NICU Glossary of Terms

abscess: A pocket of pus under the skin that may develop after an infection.

alveoli: Small air sacs in the lungs.

anemia: When there are too few red blood cells in the blood. NICU babies cannot always make red blood cells quickly enough to replace the ones lost during blood tests.

antibiotics: A type of medicine used to treat a suspected or actual bacterial infection. Babies may receive more than one antibiotic until the specific bacteria are identified.

Apgar score: A number given at one and five minutes after birth. It measures the baby’s condition based on heart rate, breathing, muscle tone, activity level and colour.

apnea: When a premature baby’s brain is still developing, they may occasionally “forget” to breathe. They may need gentle stimulation, such as a soft rub on the back, to remind them to breathe. This is common in premature babies and usually improves by 34 to 35 weeks, as their brain matures.

artery: Blood vessels that carry oxygen-rich blood away from the heart and lungs to the body’s organs and tissues. Arteries are also used to feel the pulse or measure blood pressure.

aspirate: Breast milk or formula left in the baby’s stomach from the previous feeding. The amount helps the nurse decide whether to increase the feeding volume.

aspiration: The direct result of inhaling any foreign matter into the lungs.

bagging: A special way to give babies oxygen and/or extra breaths using an air-filled bag.

bilirubin: A substance created when red blood cells break down. The liver filters it out of the blood. The premature baby’s liver is developing and does not filter as well as it should. This causes the bilirubin to build up in the blood, resulting in jaundice (a yellow-orange hue to the skin).

blood gas: A blood sample that measures oxygen, carbon dioxide and acid (pH) levels in the blood. It shows how well your baby is ventilating or breathing.

blood pressure: A measure of the force of blood moving through blood vessels. It can be taken periodically using a cuff around the baby’s arm or leg, or monitored continuously using a transducer connected to the umbilical artery catheter (UAC).

bradycardia (brady): When the baby’s heart rate drops below 100 beats per minute for longer than 15 seconds and requires stimulation to correct. It is frequently associated with apnea and happens less often as the baby matures.

breast pump: An electric machine used by parents to express milk from their breast or chest.

bronchopulmonary dysplasia (BPD): A long-term lung disease that occurs most often in very premature babies. Babies with BPD have inflammation and scarring in the lungs. Many infants with BPD recover and improve with time, achieving normal or near-normal function.

carbon dioxide: The gas we breathe out as a waste product.

central line: A special IV catheter used to give fluid, medication or nutrition. It includes long lines or PICCs and UVCs, and can stay in for an extended time, if needed.

cerebrospinal fluid (CSF): The fluid around the brain and spinal cord.

chest tube: A tube surgically inserted through the baby’s chest wall into the space around the lungs to reopen a partially or totally collapsed lung. (See pneumothorax.)

colostrum: The breast milk made in the first few days after birth. It contains many cells that protect babies from infections.

complete blood count (CBC): A blood test done for several reasons, including to check for possible infection and to see whether the baby is anemic.

continuous positive airway pressure (CPAP): A type of breathing support that delivers constant air pressure into a baby’s nose. This helps the air sacs in the lungs stay open and helps prevent apnea.

corrected age: The age of a baby from the due date, not the birth date.

CT scan: A computed tomography scan that gives a 3D view of the body’s organs and structures.

cyanosis: Dusky, bluish colour of the skin, lips and nail beds caused by having too little oxygen in the blood.

desaturation (desats): When the oxygen level in the blood falls below the set value on the saturation monitor. Acceptable oxygen levels vary by the baby’s age, and alarm limits are set accordingly.

dip: When the heart rate drops below 100 beats per minute and returns quickly without stimulation.

donor human breast milk: Expressed breast milk donated by healthy parents and pasteurized for safety. It is the preferred alternative to formula for very premature babies until a parent’s own milk is available.

ductus arteriosus: A blood vessel outside the heart that allows blood to bypass the lungs and go to the rest of the body before birth.
 

echocardiogram: An ultrasound of the heart, usually performed by a cardiologist.

edema: Also known as puffiness; this is swelling caused by extra fluid under the skin.

electrocardiogram (ECG): A machine attached to a baby’s chest to print out their heartbeat. This may be done when a murmur is heard.

electrolytes (lytes): The measurement of sodium, potassium and chloride in the baby’s blood. The results of this test help the medical staff treat the baby.

endotracheal tube (ETT): A soft plastic tube placed through the baby’s mouth or nose into the windpipe (trachea) to help with breathing.

expressed breast milk (EBM): Milk that parents express using a breast pump or by hand. It can be used soon after pumping or frozen for later use.

fortifier: Human milk fortifier is a powder added to breast milk to give it extra calories and minerals such as calcium and phosphorus.

full-term baby: A baby born three weeks or less before their due date, or at a gestational age of 37 weeks or more.

gavage feeding: Feeding through a small tube placed through the mouth or nose down to the stomach. Also called tube feeding.

gestational age: The number of weeks a person is pregnant; the age at which a baby is born.

glucose: A type of sugar in the blood. It can be monitored in different ways, but the most common uses a glucometer at the bedside.

glycerine tip: Also known as a “silver bullet” because of its packaging. A very small tip of a glycerine suppository may be used to help babies pass stool.
 

heart monitor: This monitor shows the heartbeat on a special computer screen. Three gelled electrodes (leads) sit on the baby’s skin. An alarm rings if the readings are not within the normal limits. False alarms are common and usually happen when the baby wiggles or a lead falls off.

heel stick: A method of getting blood from a baby’s heel.

hernia: A bulge of bowel from the abdomen into an area where it does not normally belong.

histogram: A graph that shows the percentage of time a baby’s monitored values (like oxygen saturation or heart rate) stay within specific ranges during a set period.

human milk fortifier (HMF): A powder added to breast milk to meet the special needs of premature infants.

hydrocephalus: Too much fluid in the normal fluid spaces of the brain (ventricles).

hyperbilirubinemia: Too much bilirubin in the blood.

hypoglycemia: Low blood sugar.

hypoxemia: When there is not enough oxygen in the blood.

hypoxic ischemic encephalopathy (HIE): Damage to cells in the central nervous system (the brain and spinal cord) caused by too little oxygen.

incubator: A heated and humidified bed for babies in the NICU. It is often referred to by the manufacturer’s name, Drager®.

inguinal hernia: A hernia in the groin in girls and in the scrotum of boys.

interstitial: Refers to an IV that is no longer in the vein and must be restarted.

intrauterine growth restriction (IUGR): When a baby’s growth slows or stops in the uterus.

intravenous (IV): A small catheter placed into a vein to provide fluid or medications. Babies can have IVs in their scalp, hands, arms, legs or feet. These sites are rotated regularly.

intraventricular hemorrhage (IVH): Bleeding into the fluid-filled areas (ventricles) surrounded by the brain.

intubation: Placing an endotracheal (ET) tube into the baby’s windpipe through their mouth.

isolette: A common term for an incubator, a bed that warms the baby.

jaundice (hyperbilirubinemia): The yellow colour seen in the skin, usually during the first two weeks of life, caused by the buildup of broken-down blood cells.

lab work: A collective term for any blood samples that a baby may need taken.

large for gestational age (LGA): A baby who is larger than usual for their gestational age.

lipid: A white, high-calorie fat solution delivered by IV or mixed with your baby’s milk or formula.

long line (peripherally inserted central catheter, PICC): A long intravenous line placed into a large vein using sterile technique. It can stay in for long periods.

low flow: One of the many ways to deliver oxygen and/or air to babies (see nasal prongs).

lumbar puncture: A small needle is placed in the baby’s lower back using sterile technique to collect spinal fluid for testing.

magnetic resonance imaging (MRI): A machine that produces pictures of the baby’s organs and structures.

meconium: The first black stools passed by a baby. They are thick and tar-like and can last for several days.

meningitis: Inflammation of the tissue covering the brain and spinal cord.

murmur: A “whooshing” sound of blood going through the heart and surrounding blood vessels, heard using a stethoscope on the chest or back. Murmurs are common in premature babies. They can be a sign of a PDA or other heart problem, or they can be benign.

nasal prongs: Small soft plastic prongs that are placed in the baby’s nose to deliver oxygen or air.

nasogastric tube (NGT) or orogastric tube (OGT): A tube placed through the nose or mouth into the stomach and secured with tape. It feeds the baby and releases built-up air and gas.

nasopharyngeal tube (NPT): A short breathing tube that goes to the back of the baby’s nose and attaches to a ventilator. The baby receives puffs of air to help them breathe.

necrotizing enterocolitis (NEC): A serious bowel condition that can arise unexpectedly in premature infants. Babies with NEC can have bloating, blood in their stools, trouble tolerating feeds and can become very sick.

neonatal: The period of time from birth to 28 days.

NICU: Neonatal Intensive Care Unit.

NPO: Nothing by mouth (no feeding).

ostomy: An opening from an area inside the body to the outside.

overbed warmer: A large warmer that can be placed over the open door of an incubator to keep the baby warm during procedures.

oxygen: An odourless, colourless gas needed by all body cells. Room air is 21 per cent oxygen. If needed, a baby can be given up to 100 per cent oxygen.

oxygen saturation (sat): A term that describes the amount of oxygen in the blood.

patent ductus arteriosus (PDA): The ductus is a blood vessel that keeps blood away from the lungs before birth because the lungs are filled with fluid. It usually closes shortly after birth. If it stays open (or patent), it may interfere with normal blood flow and heart and lung function. The PDA may be treated with medication or surgery if necessary.

phototherapy (bili lights): A special blue light used in the treatment of some types of jaundice. Eye shields are placed over the baby’s eyes to protect them from the light.

pneumonia: An infection in the lungs.

pneumothorax: Air collected in the space between the lung and the chest wall.

postmature: A baby born after 42 weeks’ gestation.

premature: A baby born before 37 weeks’ gestation.

respiratory distress syndrome: The most common breathing problem found in premature babies. Because the baby may be too young to have developed surfactant, the tiny air sacs in their lungs (alveoli) do not stay open easily. Without surfactant, the air sacs collapse and the baby does not breathe effectively. Surfactant therapy sends surfactant through a tube into the lungs, making them more flexible and easier to ventilate.

retina: The inner lining of the eye.

retinopathy of prematurity (ROP): Abnormal growth of blood vessels in the eye that is most common in very premature babies. Babies will have their eyes examined for ROP if they meet criteria or on the advice of the medical team. Ask if your baby will be getting eye exams.

retractions: Pulling in of the ribs and centre of the chest with each breath. This happens when a baby is working hard to breathe.

room air: The concentration of oxygen in the air around us, which is 21 per cent.

rooting: Head and mouth movements made by a baby searching for a nipple to suck on. The baby makes small, quick side-to-side movements of their head with an open mouth.

saturation monitor (sat monitor): A monitor that shows the amount of oxygen in the blood. The small monitor is placed around a baby’s foot or hand/wrist and can be easily identified by the red light. The light does not produce heat.

seizure: A brief period of too much nerve activity. The body tenses up and the baby may twitch or lose consciousness for a few moments.

sepsis: An infection that occurs in the blood. If there is any concern that an infection may be developing, blood samples are drawn (culture, CBC) and antibiotics are started.

septic workup: Blood drawn for CBC and blood culture. If the baby is very ill, the medical team may request spinal fluid or urine for culture.

small for gestational age (SGA): When a baby’s length, weight or head circumference is below the 10th percentile for their gestational age.

spell: A term that also describes a brady, apnea or desats.

suprapubic tap: A sterile urine sample obtained by inserting a needle into the bladder.

surfactant: A slippery substance in the lungs that spreads like a film over the air sacs (alveoli), keeping them open so air can move in and out.

tachycardia: A heart rate that is faster than the average range. The average range for premature babies is 120 to 160. A full-term baby’s heart rate would be slightly lower at 90 to 140 beats per minute.

tachypnea: A breathing rate that is faster than the average range. Premature babies breathe at an average rate of 40 to 60 breaths per minute. Full-term babies breathe at an average rate of 30 to 60 breaths per minute.

total parenteral nutrition (TPN): An IV solution (often yellow) that contains nutrients to help a baby grow. It is used when a baby cannot feed or is just starting to feed.

transfusion: Giving blood or blood products through an IV.

ultrasound: A procedure that uses sound waves to produce a picture of the baby’s internal organs (for example, the brain, heart, kidneys and liver). A series of head ultrasounds are done based on criteria or the medical team’s advice. Ask if your baby is getting head ultrasounds.

umbilical artery catheter (UAC): A soft, clear catheter placed into one of the arteries in the umbilical cord to monitor blood pressure, draw blood for testing and give fluids. In very sick or premature babies, it is placed at birth using sterile technique.

umbilical hernia: A hernia in the area of the umbilical cord or belly button.

umbilical venous catheter (UVC): A soft, clear catheter placed into the vein in the umbilical cord to give fluids and medications. In very sick or premature babies, it is placed at birth using sterile technique.

umbilicus: The belly button or cord. This cord has three major vessels (one vein and two arteries) and is clamped at birth. Usually, this cord dries up and falls off after a short time. However, with premature babies, the umbilical vessels are used to insert arterial and venous catheters.

urinary tract infection (UTI): An infection in the kidney, bladder or other structures that urine passes through.

veins: Blood vessels that carry blood from the rest of the body back to the lungs to pick up oxygen.

ventilator (vent): A machine used to help a baby breathe. The machine connects to the ETT or NPT.

ventricles (of the brain): Spaces in the brain where spinal fluid circulates.

ventriculoperitoneal (VP) shunt: A tube placed in the ventricles of the brain to drain extra fluid into the baby’s stomach.

vernix: The thick, white, creamy substance that protects the baby’s skin in the womb toward the end of pregnancy. Premature babies are often born before their vernix develops, so they may not have this protective coating.

vital signs: Temperature, heart rate, breathing rate and blood pressure that are recorded on the baby’s chart.

vitamin K: Helps blood to clot normally; all babies receive one intramuscular injection at birth.

X-rays: Pictures that show the internal structures (bones and organs) of the body. In the NICU, X-rays are also used to confirm the location of tubes or lines and to check the baby’s heart, lungs and bowel.