When pregnant people envision their impending labor and delivery, rarely is a trip to the neonatal intensive care unit (NICU) involved. But sometimes babies require extra attention after birth, which is why it's helpful for all parents to learn about what a potential NICU visit could entail, including the average time parents spend with their babies in the NICU.
Each year, about 14.4 percent of babies will be admitted to the NICU, according to a 2011 study conducted by the March of Dimes and the National Perinatal Information Center/Quality Analytic Services. Most babies are admitted to the NICU because they were born prematurely, have a low birth weight, or have a health condition that requires special care or observation, according to Stanford Children's Health. All of the these factors are considered to determine how long a baby needs to stay and the treatment plan to get them to a point when they can go home.
The 2011 March of Dimes study found that the average NICU stay for neonates was 13.2 days. However, the same study noted that there was a dramatic difference in length of stay for preterm infants compared to late preterm and term babies, with babies born at 32 weeks gestation or earlier staying an average of 46 days, while babies born at 39 to 41 weeks staying an average of 4.9 days.
While some babies who are born at low birth weights (less than 5 pounds) are healthy, babies with low birth rates have a higher risk of health problems with their lungs, brain, heart, gastrointestinal tract, liver, eyes and immune system, as cited by the March of Dimes. They may be admitted to the NICU to address one or more of these concerns, or for observation.
Other common reasons for admittance to the NICU, per the March of Dimes, include breathing distress, jaundice (which can be due to prematurity or feeding issues), infections, and hypoglycemia (low blood sugar). A 2018 study published in the Jornal de Pediatria found that 30.9% of babies developed hypernatremia — a condition caused by not getting enough breast milk or formula in their first few days of life, which can also require a stay in a special care nursery.
To find out more about how long new parents can expect their babies to be in the NICU, Romper spoke with Houston-based Neonatal Nurse Practitioner Dottie Land Jones, MSN, APRN, NNP-BC, and Omaha mom Maureen Grace, about what NICU stays look like in real life.
"We generally tell parents that their due date is a good estimate as to when a preemie will go home," Jones tells me, while noting that health status can impact when they are discharged. "The more premature the baby the bigger risk of complications that can increase the length of stay." For example, according to Jones, a baby born at 33 weeks gestation will likely only need to stay in the NICU for about three weeks. A baby born at 24 weeks gestation, however, may need to stay longer due to potential complications as a result of their premature birth.
In contrast, term babies tend to be healthier and need only a short time in the NICU. A term kid with respiratory distress usually stays less than a week," Jones tells Romper. Gestational age isn't the only factor involved in determining when a baby can go home, though. "Before a baby can be discharged, they have to be gaining weight consistently, taking all feeds by bottle or breast, and maintain their temp in an open crib," Jones says.
For Grace, the NICU became a second home. "[My son] was in the hospital for 418 days before he came home," she tells Romper. He was born at 32 weeks, 5 days, but he needed a lot of support when he was born and through his first couple years of life." Grace's son was in the NICU past his first birthday, and was then moved out of the NICU and over to a pediatric care unit because he had aged out.
Grace's son's stay was longer than most, due to his unique health needs. "Most NICU babies have to be able to breathe on their own, maintain their body temperature, and eat to be able to be discharged. Our journey was a lot different than that," she tells me. "It took so long to get him home because he had to grow enough and be stable enough on a home ventilator with a level of oxygen that we could sustain with home medical equipment,"
Jones encourages NICU parents to try to be patient while their babies get well, understanding for than most that it's easier said than done. "It’s a marathon, not a sprint. Especially with babies that have extreme prematurity," She says. "There will be setbacks. Sometimes it is two steps forward and one step back."
Grace knows about the ups and downs of being a mom to a medically fragile baby. "We didn't ever know how long [our son] would take to go home, it was anywhere from a couple months to a very open ended question," she tells me. "When we did come home, we brought him home with almost as much medical equipment as he had in the hospital, nurses included. It took a really long time for him to get there and even after he went home, he was admitted 12 times in six months."
If you're a parent and your baby is in the NICU, Jones recommends asking questions and taking notes, as the experience can be completely overwhelming. "Ask questions and write down the ones you think of when you aren’t in the NICU so you will remember them. It’s a lot of information, so it’s understandable that the same question will be asked repeatedly," she says. "We want the parents to understand."
For Grace, the NICU and her son's treatment team became a huge source of support for her family. "We celebrated his first birthday in the NICU with all our family and the staff who were like family to us," she tells me. "The NICU was our home for a very, very long time."