Doctors and nurses usually place babies who need any specialized medical attention in a special ward in a hospital referred to as the Neonatal Intensive Care Unit (NICU).
Unborn babies normally rely on their mothers for food, oxygen, immunological protection, and elimination of waste. Once born, they have to transition and carry out body functions on their own. Sometimes this does not happen and special pediatricians referred to as Neonatologist have to intervene.
Babies can get to the NICU for a number of reasons, though doctors will sure take babies born before 37 weeks of pregnancy or those that are lighter than normal to the NICU. Furthermore, doctors will also take twins and multiples, or any babies found to have a medical condition in the NICU, since these deserve intensive care. Births defects, infections as well as heart, liver, and breathing problems warrant intensive care.
Once a baby begins to show signs of good health, doctors can discharge them, but not until they pass the following tests.
20 Eye Exam
Before babies leave the NICU, one of the common tests they must pass is the eye exam. Doctors do this test to confirm if the baby has a condition called Retinopathy of Prematurity (ROP). This condition affects babies less than three pounds born before week 30. Not testing for ROP can lead to vision loss and even blindness, as indicated by WebMD.
19 Hearing Test
Premature and sick babies must pass a hearing test before they can leave the NICU. According to verywellfamily.com, this is because preemies and neonates are at a greater risk of developing hearing loss. Doctors must do the Auditory Brainstem Response (ABR). It involves placing headphones over the baby’s ears and electrodes on their heads to measure the brain’s response
18 Plasma Test
NICU babies must pass their final plasma test before they can go home. As stated by pampers.com, this test can reveal a lot of things, for example, it can tell if the baby is anemic, has high bilirubin levels, glucose levels, or whether he or she has an infection. Doctors usually draw the plasma they want to test from a vein, IV line, or from a prick on the heel.
17 Newborn Screening Test
Doctors have to perform a newborn screening test before babies leave the NICU but this also depends on the State requirements. As revealed by healthychildren.com, doctors screen the baby by placing his or her plasma drops on a filter paper to detect whether the baby has a metabolic disorder known as Phenylketonuria (PKU). Early testing allows for the treatment of the condition before symptoms arise properly.
16 Cranial Ultrasound
Before discharging a baby from the NICU, doctors have to perform a cranial ultrasound, depending on how early the baby is born. According to NCBI, a preterm infant’s brain is vulnerable to both hemorrhagic and ischemic issues if born during the late second and early third trimester. It is wise to do the test to ensure early diagnosis.
15 Car Seat Test
All NICU babies born before 37 weeks must pass the car seat test before leaving the hospital. Doctors use this test to determine the baby’s readiness to travel in a car seat. According to verywellfamily.com, the doctor places the baby in a car seat and then hooks them up to a breathing monitor and oximeter to check if they are breathing properly.
14 Behavioral Exam
Doctors usually do a neonatal behavioral exam to determine how a NICU baby responds to its new environment and if he or she has achieved the expected developmental milestones. Doctors perform this test using the neonatal behavioral assessment scale (NBAS) or the assessment of the premature infant’s behavior (APIB), as stated by Pampers.
13 Urine Test
Health professionals must carry out a urine test before NICU babies can leave the hospital. As revealed by Pampers, this test is used to determine if the little one’s kidneys are functioning well or whether they have an infection. Nurses usually collect a urine sample by placing a bag down there or using a needle to draw the urine directly from the bladder.
12 Scale Gain
Another test these tiny patients must pass is the scale gain test. This involves monitoring the pounds chart against the standard at a particular gestational age, as stated by Medline Plus. Neonates are likely to gain pounds from the time they are born to the time they get permission to leave. However not all gain, some loose. A steady gain on the scale is an encouraging sign.
11 Temperature Regulation
Babies must also pass a temperature test. This is because most NICU babies cannot regulate their own temperature and this is why they stay in an incubator, to keep warm. According to verywellfamily.com, the baby has to maintain a stable temperature while in an open crib before doctors can sign discharge papers. However, this also depends on the baby’s numbers on the scale.
Babies in the NICU especially with heart problems must pass an echocardiogram test before they can go home for the first time. This ultrasound test uses sound waves to check the baby’s heart and vessels around the heart. Doctors do this to determine how a heart is handling pumping and to detect any abnormalities in the heart, as Cincinnati Children's points out.
9 Electrocardiogram (ECG/EKG)
NICU babies must also pass the Electrocardiogram (ECG) test before checking out. This test records the electrical activity of the baby’s heart. It reveals how fast a baby’s heart is beating and whether the rhythm of the beat is regular, as stated by verywellfamily.com. The doctor will require the baby to lie still for about a minute while performing the test.
8 Respiratory Stability
NICU babies–especially preemies—usually have episodes of apnea where they develop temporary pauses in breathing, a slow heart rate and change in skin color. Sometimes doctors might have to put the baby on breathing tubes, as stated by kidshealth.com. Apnea of prematurity (AOP) usually goes away on its own as the baby matures but the doctors have to confirm this using a cardiorespiratory monitor.
7 Computed Tomography (CT) Scan
A CT scan test is necessary before NICU babies can go home. This test shows detailed images of parts of the baby’s body. During the test, doctors have to sedate the baby to reduce movement. As stated by Pampers, CT scans can also be done to determine if there is hemorrhaging in the baby’s head.
6 Arterial Pressure Test
Neonates must pass an arterial pressure test before they get permission to leave the hospital. Nurses measure this pressure by placing a small cuff around the baby’s upper arm or leg. According to Stanford Children's, a pressure monitor will then pump the cuff and measure the pressure. Nurses can also do this by placing a catheter in one of the baby’s arteries.
5 Gas Tests
This test determines how much oxygen or carbon dioxide is present in the baby’s plasma. According to Pampers, NICU babies with lung and heart problems must pass this test. Doctors perform this test on babies to measure the plasma's pH and the base excess of bicarbonate. Doctors do these tests by placing an arterial line in the baby’s ankle or wrist.
Newborns with breathing problems must pass x-ray tests before doctors discharge them. X-rays tests use electromagnetic energy and doctors use them only when they have to because, during such tests, the baby encounters low levels of radiation. X-rays are mostly required for babies with breathing problems or babies with signs of bowel problems, as revealed by March of Dimes.
3 Feeding Test
Safe oral feeding requires that a baby is able to coordinate sucking, swallowing and breathing when feeding. Before the young one can finally go home, doctors have to check on this. Kids Health also agrees that babies receiving food through gastrostomy tubes or through the vein must show they can feed on their own before going home.
2 Tests For Infections
Premature babies are at a higher risk of getting infections after birth because they have immature immunes systems. Infections in neonates can lead to serious illnesses and fatalities as Kids Health points out. Therefore, preemies must pass various tests to rule out infections. Nurses administer vaccines and other preventative meds to fight against infections.
1 Magnetic Resonance Imaging (MRI)
Preemies, especially, must go through an MRI test before leaving the hospital. MRIs usually give pictures with details that would otherwise be difficult to get using an x-ray or CT scan. Doctors do MRI tests to determine whether a baby has a brain complication that can affect his or her development as stated by health24.
Sources: webmd.com, verywellfamily.com, ncbi.nlm.nih.gov, pampers.com, healthychildren.org, medlineplus.gov, cincinnatichildrens.org, kidshealth.org, health24.com, marchofdimes.org.