About NICU
The arrival of a newborn baby is a very exciting time for parents and families. Our team of dedicated, caring and compassionate health professionals recognise that having your baby admitted to NICU can also be a difficult time. Our priority is taking care of your baby and family.
Neonatal Intensive Care Unit at John Hunter Children's Hospital
The NICU is the primary treatment facility for premature babies and sick newborns across Northern NSW.
Your baby's birth and arrival in NICU
When your baby needs support at birth, the NICU team will be there to help. There will be specialised care for your baby in your birth suite room.
The first minutes are vitally important and can seem busy. We know that the first moments of touch and sound are cherished by parents, and we'll make every effort for you to hold your baby before transfer to NICU.
The first hour in NICU can be busy as we get your baby settled in. If you're unable to be there, we'll keep you informed about your baby’s progress.
What happens in the first hour
Temperature
Maintaining the right body temperature is important for your baby’s wellbeing. In the birth suite, tiny babies are wrapped first in a type of cling wrap. Bigger babies are dried and wrapped in a blanket.
In NICU, some babies need a humidicrib to provide warmth and sometimes humidity. This bed also lets us see your baby. If your baby is in a humidicrib, we'll show you how to care for your baby.
Lungs and breathing
Breathing difficulties (respiratory distress) are important and frequent signs in NICU. Your baby’s lungs might be stiff or small, have too much fluid or infection. Some babies require help to ensure regular breathing even when lungs are normal.
Breathing support is given with CPAP or a ventilator, and extra oxygen if needed. This support will gently assist your baby’s own breathing. A chest X-ray is done in NICU when needed.
Observation
Your baby’s heartbeat, breathing, and oxygen level are observed continuously on a monitor. Sticky leads are placed on the chest, and stretchy tape holds leads on the hand or foot. Blood pressure is also measured.
All this monitoring together shows how the heart and lungs are working. If an alarm rings on this monitor, do not panic the staff caring for your baby know how to respond and will explain what is occurring to you.
Fluid and nutrition
Intravenous cannula’s (lines in veins) are used for giving fluids and nutrition, for taking blood tests, and for continuous monitoring.
Breast milk is the best food for all babies, especially preterm babies. Support, guidance, and equipment will be available for you to express. Then when your baby is ready, your breast milk is ready.
Information for parents
While your baby is in NICU, you belong here too. You're always welcome. The bedside nurse will support and guide you in the care of your baby. They will introduce you to the bed space your baby is being cared for in and the facilities available in this region.
During times of procedures or increased activity, you may be asked to wait outside your baby's room or in the Ronald McDonald Family Room. Your baby’s bed space can have no more than two parents at a time. There is a quiet time in NICU from 12pm to 3pm, during which parents may sit quietly, but visitors leave.
Watch baby Jaylen's story
A parents' journey through NICU
Parents Kurtis and Nathasha take us through their journey in the NICU with their baby Jaylen.
There are visiting restrictions on other family members and friends. Visiting is with your written permission only, and your bedside nurse will record if you give permission for others to visit your baby. Visitors are requested not to attend between 12pm-3pm (quiet time).
For the safety of your baby and others in NICU, we ask that you:
- hand hygiene is the most important thing you can do to keep your baby safe from infection in NICU. Wash your hands as you enter the unit, and gel them before and after you touch your baby.
- do not bring food or hot drinks into NICU (water is permitted)
- use the cots to move your baby around the NICU and between wards
- respect the privacy of other babies and families in the NICU/SCU
- be aware that smoking is harmful, if you do smoke, chemicals from cigarettes may stick to your skin/hair/hands and can be detected in your baby. The best way to prevent this is to stop smoking and ask our staff for assistance. If you choose to smoke, please wash your hands well and wear an over garment when smoking that can be removed when visiting your baby.
Situated within the NICU, the Ronald McDonald Family Room is available for parents to take some ‘time out’. There is a lounge area, children’s play space as well as tea and coffee making facilities.
This room is available to you 24 hours a day, 7 days a week. Ronald McDonald volunteers will be available to assist you in any way between 8am and 6pm. Basic meal provision may be available, and the room is available for all parents, both local and from regional areas of NSW. There is also a Family Room on Ward J1 that has laundry facilities.
Each bed space has a nursing side and a family side. Generally, the right side of each bed space has family facilities.
These include a recliner chair, sitting chair, breast pump, milk fridge, milk warmer and patient care board. The fridge is for you to store your baby’s milk in.
Please ask the nursing staff how to use this equipment and how long your milk can remain in the fridge.
Lockers
Lockers are available for families to store their belongings. There is a small cupboard at your baby's bed space, which is not secure. There are coin operated lockers at the entrance to NICU. Your $2 coin will be returned to you on replacement of the key.
Accommodation for families
We have limited short stay accommodation available for emergency situations only. NICU Social Workers can discuss this with families who may require it.
Places to eat
The hospital cafeteria on Level 1 (adjacent to H1) is available to parents and visitors for meals at a lower cost. 'Café Grab ‘n Go' and the Food Hall in the Royal Newcastle Centre are available for refreshments on Level 2 in the hospital foyers.
Due to safety issues hot drinks or food are not allowed in the nursery. There is a cold-water fountain for your use in the entry hall of the unit.
Parking
Parking is available 24 hours a day. Public rates and concession rates apply.
Toilets and baby change room
Toilets are available in the entrance to NICU. There is a baby change facility and shower facility in this area.
ATM
The Newcastle Permanent has one ATM located within the John Hunter main entrance. There is also an ATM located at Royal Newcastle Centre.
Chapel
A chapel is located on Level 2, adjacent to the John Hunter main entrance.
Free Wi-Fi
The Children’s Hospital has free guest Wi-Fi available. To access in NICU:
- search Wi-Fi on your device
- select ‘_NSW_Health_Guest_Wifi_HNEH’.
You and your baby
Even though your baby’s medical needs require that he or she be cared for in the hospital’s neonatal unit, you are still the most important person in your baby’s life. Your baby knew your voice even before birth and needs your special touch.
We encourage you to talk to, read to, touch and caress your baby as much as his or her medical condition will allow. The human touch, especially that of a parent, has as much to do with getting well as medical technology and expertise.
Kangaroo cuddles
This provides skin to skin contact between baby and parent, so your baby can experience the feeling of warmth and comfort associated with this contact.
There are many short-term and long-term benefits of skin-to-skin care for instance a kangaroo cuddle with you is a perfect way to help control your baby’s temperature, so we encourage and support parents to do this whenever possible.
We will help position your baby safely for Kangaroo cuddles and will always be available should you need support.
Kangaroo cuddles at NICU
Mum Sara gives her only surviving triplet Hudson, born at 24 weeks, a Kangaroo Cuddle in the NICU at the Children's Hospital in Newcastle.
We encourage all mothers to provide breast milk for their baby. Breast milk is the best tolerated food and helps protect against diseases. Even if your baby is too sick or premature to suck, we encourage expressing your milk as soon as possible.
The staff of the NICU and postnatal ward will support you in your choice of breast or formula feeding.
When your baby is ready to start milk feeds, she or he may have a tube passed through his or her mouth or nose directly into the stomach, to feed milk in small amounts. This will be increased as your baby digests the milk and grows.
The neonatologist or nursing staff will let you know when your baby is ready to start breast or bottle feeding. To make sure your baby doesn’t get too tired, sucking feeds may be offered only once or twice a day at first.
Breastfeeding
If you plan to breastfeed it is important to establish your milk supply by hand expressing every 3 to 4 hours and switching to expressing by pump once your milk supply is established. This may seem like hard work, but it's worth the effort and your baby will benefit from the breast milk.
It's normal to express small volumes of breast milk at first, but this will increase over time. To help to increase your supply, drink enough water, eat a good, healthy diet and make sure you have plenty of rest. We recommend reducing your intake of caffeine and stopping cigarette smoking. If you need assistance to stop smoking the staff in NICU can help you.
The NICU has a breast feeding and expressing room available for all expressing mothers and a breast pump and milk warmer by each bed space. This room provides a quiet, private space to use the electric breast pumps that are available.
To ensure privacy this room is for mothers only. Some mothers may prefer to express near their baby’s bed space. Breast pump kits are available on loan and can be obtained from the nurse caring for your baby. The nurse or Lactation Consultant can help you with the setting up and use of the equipment. They can answer any questions you may have.
Store your breastmilk in clean, closed containers or a special breastmilk storage bag. Containers should be washed using hot soapy water, rinsed well and dried with a clean cloth. Learn more about expressing and storing breastmilk.
The nurse caring for your baby will supply you with labels for use with these containers. These labels have your baby’s name and medical identification number printed on them. Write the date and time of expressing and place in either the fridge or freezer in your baby’s own labelled tray.
Information sheets are available on where to purchase containers and hire breast pumps or purchase pump kits for use at home. Information sheets outlining sterilising equipment, handling, storing and transport of breast milk are also available.
Tube feeding
Tube feeding is performed via a gastric tube, which is inserted through the nose or mouth into the stomach. This tube can be used to feed your baby and administer medications.
These are a communication tool to help individualise patient care for your baby. It also makes it easier for the health care team and you as a parent, family and/or carer to plan and understand the care that is provided for your baby on a daily basis. Both you and the staff can write on the boards.
Flash photography will not harm your baby, so feel free to take as many photos as you wish with your own camera. You are welcome to bring in your own video camera to take videos of your baby. Please remember to gel hands after touching any equipment before you then touch your baby.
NICView
NICView is a web camera specifically designed for use in the NICU. NICView allows you to see your baby in NICU whenever you wish when you are not in the hospital.
We provide clothes for your baby, but you are welcome to bring clothes in if you wish. We will do our best to ensure these will be placed in a plastic bag when soiled for you to take home and wash. Please label any clothes or blankets.
In the NICU you will learn how to care for your baby, including giving them a bath from time to time. This may be a gentle sponge bath for babies in cribs or a big bath for babies who are in a cot. The nurses will be there to help you along the way, so talk to them about your baby’s bath routine.
How give your baby a swaddled bath
Swaddled bathing is relaxing, calming and increases parent confidence in handling their baby.
Your baby's care in NICU
Learn more about the care your baby will receive and NICU and the equipment we use.
All babies weighing less than 1500gms and/or less than 32 weeks' gestation at birth will routinely have a number of tests and procedure as part of their care.
Head ultrasound
The head ultrasound is able to detects any changes and is done during the NICU stay. This is a painless procedure, similar to the ultrasound you may have had during pregnancy. The probe scans through the soft spot on the top of your baby’s head (fontanelle). Babies usually sleep through this procedure.
The ultrasound is usually performed within the first 5 to 7 days of life and repeated at one week of age and again at one month of age. The results will be discussed with you by the doctor when the results are available.
Eye examinations
Small babies will have an eye examination to screen for 'eye disease of prematurity' called Retinopathy of Prematurity. This will be carried out in babies born 31 weeks' gestation or less, when your baby is 28 days old and approximately 32 weeks corrected age. You will receive more information when your baby’s eye check is due. Some babies will need an ophthalmology review for other reasons.
Newborn screening test
This is a blood test for babies in the first 24 to 48 hours. If your baby weighs less than 1500 grams at birth a repeat NBST will be attended at 28 days of age. You will be given information about this test by the bedside nurse and asked for your consent.
Universal hearing screening
All babies are offered a hearing screen closer to term. This is also available at your local hospital. Learn more about the NSW Statewide Infant Screening Hearing Program (SWISH).
Saturation screening for congenital heart disease
All babies have hand and foot oxygen levels measured with a small probe placed on the baby’s hand and foot before going home. It takes less than 5 minutes. 99% of baby’s pass this test, if your baby has to be re-tested, the result will be discussed with you.
Immunisation
All infants requiring immunisation will be identified and given appropriate immunisation in a timely, safe and effective way, based on the National Immunisation Program Schedule. Parents will be given information regarding immunisation and have any questions answered to allow an informed decision to be made.
Cardiac ultrasound
A cardiac ultrasound, also known as an echocardiogram, is an ultrasound study of your baby's heart. It looks at heart structure, blood flow and muscle function. Some babies need this to screen for or diagnose problems with their heart or major blood vessels. You may also hear the words echo or cardiac echo for this test.
Blood tests
Babies in the NICU need frequent exams and monitoring as part of their care. At times this includes testing of the blood as they help to monitor your baby’s condition and to identify potential problems. Common tests include, testing for anaemia (low red blood cells), electrolyte and mineral levels, blood sugar levels or testing for infection. The tests are more commonly attended by collecting blood from the baby’s vein or heel.
Phototherapy
Phototherapy is treatment with a special type of light (not sunlight). It's used to treat newborn jaundice by making it easier for your baby's liver to break down and remove the bilirubin from your baby's blood.
Initially, seeing all of the medical equipment used for your baby can be overwhelming. The noises, beeps, clicks, alarms and flashes of machines will seem strange at first, but over time you will become familiar with the equipment and learn how each machine is helping your baby. The NICU staff will be happy to explain any equipment to you.
| Equipment name | Purpose |
|---|---|
| Omnibed (Giraffe bed)/Incubator/Humidicrib/Isolette | This is an enclosed bed that provides a warm, clean, and controlled environment for your baby. |
| Open care bed | This is an open bed with special overhead heater. These beds keep your baby warm while permitting easy access for parents, nursing and medical staff from all sides. |
| Monitor | This is a machine that displays your baby’s heart rate, heartbeat pattern, blood pressure, breathing rate, breathing pattern and level of oxygen in the body. |
| Pulse oximeter | A small device that monitors oxygen levels in the baby’s blood. It is usually attached to your baby’s hand or foot and secured with a stretchy tape. |
| Temperature probe | This monitors your baby’s skin temperature to ensure your baby’s temperature stays within the normal range. |
| Gastric tube | A soft tube inserted through the nose or mouth into the stomach. This tube can be used to feed your baby and administer medications. |
| Infusion pump | This device slowly and continuously administers fluids and medications to your baby at a desired rate through intravenous lines. |
| Nasal cannula | A method of giving oxygen or mixture of oxygen and air to your baby through small, flexible, plastic tubes placed in his/her nostrils. |
| CPAP (Continuous Positive Airway Pressure) | This a method used to help support your baby’s breathing. The CPAP is delivered by two short plastic tubes (prongs) in the nostrils |
| Ventilator | This machine is used to assist your baby’s breathing when (s)he cannot breathe well enough on his/her own. |
Preparing to transfer from NICU
When your baby was admitted to the NICU, you may have been transferred from another hospital.
Once your baby is getting better and big enough, we will organise transfer back to your referring hospital so you and your baby can be closer to home. You will be given an information pamphlet about your referral hospital.
Your baby is ready to go home from NICU when they are:
- 35 weeks corrected gestation or more
- feeding and growing well – breast, bottle or sometimes tube feeding
- maintaining temperature.
Babies born less than 1,000 grams or less than 29 weeks' gestation at birth or have complex issues will be followed up in the Neonatal Growth and Development Clinic shortly after discharge and at 3, 6, 9 months corrected age by one of our neonatal team.
At 12 months and 24 months corrected age some babies will be given a formal Developmental Assessment. This assessment involves being seen by our developmental care team who will run through a series of tasks with your baby to assess how their development is progressing.
We will contact you close to the time the assessment is due to arrange an appointment. If you change your address or phone number after discharge from NICU, contact us on (02) 4921 4362 with your new details.
The Blue Book is your baby’s personal health record and will remain with your baby during admission to hospital. Once your baby goes home, we recommend that you keep this book in a safe place and take to any clinic or doctors' appointments.
- Neonatal Intensive Care Unit - 24 hours a day – ask for the team leader
- Australian Breastfeeding Association – 1800 686 268 (1800 mum2mum)
- Your local Child and family health nurse
- Healthdirect – 1800 022 22
Ask the nursing staff for more information on these services.
Our people
There are many staff members working in the NICU. If you have any questions, please ask the nurse looking after your baby, they can help put you in contact with the correct person.
Service contacts
Find out how to contact our NICU and Special Care Unit rooms.
| NICU reception | (02) 4921 4410 |
| Room 1 | (02) 4923 6722 |
| Room 2 | (02) 4923 6627 |
| Room 3 | (02) 4923 6631 |
| Room 4 | (02) 4923 6665 |
| Room 5 | (02) 4921 3375 |
| Room 6 | (02) 4921 3496 |
| Room 7 | (02) 4923 6667 |
| Room 8 | (02) 4923 6310 or (02) 4923 6311 |
| Room 9 | (02) 4923 6308 or (02) 4923 6309 |
| Room 10 | (02) 4923 6304 or (02) 4923 6306 |
| Room 11 | (02) 4923 6301 or (02) 4923 6302 |