Neonatal Intensive Care Unit

Parents are key members (partners) of the Indiana University Health Ball Memorial NICU team. Our goal is to involve you as fully as possible in your baby's journey. We hope that you find the following information helpful.

When newborns are critically ill or premature, they require intensive care provided by a Level IIIB Neonatal Intensive Care Unit (NICU), such as the one at IU Health Ball Memorial Hospital. The Birthing Center's unit is equipped with 17 beds providing critically ill and unstable newborns with technologically complex care, as well as constant observation and monitoring.

The unit is staffed with two board-certified neonatologists, a pediatrician, a neonatal nurse practitioner, a specially trained nursing staff, and occupational, physical, speech, and respiratory therapists.

Family centered care is the core value of the IU Health Ball Memorial NICU. Our goal is to provide a family focused atmosphere and developmental supportive environment for you and your infant. Each infant is viewed for his or her uniqueness, and the goal is to form a partnership with families while providing care for their infant.

Visitation

Parents are welcomed 24-hours a day. You may have up to three people at your bedside, including one of the banded people. In order to decrease the infection risk in the NICU, we ask that you select a maximum of four people over the age of 14 in good health to be designated as “visitors” for your baby’s entire stay. We ask that you complete a health screening form for each visitor in order to prevent communicable disease and infections that your infant is highly susceptible to from entering the IU Health Ball Memorial Hospital NICU. Due to interference with some of our equipment and our desire of a quiet, healing environment for your baby, please turn off all cell phones before entering the IU Health Ball Memorial Hospital NICU.

IU Health Ball Memorial Hospital Supports Breastfeeding

The IU Health Ball Memorial Hospital Birthing Center staffs seven IBCLC certified lactation consultants. They are available seven days a week to assist mothers with breastfeeding. After discharge there is a support group that meets weekly to offer support in breastfeeding and other parenting issues. The lactation consultants are available to answer questions and offer help to new mothers by phone or in person. To contact a Lactation Consultant, call 765-747-4444.

As the mother of a baby in the IU Health Ball Memorial Hospital NICU, we strongly encourage you to provide human milk for your baby which is the best food for all babies, especially if they are born early. We have provided this basic information to help you get started even though your baby may not yet be ready to actually feed at the breast. In time, as the baby grows and becomes stronger, the baby will be placed to the breast.

The NICU at IU Health Ball Memorial Hospital supports your decision to breastfeed and wants your breastfeeding experience to be successful. If you are still undecided about how you will feed your baby, we hope you will consider the many benefits of breastfeeding. Many mothers begin pumping while they are making their decision, to provide human milk for the early feedings. Many mothers tell us that providing their baby with their milk is a comfort to them during this difficult time—it’s something only they can do for their baby.

Occasionally, there are situations that prevent mothers from breastfeeding. If you have any questions related to your ability to breastfeed or your breastfeeding goals, we’d be happy to discuss them with you.

Pumping

You will need to begin pumping as soon as you feel able. There are electric pumps available for use while you are in the hospital. There are also electric breast pumps in the IU Health Ball Memorial Hospital NICU if you would like to pump at your baby’s bed space. You will need an electric pump for home pumping. Please discuss rentals with any nurse or lactation consultant.

Pumping directions, milk storage instructions, and pump rental information are available by the Mom/Baby, NICU or lactation consultant. Please let us know if you have difficulty obtaining a pump. Keep all your pump rental receipts for your health insurance company; some health insurance policies may cover pump rental.

Storage

There are freezers in the IU Health Ball Memorial Hospital NICU specifically for human milk storage. As your baby begins feeding, you will need to give the labeled bottles/containers of human milk to your nurse who will place them in the IU Health Ball Memorial Hospital NICU freezer. A small cooler works well for transporting frozen milk from home to the NICU. It is important that the milk stay frozen during transport.

Cuddler Volunteers

A Cuddler is a specially trained volunteer that is available at various times throughout the week to hold (cuddle) babies when parents are unable to be here. All of the Cuddlers are volunteers in the hospital and have had background checks by the hospital. They have received special training to include: education about premature infant development, feeding techniques, safety, and patient confidentiality. Cuddlers are often used to hold babies during tube feedings, when you are not available, in order for your baby to still experience their feedings as a pleasurable time. Cuddlers work under the guidance of your baby’s nurse. The Cuddlers at IU Health Ball Memorial Hospital take pride in making the IU Health Ball Memorial Hospital NICU a more home like environment.

Developmental Care

The brains of babies born early are very immature and underdeveloped when compared to babies born at term (less than 37 weeks gestation). Because of this, premature babies are unprepared to handle external stimulation that they are exposed to after birth. Although some of these exposures are important for their survival, much can be done to support these babies and help them to better cope with this environment.

A goal of the IU Health Ball Memorial Hospital NICU is to provide a developmentally supportive environment, including reduced noise levels, decreased bright lights as well as lighting cycled for each babies’ needs, and grouping care activities for babies so that they will have a longer period to sleep.

The positive impact of developmental care on development continues to be researched. It is known that developmental care demonstrates some benefits with respect to growth and behavioral outcomes, decreased respiratory support, and decreased length of hospitalization.

The entire IU Health Ball Memorial Hospital NICU team of specialist that care for babies in the IU Health Ball Memorial Hospital NICU have completed special training in developmental care, Wee Care®. All staff is specially trained in assessing the behavioral cues of premature infants and customizes a plan of care for each family. Each baby’s care is individualized and designed to provide an environment that supports your baby while his or her brain is still developing. The plan of care encourages active involvement of parents in the baby’s care, promotes the comfort for the baby, and provides strategies for the baby to successfully incorporate his or her responses to environmental stimuli.

How is Developmental Care Practiced in the NICU?

Every effort is made by the medical and nursing staffs to provide a safe, comfortable, and developmentally appropriate environment for premature infants to grow and develop in. Soft “nests” are used to promote the normal flexed posturing and comfort of containment that a premature baby would enjoy when he or she was still in the womb. Water or gel pillows are used to combat the negative effects of gravity on the shape of the developing premature baby’s head. Incubators are covered with dark blankets to muffle sound and provide a darkened environment that represents the environment the premature baby would normally be experiencing in the womb.

The more immature the premature baby, the less likely he or she is able to tolerate handling and the external environment that includes bright lights and many loud sounds. The medical and nursing staff try to minimize handling of sick, fragile premature babies and allow for many periods of much-needed and uninterrupted sleep.

Parent Education

Because premature babies differ greatly from term babies in their responses to stimuli, the educational needs for parents are unique. As a parent of a premature baby, the IU Health Ball Memorial Hospital NICU staff will teach you how to handle your baby in a manner that is comforting to him/her. Interpreting a premature baby’s responses to handling and/or stimulation can be tricky for even the most experienced parents. IU Health Ball Memorial Hospital NICU parents, with the help of their baby’s nurses, tend to learn very quickly the likes and dislikes of their particular baby/babies. Parents are encouraged to contribute to and participate in their baby’s care whenever possible.

Family Centered Care

Having a baby in the IU Health Ball Memorial Hospital NICU can be a shock for many parents. Few parents expect complications of a pregnancy or their baby to be sick or premature. It is quite natural to have many different emotions as you try to cope with the difficulties of a sick baby.

The NICU is overwhelming to parents! Don’t expect to understand everything about your infant in the few visits. Each time you visit your baby, you will be come more comfortable and familiar with your baby and the care he or she receives. The NICU staff is her to support you and encourages you to ask questions.

You may feel powerless because the environment of the IU Health Ball Memorial Hospital NICU has many technical pieces of equipment that are intimidating to parents. Powerlessness is also felt by parents because parents are unable to make specific parenting decisions during the initial NICU experience.

The IU Health Ball Memorial Hospital NICU staff is here to support you. If you are having difficult dealing with your emotions, please do not hesitate to talk with a IU Health Ball Memorial Hospital NICU staff member to discuss your feeling further. We are here to support and create a partnership in caring for your baby.

Some parents find it difficult to bond with their baby when they are in the IU Health Ball Memorial Hospital NICU. We understand that this is a stressful time. It is important that you spend as much time in the IU Health Ball Memorial Hospital NICU as possible with your baby. The healthcare team (doctor and nurses) have the most updated progress on your baby. It is important for you to ask questions to understand the plan of care for your baby. If you do not understand what is happening with your baby, please ask for clarification from the healthcare team.

Kangaroo Care

The term “Kangaroo Care” refers to a baby being held skin-to-skin by his/her parent, similar to the way kangaroos and other marsupials hold their young. The baby is kept warm by the warmth of the parent’s body. Both babies and parents benefit from the physical closeness kangaroo care provides. It was developed in Bogota, Colombia, and has been used successfully in South America, Europe, and now the U.S.

Parents' benefits

  • Closer bonding to your baby/babies
  • Nursing mothers who kangaroo often find they produce more milk
  • Diapering, dressing, and bathing

Babies' benefits

  • They sleep more deeply
  • Gain weight faster
  • Oxygen needs often decrease while kangarooing with parents
  • They are less stressed by the noise and activity around them
  • A parent’s body keeps baby warm, letting him or her conserve energy and grow
  • Many babies make their first breastfeeding attempts while kangarooing with mom!

How Do I Kangaroo My Baby?

Some babies may not be good candidates for kangaroo care. It is important to talk with your baby’s doctor of nurse to see if your baby is able to kangarooed.

Protecting From Infection

Hand washing is the best way for you to protect your baby from infection. Each time that you visit your baby in the IU Health Ball Memorial Hospital NICU, you will be asked to complete a hand scrub when you enter the IU Health Ball Memorial Hospital NICU and place a cover gown over your clothing. You will also need to wash your hands before feeding and after diapering your baby, or touching contaminated objects. The best prevention from infection is hand washing.

If you have been sick or been exposed to a communicable disease, please check with your baby’s nurse before entering the IU Health Ball Memorial Hospital NICU. It is important to discuss visitation of friends, family, and siblings with the IU Health Ball Memorial Hospital NICU staff also.

Discharging from IU Health Ball Memorial Hospital NICU

Most premature babies are not ready for discharge from the hospital until approximately their original due date. All babies must be able to maintain their temperature in a crib, gain weight, bottle or breast all of their feeds, and be free of apnea and bradycardia spells for one week before discharge.

IU Health Ball Memorial Hospital’s NICU is designed and staffed to provide acute, critical care for babies who are sick, and transitioning care as babies move toward their last phase of hospitalization. We start planning for your baby’s discharge home at the time of delivery. Remember each baby is unique and his/her progress will vary.

Your baby will require some special screenings prior to discharge. Some of the screenings will depend on your baby’s gestational age.

  • Infant Hearing Screening Program
  • Safe Sleep After the Hospital
  • Vision Screening

Please ask the knowledgable IU Health Ball Memorial Hospital NICU staff for explanations of the various screen tests for more detail.

Car Seat Safety

If your baby weighs less than four-and-one-half pounds at discharge and/or was born at less than 37 weeks' gestation, he/she will have a period of car seat monitoring prior to discharge. Before your baby is discharged, it is recommended that you purchase a car seat that fits your baby’s weight. Your baby's nurse will assist you with positioning your baby in the car seat you have chosen.

It is recommended that you take your baby and car seat to a Car Seat Fitting Station to ensure proper installation of the seat and position of the baby in the car seat. Please call 765-741-1073 to schedule an appointment with a car seat technician.

Follow-Up Clinic

IU Health Ball Memorial Hospital offers a free follow up clinic for IU Health Ball Memorial Hospital NICU graduate newborns. The IU Health Ball Memorial Hospital NICU Follow Up Clinic offers a comprehensive developmental screen via a team of individuals with multitude of expertise. The infant/toddler will be followed after discharge from the IU Health Ball Memorial Hospital NICU through the first 18 months of life.

The team will provide developmental evaluation using the expertise from pediatric speech therapist, pediatric occupational therapist, pediatric physical therapist as well as a consultation with a registered nurse and neonatologist from the IU Health Ball Memorial Hospital NICU. If the infant/child is not exhibiting his/her developmental milestones, further recommendations via the team are provided and appropriate community referrals are initiated and implemented.

The IU Health Ball Memorial Hospital NICU Follow Up Clinic is available to infants meeting a specific criteria determined by the medical team caring for the infant in the IU Health Ball Memorial Hospital NICU. Appointments are made prior to discharge from the unit.