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NICU

The neonatal intensive care unit (NICU) provides critical care to newborns who are ill or premature. Many factors may lead to a newborn being admitted to the NICU, including low birth weight or complications during delivery. The NICU staff works closely with parents to develop a treatment plan for their newborn.

Advanced care for infants in Austin and Central Texas

At our neonatal intensive care units (NICUs), your newborn will receive the special attention they need.

Our board-certified neonatologists and neonatal experts are available 24/7 at our NICUs. These nurseries are designed to provide stabilizing care for your child in the event of a high-risk pregnancy or complication.

NICU levels

NICUs range from Level I to Level IV. Rankings are determined by several factors, from the age of your baby (e.g., early term, late preterm or very preterm babies) to the type of training and outreach provided. All units feature advanced technology and offer stabilizing care for newborns.

NICU Levels

  • Level I: Regular nursery care available at most hospitals that deliver babies
  • Level II: Intensive care for sick and premature infants
  • Level III: Comprehensive care for more seriously ill newborns
  • Level IV: Major surgery, surgical repair of serious congenital heart and anomalies that require cardiopulmonary bypass and/or extracorporeal membrane oxygenation (ECMO) for medical conditions. Level IV units include the capabilities of Level III with additional capabilities and considerable experience in the care of the most complex and critically ill newborn infants and should have pediatric medical and pediatric surgical specialty consultants continuously available 24 hours a day.

NICUs at our hospitals

Whether your baby needs a little or a lot of extra help, we provide the care they need at our NICUs. These services are available at:

NICU nurses and team members

Every St. David's NICU has a trained medical team ready to provide support, medical treatment and developmental care. Neonatal specialists at our hospitals include:

  • Case managers
  • Dietitians
  • Lactation consultants
  • Neonatal nurse practitioners
  • Neonatologists
  • Occupational therapists
  • Pediatric subspecialists
  • Pharmacists
  • Registered nurses
  • Respiratory therapists
  • Social workers
  • Speech therapists

Your primary care doctor may order a consultation with a neonatologist before your delivery. In that case, a neonatal doctor will come to your room and explain what to expect if your baby is born prematurely. A NICU nurse may also visit and tell you more about our units and services.

NICU nurse navigators

Expectant mothers at our hospitals have access to a team of nurse navigators. These navigators work with families and medical teams to:

  • Offer guidance about all of our labor and delivery services, including NICU care
  • Schedule face-to-face meetings with our board-certified neonatologists
  • Schedule tours of our NICUs

Neonatal surgery

With a Level IV NICU, St. David's Medical Center is uniquely equipped to provide advanced care. Neonatal specialists at this hospital perform a wide range of surgeries, including procedures related to the following specialties:

  • Cardiology
  • Dermatology
  • Gastroenterology
  • General surgery
  • Hematology
  • Infectiology (infectious disease care)
  • Nephrology
  • Neurology
  • Neurosurgery
  • Ophthalmology
  • Orthopedic surgery
  • Otolaryngology (head and neck care)
  • Pulmonology
  • Radiology
  • Urology

Conditions we treat in the NICU

We build treatment plans for a wide range of conditions, including:

Congenital lung malformations

Congenital cystic adenomatoid malformation (CCAM) is a benign lung lesion that appears before birth as a cyst or mass in the chest. It is made up of abnormal lung tissue that does not function properly but continues to grow. CCAM is also frequently referred to as a congenital pulmonary airway malformation (CPAM). The vast majority of CCAM/CPAM lesions are small enough that they will not cause any problems to your baby during pregnancy, and the CCAM/CPAM can be removed after birth. However, some large lesions can cause serious and even fatal complications, including fetal heart failure (also called fetal hydrops). These cases may require treatment before birth.

Congenital diaphragmatic hernias

A congenital diaphragmatic hernia is an abnormality in the formation of the diaphragm, the muscle separating the chest cavity from the abdomen. The diaphragm helps in breathing, so it is critical to the respiratory system. In a diaphragmatic hernia, the diaphragm does not completely form, leaving a gap between the chest and the abdominal cavities.

Esophageal atresia

A congenital condition where your baby's esophagus develops improperly. The esophagus carries food and water from the mouth to the stomach. The esophagus normally develops in two parts, a top and bottom part, that grow together during development. In the case of esophageal atresia, the esophagus fails to connect in the middle resulting in a top (proximal) and bottom (distal) esophageal pouch. These two pouches are eventually brought together surgically to create a complete esophagus.

Fetal gastroschisis

A congenital abnormality or opening in your baby's abdominal wall next to the umbilical cord, allowing the intestines to protrude out into the amniotic fluid, causing them to cease their normal movement.

Fetal hernia/hydrocele

During fetal development, a sac that surrounds normally descending sexual organs does not close, allowing the intestine to bulge through the opening, or fluid to build up.

Fetal intestinal atresia

A congenital abnormality in which a part of the intestines fails to form properly, resulting in an obstruction or blockage. Examples are duodenal atresia, jejunal atresia and ileal atresia.

Fetal omphalocele

A congenital abnormality or opening of the central abdominal wall, allowing abdominal organs to protrude through it. A translucent membrane or sac covers the protruding organs.

Gastrostomy tube

Some kids have medical problems that make it hard for them to get enough nutrition by mouth. A gastrostomy tube (also called a G-tube) is a tube inserted through the belly. It brings nutrition directly to the stomach and is one way that doctors can ensure kids who have trouble eating get the fluid and calories they need. A surgeon inserts a G-tube during a short procedure called a gastrostomy. The G-tube can stay in place for as long as your child needs it.

Babies need G-tubes for different kinds of health problems, including congenital (present at birth) problems of the mouth, esophagus, stomach or intestines, sucking and swallowing disorders (due to premature birth, injury, a developmental delay, or another condition) and failure to thrive (when a child can't gain weight and grow normally).

Hernia

A protrusion of tissue or organs through an opening or weakness in the muscle wall that usually contains it. Infants can be born with them or can develop them if born prematurely. Examples include inguinal hernia or umbilical hernia.

Hirschsprung disease

A condition that occurs when the intestinal wall is missing the nerve cells which signal the muscles in the large intestine to push stool towards the anus, causing an intestinal blockage.

Hydrocephalus

A baby with hydrocephalus has extra fluid in and around the brain. This fluid is called cerebrospinal fluid (CSF). Most CSF is found in fluid-filled areas (ventricles) inside the brain. Its purpose is to cushion and protect the brain and the spinal cord. Too much CSF can increase the pressure in your baby's head. This causes the bones in your baby's skull to expand and separate. Babies can be born with hydrocephalus or develop hydrocephalus if born extremely premature and experience severe intraventricular hemorrhage.

Hypertrophic pyloric stenosis

A narrowing of the lower portion of the stomach that leads into the small intestine, resulting in food not moving easily into the intestine for digestion.

Imperforate anus

This birth abnormality caused by improper development of the rectum and anus during pregnancy, causing the opening at the rectum/anus to be absent so stool cannot leave the body.

Intestinal malrotation and volvulus

A birth abnormality involving a malformation of the intestinal tract; occurs while a fetus is forming in its mother's uterus.

Necrotizing enterocolitis

A serious intestinal illness in babies, typically born premature, involving damage to intestinal tissues, which can lead to a perforation (hole) in the intestines, allowing bacteria in the intestine to leak into the abdomen (belly). This can lead to a serious infection known as peritonitis (inflammation of the abdomen lining).

Spontaneous intestinal perforation

Spontaneous intestinal perforation (SIP) is a hole in a premature baby's intestine. Though uncommon, SIP typically occurs in the first week of life. The hole can cause the intestine contents to leak into the abdomen (belly), which can lead to a serious infection known as peritonitis (inflammation of the abdomen lining). SIP is a surgical emergency and once diagnosed, it is treated as soon as possible.

Ovarian cysts or mass

An accumulation of fluid in the ovary encapsulated inside a thin wall of tissue. It is very common and usually harmless, but it may require surgical removal depending on the size of the mass.

Posterior urethral valves (PUV)

Posterior urethral valves (PUV), a cause for bladder outlet obstruction (BOO), are obstructive membranes that develop in the urethra (the tube that drains urine from the bladder), close to the bladder. The valve can obstruct or block the outflow of urine through the urethra. When this occurs, the bladder, ureters and kidneys become progressively dilated, which can lead to damage.

Sacrococcygeal teratoma

A congenital condition where rare tumors form at the bottom of the spine by the tailbone.

Spina bifida or myelomeningocele

Spina bifida (Latin for "split spine") is a type of neural tube abnormality, a problem with the spinal cord or the structures covering it. The neural tube normally closes during the early weeks of embryo development, and can occur at any point along the spine ("backbone"). The spine normally protects the spinal cord. Spina bifida occurs because of the neural tube not closing completely during an unborn baby's development, causing a hole in some of the bones of the spine (vertebrae). This may result in spinal cord and nerve damage, which may cause mild to severe disabilities.

Tracheoesophageal fistula

A congenital condition in which an abnormal connection exists between the trachea (windpipe) and the esophagus (the tube that carries food and water from the mouth to the stomach).

Tracheostomy

A tracheostomy is an opening surgically created through the neck into the trachea (windpipe) to allow direct access to a breathing tube that may be required for babies with severe lung disease needing long-term mechanical ventilation (breathing machine) or significant upper airway obstruction.

Family Rooms

At St. David's Medical Center and St. David's Women's Center of Texas, families with a newborn in the NICU can take advantage of our Ronald McDonald Family Rooms. These dedicated spaces enable you to rest and heal while your baby receives care.

Ronald McDonald House

St. David’s Women’s Center of Texas also offers a home-away-from-home for NICU families who live outside Austin. The Ronald McDonald House, just a short drive from our hospital, is open to families who need a comforting place to stay while their newborn is in the NICU. Your neonatal nurse or case manager can make a referral if you need to use this space.

Leaving the NICU

We ensure every NICU "graduation" is a celebration. We also plan your child's discharge from the hospital with patient education in mind. To this end, we ensure all families are equipped to care for their newborns independently at home. We will go over some basics of infant care, including dressing, feeding and bathing. We will teach you how to:

  • Give any needed medications
  • Take your child's temperature
  • Use medical equipment at home

Before leaving, we will give you a discharge checklist and other information about your baby's ongoing care.

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