Neonatal Intensive Care unit FAQ

The NICU is located on the fourth floor of the St. Catharines Hospital Site. When exiting the main elevators, follow the hallway on the right-hand side with the bay of windows. The NICU is at the end of this hallway on the left-hand side before the double brown doors. There is signage to help locate us. There is also a phone outside of the door that connects to the nursing station to be let into the unit.

In our NICU, parents/caregivers are a fundamental part of our care team. We expect you to be involved in your baby's care, including doing diaper changes, baths, and feedings. You are welcome and encouraged to stay at the bedside for the duration of your baby’s admission, we will provide you a cot to do so. It is important for you and your baby to ensure a strong bond and promote their health by being present as much as possible, however, we do understand that you need to care for yourself as well.

The NICU is a locked unit, which means that each entry point to the unit is locked and requires a NICU staff badge or key fob to enter. In most cases, we will be able to provide you with a key fob for ease of coming in and out of the unit. If key fobs are unavailable, there is a phone outside of each door that connects to the nursing station when picked up and we will be happy to let you in. Additionally, we have equipment to provide babies with security bands that will alarm the unit and the security department if ever the baby leaves the unit. This technology also allows us to locate babies within the hospital and lock doors to ensure their safety. While in the NICU, your baby will be placed on continuous monitors to allow staff to know your baby's vital signs at all times. The unit also has central monitoring, meaning that staff can see your baby's vitals from each nursing station – this helps us to keep eyes on your baby at all times. It is important to know that these monitors frequently alarm to alert staff of any changes, and the team has the specialized knowledge to differentiate these sounds and respond appropriately.

The NICU does not have visiting hours. Days and nights look similar for babies, so we welcome you to be here at any time.

We have a large team of specialized care staff that will be looking after your baby. This includes registered nurses, physicians (paediatricians and neonatologists), nurse practitioners, respiratory therapists, occupational therapists, dietitians, pharmacists, lactation consultants, social workers, student learners (medical and nursing), ward clerks, and environmental staff.

We encourage you to stay for the duration of your baby’s admission. It is great for your bond with your baby to stay overnight and be involved in care around the clock. It also helps to establish a routine for when you are discharged. Each room has a cot for you to sleep on at the bedside. We have storage for your personal belongings and will facilitate a comfortable environment for you to care for your baby.

The NICU has a typical flow with regard to care for your baby. On admission, your baby’s nurse will start a feeding schedule that will help you and your baby develop a routine. Typically, this feeding routine will start at either 7:30, 8:00, 8:30 or 9:00, and will repeat every three hours. Smaller babies may feed every two hours, and larger babies may be able to feed every four. Your nurse will want to do vitals and assess your baby before each feed. Nursing shifts are 12 hours, and shifts change at 7:00 am and 7 pm. We ask that you wash your hands each time you enter the unit and before you handle your baby. We try to assign you the same few nurses throughout your stay for continuity and to build a rapport. Rounds are done in the morning as a team from 8:00-9:30 am. We weigh your baby each night before their first feed.

It can be very difficult to see your baby in the NICU, and it is even harder when you are not able to handle your baby as often while they grow and heal. We empathize with you and will work with you to promote bonding. You can and will still form a powerful bond with your baby while they are in an incubator. Some ways to care for your NICU baby include asking to participate in care (for example, do diaper changes, take temperatures), reading them your favourite books, holding their hands, taking many photos to see how far you will come, accept help from others, and create an environment you feel safe and comfortable in (this is your home away from home for now).

It is also important to take time to care for yourself, you have to be able to care for yourself in order to care for your baby. For our smaller, more fragile babies, sometimes touch can be stressful and overstimulating. These babies are still supposed to be growing inside of the uterus, and need lots of rest. You will see that your baby does not respond well to frequent touch, so we do not handle them as often to let them grow. However, there are still many ways to connect with your little one. Sing and talk softly to your baby, this will let them become comfortable with interaction. Massage and hold your baby's hands. Smaller babies also love comfort holding, which is when you cup a hand around the top of their head and around their bottom and apply light pressure. This mimics the feeling of being in the uterus and helps to soothe them. Pay attention to how your baby responds to touch, and navigate this carefully with them. We will be there to support you in learning these comforting techniques.

Each morning the NICU team will round on your baby, meaning they will go over your baby’s care planning and stay updated all health information. You are encouraged to be involved in our rounds, so you can hear any updates from the team and ask any questions you have. To be involved with rounds, we recommend you be present in the unit by approximately 8:00 am.

Our unit will have all supplies for babies including diapers, wipes, bottles (unless we ask you to bring a specific kind), soothers, etc. You will have access to bottle warmers and breast pumps during your NICU stay, however, you may have to purchase a breast pump kit. We also have baby clothes if needed, but recommend that you bring sleepers for your baby (zipper or buttons are ok). We recommend that you bring your own pillows and blanket, as we provide you with hospital ones but they are not as comfortable. The unit also has a lot of unfamiliar noises and bright lights, so eye masks and earplugs can be helpful to sleep. We do not allow food or drinks (other than water) on the unit, but we do have a fridge for you to keep food in to eat in the cafeteria (we just ask that you label it with your name). We have a water and ice machine on the unit, and supply you with cups – during COVID-19 we ask that you do not bring a reusable water bottle, but in other instances, we would recommend this. Bring comfy clothes and slippers or shoes to wear in the unit, as well as toiletries. It is also great to bring some form of entertainment to keep you occupied between feeds. During COVID-19, the hospital offers free wifi. In addition, at present we ask that all visitors wear a level 1 mask to reduce the spread of COVID-19. If you do not have a level 1 mask, we will provide you with one.

The most frequently asked question is how long your baby will be admitted in the NICU. The answer to this varies greatly depending on the reason for admission, and each baby is different. We will keep you informed along the way to help you plan for care and discharge. There is usually a large difference for babies who are premature versus those who are term. A general rule of thumb for premature babies is to expect to be in the NICU until your baby’s due date. One of the main reasons that keep our babies in the NICU is the need to establish effective feeding, which takes time. Keep in mind that your baby is in the NICU because they are not considered a “healthy newborn”, which changes our expectations for their progress. Be patient with your baby, and know that they will show you when they are ready to go home.