URINE AND STOOL

Babies urinate all the way through their fetal development, so it is no surprise that a premature baby, like a full-term baby, urinates soon after he is born. But babies typically do not stool until about 34 weeks of gestation, so it is surprising that a premature baby begins stooling very shortly after he is born. He usually will not stool in large amounts or very frequently, but he is able to move his bowels even before he begins eating.

The nurses in the NICU wilt take extra care to measure how much urine and stool a baby produces within each 24-hour period. Diapers are typically weighed in order to calculate the daily amount. If a baby has a catheter in the bladder, then the urine will be collected in a bag so that the volume can be easily measured.

It is important to keep track of how much urine and stool baby is putting out so that it can be compared with how much fluid the baby is taking in. These numbers - often called the ins and outs - should be relatively well balanced. If they are not, then the baby may be getting too much or too little fluid, which can lead to other problems.

The colour and quality of the urine and stool are also important. Bloody stool can be an indicator of infection, as can dark or foul smelling urine.

MONITORS, IVS, AND OTHER TUBES

A baby in the NICU will usually be hooked up to several monitors. The tubes and wires attached to a baby can look overwhelming.

All babies in isolettes have temperature probes placed on the middle of their chest or abdomen. This probe is a sticker attached to the baby's skin and connected by a long skinny wire to a monitor outside the isolette. The probe allows the nurses to constantly monitor a baby's temperature without having to use a traditional thermometer.

Many premature babies need intravenous lines (IVs). These are catheters that are inserted into veins to help deliver medicines and draw blood. Sometimes catheters are placed in arteries to monitor vital signs. Only in newborns can catheters be put into the belly button to monitor the baby. The belly button contains two umbilical arteries and one umbilical vein. Shortly after birth, these vessels begin to shrink down. But in the first several hours of life. they are open, and a catheter can be inserted into one (or more) of them.

Umbilical artery catheters (UACs) and umbilical vein catheters (UVCs) are very helpful because they allow for continual monitoring of the blood pressure and other vital signs. Typical IVs can also be used in babies. These catheters are placed in the arm or leg or sometimes the scalp. They provide access to deliver medication or fluids to the baby.

The most common mechanisms for oxygen delivery include the endotracheal tube - which is inserted all the way into the lungs - the face mask, the nasal cannula, and the nasal CPAP.

If there is concern about the urine or urinary tract, then a catheter may be placed through the urethra into the bladder. This tube drains the bladder, collecting urine as it is produced.

Most babies in the NICU wear eye shields at some point during their hospitalization. This may be done because the isolette is too bright or because there are treatments being given that can be toxic to the eyes. One example of this is phototherapy for jaundice. Babies placed under bright phototherapy lights will often have their eyes covered. The eye shields look like cloth sunglasses. They are soft and strapped around the baby's head.