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newborn NICU admission
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When Does a Newborn Need NICU Admission

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When Does a Newborn Need NICU Admission? Not every newborn needs special care. However, some babies need extra medical care soon after birth or during their first few weeks. A baby may need to stay in the Neonatal Intensive Care Unit (NICU) if they are born too early or have health problems. These problems may include trouble breathing, serious infections, severe jaundice, seizures, low oxygen levels at birth, or low blood sugar. Parents should get medical help immediately if their newborn has trouble breathing, blue lips or tongue, difficulty feeding, unusual sleepiness, pauses in breathing, or seizures. At Dr. Vivneet’s Vardaan Hospital, Patiala, newborn care includes close health monitoring, breathing support, and care from a team of newborn specialists. What Is NICU Admission? A Neonatal Intensive Care Unit (NICU) is a special unit for newborn babies who need extra medical care. Some babies need NICU care because they are born too early or have a low birth weight. Other babies may develop health problems shortly after birth. The NICU team checks the baby’s breathing, heartbeat, oxygen levels, body temperature, and feeding. Doctors also check other important signs and give treatment according to the baby’s needs. Some babies need NICU care for a few days, while others may need to stay for several weeks. The length of stay depends on the baby’s health and recovery. When Does a Newborn Need NICU Admission? Doctors may suggest NICU care when a baby needs special treatment or close health monitoring. 1. Premature Birth Babies born before 37 weeks of pregnancy are called premature babies. Their lungs and other organs may not be fully developed. Because of this, they may have trouble breathing, keeping their body warm, or feeding properly. Some premature babies may need an incubator to stay warm, help with breathing, feeding through a tube, or regular health checks. 2. Low Birth Weight A baby weighing less than 2.5 kg at birth is considered to have a low birth weight. However, not every baby with a low birth weight needs NICU care. Doctors check the baby’s breathing, body temperature, blood sugar, feeding, and overall health to decide if special care is needed. If the baby needs extra support or close monitoring, doctors may recommend NICU care. 3. Breathing Problems After Birth Some newborns have trouble breathing soon after birth. This may happen because they are born too early, have lung problems, develop an infection, or face problems during delivery. Watch for these warning signs: Fast or difficult breathing Grunting sounds while breathing The chest pulling inward with each breath Blue or grey lips or tongue Repeated pauses in breathing Doctors may provide oxygen, CPAP, high-flow breathing support, or a ventilator, depending on the baby’s condition. 4. Severe Newborn Jaundice Jaundice makes a baby’s skin and eyes look yellow. It happens when too much bilirubin, a yellow substance, builds up in the baby’s blood. Mild jaundice is common in newborns. However, very high bilirubin levels can harm the baby’s brain if left untreated. Doctors check the bilirubin level in the baby’s blood and look at the baby’s age and other health risks. Treatment may include phototherapy, which uses special light to reduce bilirubin levels. Severe cases may need additional treatment and close monitoring. Important: Yellow skin or eyes during the first 24 hours after birth need prompt medical assessment. 5. Newborn Infections Newborn babies can get serious infections, such as sepsis. These infections can become dangerous very quickly, so early medical care is important. Warning signs may include: Poor feeding or refusing milk Unusual sleepiness Fever or a low body temperature Breathing problems Changes in skin colour Reduced activity or unusual crying Doctors may suggest blood tests and other checks to find the infection. They may also give antibiotics and closely monitor the baby’s health. 6. Birth Asphyxia or Low Oxygen at Birth Sometimes, a baby does not get enough oxygen around the time of birth. This is called birth asphyxia. Affected babies may need immediate breathing support and careful monitoring. Doctors may also check the baby’s brain activity and the function of other organs. Some babies develop a condition called hypoxic-ischaemic encephalopathy (HIE). It can affect the brain when it does not get enough oxygen. Some babies may benefit from a treatment called therapeutic hypothermia. Doctors must check these babies quickly because treatment usually needs to start within the first six hours after birth. 7. Low Blood Sugar Newborn babies need enough sugar in their blood to support normal body functions. Some babies are more likely to have low blood sugar. These include babies born too early, babies with low birth weight, and babies born to mothers who have diabetes. Possible signs include: Poor feeding Shaking or trembling Unusual sleepiness Low body temperature Seizures Some babies may not show any clear symptoms. Doctors may check the baby’s blood sugar and provide extra feeding support if needed. They may also use glucose gel or give glucose through a vein. The baby may need NICU care for close monitoring or special treatment. 8. Seizures or Unusual Movements Seizures in newborns may cause repeated jerking, unusual stiffness, staring, or strange movements of the face, arms, or legs. Some seizures are difficult to notice. Possible causes include infections, low blood sugar, changes in blood salts, or brain injury around birth. A newborn with possible seizures needs urgent medical care. Doctors may use EEG or aEEG/CFM monitoring to check the baby’s brain activity if needed. 9. Feeding Problems and Dehydration Some newborns cannot take enough milk or have difficulty feeding safely. This may happen because of premature birth, breathing problems, or other medical conditions. Doctors check the baby’s feeding, weight, urine output, and signs of dehydration. Some babies may need feeding through a tube or fluids through a vein. Doctors may also do other tests to find the cause of the problem. Seek medical help immediately if your baby feeds poorly, seems very sleepy, has trouble breathing, or does not respond normally. 10. Birth Conditions or Other

Advanced NICU care for newborns in Patiala
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Your Baby Needs a Ventilator or Advanced NICU Care

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Your Baby Needs a Ventilator or Advanced NICU Care. Do You Have to Travel to Chandigarh? When a newborn has serious breathing problems, an infection, complications from being born early, or a brain injury caused by low oxygen, quick medical care is very important.If doctors suggest taking the baby to PGIMER Chandigarh or another specialist hospital, parents may worry about the journey, finding a hospital bed, and the cost of treatment. Another important question is whether your baby can safely get the needed treatment at a well-equipped NICU closer to home. However, going to Chandigarh may still be the right medical choice. However, if the right care and a suitable NICU bed are available in Patiala, staying closer to home may help avoid an unnecessary long journey. Advanced newborn care available in Patiala Dr. Vivneet’s Vardaan Hospital, near Rajindra Hospital, has a Level III NICU for newborns who need advanced care. Its listed services include: Conventional and high-frequency ventilation (HFOV):Breathing support for newborns with serious breathing problems, based on their medical needs. Inhaled nitric oxide (iNO): A specialised treatment that may be use for some newborns with high blood pressure in the lungs, after proper medical assessment. Therapeutic hypothermia: Carefully controlled cooling for selected babies with moderate to severe HIE caused by a lack of oxygen around birth. Brain and bedside monitoring: This includes aEEG/CFM, close monitoring of newborns, and other tests and intensive care support. Transport and continuing care: Neonatal transport support, care for premature babies, nutrition support, and treatment for serious newborn infections. The hospital also has a PICU for seriously ill babies and children who need close monitoring and intensive care. This may include children with severe pneumonia, breathing problems, sepsis, or other serious conditions.The hospital provides 24-hour emergency care and medical support. However, a specialist should confirm that the needed service, medical team, and suitable bed are available before accepting the child. If your doctor recommends transfer to PGI, ask these seven questions What is my child’s diagnosis and what treatment is urgently need? Ask why the baby needs to be transferred. It may be for a ventilator, a specific treatment, specialist surgery, or another medical service. Has the receiving hospital accepted the patient? When possible, the doctors at both hospitals should speak directly and confirm that the right bed and equipment are available. Is an appropriate facility available in Patiala? A local NICU or PICU should be choose only if it can safely provide the care your child needs. How will the child be stabilise before departure? Discuss the baby’s breathing, blood flow, temperature, blood sugar, medicines, and monitoring needs. What equipment will the ambulance carry? A very sick newborn on a ventilator may need a transport ventilator, incubator or warming support, monitors, enough oxygen, and backup equipment during the journey. Who will care for my child during the journey? A trained medical transport team should travel with a child who needs intensive care. They should also have a plan in case the child’s condition gets worse during the journey. What is the payment arrangement at the destination? Check the current scheme eligibility, hospital approval, and treatment package. In an emergency, money-related checks should not delay urgent treatment or a medically needed transfer. Ask why the baby needs to be transferred. It may be for a ventilator, a specific treatment, specialist surgery, or another medical service. When possible, the doctors at both hospitals should speak directly and confirm that the right bed and equipment are available. A local NICU or PICU should be choose only if it can safely provide the care your child needs. Discuss the baby’s breathing, blood flow, temperature, blood sugar, medicines, and monitoring needs. A very sick newborn on a ventilator may need a transport ventilator, incubator or warming support, monitors, enough oxygen, and backup equipment during the journey. A trained medical transport team should travel with a child who needs intensive care. They should also have a plan in case the child’s condition gets worse during the journey. Check the current scheme eligibility, hospital approval, and treatment package. In an emergency, money-related checks should not delay urgent treatment or a medically needed transfer. These questions follow standard principles for newborn referral and transport, including communication between hospitals, stabilising the baby before transfer, and using a properly equipped transport team. Why timing matters – especially for babies needing cooling Therapeutic cooling is not need for every baby after a difficult birth. For selected newborns with moderate to severe HIE, doctors may start cooling as early as possible, ideally within six hours of birth. The treatment is usually carefully monitor for 72 hours. If HIE is suspect, families should speak to the treating neonatologist immediately. They should not wait for routine paperwork or try to cool the baby themselves. Can treatment be cashless under a government health scheme? For eligible families, the answer may be yes. However, a health card does not mean every treatment is free at every hospital. Eligibility, the treatment package, hospital approval, and any require authorisation should be check.  Punjab families – Mukh Mantri Sehat Yojana: The state scheme may provide eligible families with cashless hospital treatment cover of up to ₹10 lakh per family each year at participating hospitals in Punjab and Chandigarh, subject to the scheme rules and approved treatment packages. Eligible families from other states – Ayushman Bharat PM-JAY:National portability allows eligible PM-JAY beneficiaries to use approved cashless treatment at empanelled hospitals across India, subject to verification and scheme rules. The standard national cover is ₹5 lakh per family per year. Any additional state-funded cover may have separate portability rules. Advanced newborn treatment packages: The National Health Authority lists therapeutic cooling under advanced newborn care and HFOV/iNO under critical newborn care. However, the exact package available in Punjab and whether the hospital can provide it cashlessly should be confirmed for each admission. For treatments covered under an approved cashless package, eligible patients generally should not have to pay separately for those covered services. Ask

iNO therapy for newborns in NICU
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What Is iNO Therapy

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What Is iNO Therapy? A Complete Guide for Parents When a newborn has trouble breathing, doctors may use different treatments to help the baby breathe and keep oxygen levels normal. One treatment is called iNO therapy, or inhale nitric oxide therapy. iNO therapy may help some newborns with serious breathing problems and low oxygen levels. It is usually give in the NICU with close medical monitoring. Understanding this treatment can help parents feel more informed during their baby’s NICU stay. This guide explains what iNO therapy is, when doctors may use it, how it works, and what parents can expect. What Is iNO Therapy? iNO therapy means inhaled nitric oxide therapy. It gives a controlled amount of nitric oxide gas directly into the baby’s lungs through their breathing system. Nitric oxide helps relax the blood vessels in the lungs. This can improve blood flow and may help the baby get more oxygen. Doctors may use iNO therapy when a newborn has low oxygen levels due to certain lung or blood vessel problems. How Does iNO Therapy Work? Nitric oxide mainly acts on the blood vessels in the lungs. It helps widen the blood vessels in the lungs. This allows blood to flow more easily through the lungs. It may also help the body take in oxygen and remove carbon dioxide. The baby usually receives iNO through a breathing support system. Doctors carefully control the amount of nitric oxide and closely watch how the baby responds. When Is iNO Therapy Use in Newborns? Doctors may use iNO therapy for some newborns with conditions such as persistent pulmonary hypertension of the newborn (PPHN). It may also be use for some babies with serious breathing problems when other treatments have not help enough. However, iNO therapy is not right for every baby with breathing problems. The neonatologist decides if it is suitable after checking the baby’s condition, oxygen levels, and overall health. What Is PPHN? Persistent pulmonary hypertension of the newborn (PPHN) is a condition where the blood vessels in a baby’s lungs stay too narrow after birth. This can make it difficult for blood to receive enough oxygen in the lungs. In some babies with PPHN, iNO may help relax the blood vessels in the lungs and improve oxygen levels. How Is iNO Therapy Give? iNO is usually give through the baby’s respiratory support system. Depending on the baby’s condition, respiratory support may include: Mechanical ventilation CPAP or other breathing support Other respiratory support methods recommended by the medical team The medical team uses special equipment to give nitric oxide and carefully check its levels. How Long Does iNO Therapy Last? The duration of iNO therapy is different for every newborn. Some babies may need iNO for a short time, while others may need it for longer. The medical team regularly checks the baby’s oxygen levels, breathing, blood gases, and other signs. When the baby’s condition improves, doctors may slowly reduce the nitric oxide level instead of stopping it suddenly. How Do Doctors Monitor a Baby During iNO Therapy? Close monitoring is an important part of iNO treatment. The NICU team may monitor: Oxygen saturation Heart rate Breathing rate Blood pressure Blood gas levels Lung function The baby’s overall clinical condition Response to the treatment The medical team may also do tests such as an echocardiogram to check the baby’s heart function and blood flow through the lungs. Are There Risks or Side Effects of iNO Therapy? Like any medical treatment, iNO therapy can have potential risks. The medical team carefully controls the dose and closely monitors the baby during treatment. In some cases, iNO may affect blood pressure, increase methemoglobin levels, or cause lung-related effects. Stopping iNO too quickly may cause oxygen levels to drop suddenly in some babies. Therefore, doctors usually reduce the treatment slowly when appropriate. The exact risks depend on the baby’s condition and other treatments being use. Is iNO Therapy Safe for Newborns? iNO therapy can be an important treatment for some newborns, especially those with certain types of pulmonary hypertension and low oxygen levels. However, it is not a routine treatment for every newborn with breathing difficulty. A neonatologist checks the baby’s condition and decides if the possible benefits of iNO therapy outweigh the risks. What Can Parents Expect During iNO Therapy? Seeing your baby connected to breathing equipment can feel worrying. It is normal for parents to have questions. During iNO therapy, your baby may be connect to several monitors and breathing support machines. The NICU team will closely watch your baby’s condition throughout the treatment. Parents can ask the medical team: Why does my baby need iNO therapy? What condition is the treatment helping? How will you know if it is working? How long might my baby need it? What other treatments is my baby receiving? What signs show that my baby is improving? Talking openly with the NICU team can help you understand your baby’s treatment and progress. What Happens After iNO Therapy? Once the baby’s oxygen levels and overall condition improve, doctors may slowly reduce iNO therapy. The baby may still need other breathing support or oxygen for some time. This depends on the baby’s condition and how well the lungs and heart are working. The medical team will continue monitoring the baby during this period. Why Is Specialist NICU Care Important? Newborns receiving iNO therapy need close monitoring because their oxygen levels and breathing can change quickly. A specialised NICU team closely watches the baby, adjusts breathing support, and responds quickly if the baby’s condition changes. At Dr. Vivneet Vardaan Hospital, newborns with serious breathing problems can receive specialist neonatal care, continuous monitoring, and medical support. Conclusion iNO therapy is a specialised treatment for some newborns with serious oxygen problems, especially certain cases of pulmonary hypertension. It helps relax the blood vessels in the lungs, which may improve blood flow and oxygen levels. Because every newborn is different, an experienced neonatal team should decide the treatment after carefully checking the

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