Having a baby in the NICU is something no parent plans for. Whether your child is born premature, needs extra support after delivery, or faces unexpected medical challenges, the NICU experience can feel overwhelming and full of unknowns.

You’ll learn:

• Why babies are admitted to the NICU (and what that first moment feels like for parents)

• What doctors, nurses, and staff monitor day-to-day to support growth and healing

• How NICU rounds work and the key questions parents can ask

• Why every care plan is individualized—and how parents are essential members of the team

• The emotional side of being a NICU parent, from guilt to uncertainty, and how staff help families feel supported

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00;00;00;03 – 00;00;25;22

Dr. Mona

Welcome to the PedsDocTalk podcast. I’m Doctor Mona, your pediatrician and online mom friend, and this is the follow up. Where we revisit a favorite past episode with a little more pizzazz. September is Nike Awareness Month, and this one is personal for me. Maybe some of you don’t know this, but I am a NICU mom. Even as a pediatrician married to an ER doctor.

 

00;00;25;25 – 00;00;49;20

Dr. Mona

Nothing prepared us for what happened when my son Ryan was born and became a full term baby in the NICU. He was full term, and yet at just 24 hours old, we found out he’d had a stroke during delivery and was having seizures. Traumatic delivery was more than I could have ever imagined. And he came out blue, not breathing, and was whisked away to the NICU.

 

00;00;49;20 – 00;01;18;10

Dr. Mona

And so began our journey as a family after a traumatic birth. Hearing that news and watching him go to the NICU was one of the hardest periods of my life. I had taken care of kids in the NICU. As a resident, I knew the medicine, but becoming an ICU mom is a completely different lens. I’ll never forget the nurses who comforted me when I cried, who explained things when I was terrified of the unknown, who gave me space to both be a mom and a doctor without judgment.

 

00;01;18;13 – 00;01;41;25

Dr. Mona

Our ICU nurses, whether it’s in the NICU or pick you, are incredible. They care for the sickest of the sick. But when you’re the parent on the other side, you see just how much heart goes into their work, including the staff in the NICU. Every single person, including the doctors, the nurses, the nurse practitioners, the PA, and all the ancillary staff make this easier for families at such a hard time.

 

00;01;41;28 – 00;02;00;08

Dr. Mona

So today, in honor of Nikki, awareness Month, we’re revisiting this episode on what to expect if your baby needs the nCCU. It’s for anyone who’s been there who May 1st day walk through it, or who’s living it right now, or who just wants to celebrate the families and the professionals who make the Nikki what it is. And before we jump in, don’t forget.

 

00;02;00;09 – 00;02;18;05

Dr. Mona

Download this episode. That’s what helps the show the most. And if it resonates with you, share it on social and tag at PedsDocTalk and at the PedsDocTalk podcast so more families can feel seen and supported. Let’s get into it.

 

00;02;18;07 – 00;02;26;23

Dr. Mona

From the beginning, you know, and the delivery, but also just in general, like, what are the things that you all are managing, looking out for when a baby’s admitted to the ICU?

 

00;02;26;25 – 00;02;46;09

Dr. Kate Rubey

Yeah. And that’s a great question. And kind of like you said, there’s so many things to cover within the Q because there’s such a wide berth of babies that we see from very premature babies to full term babies, surgical babies. So it is a tough one to answer. You know, I usually think about going to deliveries.

 

00;02;46;09 – 00;03;08;08

Dr. Kate Rubey

I tell people, you know, when we’re going to be called to a delivery, anything that’s not a straight forward, completely normal vaginal delivery. So the list of reasons that a neonatal just or just a pedes, you know, team in general is called. It’s quite long, actually. And I always feel bad because I don’t think everyone knows that.

 

00;03;08;08 – 00;03;36;19

Dr. Kate Rubey

And so then, you know, five people storm into the room, and majority of the time that I’m there, we dry the baby off, we say, happy birthday. We wait, get our pictures with the weight and the hat and give them back to their parents and say, like, congratulations and leave. You know, and then another smaller part of the time, we do a little bit of help with the baby because essentially they’re coming out of a pool and trying to learn how to breathe air like we’ve all been doing.

 

00;03;36;22 – 00;03;54;13

Dr. Kate Rubey

And so they need just a little extra help. And then we do the same thing with the weight and graduations and we leave. And then another very tiny part of the time. But an important part of the time, especially if it’s your baby, something is going on that we need to continue addressing. And so we have to take the baby with us.

 

00;03;54;16 – 00;04;11;24

Dr. Kate Rubey

And I think that’s one of the hardest things is, you know, telling a mom who just said her baby, especially when she’s not expecting it. You know, if it’s a premature baby, we are meeting with the family before the delivery happens. Most of the time, we’re talking about, you know, who’s going to be at the delivery. What’s going to happen to the baby afterwards?

 

00;04;11;24 – 00;04;27;19

Dr. Kate Rubey

So they get at least a little bit of a frame shift of what it’s going to look like. But when it’s a baby that we’re not sure is going to be need extra help, it’s, you know, really hard for us to say, I’m sorry you have to take your baby with us. But, you know, it’s always for the best.

 

00;04;27;19 – 00;04;47;09

Dr. Kate Rubey

For the baby. And then once they get upstairs, you know, most of the stuff that we’re looking at is kind of breathing oxygen levels. You know how well the heart is functioning. And then when the babies are small, we’re looking at waiting for them to grow big enough that they can do the things we need them to do, which is gain weight and eat.

 

00;04;47;09 – 00;04;54;19

Dr. Kate Rubey

So there’s not a lot of expectations for the little ones, but they’re hard things for them to do and for them to learn how to do.

 

00;04;54;21 – 00;05;19;01

Dr. Mona

That’s amazing. And you’re so right. I mean, the experience when everyone comes rushing into the delivery room, can be so overwhelming. Because obviously a parent is delivering a baby and then all of a sudden you’re like, what’s going on? Why is everyone coming? And why is everyone panic? And, you know, I obviously have been on the other side from a medical professional standpoint, but when it was me on the table on a C-section, I remember making eye contact with one of the nurses that came down.

 

00;05;19;06 – 00;05;33;06

Dr. Mona

And like, I literally just locked eyes with her. And I knew, like, I knew something was not right and that they were going to take Ryan. She didn’t even come to me to tell me that they were taking him because I had my own issues. But like, I literally remember locking eyes and I was like, yep, I know, I get it.

 

00;05;33;12 – 00;05;49;17

Dr. Mona

It doesn’t make it any easier. But it’s like, you know, you know, when you have the medical understanding, you’re like, yep, you need to go. This is not going to be something that’s resolved now. But it can be really hard. And like I said, from the perspective, of someone who’s been there from the mother’s side, I know how hard it is.

 

00;05;49;18 – 00;06;06;00

Dr. Mona

I know it feels like, well, we’re to my baby girl, but then the team is there to obviously keep that baby at its best, you know? And that’s so important to remember. I know it’s so hard sometimes, but like I said, the team is fantastic, and their goal is to support the baby in what they need.

 

00;06;06;02 – 00;06;20;19

Dr. Mona

And so you mentioned, like, obviously when the baby goes, depending on prematurity, depending on age, depending on what the concern is that brought them to the Nic, you, you’re literally just monitoring obviously all their major organ systems that are directed towards their diagnosis. Right?

 

00;06;20;21 – 00;06;43;04

Dr. Kate Rubey

Yeah. So every baby that comes gets a tailored assessment to the concern that we had, whether it be something that we were planning for, you know, based on what we knew prenatally about the baby before they came out or what we see in the delivery room. But by the time we bring them up to the Nic, you, they all get their own individualized plan, based on what our concerns are.

 

00;06;43;06 – 00;06;45;09

Dr. Mona

That’s amazing. And tell me more.

 

00;06;45;09 – 00;06;46;07

Dr. Kate Rubey

What happens.

 

00;06;46;07 – 00;07;05;05

Dr. Mona

On Nicky rounds. So this is something that obviously is really important. And I know maybe it may work differently in different nicus, but what are the goals? You know, generally for Nicky Rounds, what would you want parents to ask? What would you want parents to remember? You know, you have this platform on this podcast, for what happens on these, rounds.

 

00;07;05;07 – 00;07;37;01

Dr. Kate Rubey

Of course. Yeah. So I think of Nicky rounds and into separate parts. Right. And so the first part is going through all the numbers and all the things that happened overnight. And I think that can be very overwhelming. For many of the parents that I have worked with in the past, and I think that’s very normal. Thinking about the fact that, you know, to run rounds, I did four years of medical school and then six years of training after that, just to be, you know, in charge of running them.

 

00;07;37;01 – 00;08;02;21

Dr. Kate Rubey

And everyone else on the team has also done so much training and so much schooling. And so I think there’s that first part that happens. And then the next part is really on the providers within the team to explain what do all of these numbers actually mean in a way that’s not something that requires ten extra years of learning to figure out, and that’s the perfect spot for parents to be present with us.

 

00;08;02;21 – 00;08;18;28

Dr. Kate Rubey

If they can. We actually in our nick, you have a lot of parents who can’t come in for various reasons, which completely understandable because even after you have a baby, you still have a whole life that existed before that baby got there. So we call them during rounds. If they want to be a present, we can call afterwards with updates.

 

00;08;18;29 – 00;08;39;00

Dr. Kate Rubey

You know, every family has something different that works for them. And, you know, I feel like as a provider, team work here to figure out what works best for each family for their baby. But that second part is really important because that’s where parents have the floor to say this is something I saw because they are at the bedside frequently when we are not.

 

00;08;39;00 – 00;09;02;05

Dr. Kate Rubey

So sometimes they see things that we haven’t seen. They see patterns that we haven’t come across yet. And then they can also just say, you know, you guys said X, Y or Z yesterday and I’m confused. Tell us more about what that means. And so the the question asking part is so important because, I hate for any family to ever feel like they don’t know what’s happening with their baby.

 

00;09;02;08 – 00;09;23;11

Dr. Kate Rubey

I’ve never had a baby, so I cannot understand. But based on what I’ve heard from parents that I’ve worked with is, you know, it’s your child and it’s not normal to not be with them right away. And so some of what’s very difficult in the NICU experience is that there’s a team taking care of your baby, and you kind of don’t exactly know what’s going on.

 

00;09;23;11 – 00;09;42;17

Dr. Kate Rubey

And that’s why I think, you know, what’s so important is for us to all work together because parents know the most about their own baby, and then we come in with our own, expertise and knowledge, and we work together as a team to get the baby to a spot where they’re healthy enough to be able to go back home with their parents.

 

00;09;42;19 – 00;10;03;03

Dr. Kate Rubey

And so that’s why I think it’s so important for parents to be involved with us so they can ask the questions, and we can all be on the same page together. And like you asked, you know, exactly what happens on rounds is different in every hospital. You know, I’m at a very large, children’s hospital. So at our hospital, we have many people on rounds.

 

00;10;03;03 – 00;10;28;02

Dr. Kate Rubey

We have a dietician, we have, a pharmacist, we have a nurse. So we have a lot of people, which is nice. And there’s lots of brains thinking about every baby, every day. But there’s other institutions where it’s just the neonatologist or just the neonatologist and the nurse. And that’s also a really great forum, because then you have a very concrete number of people that you need to get together to talk.

 

00;10;28;05 – 00;10;47;05

Dr. Kate Rubey

But I think it’s just such a good opportunity for parents ask their questions and to get more clarity about what are the goals of the day. Because what happens in the NICU frequently is that we’re talking about days like today. This is what we’re going to do tomorrow. This is what we want to do. And those days then turn into longer term trajectories over time.

 

00;10;47;07 – 00;11;02;22

Dr. Mona

Yeah. I loved, you know, most of the nicus that I’ve worked at, I’ve been in three from obviously, my experience with Ryan, but also just, in residency and rotations whatnot. But, you know, they have a board in there that says, you know, the nurses name for the day, the attendings name, and then also, yes.

 

00;11;02;22 – 00;11;18;08

Dr. Mona

Like the goal for the day, which, like you said, it’s baby steps many times. And it’s really hard to kind of understand that sometimes until you’re in it, but how important it is to look at the day versus, well, when are we going to go home? When are we going to go home? Right? I know everyone’s goal is to go home, but it is important to look at day by day.

 

00;11;18;10 – 00;11;35;08

Dr. Mona

So what do you wish that every parent who has a child in the NICU would know about your work and the work of your staff? Like if you could say like, hey, this is what I wish you could know about or, how to prepare or something like that. What would be your message to these parents who have.

 

00;11;35;11 – 00;12;09;27

Dr. Kate Rubey

That’s a tough one. I think what I would emphasize to every family is that every person who is on the team is there for the baby, and so we all want what is best for the baby. And we are here to partner with families to get that baby into whatever the best situation for them is in whatever time frame works for the baby.

 

00;12;09;27 – 00;12;34;20

Dr. Kate Rubey

I always tell people, like, listen, they come out and they just want you to know that they’re the boss. So, like, I can pretend that I’m the boss, but I am not. I can only do as much as they let me. I think, you know, we get a lot of messaging. It’s through our culture, through friends or families, and people feel that there’s an expectation.

 

00;12;34;22 – 00;13;01;09

Dr. Kate Rubey

And in the nick, I always tell my family’s business a judgment free zone. I have no expectations. I cannot tell you what works for your family, what works for your family life, what is the quality of life that you were hoping for your baby? And so when we are making difficult decisions with families, I just wish everyone one could release the guilt.

 

00;13;01;09 – 00;13;22;21

Dr. Kate Rubey

I know that’s like we would be living in a perfect world, right? If everyone could feel guilt free. But I get a lot of families who end up getting so much input and they just feel like they don’t know what to do. And I want all of them to know that in that situation in the Nicky, your team is there to support you.

 

00;13;22;23 – 00;13;47;23

Dr. Kate Rubey

And we’re in no way judging whatever decisions that you need to make, have to make. We’re here to just present the options that are available, and we’re here to support you through whichever one works for your family. Because everyone is different. Everyone’s in a different, you know, place in life. And what families look like and how families function is unique to every single family unit.

 

00;13;47;25 – 00;14;16;08

Dr. Kate Rubey

And so I just want everyone out there to know, like anyone who’s in the NICU is there to do what’s best for babies, and they just want to do whatever they can to make this kind of unexpected. A lot of times, I think unwanted time in the nick you as like, nice is a bad word, but, you know, as nice as it could be, because it is, like you said, nothing that anyone usually plans for.

 

00;14;16;10 – 00;14;37;22

Dr. Kate Rubey

So we’re very understanding that this is not where anyone thought they would be. And so now we all get to be on a journey together, and we really just want to partner with families and we want to, you know, get their baby wherever they need to be in the quickest and safest way possible. And, you know, we always hope that’s home with them.

 

00;14;37;24 – 00;14;50;08

Dr. Kate Rubey

And unfortunately, that’s not always the case. But we are here for every baby, no matter what the outcome looks like.

 

00;14;50;10 – 00;15;11;20

Dr. Mona

And that’s your follow up. Just a small dose of the real, relatable and eye opening conversations we love to have here. If you smiled, nodded, or had an moment, go ahead and download, follow and share this episode with a friend. Let’s grow this village together for more everyday parenting wins and real talk. Hang out with us on Instagram at the PedsDocTalk podcast.

 

00;15;11;27 – 00;15;27;10

Dr. Mona

Want more? Dive into the full episode and more at PedsDocTalk.com. Because parenting is better with support and remember, consistency is key. Humor is medicine and follow ups are everything. I’m Doctor Mona. See you next time for your next dose.