Being in hospital is sometimes a completely new (often overwhelming) experience. You’re likely to have lots of questions that you want answers to and the doctors and nurses may use terms that you’ve never heard of before. Here’s a helping hand for some of the common terms that might be used.
Click on each of the terms below to expand
What does Apgar stand for?
Apgar is “appearance (skin colour), pulse (heart rate), grimace (reflexes), activity (muscle tone) and respiration (breathing rate and effort)”. It is a method used to quickly assess the health of a newborn baby.
This is a medical term that refers to slowed or stopped breathing.
Sometimes infants in hospital will have an apnea alarm or monitor, to alert any episodes.
These are tubes that go in to an artery so that blood samples can easily be taken, and blood pressure can be monitored.
What’s an aspirate? An aspirate is what is taken from the stomach before a tube feed. If you’re in NICU (neonatal intensive care) it’s usually done by a nurse, who will use a syringe to draw up a bit of liquid from the stomach – they then test it (by using a pH strip and checking the colour) to make sure that the tube is still in the right place. It may be that you can get involved in taking an aspirate, and you will be shown how to do this.
This is a blood test which measures the amount of oxygen and carbon dioxide in the blood. It can also be used to measure the acidity of the blood. The blood can be taken either from a heel prick, or umbilical artery catheter (UAC) if your baby has one.
This is when a baby’s heartbeat slows to less than 100 beats a minute.
A small plastic tube that is often put in to a baby’s hand or foot to get fluids (such as medicines) in. Whilst cannulas can make things a bit fiddly, it doesn’t stop you being able to have cuddles with your little one.
What does CFM stand for?
CFM is cerebral function monitoring. It’s a term you might hear in neonatal care. A cerebral function monitor is a special monitor that records brain activity. The doctors will then use this information, along with other observations, to assess your baby. CRM does not hurt.
You can read more about it here.
Continuous Positive Airway Pressure – this is gentle breathing support that keeps the baby’s lungs inflated.
What does CVI stand for? Cortical Visual Impairment (sometimes called Cerebral Visual Impairment). CVI is where the connections don’t work as they should between the eyes and the brain (the eyes themselves are healthy). It is different to other forms of visual impairment that are caused by physical problems with the eyes.
CVI can change, and improve. There’s lots of information at Little Bear Sees.
What does it mean if they say my baby is having “desats” or “desatting”?. Desats is is a term used to mean that saturations (oxygen levels) are dropping. Oxygen is getting lower. Desat is short for desaturate. Often babies in NICU have their saturation levels (sats) monitored – the machine (called a saturation monitor) will beep if they drop below a certain level. Sometimes the oxygen levels come back up on their own, sometimes they need a little help.
Expressed breast milk. If you aren’t able to breastfeed your baby at the moment then you may want to try expressing. Ask one of the nurses if there is support available, or contact La Leche League . EBM can then be given via a feeding tube (see NG tube). Please don’t be disheartened though if you struggle to express, it’s not always easy and not for everyone.
Electroencephalogram – this is a test that measures brain wave patterns. It’s done by placing small discs attached to wires on to the scalp. These send signals to a computer where the results are recorded. It’s not painful, but getting the glue from the discs off after can be a little challenging!
Fi-Care is a model of care than integrates you, the family, in to the team caring for your baby. You can read more about it from our friends at Spoons here.
What is HIE? HIE is short for Hypoxic-ischaemic encephalopathy (hypoxic = lack of oxygen, ischaemic = restricting blood flow, encephalopathy = affecting the brain). It’s sometimes also known as perinatal hypoxic-ischemic encephalopathy),
It can be quite a mouthful to say, and even harder to spell! There are sometimes variations between the spellings, with English “ischaemic” and American “ischemic” but they mean the same thing.
A question that’s often asked is “is HIE curable?“. HIE is an event, so it happens, and can’t be undone, but Therapeutic Cooling is sometimes a suitable treatment to limit the extent of any injury.
So what causes HIE? Well there can be lots of reasons – placenta abruption, shoulder dystocia, cord compression, trauma during delivery…the list is long, and it’s not always obvious as to what might have happened, so it’s best to speak to your healthcare professional if you’re unsure.
Does HIE cause cerebral palsy? HIE can cause cerebral palsy, but not in every case. Cerebral palsy is a condition that affected motor function. It can be caused by the injury to the brain caused by the HIE event. More information on cerebral palsy can be found here.
Some of the symptoms of HIE include, but are not limited to: low Apgar scores, seizure activity, organ problems, breathing difficulties, and feeding issues.
So is HIE the same as cerebral palsy? No, it can sometimes cause cerebral palsy, which is a motor dysfunction caused by an injury to the brain, but not every child who has had a HIE event will go on to have a cerebral palsy diagnosis.
If they do, it’s always important to try to remember that a diagnosis does not define your child – they will write their own rules!
Also IV drips, are tubes that put fluids and medicines directly in to the baby’s veins. They can go in to different parts of the body (sometimes finding a suitable place can be a bit tricky!)
Jejunal feeding is the method of feeding directly in to the small bowel.
The small bowel –jejunum/duodenum is part of the gastrointestinal tract after the stomach and before the large intestine. This is where digestion and absorption of liquid food takes place
Kangaroo care is another term for “skin to skin”. It can sometimes feel a little daunting, and tricky if there are wires and tubes, but a nurse will guide you through. The baby will be on your chest (great for mums and dads!), and can be lovely for soothing and bonding.
Kangaroo care has been shown to have many benefits. More information can be found here.
This is a procedure where a needle is put in to the back (the spinal canal) to take fluids for testing.
Magnetic Resonance Imaging – is a scan that takes images of the brain and can determine where any injury may have occurred.
The hospital team will explain what results mean, and it’s always important to remember that these are just part of the jigsaw, not the whole piece.
What does a neurologist do? A neurologist is a medical professional who specialises in diagnosing and treating conditions related to the brain and the nervous system.
You may see a neurologist while you’re in hospital, and possibly for follow up appointments once you go home.
Nasogastric tube – a thin plastic tube that goes to the stomach via the nose, to get milk and medicines in to little ones who can’t feed or struggle to swallow. Sometimes they are used along side other feeding (breast, bottle for example), whereas some babies are exclusively tube fed. They are a pretty amazing bit of kit, getting all those nutrients/medicines in in the easiest way.
What does NICU stand for? It’s Neonatal Intensive Care Unit – a special place for our most important peeps, where there are medical professionals and advanced equipment to provide care when it’s most needed. There are different levels of NICU, and depending on what care a baby needs, they may have to be transferred to a different unit for some time. This can be hard, especially if it’s further away from home, but it ensures they are being looked after in the best possible way.
Orogastric Tube – this is the same as the NG tube, but goes to the stomach via the mouth. Sometimes babies need help breathing through their nose, so an NG tube isn’t possible.
Physiotherapist (physio) – you may be introduced to a physio early on. They can help look at your baby’s muscles and tone. Some HIE babies may be quite stiff whilst others a bit floppy. Physios can also look at their chest if they are a bit crackly. They may show you some stretches and moves to do with your baby to help, and look at good positioning in the cot.
What is SALT short for? SALT stands for Speech and Language Therapist – one of a team of professionals that you may be introduced to. Even though you may think your baby is too small to be speaking, they can often look at how your baby is swallowing, and recommend exercises you can do to help them if they are struggling.
More information can be found here: https://www.rcslt.org/speech-and-language-therapy/.
Also known as Sarnat grading scale or classification – this is a classification scale for HIE and ranges from mild (Grade I) to sever (Grade III).
A Sats monitor is a machine that measures oxygen saturation levels. You might also hear the term “pulse oximeter”. A probe shines a light through a finger or toe. This measures how much oxygen your baby is getting. The top score is 100, but your nurse/doctor will explain what is an acceptable level for your baby. If they drop below then they might need some oxygen to help them. Sats probes don’t hurt, but you will find the nurses change the position of them on a regular basis.
Special Care Baby Unit – just like NICU, this is a special place for our most important peeps, where there are medical professionals and equipment to provide care. It is sometimes referred to as low dependency. SCBUs are for babies who need some level of extra care, but not in Neonatal Intensive Care (see NICU), or maybe for those who have been in NICU and are transitioning towards going home.
Suctioning is where excess secretions are removed, from the nose (nasal cavity), mouth, throat or trachea. A suction machine is used. In hospital these are often fixed to the wall, but you can also have mobile ones that can be carried about. A catheter (a thin flexible plastic tube) is most commonly used for nasal suction. A Yankauer (a fixed plastic tube) is more commonly used for clearing secretions in the mouth.
You may realise your child needs suction by seeing their sats (oxygen levels) go down, by hearing gurgling or bubbling noises, or by seeing your child having difficulty in clearing secretions. Always ask questions of the doctors and nurses looking after you, so you learn as you go along.
Healthcare professionals can train parents/carers to carry out suction. It can feel a little daunting at first, but soon becomes second nature.
You can read more about the different types of suction here.
This means having a fast heart rate.
What’s cooling? Therapeutic cooling is also sometimes called hypothermia treatment. Cooling is a well established, standard treatment for babies over 36 weeks who have experienced moderate to severe HIE. The baby’s temperature is lowered to 33.5 degrees (from 37 degrees). It is done by using a special cooling mattress or cooling wrap. The mattress or wrap are filled with liquid, so the temperature can be adjusted as needed.
How is the baby’s temperature measured?
A rectal thermometer is used. This is a probe placed inside the baby’s bottom.
When does cooling happen? Cooling treatment starts as soon as possible, and generally within the first 6 hours of the HIE event happening.
How long are babies cooled for? Usually cooling treatment takes place over 72 hours. After this time, the baby is gradually rewarmed, over several hours, back to normal body temperature.
Does cooling cure HIE? Cooling is to limit the extent of injury that may have occurred. Whilst it can’t reverse any injury that has occurred, it can limit further injury.
Please speak to your healthcare professional for more information, and any specific questions you have for your baby if they are receiving cooling treatment.
Tubes that go in to the umbilical cord to give fluids and medicines and to monitor blood pressure.
A machine that helps with breathing, by pushing air and oxygen, via a tube in the windpipe to the lungs.