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Understanding neonatal care – terminology

While you’re on the neonatal unit, you may hear some medical words and phrases that are unfamiliar. The guide below is here to help explain some of the terms you might come across.

Term

Description

 Anaemia

Too few red blood cells.

Apnoea

A pause in breathing which may require intervention.

Bagging

A term used to describe the pumping of air and/or oxygen into a baby’s lungs via a device called a neopuff. This is done when a baby’s oxygen level is low and not recovering.

BIPAP/Biphasic

These terms mean the same thing. It’s another mode on the SIPAP machine, which is like CPAP in that it gives a baseline pressure to the lungs. However, in Biphasic mode, the neonatal team can set a breath rate (usually around 30 per minute) which will increase the pressure slightly with every set breath. Oxygenation will improve in babies that are struggling on CPAP.

Bilirubin (Bili)

A product of the breakdown of red blood cells. Too much bilirubin causes a yellowing of the skin and the whites of the eyes.

Blood gas

A blood test to determine how much oxygen and carbon dioxide are in the blood, usually taken from the baby’s foot. Other things can also be recorded from the test such as pH of the blood and blood sugar levels. It’s an important test as the results determine the right amount of ventilatory support the baby receives.

Bradycardia (Brady)

A slowing of the heart rate to lower than normal.

Cares

A term used to describe nappy changing and cleaning of the mouth, eyes and ears. During this time, the baby may be examined by a doctor to assess skin integrity and feed tolerance. Bedding is usually changed around cares time, so baby feels comfortable.

Cannula

A tube that is placed into the vein, usually in the hand or foot but can also be positioned on other parts of the body. This is used to deliver fluid and drugs to the baby.

Cooling

The baby will be nursed naked on a cooling mattress for 72 hours. This is then followed by a period of slowly re-warming to normal body temperature. Cooling treatment is used to aid the healing process in the brain after a traumatic birth. Only NICU (Neonatal Intensive Care Units) can offer this treatment. If the baby is born in a local neonatal unit and needs cooling, they’ll need to be transferred to a hospital with a NICU.

Continuous positive airway pressure (CPAP) machine

Air is delivered through nasal prongs or a nasal mask to provide a continuous pressure in the lungs to make breathing easier for the baby.

CRP

C-reactive protein is a substance produced by the liver in response to inflammation. High levels in the blood can be a sign of inflammation, which may suggest an infection.

Containment holding

Positive gentle touch. This is done by placing one hand behind the baby’s head and the other hand around their bottom and holding the position still (not stroking). While you’re doing this, talk to your baby or sing to them. This holding position can calm a stressed baby and provide reassurance. It’s also a good way for parents to bond if baby is unable to come out of the incubator or cot.

Desaturation (Desat)

A drop of oxygen levels in the blood stream.

Developmental care

Developmental care refers to care that is tailored to each baby’s individual needs, supporting their neurological development and helping to reduce long-term cognitive and behavioural problems.

Expressed breast milk (EBM)

This can be collected via hand expressing or by using a pump.

Endotracheal tube (ET tube)

A thin tube passed through the mouth into the windpipe. The ET tube is then attached to a ventilator.

Family integrated care (FiCare)

A type of care which supports and educates parents to become part of their baby’s care team. Parents are taught to be involved in many aspects of their baby’s care, such as taking temperatures, cares, feeding via an NG tube, giving medication and taking part in ward rounds.

FBC (full blood count)

The amount of red and white blood cells along with platelets are counted. This is used to screen for things such as anaemia.

Fortifier

A powdered supplement added to expressed breast milk. It provides the extra protein, vitamins and minerals that very premature babies are unable to absorb from breast milk alone.

Glucose

Sugar.

Hypoxic ischemic encephalopathy (HIE)

Hypoxic ischemic encephalopathy. A type of brain damage that occurs when an infant’s brain doesn’t receive enough oxygen and blood, usually during or shortly after birth. HIE can affect all baby’s organs: the lungs, liver, heart, kidneys, and particularly the brain. The severity can be mild, moderate or severe.

High frequency oscillation (HFO)

A special ventilator setting that is capable of breathing for a baby at much higher rates than a normal ventilator. The baby will “wobble” due to the high breath rate, but this is absolutely normal.

Hot cot / Inditherm/ Cosytherm cot

An extra electric mattress added to an open cot. The mattress is heated to help the baby maintain a normal body temperature.

Hydrops fetalis

A severe swelling that can occur in unborn or newborn babies. It develops when too much fluid leaves the bloodstream and goes into the tissues and can be either immune or non-immune. Hydrops occurs when disease or complications interfere with the baby’s ability to manage fluid.

Hypoglycaemia

Blood sugar level that is below normal range.

Incubator

A heated enclosed environment that acts as a cot for a premature or sick baby. Humidity and oxygen can also be delivered through the incubator if needed.

Infusion

A continuous flow of fluid (drugs or TPN) via an IV cannula, UVC or long line.

Intra-ventricular haemorrhage (IVH)

A bleed into the ventricles of the brain which is common in babies born prematurely. There are different grades of IVH. Some can be serious but in many cases it causes no long-term problems.

Intravenous

Into the vein.

Jaundice

A term to describe the appearance caused by a high bilirubin level, which makes the skin and whites of the eyes look yellow.

Kangaroo care

A method of skin-to-skin contact between baby and mum or dad. It has lots of benefits for the baby including stabilising body temperature and reducing the risk of infection. It’s also a greatl way for parents and babies to bond.

Long line (central line)

A thin tube inserted into the baby’s veins. Unlike a cannula, this type of line can be left in situ for a long time.

LNU

Local neonatal unit, often referred to as a level 2 unit.

Lumbar puncture (LP)

A procedure which involves a needle being inserted into the lower spine to obtain spinal fluid for diagnostic testing.

Meconium

The first poo a baby passes, which is dark green in colour and sticky.

Meconium aspiration or meconium aspiration syndrome (MAS)

When a baby breathes meconium from the amniotic fluid into the lungs during delivery. The meconium then interrupts the normal flow of oxygen and carbon dioxide in the lungs.

Necrotising enterocolitis (NEC)

This occurs when part of the wall of the intestine is swollen or inflamed due to damage to the lining, which can then become invaded by bacteria. The abdomen may swell up, and blood is passed through the bowels. NEC can be treated by stopping the baby’s feeds to allow the bowel to rest and starting the baby on antibiotics. Sometimes, though rarely, a hole may form a perforation in the gut wall or part of the bowel may die, which can result in baby requiring surgery.

NG tube

Nasogastric feeding tube. A thin tube passed through the nose and into the baby’s stomach. This is used to provide milk to the baby.

NICU

Neonatal intensive care unit.

Nitric oxide

A gas normally produced in the body which relaxes blood vessels and improves blood flow to all parts of the body. When the blood vessels to the lungs remain narrowed, nitric oxide is given via inhaled air and oxygen. This causes the blood vessels in the lungs to relax and then increases blood flow to the lungs.

Oedema

Swelling caused by excess fluid in the tissues under the skin.

OG (orgogastric feeding) tube

The tube is passed through the mouth and into the baby’s stomach. This is used to provide milk to the baby.

Optiflow

A machine which can deliver humidified air and/or oxygen to a baby at a high pressure to help baby breathe more easily.

Patent ductus arteriosus (PDA)

The ductus arteriosus is a blood vessel that allows blood to bypass the lungs when the baby is in the womb. After delivery, the baby no longer requires this, and it will close. Sometimes this doesn’t happen, resulting in a PDA, which means oxygen is not delivered to the lungs effectively.

Phototherapy

Special blue lights used to treat jaundice. The ultraviolet light breaks down the excess bilirubin in the skin.

Pneumothorax

A collapsed lung. It occurs when there’s a collection of air in the space around the lungs. This build-up of air puts pressure on the lung, meaning it can’t expand as much as it normally does when taking a breath.

Positive touch

Foundation of bonding between baby and family. It includes containment holding, kangaroo care and cuddles.

Quiet time

A period of the day set aside to aid baby’s development. Noise levels and lighting are reduced, and only urgent procedures are undertaken. Skin-to-skin is encouraged during this time.

Reflux

When the stomach contents come back up the oesophagus and into the mouth. Reflux is very common in newborn babies.

Respiratory distress syndrome (RDS)

Respiratory distress syndrome happens when a baby’s lungs aren’t fully developed and can’t provide enough oxygen, causing breathing difficulties. Premature babies are more prone to this as their lungs don’t have enough surfactant to help keep the lungs open and prevent collapse.

Retinopathy of prematurity (ROP)

Damage to the retina, the area of the eye that is sensitive to light. It’s usually linked to the amount of oxygen in the blood reaching the retina and is prevalent in extremely premature babies (less than 28 weeks). These babies are routinely checked for retinopathy of prematurity and laser eye treatment is given to those badly affected.

Rooming in

When baby is close to being discharged, parents are invited to stay in the parents’ accommodation with their baby. The aim is for them to feel confident caring for their child without the nursing staff, to reduce anxiety around discharge.

Saturation probe (Sats)

A non-invasive method of measuring the oxygen levels in the blood. The monitor is called a pulse oximeter and the light attached to the baby’s hand or foot is the probe.

SBR (serum bilirubin)

Taken from a blood sample, it determines whether the baby has a jaundice level that needs treatment.

SCU

Special care unit, often referred to as a level 1 unit.

Sepsis

An infection that can be present in the blood or other parts of the body.

Steroids

Steroids are given antenatally to mothers where the birth seems likely to occur early. The drug crosses the placenta and causes the baby’s lungs to mature for breathing. After birth, babies with chronic lung disease may require low doses of steroids to aid weaning them off the ventilator.

Surfactant

Surfactant is a mixture of chemicals that prevent the lungs from collapsing when the baby breathes out. Surfactant in the lungs starts being produced at approximately 24 weeks gestation but is not well developed before 36 weeks gestation. This can be the cause of respiratory distress syndrome (RDS). Replacement surfactant can be given as a liquid into the lungs of the premature baby to help support their breathing.

Suction

Removal of mucus from the ET tube, nose or throat by means of a tube.

Tachypnoea

Abnormally fast breathing.

Tachycardia

Abnormally high heart rate.

Total parenteral nutrition (TPN)

A type of intravenous fluid that provides total nutrition to someone who can’t take any nourishment via the gut. TPN contains sugars, electrolytes, vitamins and proteins, and can supply all of the nutrients that the body needs.

Transfusion

Transferring donated blood, blood products, or other fluid into the circulatory system of the baby. Blood transfusion is a common occurrence on the neonatal unit.

Umbilical catheter (UVC and UAC)

A small tube that’s inserted into the artery or vein of the umbilical cord so fluid and drugs can be given.

Vapotherm

A machine which can deliver humidified air and/or oxygen at a high pressure to support a baby to breathe independently.

Ventilator

A machine used to deliver air and/or oxygen at a set breathing rate to support the baby with breathing.

Wean

To take away gradually. Weaning is often used to describe the process of removing an infant from any respiratory support.