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Introduction to the NICU

Welcome Letter to Parents
Hand-Washing Guide
Your Role in Your Baby’s Care
Your First Time in the NICU
Finding Your Baby’s Room
Finding A Primary Nurse
Your Baby’s Visitors
NICU Family Room
Sleepover Rooms for Parents
Breastfeeding
Breast Pumps
Photography and Videography
Contacting the Nursery
NICU Garden
Food
Cell Phones
Baby Journal
Nursery Staff
Important Terms
Chaplaincy Program
Confidentiality
Interpreter Services
Transportation Options
Driving Directions
Parking
Kangaroo Care
Compassionate Beginnings™ Program
Parent Education Classes
Online Health Library Articles

Welcome Letter to Parents

Dear Parents:
The physicians, nurses and staff of the Newborn Intensive Care Unit (NICU) welcome you to the nursery.

Having a sick or premature baby can be frightening. The joys of starting a family, of building a dream for the future must sometimes be put on hold when a baby is born sick or premature. We recognize this is a difficult time for you. Our staff and physicians are here for you and your baby.

We believe that only you can provide your baby with the special care and tenderness of a parent. It’s our goal to make you as comfortable as possible while being with your baby and to respect and nurture the bond between you. Our guiding principal in the design of our nursery is that parents do not “visit” their baby, but rather provide care and parenting.

Knowing more about us and knowing more about your baby will help you feel comfortable about coming to your new surroundings and taking an active role in the care of your baby.

We have put together this web page to introduce you to our unit and give you information about the support services that are available to all of our families.

Again, we want to welcome you and support you during this time. Please let us know if we can do anything to make things easier for you during your baby’s stay in the NICU, or if there is some aspect of your baby’s care that you would like to learn.

Sincerely,
The NICU Staff

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Hand-Washing Guide

NICU babies are extremely vulnerable to infection and the best way to fight the spread of disease is by washing your hands. For your baby’s safety, please follow these guidelines for washing your hands upon
entry to the unit:

Remove watches, bracelets, rings and any other jewelry
Thoroughly wet your hands
Apply soap and vigorously rub hands together for at least 15 seconds
Take special care to rub in between your fingers and the front and back of your hands
Rinse hands thoroughly
Dry your hands

Using waterless hand cleanser (dispensers available throughout the unit):

Apply a grape-sized amount on to the palm of your hand and then rub hands together, making sure you get the cleanser in between your fingers
Do not rinse the cleanser off with water
Let hands dry completely

Before touching your baby:

Rewash your hands in the same manner as above, or
Use the waterless hand cleaner (dispensers available throughout the unit and at your baby’s bedside)
If you have multiples, please cleanse hands
between siblings

If you leave the unit and then return:

Rewash your hands in the same manner as above or use the waterless cleanser

After touching your baby:

Rewash your hands in the same manner or use the waterless cleanser every time you touch your baby, including diapering and feeding and before pumping or breastfeeding.

Your Role in Your Baby’s Care

As parents, you are the most important members of your baby’s care team. Your input is essential for your baby’s care and we encourage you to express your concerns or questions to your baby’s nurse, doctor or social worker. All information regarding your baby’s medical condition, plan of care and progress is available to you. And to help you through this difficult time, you can count on our staff to give your baby excellent care.

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Your First Time in the NICU

You will receive a colored wristband that identifies you as your baby’s parent. This identification band will help make it easier for you to come and go. Staff will be looking for this wristband every time you come into the nursery. Please wear the wristband until you take your baby home.

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Finding Your Baby’s Room

Please check the board located directly across from the scrub sink for the teddy bear magnet with your baby’s name and room number. Always double check the board before you go to find your baby as we often have to move babies! Once you have arrived at your baby’s bedside please double check the crib card.

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Finding A Primary Nurse

Primary care nursing means that a consistent nurse or small group of nurses will be assigned to care for your baby. The nurses will get to know your baby, you and your family. They will be responsible for your baby’s care and assisting you to participate as much as possible. These nurses will usually be assigned to your baby and when they are not available another nurse will care for your baby. A change of primary care nurses may occur to meet the changing needs of your baby. When this occurs your baby‘s nurse will talk with you about changes in your baby’s care, or changes in the primary nurse team. You may request a primary nurse from the charge nurse or ask any nurse caring for your baby.

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Your Baby’s Visitors

We encourage you to be with your baby as much as you wish. However, we ask that only two people (including you) be at the bedside at a time. This enables us to provide a quiet, nurturing environment while maximizing our ability to care for your baby. Additional visitors may wait in the family room.

Please help protect your baby by telling your family and friends not to visit if they have a cold, cold sores, rashes, chicken pox, intestinal problems or any other infectious disease. Babies are very vulnerable to infections and can easily get sick from visitors. If you are in doubt about whether or not you or a relative should visit, please talk to your baby’s nurse.

You may wish to have close family or friends spend time with your baby when you can’t be in the NICU. Please inform your family and friends who are visiting that we cannot provide information about your baby to anyone other than you. You will be asked to identify up to four people on your baby’s visitor card. Additional family or friends can come with you at any other time. To ensure privacy during report time, only parents can be at the bedside. All other visitors will be asked to leave or wait in the family room during this time (7:00 a.m. – 7:30 a.m., 3:00 p.m. – 3:30 p.m., 11:00 p.m. – 11:30 p.m.)

If they are healthy, siblings are welcomed into the nursery at any time. However, any other children under the age of 14 are not allowed. All children must have adult supervision at all times. Children may not be in the NICU garden alone.

Please review the following guidelines regarding sibling visits:

All children must be free from colds, fever, cough or rashes. Any children exposed to the chicken pox or any other contagious disease should not come to the NICU for three weeks after the exposure. If you are uncertain, contact the charge nurse.
Prepare children ahead of their visit by describing what they may expect to see, including the special equipment.
Prepare your children for their visit by explaining the rules of the unit and the importance of being quiet. Please supervise your children at all times.
Help them wash hands and tell them the
importance of not touching the equipment.

NICU Family Room

We have a space on the unit for families and visitors to eat and rest when not at the baby’s bedside. Children under 14 years old must be supervised in the family room at all times. There is a microwave and refrigerator available if you wish to bring your own food when visiting your baby. Lockers available in the family room for day use only. Lockers are cleared out on the night shift. There are designated lockers for family members who stay overnight. Please check at the front desk for more information.

Food must be labeled with your name and date and must be taken home at the end of every day.
Food may only be eaten in the Family Room and is not allowed in the NICU.

Sleepover Rooms for Parents

We offer two sleepover rooms to encourage additional parent involvement and infant care. Rooms are reserved day by day and are offered first to parents of critically ill babies or to those preparing for discharge in the immediate future. If you are spending the night to prepare for discharge, please check with the night nurse at 11 p.m. to discuss your night feeding plan.

The charge nurse has information about room availability and reservations and you can sign up for a room at the front desk. Rooms are assigned at 7:00 p.m. and must be vacated by 9:00 a.m. the next day. If space allows, cots are available if you would like to spend the night caring for your baby. Cots need to be rolled up by 9:oo a.m.

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Breastfeeding

NICU staff support and encourage breast feeding and offer the services of lactation consultants to new moms. Members of our lactation team are available in the unit to:

Promote and support breastfeeding
Provide education for parents
Assist with initiation of breastfeeding
Consult with moms experiencing difficulties, such as low milk supply, engorgement, collection of milk, etc.

The NICU has a private pumping room in which moms can pump milk. You can also pump at your baby’s bedside.

Please talk to your nurse if you would like to meet with the NICU lactation consultant, available Monday through Thursday. Post-partum lactation consultants may be available Friday and weekends.

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Breast Pumps

We offer electric breast pumps for your use while you are here. Your nurse will show you how to use the pump and will provide you with a breast pumping kit. Please return the pump to the NICU hallway outside your baby’s room after pumping. Please label your pump tubing with your baby’s sticker and remove it from the pump after each pumping. If you would like to rent a breast pump, talk with a lactation consultant. The pump rental phone number is (510) 204-6546.

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Photography and Videography

We encourage you to take pictures and to make movies of your baby. However, be sure to protect the privacy of other families by not including their babies or families in your photos or film footage.

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Contacting the Nursery

Call anytime at (510) 204-1626. From your hospital room, dial 1626.

Please feel free to check on your baby’s progress whenever you are away. Call anytime day or night, except during shift changes which are between 7:00 and 7:30 a.m., 3:00 and 3:30 p.m. and 11:00 and 11:30 p.m. If, when you call, your baby’s nurse can’t come to the phone, you can either call back later or leave a message and your nurse will call you back. We have provided you with a helpful guide, “Understanding Your Baby’s Plan of Care,” which you may use when calling to check on your baby. We suggest that you call before coming in for your baby’s feeding, as feeding times may need to be adjusted.

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NICU Garden

We have a special NICU garden area for your enjoyment. The entrance is located near room 21 in Nursery 3. Our garden is for NICU families and visitors. Children may not be left unattended in the garden. There is no smoking permitted in the garden.

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Food

For the safety of the babies, there is no food allowed in the NICU. If you would like to have a meal, you may eat it in the NICU family room or NICU garden, or go to the cafeteria on the ground floor of the hospital. The cafeteria is open from 7:00 a.m. to 7:30 p.m. Monday – Friday and from 7:30 a.m. to 10:15 a.m. and 11:00 a.m. to 2:30 p.m. on Saturday and Sunday. There is also a Whole Foods located on the corner of Telegraph and Ashby as well as many restaurants on College Ave.

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Cell Phones

Cell phone use is not allowed at the baby’s bedside. Please be sure to turn the ringer off when you enter the unit. Please keep your cell phone conversations in other areas of the NICU to a minimum.

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Baby Journal

The baby journal is a place for you to record all the special moments in your baby’s stay here in the NICU. The journal is meant for babies who are here longer than 4 weeks. Ask your baby’s nurse about how to sign up for a beautiful journal.

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Nursery Staff

Your baby receives care from a specially trained and
experienced team of health care professionals, including:

Neonatologists
A neonatologist is a pediatrician with a specialty in caring for sick babies. Our medical director oversees your baby’s care and directs our team of neonatologists. Neonatologists are on the unit or are on call 24 hours per day. A physician examines your baby daily.
"In-House" Pediatricians
Pediatricians are available around the clock. Pediatricians collaborate with neonatologists to care for your baby and are experienced in taking care of sick babies.
Pediatric Residents
A doctor who works with the Neonatologist and/or pediatrician to provide medical care for your baby.
Neonatal Nurse Practitioners
A neonatal nurse practitioner is a specially trained registered nurse who manages the medical care of sick and premature infants.
Charge Nurses
There is a charge nurse available on each shift. You may ask to speak with them about any issues or concerns you may have.
Nurses (Registered Nurses, Licensed Vocational Nurses)
Our experienced and specially trained nurses provide care for you and your baby and carry out the neonatologist’s orders.
Clinical Nurse Specialist
Our clinical nurse specialist is a registered nurse who has a master’s degree in clinical nursing. Serving as a resource for NICU nurses, clinical nurse specialists ensure ongoing staff education, and develop programs and protocols that ensure cutting-edge treatment for NICU babies.
NICU Lactation Consultant
A registered nurse who is specially trained in lactation and breastfeeding.
NICU Nurse Manager and Assistant Manager
The nurse manager and assistant manger are responsible for the 24-hour-a-day operations of the NICU. If you want to speak with either manager, please ask your nurse for the contact information.
Respiratory Therapists
Respiratory therapists assist the nurses and doctors if your baby has breathing problems. They operate ventilators and other respiratory equipment and make sure your baby receives excellent respiratory care.
NICU Social Workers
Social workers are available for support and as a resource for referrals to community services. A social worker is assigned to every NICU family and will contact you during the first few days of your baby’s admission to the NICU. You may also ask to speak to a social worker during regular office hours, Monday through Friday from 9:00 a.m. to 5:00 p.m. and on weekends.
Physical Therapists
Physical therapists may help you with handling your baby throughout his or her development. The therapist can show you ways of touching and handling your baby and will help you monitor and evaluate your baby’s progress.
Unit Secretaries
Secretaries make sure that the NICU operates smoothly and that you get what you need. They answer and direct phone calls, will greet you when you arrive, remind you to wash your hands and lead you to your baby. Please show the unit secretary your colored wristband upon entering the unit.
Cuddlers
Cuddlers are specially trained volunteers who come to the NICU to hold and comfort babies.

Important Terms

To assist you in understanding your baby’s care, we’ve provided a list of terms you may hear from physicians or nurses. If you have any questions regarding these or any other terms please ask your nurse or physician.

Apnea (A’s): A 15-second (prolonged) pause between breaths.
Aspiration: Mucous or other material that your baby may have inhaled into the lungs or windpipe.
Bilirubin (Bili): A naturally occurring substance that causes jaundice, a yellowing of the skin. This is a very common occurrence in all babies.
Blood Gas: A blood test that shows how much oxygen and carbon dioxide is in the blood to help diagnose the cause of a baby’s breathing distress.
Blood Sugar: A simple blood test that looks at the amount of sugar in your baby’s blood. (Chem strip, sure step)
Bradycardia (B’s): Sometimes called a brady, this is the brief slowing of the heartrate.
Colostrum: Early breast milk that flows during the first 3-4 days after giving birth. It is especially high in infection-fighting properties.
Continuous Positive Airway Pressure (CPAP): Stimulates your baby to breathe by delivering a slight amount of pressure to the lungs by soft prongs in the nose. Allows babies to breathe at their own pace while providing support if they get tired.
Desaturation (desat): A time when your baby’s blood oxygen level is low; often related to an apnea.
Electrode, Probe, Sensor or Leads: A strip placed on the baby’s skin to relay signals from the heart, lungs and skin to monitors.
Gavage Feeding: Babies who are unable to suck receive breast milk or formula through a tube that is placed through the nose or mouth into the stomach.
Heelstick: A way to draw blood for testing through a small prick on the baby’s heel.
Hyperalimentation(Hyperal, TPN HA): Special nutrition given by IV.
Isolette (incubator): An enclosed, temperature controlled bed to keep the baby warm.
IV – Intravenous: Injection of medication and fluids through a catheter inserted in the vein.
Lipids: Special fat given by IV to help a baby gain weight.
Monitor: A machine that measures heart rate, breathing rate and other vital signs.
Nasal Cannula: Small clear tubes that blow a light flow of oxygen through your baby’s nostrils.
Open Warmer/Table: An open bed kept warm by an overhead heater. Used for admissions and often for procedures or observations.
Parent Conference: An opportunity for you and your baby’s healthcare team to discuss your baby’s plan of care, including treatments and decisions regarding discharge. Please contact your doctor or social worker if you would like to request a conference.
Phototherapy: A light used to treat jaundice caused by bilirubin.
PICC line (Perc): A catheter that is inserted into a large vein that allows access for medications and fluids. This IV line may last several weeks.
Primary Care Nursing: A nurse or small group of nurses consistently assigned to care for your baby. Parents may choose a primary nurse or group of nurses to be primary nurses.
Pulse Oximeter (Pulse ox): A sensor that looks through the skin at your baby’s red blood cells to measure the oxygen level.
Residual: Measured amount of food left in the stomach after feeding.
Rounds: Physicians and nurse practitioners round every day on every baby on their team. This means they do a physical examination of your baby, check lab work, respiratory status, feedings, and establish a plan of care for the day.
Septic Work-Up: A few routine blood tests that are done to rule out infection in your baby.
Ventilator: Also known as respirators or breathing machines, ventilators deliver oxygen to your baby’s lungs at different rates and pressures to support your baby’s breathing, as needed.

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Chaplaincy Program

Our chaplaincy program provides compassionate, confidential support for people of all faiths and backgrounds who come to Alta Bates Summit Medical Center. Chaplaincy services are provided free of charge and include:

Interfaith chapel (located on the first floor, across from the elevators).
Copies of Scriptures and holy writings are available from various faith traditions.
Religious services and rituals, including prayer, emergency baptism, communion, and anointing.
Assistance with referrals to local religious leaders and faith communities.

To contact a chaplain, please ask your nurse or call (510) 204-6730 or page the on-call chaplain at (510) 801-5050. Chaplains are available 24 hours a day, 7 days a week. Please feel free to invite your own religious leader or spiritual advisor for support.

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Confidentiality

You can be assured that we protect the confidentiality of you and your baby. We accomplish this by discussing your baby’s health only with you, the parents. We do not give any information about your baby to your family and friends or to any other NICU parents or visitors. Also, we cannot answer any questions about any other babies. We ask that all patients and their visitors stay at their baby’s bedside. We also ask that you and your visitors respect the confidentiality of others.

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Interpreter Services

Alta Bates Summit offers certified Sutter translators by telephone or in person for assistance with medical information and education. Family members and friends are also welcome to help you with other non-medical translation. American Sign Language interpreters are available as well. Please ask your nurse to request any of these services.

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Transportation Options

The Alta Bates Campus is accessible by public transportation. There are two BART stations nearby, both of which are served by our shuttle bus:

Ashby Station – Located at Ashby Ave and Adeline Street, the Ashby station is on the Richmond BART line. It is located approximately 1 mile west of the medical center
Rockridge Station – Located at College and Shafter, the Rockridge station is on the Concord BART line. It is approximately 1 mile south of the medical center.

There are also several AC Transit bus lines with stops within a few blocks of our front door. For BART information, call (510) 465-BART. For AC Transit information, call (510) 839-2882.

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Driving Directions

From East and West-bound 80:

Take 80 to Berkeley, exit at Ashby Ave.
Travel east on Ashby for approximately 2.5 miles.
Turn right on Colby Ave to the main entrance.

From North-bound 880 and 980:

Take 880 North to 980 East.
From 980, take 24 to the 51st St. exit.
Turn right on 51st St.
Turn left on Telegraph Ave.
Turn right on Ashby Ave.
Turn right on Colby.

From West-bound 24:

Take 24 to Telegraph Ave. exit.
Turn right on Telegraph Ave.
Turn right on Ashby Ave.
Turn right on Colby to the main entrance.

Parking

The parking garage at the Alta Bates Campus is a fivestory structure directly across from the hospital’s main entrance. The garage is operated for the hospital by a private company. The garage is convenient because it is near the hospital and is open 24-hours per day. At night, security guards patrol the area between the hospital lobby and the garage gate. However, parking is expensive. At current rates, your parking costs add up very quickly over the course of your baby’s hospitalization.

Parking Assistance: The NICU social workers have a very limited number of parking passes for use in the parking garage. These passes are intended for families who are truly needy. Unfortunately, there are not enough passes for all of the families with babies in the NICU. If the parking situation is causing an extraordinary hardship for your family, please contact your social worker. Also, discounted 3-day and 7-day passes are available in the parking garage. Please return any unused parking passes to the ward clerk upon discharge. This will ensure additional parking for other families.

If you choose to park on the street, please keep the following in mind:

Preferential Parking: Parking spaces in the Elmwood and South Campus neighborhoods of Berkeley are reserved for neighborhood residents. Preferential parking is in effect from 9:00 a.m. to 7:00 p.m. every day except for Sunday and holidays.
Street Sweeping: Local streets are swept once per month and parking on the street during sweeping is prohibited. Look for the street sweeping signs before you park.
Meter Enforcement: Parking meters are strictly enforced in Berkeley. If you are planning to stay in the NICU for more than one hour, you should not park in a metered space.
Safety: If you are coming to the nursery after dark, you should park in the garage and not on the neighborhood streets.

Kangaroo Care

Kangaroo Care is a loving, sensitive way of holding your baby. It helps meet the baby’s natural need for a secure connection after birth, and has been shown to promote the vitally important bonding process that takes place between the infant and parents. Kangaroo Care involves direct skin-to-skin contact, achieved by comfortably positioning the infant on the bare chest of either parent. This can be done for varying lengths of time depending on how well your baby tolerates this position. Please allow at least 30 minutes for this activity.

Kangaroo Care first began in the early 1970s as a way to care for small, fragile babies. Through research, it has been shown to help a baby’s heart rate, temperature and oxygen use (oxygen saturation). It may also increase the mom’s milk supply. In addition, it has a calming effect and is pleasurable for both parents and baby – enhancing quality of life while in the NICU.

Alta Bates Summit staff is trained to support the use of Kangaroo Care in the NICU, ensuring that baby and parent find a comfortable position in which to relax and share time growing their love for one another. It is an important and encouraged aspect of our Compassionate Beginnings™ program.

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Compassionate Beginnings™ Program

The parent-child relationship is essential to the longterm well-being of any infant, but especially for newborn babies who are pre-term or medically vulnerable. For this reason, we offer the Compassionate Beginnings Program to families with an infant in the NICU.

Touch is the first sense to be developed by babies, starting in the womb at approximately 4 - 6 weeks gestation. As the baby experiences various types of touch, pathways are created in the baby’s brain from these experiences.

Knowing that the sensation of touch plays a vital role in a baby's health and development, our NICU staff members, trained in the Compassionate Beginnings (CB) techniques, teach parents how to communicate in their
baby’s first developed language ~ the language of touch.

CB helps babies “learn” about their parents and the environment outside of the womb. Parents learn to comfort their fragile infant and play a vital role in their development. Parents are shown ways to counteract the
experiences of invasive or painful procedures for the baby while living in the NICU.

With the help of a trained health care professional (such as a nurse, respiratory therapist, or physical therapist), parents learn how to read their baby’s cues and behavior to identify when they are ready to be touched.

When ready, a parent begins by taking some deep breaths and/or a few shoulder stretches at the crib side to relax. Once focused, the parent may be guided to slowly place their calm, warm hands on the baby's bottom and head. This tells the infant that their parent is close by, and that there is security and comfort in this “new world” outside of the womb. Contact may continue for up to 30 minutes, or at times, for only a few minutes, as tolerated by the infant. The parent communicates love and caring through touch and voice. The baby’s cues and the medical monitors let the parent and health care professional know how well touch is being tolerated and when to stop.

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Parent Education Classes

Discharge Preparation Class
The discharge prep class is taught in English and Spanish and is highly recommended to prepare to take your baby home. Check front desk for dates and times. Cantonese class available upon request.

Mother-Baby Class
Provided Monday through Saturday at the Family Care Center.

Infant CPR
This 90-minute class teaches basic Infant CPR skills and safety for parents of children from birth – 12 months. Classes take place every Saturday in the NICU. Please sign up at the front desk.

NICU Post Discharge Infant Massage Class
Free to all parents. Series of four weekly classes designed for our NICU graduates and their families to learn how to massage their babies.

Parent Share
A support group led by a NICU nurse who had a premature baby.

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