1. We calculate pee. Constantly. Low urine output is one of the very earliest signs of infection in a neonate. With adequate fluid provided ( ~100 cc/kg/day) babies should make 1cc (or mL) of urine per kilogram of body wt per hour. Anything less is cause for alarm.

2. Formula kills- it is poison to an immature infant. Babies less than 34 weeks fed formula are colonized with a different gut flora (bacteria) than breast milk-fed infants. this puts them at very high risk of developing NEC (necrotizing enterocolitis), an often fatal disease, because of their immature gut and immune system. Therefore, we only give mom’s milk or donor human milk (from a milk bank) to infants 34 weeks gestational age or less.

3. All babies (healthy and term or sick and premature) lose weight in the first several days of life. It’s water weight. Newborns are comprised of 75-85% water, most of it extravascular. Cutting the umbilical cord at birth sets off a chain of events in the circulatory and renal systems which directs the kidneys to get rid of sodium. We all know that water follows sodium- voila- weight loss! Its how infants can lose crazy amounts of sodium through their urine, yet their serum sodium INCREASES to normal levels! Amazing the design of the human body! Major props to our Creator, on that one!

Incidentally, the measure of sodium in a body is a concentration in relation to total body water. Hence, when one is dehydrated, it’s because there is not enough water and the concentration of sodium increases.

4. We give some babies Viagra. The common name is sildenafil, but its the same drug. Infants born less than 37 weeks who continue to require supplemental oxygen and at risk for pulmonary insufficiency and chronic lung disease as a result of immature lungs. The earlier the infant, the higher the risk of abnormal lung growth and development. The vessels in the lungs are abnormal also and tend to constrict, decreasing blood flow to the lungs, causing respiratory problems and the need for extra oxygen. Viagra (or sildenafil) causes those vessels in the lungs to dilate or “open up,” increasing blood flow to the lungs.

There are so many more interesting facts about NICU nursing- this meager offering is but the tip of the proverbial ice burg. Endless potential exists, to learn in the NICU environment. Truly, a lifetime of learning awaits a nurse here. Each infant is a unique individual, none look the same, and all babies are beautiful to me! NICU nurses, MDs, and NNPs demonstrate great teamwork and are masters of multitasking – I could devote an entire post to that subject! The vocation is difficult and rewarding, chaotic and technical, emotional. It encompasses almost every aspect of the experience of being human- birth, death, love, pain, hope, disappointment, happiness, wonder, awe. It’s wonderful and overwhelming at times….and it absolutely is what I was created to do.