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NICU Follow-Up Care: What You Need to Know

While the birth of a child is always cause for celebration, when a baby graduates from the Neonatal Intensive Care Unit (NICU)—this is especially true. Bring out the band and confetti!

After spending, days, weeks and even months in the NICU, it’s finally time to bring your bundle of joy home. While undoubtedly a joyous occasion, your child may still require special attention and follow-up care, which can cause some anxiety and stress for new parents. You may wonder if you’re prepared to make that transition from the NICU to home care.

Have no fear! Your child’s NICU follow-up care team is here to help your little one and your family make a smooth transition. To better understand what you can expect to help ease into the transition, we chatted with Radley Helin, DO, a Banner Health neonatologist and director of the High-Risk Nursery Follow-Up Clinic.

Q: What challenges might my baby who spent time in the NICU face that other babies don’t?

Dr. Helin: Especially during the first year of life, many can experience poor weight gain and difficulty feeding. They may be on oxygen or special medications that require extra monitoring. And within the first three years of life, many are at higher risk for delays in reaching normal development milestones such as rolling over, sitting, interacting with their environment and developing early language skills.

This is why many hospitals across the country offer follow-up clinics and programs, such as the Banner High-Risk Nursery Follow-Up Clinic, so we can identify those needs as early as possible and get them necessary services and support.

Q: Why is NICU follow-up care important?

Dr. Helin: The growth and development between birth and three months is critical for your baby’s long-term success. Without the specialized and detailed assessment available in the follow-up program, many developmental problems are recognized later in the game when they can be more challenging to address and take longer to correct.

Untreated developmental delays can have a snowball effect, causing delays in other areas. For example: if your baby is unable to sit up on their own at the typical age, that can delay their ability to pick up an object or pass it from hand-to-hand, which puts a limit on your child’s ability to explore their environment. Babies learn by touching, mouthing, holding, listening and seeing objects.

Follow-up care is not only important for baby, but it also helps you to understand your child better.  The follow-up clinic is led by a neonatologist or a pediatrician who specializes in developmental disabilities and staffed by a group of therapists and often a nutritionist. Every team member has a unique perspective on your baby and these views will be synthesized and communicated to you and your child’s primary care provider.

Q: What are the benefits of a follow-up care clinic and program?

Dr. Helin: The bulk of primary care that’s available for patients, particularly those in rural areas, is provided by practitioners who do not have extensive training caring for babies who were in the NICU.  Additionally, therapy for young children is provided by a program called “Early Intervention.”  Once a need is identified, it can take a while to begin treatment.

The specialized NICU follow-up program provides both a valuable resource to your child’s primary care provider and will advocate on your child’s behalf to ensure therapy is started on a timely basis.

Q: What follow-up care can we expect?

Dr. Helin: Many clinics are staffed by a multidisciplinary team who perform evaluations on your baby in all developmental areas, in one location. These specialists all work together to develop the best treatment plan for your baby’s individual needs. Depending on your child’s age, this may include:

  • Pediatrician: Monitors the baby’s overall health and development
  • Pediatric nutrition specialist: Evaluates your baby’s nutritional needs and develops a specialized eating plan
  • Infant feeding specialist: Recommends treatment for issues that may affect your baby’s eating, including with chewing, sucking, feeding or swallowing
  • Physical therapist: Determines if your baby needs a program to stretch or strengthen important muscle groups that are important in the development of gross motor skills, like being able to hold his head up while sitting
  • Occupational therapist: This professional works to help your baby’s fine motor skills, like dropping and picking up a toy.
  • Child psychologists: Aids in your child’s intellectual and emotional development and behavior

Q: What happens during a NICU follow-up appointment?

Dr. Helin: During a typical appointment, your child will be weighed and measured.  The physician will perform a physical examination, and the developmental specialists will perform a detailed evaluation of your child’s neurologic, motor, cognitive and language development, typically lasting 30-60 minutes.  If needed, you will be connected with other professionals for further care. The team members will also answer any questions you might have regarding their behavior, development and health.

Q: How often will they be seen by the NICU follow-up care team?

Dr. Helin: Visits may be scheduled from birth to school age as indicated by your child’s NICU follow-up care team. Standard follow-up is typically for five years, but the duration will depend on the age of the baby.

Q: What do you recommend if our hospital doesn’t have a follow-up care program or clinic?

Dr. Helin: Taking your baby home from the NICU can be a daunting and stressful time for new parents. Currently, it is recommended that all tertiary care centers with NICUs have follow-up care programs to assess outcomes of their graduates. However, if your center or hospital does not, find a pediatrician who has experience caring for babies who’ve spent time in the NICU, with strong relationships with other care providers your baby will need. It’s important that all care providers are in communication and working together on your baby’s treatment plan.

Also, don’t forget about yourself. Although your focus will naturally be on providing for your baby’s needs, take steps to manage your stress and seek out help from a mental health provider if needed.

Get the care your baby needs. To find a Banner Health pediatric care provider for your new baby, visit bannerhealth.com.

Caregiving Children's Health Nutrition Parenting Physical Therapy Stress Wellness

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