Baby Is In The NICU: A Comprehensive Guide For Singaporean Parents

Preterm birth is a stressful event for families. Having a baby and taking your baby home is something all parents look forward to, whether you’re a first time parent or not. When things don’t go to plan and your baby starts their journey in the NICU it can be very overwhelming.

What is a NICU?

NICU stands for Neonatal Intensive Care Unit – a specially designed part of a birthing hospital that’s suitable for even the tiniest of patients. It contains equipment that caters for preterm birth and it’s manned by staff specially trained in neonatal care. 

Not every hospital has a NICU and therefore some babies needing specialist care will need to be transferred to a hospital that does have one. The first thing you’ll see is a series of taps or antibacterial gel dispensers at the entrance. You need to wash your hands with sterilising soap for several minutes before going in as babies in NICUs can easily catch infections.

Inside you’ll find incubators and cots under heat lamps which help to regulate small babies’ body temperature. Lights are dimmed and it’s quiet, as babies in the NICU can be overwhelmed by too much noise and light. 

Depending on what medical support your baby needs there might be:

• ventilators to help with breathing
• machines to give measured amounts of fluids and medicines through tubes going into their veins
• monitors attached with cords to measure heart rate, breathing and the amount of oxygen in baby’s blood
• special cooling beds to help reduce brain injury following a difficult birth.

All of this technology and machinery keeps your baby comfortable, with as little extra handling as possible. It monitors them and lets medical staff know when your baby needs extra care.

Other large machines are brought into the NICU when they’re needed. These might include machines to:

• take X-rays and ultrasounds
• monitor brain function
• give babies phototherapy, or treatment under lights, for jaundice.

What to expect from a NICU

The NICU is usually a calm place, with nurses and doctors quietly looking after the babies and other specialists coming in and out. Monitors will sound to alert the staff if a baby’s breathing or heart rate is out of the normal range.

NICUs have highly trained medical and nursing staff and specialist equipment for premature babies and sick newborns. Each baby is closely monitored by an individual bedside nurse and other specialists, including a:

• Neonatologist. This is a paediatrician with extra training in the care of sick and premature babies. The neonatologist (often called the attending physician) supervises pediatric fellows and residents, nurse practitioners, and nurses who care for babies in the NICU.
• Neonatal nurse practitioner. This is a registered nurse with extra training in the care of newborn babies. He or she can do procedures and help direct your child’s care.
• Respiratory therapist. This is a person with special training in giving respiratory support. This includes managing breathing machines and oxygen.
• Physical, occupational, and speech therapists. These types of therapists make sure a baby is developing well. They also help with care including positioning and soothing methods. Speech therapists help babies learn to eat by mouth.
• Dietitians. Dietitians ensure the babies are growing well and getting good nutrition. They watch your baby’s intake of calories, protein, vitamins, and minerals.
• Lactation consultants. These are healthcare providers with extra training and certification in helping women and babies breastfeed. They can help with pumping, maintaining milk supply, and starting and continuing breastfeeding.
• Pharmacists. Pharmacists help in the NICU by assisting the care providers choose the best medicines. They check medicine doses and levels. They keep the team aware of possible side effects and monitoring that may be needed.
• Social workers. Social workers help families cope with many things when a child is ill. They give emotional support. They help families get information from healthcare providers. They support the family with other more basic care needs, too. These can include money problems, transportation, or arranging home healthcare.

NICU team members work together with parents to create a plan of care for high-risk newborns. As well as the NICU team there are parent support groups and other programs designed to help you manage what can be a difficult and stressful time. 

Choosing the best hospital and level of care

All NICUs care for babies who need special help but not all NICUs are equal. There are different levels of care for different NICUs and it’s important you choose the right one. 

• Level I NICUs are sometimes referred to as “well baby nurseries.” They provide care for healthy, full-term babies and also stabilise babies born near term to get them ready to be moved to facilities that provide special care.
• Level II NICUs offer nursery care for babies born at or after 32 weeks and babies who are recovering from more serious health problems. Level IIA facilities do not provide respiratory support for babies with breathing problems, while level IIB nurseries provide assisted ventilation for less than 24 hours, as well as continuous positive airway pressure (CPAP).
• Level III NICUs care for very sick babies and offer access to a wide range of pediatric specialists and equipment, such as X-rays and ventilation support. The babies in these nurseries are generally born earlier than 32 weeks or have critical illnesses.

There are other factors to consider also, such as:

• How accessible is the hospital? The closer the NICU is to your home, friends and family the better for visits. Good public transport could also be a factor. 
• How many babies are cared for each year? NICUs that treat lots of babies not only has the experience to care effectively but likely the equipment too.
• What trained specialists are available to your baby? A good NICU should have a rotating roster of highly trained pediatric medical, surgical and nursing specialists on hand 24 hours a day.
• What’s the environment like? Soft lights and low noise levels allow your baby the rest it needs. The environment should be soothing and secure for both you and your child. 
• What kind of support with YOU get? You’re a core part of your baby’s recovery therefore how you’re looked after matters. Are there counselling and other services you can tap into to ensure your own needs are met? 
• Will there be post-NICU support? A plan should be put in place to keep you and your baby comfortable when transitioning from the NICU to home. Skills training may be required. 

NICU costs in Singapore

In Singapore, both the private and public sectors are typically safe and reliable. Deciding between both is generally a matter of choice, as both systems deliver top-of-the-line medical care. 

The largest benefit of going public is the affordability factor. Costs are generally lower than those in private hospitals, as public hospitals are subsidised by the government for Singaporean citizens. Another advantage is that public hospitals are usually better equipped to deal with birth and delivery complications. Singapore’s public hospital NICUs are all Level 3, while only some private hospitals offer Level 3. 

The largest benefit of going private is less waiting times, more comfortable amenities and a greater sense of luxury. You can relax in beautiful waiting rooms and enjoy smoother administration and billing processes. 

As a guide…

• KK Women’s and Children Hospital has inpatient daily ward charges from S$35 to S$533.95.
• Mount Elizabeth Hospitals have NICU rates from S$278 (Level 1) to S$748 (Level 3). 
• National University Hospital has NICU rates from S$150 (C Class Daily Ward) to S$695.50 (A1 Class Daily Ward)
• Thomson Medical has NICU rates from S$280 (Level 1) to S$560 (Level 3) with suites an additional S$100-$125.
• Gleneagles Hospital has NICU rates from S$268 (Level 1) to S$718 (Level 3).  

Where to find support

Some parents know well in advance that their baby will likely spend time in the NICU but for others it can come as a complete shock. Either way, it pays to understand what support is available.

A good way to start your supported journey to parenthood is with prenatal classes. Prenatal classes are a great way to get ready for childbirth and will help to ease many of your concerns as you approach the big day. If it’s your first pregnancy you will no doubt have many questions about your body, diet, exercise, hospitals, and health. Even if it’s not your first child, you may still have questions, or may wish to have a different experience this time and going to a prenatal class can be a great way to learn more and feel as prepared as you can.

Another thing you might like to do is take a tour of the NICU and build a rapport with NICU staff. Learn what to expect should your baby be admitted there. Talk to other parents too. The NICU can feel like a lonely place for parents, even though it’s a bustling hive of activity. Connect with other parents of NICU babies through support groups and talk about your experience. Communicate your feelings and be sure to give yourself some downtime when you can. 

Going with the flow

Many couples say they will ‘go with the flow’ when it comes to childbirth but we say it pays to be prepared. ‘Going with the flow’ takes the pressure off parents to “perform” and have the “perfect birth” but it can also be detrimental to your baby’s health. 

Childbirth can go to plan and sometimes it doesn’t. The right research can pay dividends, but flexibility is key. Remaining flexible with a Plan A, Plan B and Plan C means letting go of concrete plans but knowing enough to not be stressed by the unknown. By doing your research you can make informed and timely decisions so that the ‘flow’ doesn’t lead you somewhere you don’t want to go. 

Find out your options, inform yourself, and then should NICU become a reality, you’re prepared and ready for the situation. This includes understanding nutritional needs, which Bellamy’s Organic can help you with. Our team of experts are dedicated and passionate about creating high quality, nutritionally balanced and delicious organic baby food and formula so that you can give your baby the purest start to life. 

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