Neonatal intensive care unit (NICU)

The NICU is a hospital ward with specialist medical staff and equipment to care for premature and sick newborn babies. This part of the hospital is sometimes called the intensive care nursery or newborn intensive care unit.

The NICU has highly trained staff and specialist equipment to support the special needs of newborn babies who are sick. Not all maternity hospitals have a NICU, so if your baby needs specialised care, you may need to travel to a different hospital.

The length of stay in the NICU varies from baby to baby. When babies no longer need the high level of care offered in the NICU, they may move to a special care nursery or special care baby unit.

Babies may need to spend time in a NICU if:

• they are premature (born before 37 weeks of pregnancy)
• there were complications during labour
• there are complications such as breathing problems, infections, birth differences, or the baby needs surgery
• they have a low birth weight or have feeding problems

It may seem overwhelming the first time you see your baby in this part of the hospital. Understanding how the NICU works may help you cope better, so you can focus on looking after your baby and recover from the birth.

Infection control

Babies in the NICU can easily catch infections such as colds, flu and diarrhoea. It is very important for all visitors to sanitise their hands (Opens in new tab) before they enter. You can use soap and water, or the antibacterial gels provided. If you or someone you have contact with has been ill, talk to the medical staff before you come onto the ward.

Stimulation control

The NICU is usually a quiet and calm place, so babies aren't overwhelmed by noise and light. There may be times when the lights are dimmed so the babies can rest. The aim is for staff to handle babies as little as possible.

Medical equipment

There are many different types of medical equipment in the NICU. These include:

• an incubator or heated cot to keep your baby’s body at the right temperature  
• a ventilator to help with breathing
• infusion pumps to give your baby fluids and medicines through tubes in their veins
• monitors attached to the baby's body to check their heart rate, breathing rate and blood oxygen levels

Parents are usually welcome in the NICU 24 hours a day, but other visitors may be limited.

Bonding with your baby and helping to care for them will also help them get well. NICU staff will include you wherever possible in your baby's care and will teach you how to look after your baby. This may include how to change nappies, take your baby's temperature, and how to bathe, feed and cuddle them.

You may be able to provide 'kangaroo care', or skin-to-skin care, with your baby. Holding your baby next to your skin is helpful for both parents and babies. For example, it helps to regulate your baby's body temperature, heart rate and breathing rate.

Kangaroo care is not suitable for all babies, so ask the NICU staff. Even if your baby is not well enough for kangaroo care, you can still comfort them by touching them, hand-cuddling, letting them hold your finger or by talking and singing to them.

There are a few different ways you can feed your baby in the NICU. It will depend on the medical condition of your baby and the NICU staff will be able to advise you on what is best for your baby at each stage.

Breastfeeding in the NICU

If your baby is premature or sick, it may take time for them to start to breastfeed well. In many cases, this may take weeks — this is very normal.

Holding your baby skin-to-skin can help your baby feel secure and can help to stimulate your milk supply. Skin-to-skin feeding is a good way to help prepare you and your baby for breastfeeding.

When you hold your baby skin-to-skin you may notice them becoming more alert, sucking their fingers or lips and moving closer towards your breast. These are signs that your baby may be ready to feed. Your baby might take some time to learn to breastfeed — try to go at their pace. With time, your baby will start to feed better.

The NICU staff or a lactation consultant may be able to help you to start breastfeeding.

Expressing milk

Many babies in the NICU may not be able to breastfeed at first. They will feed through a tube in their nose that carries the milk straight to their stomach (called 'gavage feeding').

The NICU staff may ask you to express breast milk to feed your baby. Your breast milk may be stored in the fridge or frozen to use later. Expressing milk will keep up your milk supply so you are able to breastfeed when you and your baby are ready.

The NICU staff or a lactation consultant may be able to help you learn to express milk.

Other forms of feeding

If you do not want to breastfeed or don't have enough milk, the staff will discuss other forms of feeding such as formula feeding or donated breast milk with you.

If your baby is not able to breastfeed, you can try expressing milk. You can start expressing as soon as you are able to after your baby is born, ideally within the first hour after birth.

How often you express will depend on your circumstances. You may need to express more often at first to establish your milk supply.

You can express at home or in the NICU.

There are a few different ways you can express milk:

• by hand — using your hand to gently massage the breast to push the milk out of the nipple
• using a manual pump
• using an electric pump
• using a double pump — this allows you to pump both breasts at the same time

There may be breast pumps available to use in the NICU, but if you plan to express long-term, think about hiring or buying a good quality pump that is comfortable for you.

Here are some tips on storing and transporting breast milk for babies in the NICU:

• Ask NICU staff for milk bags to store your expressed breast milk.
• Label all expressed milk with the following information:
  • your name or your baby's names
  • EBM ('expressed breast milk')
  • the date and time you expressed
• If you defrost your breast milk, be sure to label it with the time and date it was defrosted.
• If your baby is not going to have your milk within 4 hours of expressing, be sure to refrigerate it.
• If you are transporting frozen expressed milk, make sure to transport it in a cooler with ice so that it stays frozen.
• Once breast milk is defrosted, it needs to be used within 24 hours and cannot be refrozen.
• Check that the NICU has space to store your frozen milk before you leave home.

Read more on expressing and storing breast milk.

Having a baby in the NICU can be an emotional experience. It is common to feel sad and frightened, overwhelmed or disappointed. It can be especially hard to go home without your baby.

Parents might be worried that they won't be able to bond with their baby.

Make sure you talk to the staff if you have any concerns. Many NICUs offer parent support groups where you can share your experiences with other families. Don't forget to look after yourself too.

Practical tips for parents managing their feelings

Here are some tips for getting through your baby's time in the NICU:

• Kangaroo care and talking to your baby can help you bond with your baby.
• Seek support from friends and family.
• Take time to care for yourself — don't ignore your physical and emotional needs.
• Be involved as much as you can with your baby's care.
• Professional mental health care can help you manage your feelings and emotional needs.

For advice and to connect to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.   

The Miracle Babies Foundation (Opens in new tab) provides information and support for families with a baby in the NICU.

The NurtureProgram (Opens in new tab) through the Miracle Babies Foundation has many resources to support families with a baby in the NICU, including the NurtureLine 1300 622 243 (1300 MBABIES) family support helpline.

The Royal Women’s Hospital has a number of fact sheets (Opens in new tab) on many topics related to the NICU.  

King Edward Memorial Hospital has a video (Opens in new tab) explaining how to hand express breast milk.

Languages other than English

The Victorian Government has fact sheets (Opens in new tab) about supporting your baby’s development while in the NICU in many languages other than English.

Information for Aboriginal and/or Torres Strait Islander peoples

Miracle Babies Foundation (Opens in new tab) provides information for Aboriginal and/or Torres Strait Islander peoples about the NICU.

Raising Children’s Network provides a picture guide on breastfeeding (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples.

Information for sexually and gender-diverse families

Rainbow Families has a lactation guide (Opens in new tab) for sexually and gender-diverse families.