Navigating MyCare
in the Neonatal Intensive Care Unit (NICU)
Sunnybrook cares for 600 babies a year in our Neonatal Intensive Care Unit, or NICU. While all family stories are unique, this care pathway will outline some of the common steps along the journey.
Note: During the pandemic, while we are still welcoming parents into the unit, there may be restrictions on who can be present and at what times. Your baby’s team can update you on current requirements.
Let's look at
-
Admission
Your baby's admission to the unit.
-
Your baby's stay
Information about the NICU, your baby's care team, and more.
-
Leaving Sunnybrook
Your baby's transfer or discharge from the Sunnybrook NICU.
-
Life as a graduate family
After you and your baby leave the unit, there are many ways to keep connected.
Admission
Your baby’s admission to the unit
Your baby may be born at Sunnybrook or be transferred from another hospital for care. Sunnybrook is a level III NICU, which means we have capacity to care for the sickest and most premature babies. Most babies admitted to the unit are preterm or “born too soon”. We look after the most “micro-preemies” in Canada. These babies, like Emery, weigh less than three pounds and are born at fewer than 26 weeks of pregnancy.
When your baby is admitted, you will receive an orientation bag with information about the NICU, including its programs and supports. You will also be given an electronic fob which is your key to the parent corridor, your baby's room and other family-only areas.
In the family corridor, there are entrances to the pods (labeled from A to D) where the baby rooms are, as well as social worker offices, bathrooms with showers, care-by-parent rooms for families who need to stay over in a separate room, a pump room where mothers can go to pump milk (M4-311), and the milk preparation area (known as the Dairy Queen).
Your baby's stay
Your baby's room
Your baby will have their own room, which you can access with your fob from the parent hallway. When you are coming to be with your baby, use your fob to open the door of your pod. After you enter your baby’s room, wash your hands in the sink and then sanitize. You will clean your hands every time you enter the unit, and before and after touching your baby. Staff will provide instruction on how to do this properly.
You will notice message boards outside each baby's room; you can use these to communicate with other family members or to NICU families you meet during your stay with us. You are encouraged to connect with other parents you meet in the NICU in the Family Lounge; other NICU parents cannot come into your baby’s room.
Most rooms have a bench at the back that you can sleep on or a comfortable chair, and there is a curtained area if you want privacy for pumping, sleeping or reflecting.
Only water is permitted in your baby's room. There is a water and ice machine in the Family Lounge, which is also where you can have meals and snacks. For safety reasons, please keep all personal items within the curtained area.
Using your phone, laptop or computer
You can use your cell phone or computer in your baby's room within the curtained area; please keep in mind that a quiet environment is best for your baby. Please turn down the volume or use headphones and also put your phone on vibrate. There is guest access to Wi-Fi in the hospital: visit sunnybrook.ca/wifi for more information. Bluetooth devices should not be used in the NICU because they can interfere with other communication devices. Please keep your electronic items clean and clean your hands between every use.
To avoid damage caused by using disinfectant wipes, we encourage you to put your phone into a plastic bag which we will provide if you are going to use your device in the room.
Each time you come to the NICU
When you arrive in your baby's room, please greet your baby's nurse and talk about your hopes and plans for the day. You are also welcome to share this via telephone prior to arriving. Please know as well that you are always welcome to phone in for information about your baby by calling 416-480-6055.
Your baby's care team - it includes you!
As a parent in the NICU, you are not a visitor. You are the constant in your baby's life and being by their bedside day-by-day, you know them best. Your presence as a parent is irreplaceable for your baby and you provide supports to them that only you can give.
Our health-care team will provide excellent, state of the art medical and technical care, and we can provide comfort, warmth and affection for your baby, but we cannot parent your baby. As a parent, you provide love and devotion to your baby that only a parent can.
Rounds happen every morning. This is when your baby’s medical team comes together to discuss your baby and we encourage you to be there. Ask your nurse for more information about when rounds will be for your baby. While the health-care team discusses other babies in the pod, we will close the door to your baby's room until your baby is the focus of discussion. Confidentiality is important for all in the NICU.
Sunnybrook provides family centred care, which puts your baby and family at the centre of the circle of care. Also have a look at our FAQ for answers to some common questions. There are many activities you can do, including hand-hugging or skin-to-skin with your baby, taking temperatures, reading and singing to your baby, changing diapers or holding feeding tubes.
The importance of breast milk
In the NICU, breast milk represents more than just food. It is medicine that protects your baby from infection, reduces the severity of illness if they should become sick, and promotes healing, growth and development that will last a lifetime.
You are encouraged to begin hand expressing breastmilk as soon as possible after your baby is born, ideally within an hour. After a few sessions of hand expressing, you will be shown how to use a breast pump. While your baby is in the NICU, you will be given a breast pump to use at home free of charge. We will also give you kits you can use with your pump. These kits can be cleaned in our special dishwasher in the unit pump room or can be cleaned at home.
You can pump in your baby’s room (it often helps to look at your baby while pumping) or in our pumping room in the family corridor.
A breastfeeding resource nurse is readily available for families and will check in on you during your baby’s stay.
Family lounge
When you arrive on the 4th floor and enter the NICU area, you will first walk past the family lounge (M4-201). This is a room open to all NICU families. There are tables, a kitchenette, computers, a play area for siblings, a TV/DVD player, a bathroom and telephones available for your use.
We hold group educational and support events for families in this space and hope to resume these when safe to do so.
Support for you
While you and the care team will be taking care of your baby, who is taking care of you? We have NICU Family Support Specialists available to offer you support; they have all had babies in our unit and can relate to what you are going through. We also have social workers who can help you navigate issues like accessing benefits, and who can help you cope with stress, family situations, and complex emotions.
Leaving Sunnybrook
When your baby is transferred
Most babies will spend some time at our NICU and then be transferred to a Level II hospital. Level II hospitals care for babies who do not need full neonatal intensive care but still need support as they grow. Transfer can be a stressful time for families, but it can also be seen as an important step on the road to home. We can provide you with some information about Level II hospitals close to your home, and your nurse or other staff members will speak to you about transfers as well.
Your baby may be transferred to another hospital for many reasons including:
- Your baby is stable and more mature and no longer requires the intensive level of care that we provide.
- Your baby is no longer on a ventilator but may still have an IV, low flow oxygen, tube feeds and be on medications. Some babies still on CPAP may be eligible for transfer to appropriate NICUs.
When your baby is discharged
It’s natural to want to know when your baby can go home. Some babies go home a few weeks after their due date, some go home around their due date, and some go home a bit before. Generally speaking, the earlier your baby was born, the longer the hospital stay. Babies are ready to go home when their breathing is stable (no spells for a week), they are feeding well, they are gaining weight reliably, they have passed a car seat test, and they have no pressing clinical issues that need monitoring at Sunnybrook.
The discharge co-ordinator will meet with you before your baby is ready to go home to discuss the steps that are involved. We can help you find an appropriate pediatrician, will give you copies of discharge letters, and will arrange for any necessary follow up appointments before you go.
Life as a graduate family
Neonatal Follow-Up Clinic
If your baby weighed less than 1500 grams and was born at less than 30 weeks gestation, you will most likely visit the Neonatal Follow Up Clinic. The clinic also schedules visits with babies who were very ill during their stay in the NICU.
The clinic provides assessment of your baby’s physical, motor and cognitive development, with referral to community services and specialized professional consultation. The clinic’s website has valuable educational resources and videos for both parents and kids.
Visit the Neonatal Follow-Up Clinic websiteNICU Families Facebook Group
After leaving the hospital, you can join the private Facebook group to stay connected to the many friends you made while your baby was at Sunnybrook. This group is a mix of graduate families and staff members. The group provides an opportunity for families to share photos and updates with special caregivers and gives updates on events like our annual Preemie Picnic.
Our Family Advisory Committee
If you would like to stay connected and give back to other NICU families, we have a Family Advisory Committee (FAC) consisting of family and staff representatives. Our FAC helps us provide family centred care, assists with planning and holding events, and co-designs educational and support materials for families. Please email Karen Bong or Kate Robson for more information.
Preemie Picnic
This annual event is a celebration of all premature infants who have stayed in Sunnybrook's NICU. NICU graduate families have the chance to meet members of the health-care team who cared for their babies. The event is hosted by Sunnybrook's Neonatal Follow-Up Clinic and the Neonatal Intensive Care Unit. Look for details on the Sunnybrook events calendar, or the NICU Families Facebook Group.
