! Your child may not meet milestones at the same time as other children.
• NICU babies face different challenges and obstacles than other children, and therefore staying patient and staying in contact with your providers is crucial.
• Always discuss your developmental concerns with a provider.

For videos, brochures, and milestones by age and topic, refer to: https://pathways.org/free-tools-maximize-child-development/

For information about typical speech and language development from birth to 5 years old, refer to: https://www.asha.org/public/speech/development/chart/

For information about typical feeding development from birth to 15 months, refer to: https://pathways.org/topics-of-development/feeding/milestones/

• Always place a baby on their back for safe sleeping.
• Use a firm sleep surface covered with a fitted sheet.
• No pillows or mattress toppers.
• There may be risks with sharing the family bed with your baby. Talk to your provider if you have concerns or further questions.
• Sleep clothing may be better than using a blanket. Talk to your provider if you have questions.

Learn more at the Safe to Sleep campaign: https://safetosleep.nichd.nih.gov/

Bringing equipment home:

• Some babies will need medical equipment when being sent home.
• Try to learn how to use the equipment while your baby is still in the NICU.
• Try to get your home organized for when the baby comes, and make room for any equipment.
• If you have concerns regarding electricity or electricity needs for your baby’s equipment, please consult with your provider.

Website: https://m.raisingspecialkids.org/start-here/for-parents-and-families Fact sheets available in English and in Spanish
Phone: 800-237-3007 Family Support Specialists
Email: info@raisingspecialkids.org

Programs and services are provided at no charge!

Programs and services for families:

• Assistance and support at all ages and stages of your child’s development from birth to age 26.
• Individual problem-solving support to understand and access the programs, health plans, and services your child may need.
• Accurate, authoritative information related to your child’s disability or special health condition.
• Special education consultations, training, and problem-resolution.
• Parent-to-parent connections with a trained parent “mentor” who has a child with a similar diagnosis and is skilled at providing information and support.
• Workshops and training geared to increase advocacy skills, and improve your ability to work with professionals on your child’s educational and medical needs.
• Referrals to agencies, organizations, and community resources with expertise to meet your family needs.

Pathways.org offers a brochure about Tummy Time in English, Spanish, and Portuguese: https://pathways.org/tummy-time-brochure/

Baby and Me Group
For parents and infants age newborn to one year no matter where you gave birth.
Meet at the Flagstaff Birth and Women’s Center every Wednesday 12:30pm to 2:00pm for postpartum support, socializing, and parent education in a casual environment.

Flagstaff Christian Fellowship, Mothers of Preschoolers (MOPS)
MOPS is a socialization group for Moms. All Moms are welcome. Website: www.fcfmops.com/

Parenting Arizona
Phone: 928-773-9133
Location: 201 E. Birch Avenue, Suite 1, Flagstaff, AZ 86001 Website: www.parentingaz.org

• Offering education classes for: Parents, children, teens, adoptive and foster
• In home support for families
• Teen Services

Family Resource Center: Flagstaff Unified School District
Phone: 928-774-1103
Location: 4000 North Cummings Street, Flagstaff, AZ 86604

• Tutoring, parenting classes, ESL adult classes, preschool story time, computer and internet access, resources, games for kids, and more!
• All services offered in Spanish (Espanol)
• All services are free!

Hussey-Gardner, B. (2008). Understanding My Signals: Help for Parents of Premature Infants. Palo Alto, CA: VORT Corporation.

March of the Dimes. (2017). Getting ready to go home from the NICU [Website] Retreived from https://www.marchofdimes.org/complications/getting-ready-to-go-home-from-the-NICU.aspx

National Association of Neonatal Nurses. (2018). NICU discharge module [PDF]. Retrieved from http://babystepstohome.com/nicu-discharge-module.pdf

Project Sweet Peas. (n.d.). NICU guide for parents [PDF]. Retrieved from https://www.projectsweetpeas.com/uploads/2/7/6/8/27680953/nicu_guide_final_draft_4.24.15_pdf.pdf

Tartakovsky, M. (2018). 5 Self-Care Tips for New Moms. Psych Central. Retrieved from https://psychcentral.com/blog/5-self-care-tips-for-new-moms/