Nobody hands you a dictionary when your baby is admitted to the NICU.
And yet, suddenly you’re hearing things like brady, desat, CPAP, gavage, PICC, and bilirubin while trying to process the fact that your baby is in the hospital.
Someone says, “She had a brady, and a desat overnight,” and everyone around you seems to know exactly what that means.
Meanwhile you’re standing there thinking:
I’m sorry. She had a what?
If that’s you, this is for you.
You aren’t supposed to already know NICU language.
Ask what something means. Ask them to explain it again. Write it down. Pull this guide up on your phone during rounds if you need to.
Here are some of the words and abbreviations you may hear during your baby’s NICU stay.
First, the people and everyday NICU language
NICU
Neonatal Intensive Care Unit.
A specialized hospital unit that cares for newborn babies who need additional medical care or monitoring.
Some babies are in the NICU because they were born prematurely. Others may need help breathing or feeding, treatment for an infection or another kind of specialized care.
Neonatologist
A pediatrician with additional specialized training in caring for sick and premature newborns.
You may hear your baby’s neonatologist referred to as the attending physician. The neonatologist typically directs your baby’s medical care in the NICU.
Rounds
A regular time when members of your baby’s medical team come together to discuss how your baby is doing and make plans for their care.
This can sound intimidating at first because there may be a lot of medical language happening very quickly.
If you’re allowed to participate, don’t be afraid to ask questions.
This is your baby. You’re allowed to need things explained in normal human language.
Cares
You may hear a nurse say that it’s almost time for your baby’s “cares.”
This generally refers to routine hands-on care such as taking your baby’s temperature, changing their diaper, repositioning them or feeding them.
Exactly what happens during cares will depend on your baby and your NICU.
Isolette or incubator
That clear enclosed bed you may see around a premature or medically fragile baby.
It creates a controlled environment that helps your baby maintain things like body temperature while still allowing the medical team to monitor and care for them.
The monitors and alarms
This is one of the strangest parts of walking into a NICU for the first time.
Your tiny baby may have wires and sensors everywhere.
Then something starts beeping.
Then something else starts beeping.
And your entire nervous system decides this is an emergency.
Sometimes it is something the medical team needs to respond to. Sometimes an alarm happens because a sensor moved or a reading briefly changed.
Your baby’s nurse can explain what each monitor is measuring and which alarms are important for your baby’s particular situation.
Leads
Small sticky sensors placed on your baby’s chest.
They’re connected to a monitor that tracks things such as your baby’s heart rate and breathing.
Pulse ox
Short for pulse oximeter.
A sensor that estimates the percentage of hemoglobin in the blood that is carrying oxygen, called oxygen saturation.
Sats
Short for oxygen saturation.
This is the oxygen level being measured by the pulse oximeter.
You may hear someone say your baby’s “sats look good” or that their sats dropped.
Desat
Short for desaturation.
It means your baby’s blood oxygen level dropped below the range their medical team wants for them.
What counts as significant and what needs to be done about it depends on your baby’s individual situation.
Apnea
A pause in breathing.
Apnea is especially common in babies born prematurely because the systems that control breathing are still developing.
Brady or bradycardia
A slower-than-expected heart rate.
In premature babies, bradycardia can happen along with apnea.
A’s and B’s
Short for apnea and bradycardia.
Yes, the NICU has abbreviations for its abbreviations.
You may hear your baby’s team talk about whether your baby has had any “A’s and B’s.”
A/B/D
Apnea, bradycardia and desaturation.
These events can sometimes happen together, which is why you may hear the three grouped into one very efficient little acronym that initially means absolutely nothing to you.
Breathing support
If your baby needs help breathing, there are several different kinds of respiratory support you may encounter.
They don’t all mean the same thing, and needing breathing support doesn’t necessarily mean your baby can’t breathe at all.
Nasal cannula
Those two tiny prongs you may see sitting inside a baby’s nose.
A nasal cannula delivers air or oxygen to help support breathing.
High-flow nasal cannula
A type of nasal cannula that delivers warmed, humidified air and oxygen at a higher flow.
Your NICU team may simply call it high flow.
CPAP
Continuous Positive Airway Pressure.
CPAP provides pressure through small tubes or prongs to help keep your baby’s airways and lungs open while they breathe.
And yes, the little CPAP hat and tubes can make your already-tiny baby look like they’re wearing an alarming amount of equipment.
It can be a lot to see.
Intubation
Placing a breathing tube into your baby’s airway.
ETT
Endotracheal tube.
This is the breathing tube used when a baby is intubated. It goes into the windpipe and allows air and oxygen to reach the lungs.
Vent or ventilator
A machine that provides breathing support through an endotracheal tube.
There are different kinds of ventilators and different levels of support, so your baby’s team can explain exactly what the ventilator is doing for your baby.
Blood gas
A blood test that gives the medical team information about things like oxygen, carbon dioxide and the acid-base balance in your baby’s blood.
It can help them understand how well your baby’s lungs and breathing support are working.
Feeding and breastmilk terms
This is where you may encounter an entirely new collection of tubes and abbreviations.
Again.
Because apparently parenting a NICU baby also comes with a surprise medical vocabulary course.
Gavage feeding
Feeding milk through a tube that goes directly into your baby’s stomach.
Premature babies may need gavage feeds while they’re still developing the coordination needed to suck, swallow and breathe during a feed.
NG tube
Nasogastric tube.
A small feeding tube that enters through your baby’s nose, travels down the esophagus and ends in the stomach.
Breastmilk, formula and some medications can be given through it.
OG tube
Orogastric tube.
Very similar to an NG tube, except this one enters through your baby’s mouth before traveling to the stomach.
Easy way to remember:
NG = nose.
OG = oral/mouth.
One less acronym to Google at 3 a.m.
PO
By mouth.
You may hear this when your baby begins taking milk directly by breast or bottle rather than entirely through a feeding tube.
NPO
Nothing by mouth.
Nothing by mouth. In the NICU, this generally means milk or other enteral feeds are temporarily being withheld; IV fluids or nutrition may still be given. There can be many reasons for this, so your baby’s medical team should explain why it’s necessary.
TPN
Total Parenteral Nutrition.
Total parenteral nutrition. Carbohydrates, protein, fat, vitamins and minerals given through an IV or central line when a baby cannot get enough nutrition through the digestive system.
It can provide nutrients to babies who aren’t yet able to receive enough nutrition through milk feeds.
Fortifier
Extra nutrition added to human milk to provide additional calories, protein, minerals or other nutrients.
Premature babies can have higher nutritional needs, so some babies receive fortified breastmilk even when they’re receiving their mamma’s milk.
Needing fortifier doesn’t mean your breastmilk isn’t “good enough.”
It means your very small baby may have very big nutritional needs.
Trophic feeds
Very small amounts of milk given to help introduce feeding to the digestive system.
You may also hear these called minimal enteral feeds.
Non-nutritive sucking
Sucking without taking a full milk feed.
A baby may practice at the breast or with a pacifier while receiving nutrition another way.
It’s basically feeding practice before feeding becomes the full event.
Lines, IVs and bloodwork
Seeing tubes and lines attached to your baby can be one of the hardest parts of the NICU.
Knowing what they’re actually doing can make them a little less mysterious.
PIV
Peripheral IV.
A small IV placed into a vein, often in a baby’s hand, arm, foot or scalp, that can be used to give fluids or medications.
And yes, an IV in the scalp can look terrifying the first time you see one.
That doesn’t mean something has happened to your baby’s head. Sometimes a scalp vein is simply one of the accessible veins available in a very tiny baby.
Central line
A small tube placed into a larger blood vessel.
Central lines can be used to give medications, fluids or nutrition, and in some cases to obtain blood samples.
PICC line
Peripherally Inserted Central Catheter.
A type of central line inserted through a vein and advanced until the tip reaches a larger central blood vessel.
UVC
Umbilical Venous Catheter.
A line placed through the vein in your baby’s umbilical cord.
It can be used shortly after birth to give fluids, medications or nutrition.
UAC
Umbilical Arterial Catheter.
A line placed through an artery in the umbilical cord.
It can be used for things such as monitoring blood pressure and drawing blood samples.
Heel stick
A small puncture made in your baby’s heel to collect blood for certain tests.
Tiny heel. Tiny needle.
Still somehow very difficult to watch when it’s your tiny heel.
CBC
Complete Blood Count.
A blood test that measures different types of blood cells and can give the medical team information about things such as anemia or possible infection.
Culture
A laboratory test used to look for bacteria or other germs that may be causing an infection.
You may hear about a blood culture, for example, if your baby’s team is evaluating them for infection.
Conditions you may hear about
Not every NICU baby will experience these.
Seeing one of these terms in a guide does not mean your baby will develop it.
These are simply some of the conditions that may come up when caring for premature or medically fragile newborns.
RDS
Respiratory Distress Syndrome.
A breathing condition especially common in premature babies whose lungs haven’t yet produced enough surfactant, a substance that helps keep the tiny air sacs in the lungs from collapsing.
BPD
Bronchopulmonary Dysplasia, sometimes called chronic lung disease.
A lung condition that can develop in some babies who have needed significant respiratory support.
PDA
Patent Ductus Arteriosus.
Before birth, babies have a normal blood vessel called the ductus arteriosus that allows blood to bypass the lungs.
It’s supposed to close after birth.
When it remains open, it’s called a PDA. Premature babies are more likely to have one.
NEC
Necrotizing Enterocolitis.
A serious intestinal condition that primarily affects premature or medically fragile babies.
If your baby’s team is concerned about NEC, they may temporarily stop milk feeds while evaluating and treating your baby.
IVH
Intraventricular Hemorrhage.
Bleeding into or around the fluid-filled spaces of the brain.
Premature babies, particularly those born very early, can be at higher risk, which is why some babies receive routine head ultrasounds to look for it.
ROP
Retinopathy of Prematurity.
A condition involving abnormal development of blood vessels in the retina of the eye.
Premature babies at risk for ROP receive eye examinations so it can be detected and monitored. Many mild cases improve without treatment, while more serious cases may require treatment.
Sepsis
A serious, potentially life-threatening response to an infection that can affect multiple organs and body systems.
Newborns, particularly premature babies, can have difficulty fighting infections, so the NICU team may investigate quickly if they see signs that could suggest sepsis.
Bili or bilirubin
Bilirubin is a yellow substance produced when red blood cells break down.
When bilirubin builds up in a newborn’s blood, it can cause jaundice, which makes the skin and eyes look yellow.
You may hear someone say they’re checking your baby’s “bili.”
Phototherapy
Treatment using special light to help lower bilirubin levels.
This is when your baby may be under blue lights wearing what looks like the world’s tiniest pair of sunglasses.
The good words you may start hearing closer to home
After days or weeks of learning about oxygen levels, tubes, tests and alarms, the vocabulary may slowly start changing.
And these are some of the words you’ve been waiting for.
Open crib
Moving from an incubator into a regular hospital crib while maintaining body temperature without the extra controlled environment.
For a premature baby, that little crib can feel like a very big deal.
Ad lib feeding
Feeding based more on your baby’s hunger cues rather than strictly scheduled or predetermined feeding amounts.
Whether and when this is appropriate depends on your baby’s individual feeding progress.
Corrected age
An age used when looking at the growth and development of babies born prematurely.
It’s based on how early your baby was born compared with their due date.
So if your baby is four months old but was born two months early, their corrected age would be approximately two months.
Car seat test
Before discharge, some premature or medically fragile babies may need to spend time sitting in their car seat while their breathing, heart rate and oxygen levels are monitored.
Your NICU will tell you whether your baby needs this and how the test works.
Discharge
Home.
Okay, technically it means your baby is medically ready to leave the hospital.
But after you’ve spent days, weeks or months in the NICU?
It means home.
You are allowed to keep asking
The NICU has its own language.
Eventually you may find yourself saying things like, “She had two bradys but no desats overnight and they’re increasing her PO feeds today,” and realize that somehow this vocabulary has become part of your life.
But you don’t have to learn it overnight.
And you don’t have to pretend you understand something when you don’t.
Ask the nurse. Ask the doctor. Ask them to slow down. Ask them to explain it without the acronym. Ask again tomorrow if you forget.
You have enough to carry right now.
Memorizing a medical dictionary doesn’t need to be one of those things.
Sources & Further Reading
March of Dimes
Common NICU Equipment
March of Dimes
Common Conditions Treated in the NICU
American Academy of Pediatrics / HealthyChildren.org
NICU Medical Team
American Academy of Pediatrics / HealthyChildren.org
Premature Babies: Information for Parents
American Academy of Pediatrics / HealthyChildren.org
Skin-to-Skin Contact: How Kangaroo Care Benefits Your Baby
This article is intended for general educational information and isn’t a substitute for medical advice. NICU terminology, practices and treatment can vary between hospitals and according to your baby’s individual needs. Always ask your baby’s NICU team to explain the terms, equipment and treatments being used in your baby’s care.
