Premature baby: everything you need to know about hospitalization in neonatal intensive care

Beeps, monitors, self-pulsing syringes and an incubator in which a tiny baby clings to life. In this neonatal intensive care unit, he will not fight alone, a whole team of caregivers and the love of his parents will help him. For several weeks, sometimes several months, many parents of premature children will “live” in this timeless place. To help them in their efforts and facing the physical and psychological upheaval of this birth on them, but also on their baby, TipsForWomens interviewed four experts who work alongside them on a daily basis. Discover our survey of healthcare professionals from these hospital services and the SOS Préma association.

In which cases is baby hospitalized in neonatal intensive care?

A premature birth occurs before the end of the pregnancy. In Europe, there are 41 weeks of amenorrhea (from the date of your last period) or 39 weeks of pregnancy (date of your ovulation). According to the SOS Préma association, a baby is born prematurely every 8 minutes in Europe. This represents 60,000 premature babies per year. As a reminder, according to Inserm, there are three levels of prematurity:

• The average prematuritywhich corresponds to a birth between the 32nd and 36th week of completed amenorrhea (7 months to 8 months of pregnancy);
• The extreme prematurityfor births occurring between the 28th and 32nd weeks (6 months to 7 months of pregnancy);
• The very prematurefor births before 28 weeks, i.e. less than 6 months of pregnancy.

“Around 70% of premature births are spontaneous, due to early contractions whose cause is rarely identified, or to premature rupture of the fetal membranes (these ruptures sometimes being of infectious origin)“.

If your baby is born earlier than expected, several situations may lead the medical team to transfer your child to the neonatal intensive care unit. “These situations can be very varied” specifies Dr Sabine Réthoré, pediatrician in neonatal intensive care at the Valenciennes Hospital Center (NIDCAP certified). “One of the first situations is the premature birth of the baby, but it can also be in case one of the baby’s organs is in distress. In the presence of respiratory distress, a baby can also be transferred to this emergency department. Another situation, if a malformation was diagnosed during the antenatal or postnatal period“. Aurélie Guillou, pediatric nurse in neonatal intensive care at the Yves le Foll Hospital Center in St Brieuc (NBO and APIB certified, NIDCAP trainer) confirms: “Babies born early, from 24 weeks can be transferred to intensive care or neonatal intensive care. We can also find small babies in these departments, or those who have contracted an infection or who have a cardiac or digestive pathology.“.

Administrative procedures to be carried out in the event of premature birth

Despite the shock linked to this premature birth, certain steps must be taken quickly. “If the parents are unable to do so, do not hesitate to designate a relative who will take charge of these procedures. recommends Morgane Harré, expert in administrative issues for the SOS Préma association. So, you will have to do:

• The birth declaration from the civil status service of the town hall where your baby was born,your health insurance fund (mother + father), the family allowance fund, the employer (mother + father), the mutual insurance (mother and father), taxes.
• In order for the co-parent to be entitled to their leave, this declaration of birth is mandatory to the employer and the health insurance fund. Thus, he will be able to obtain 3 days of birth leave + the first 4 compulsory days of paternity and childcare leave. Then, he will be able to provide a certificate of hospitalization in order to obtain 30 days (maximum) of specific leave and reception of the hospitalized child (to be taken in the first 7 days during hospitalization). The balance of paternity leave can be taken within 6 months following the birth (21 days for a single birth and 28 days for a multiple birth).

Please note: Concerning maternity leave, the birth having taken place before the expected date, the end date of maternity leave remains unchanged. You can check the dates of your maternity leave on your Ameli account.

Our administrative expert also specifies that several rights can be granted to parents of premature babies. Therefore, if your child is transferred to another hospital, you can ask the CPAM for a request for exceptional costs in order to obtain reimbursement of part of the mileage costs. On the other hand, if your baby’s hospitalization is long, parental leave may be requested (full or part time). You will therefore be entitled to 310 days of leave. You must notify your employer, who cannot refuse. The dad (or co-parent) can also make this request, he benefits from 22 days.

To find out more about your rights depending on your situation, do not hesitate to call SOS Préma, our expert expert in administrative matters is available all day on Tuesday and Thursday afternoon.

Neonatology department, technical and caring place

“All neonatal intensive care units are different” immediately point out Dr Sabine Réthoré and Aurélie Guillou. Your child’s care will depend on their level of prematurity, but also on their state of health. Generally, extremely premature and extremely premature babies are admitted to the neonatal intensive care unit. They are then sent to intensive care, then to the neonatal unit when their state of health is stable.

“Obviously, it all depends on the situation and the hospital center in which you gave birth.” completes the pediatrician. “Today, many establishments ensure that there is “zero separation” with the mother (or co-parent). Likewise, there are more and more individual rooms even if in most cases your baby will be in a shared room with other infants..

Machines, beeps, ringtones… What devices surround the baby?

Many parents will undoubtedly be impressed by the technicality of the neonatal intensive care unit, which combines an incubator, machines, alarms and numerous staff present. A source of stress, these machines which sometimes emit “beeps” or ringtones can make them anxious. “It’s a very unusual environment for parents. The medical team is also present to explain to them what the machines are used for near their baby.” explains the pediatrician. “It’s a world in its own right, a very technical environment but essential for monitoring the health of babies.” completes the childcare nurse.

Among all these devices, we can find:

• The scope (or surveillance monitor): This is a screen that allows you to constantly monitor vital parameters such as heart rate, pulse, blood oxygen level (SpO2), blood pressure and even temperature. It is connected to the baby by electrodes. In the event of a rhythm disturbance, for example, the device triggers a visual and audible alarm;
• Self-impulse syringes also make noise. It is a medical device used to administer small amounts of fluid (with or without medication) to the baby via an infusion pump and syringe;
• The incubator or incubator allows the baby to be correctly installed to receive certain care, but above all to regulate his temperature;
• Non-invasive respiratory support called CPAP can help the child breathe;
• Artificial ventilation may be necessary in certain cases;
• A nasogastric tubeit is a small tube inserted through the nose or mouth and goes directly into the baby’s stomach so that it can be fed.

“Devices remain devices and the intervention of the medical team is essential to analyze whether it is an emergency or false alarms. There are also alarms warning that an infusion is about to end, for example. Obviously, parents can’t tell the difference and it’s very anxiety-inducing for them, but the healthcare team recognizes these different sounds and acts accordingly.” specifies the pediatrician.

Neonatology: many professionals serving babies (and parents)

In a neonatal intensive care unit, you will come across many members of the nursing staff. “It’s a multidisciplinary team.” comments Dr Sabine Réthoré. Thus, you will be able to meet pediatricians, medical interns, childcare nurses (some are specialized: lactation consultant, baby development, specialist in pain, orality, carrying, palliative care, etc.), nursing assistants. childcare, physiotherapists, psychologists, psychomotor therapists, speech therapists, medical secretaries, social workers, maintenance workers… A complete team fully mobilized at your side.

Medical examinations for a premature baby

Techniques and…