Penn State Health Children's Hospital Small Baby Unit was established in January, 2021 for the coordinated and consistent care of newborns born at 23 to 28 weeks’ gestation (12 to 17 weeks before their due date).

The purpose of the Small Baby Unit within the NICU is to provide the best possible care to our most premature newborns. We combine an evidence-based team approach to care using our experienced and interested caregivers to reduce mortality and morbidity in our smallest patients.

Very premature infants will initially be admitted into quiet, private rooms, anywhere in the NICU, to limit stimulation that can be overwhelming. Then, once medically stable and off ventilators, and if parents are unable to stay with their infants, they will be moved to one of the open bay rooms where they will experience human voice and other stimulation. If parents are able to stay, the infant and parents will be able to remain in the private rooms. Research shows that most premature infants can experience significant developmental delays without regular exposure to a human voice. Our hybrid room model assures that your baby will have the best neurodevelopmental outcomes.

The guidelines and recommendations for care in the Small Baby Unit were developed by Penn State neonatologists, NICU nurses, the Chief of NICU clinical research, advanced practice providers, neonatal-perinatal medicine fellows, respiratory therapists, NICU dieticians and pharmacists, radiology technicians, NICU lactation specialist, the NICU Clinical Practice Nurse Leader and Nursing Quality Specialist.

Bringing Milk to the Milk Lab

The NICU Milk Lab is located immediately outside the NICU entrance, on the eighth floor of the Children’s Hospital. Parents can drop breast milk off at the Milk Lab window, open daily during the following times:

• 7-9 a.m.
• 10 a.m.-noon
• 3-7 p.m.

If the drop-off window is closed, parents can store a small amount of milk in the specialized refrigerator available in every baby’s hospital room until a milk technician can retrieve it for storage in the Milk Lab. If parents have frozen milk or a large volume of milk, they should inform their nurse of their storage needs.

For security reasons, when milk is dropped off at the Milk Lab window or retrieved from a baby’s room by a milk technician, two people will check that the correct label is on the container before it is placed in baby-specific bins in the Milk Lab refrigerator.

Suggested Containers for Milk Storage

The NICU Milk Lab team recommends storing milk in Snappies brand milk containers, available at the drop-off window. All containers must be labeled with special breast milk labels available at the lobby check-in desk or from your nurse.

Types of Feedings

The type of feeding each baby receives is determined by the providers and the care team. When appropriate, the NICU will use parent-provided breast milk first, if available that day by noon. If the Milk Lab runs out of parent-provided breast milk, then the appropriate alternative will be prepared.

Checking on Milk Supply in Storage

Parents can stop by the Milk Lab drop-off window when it is open and ask a milk technician to check how much of their stored milk supply is left.

How to Find Out More

Parents who have questions or need additional information are welcome to ask their bedside nurse to contact the Milk Lab’s team of dietitians, certified milk technicians and nursing leadership.

We pride ourselves on being at the forefront of neonatal care technology. We use all forms of invasive and non-invasive respiratory support and perform all advanced radiological procedures and cardiac imaging on an emergency basis. In addition to 24/7 in-hospital coverage by board-certified and board-eligible neonatologists, our hospital has all pediatric subspecialists and pediatric surgeons available 24 hours a day. We have the capability for surgical repair of all complex conditions including congenital heart malformations. Pediatric surgeons are also continuously available to place sick infants with severe respiratory failure on extracorporeal membrane oxygenation (ECMO), a form of cardio-respiratory bypass that is lifesaving when medical treatment is not effective.

Our NICU is also equipped with a specialized ventilator called neurally adjusted ventilatory assist (NAVA). It is a device that uses electrical signals generated by the baby’s diaphragm to control breathing.

Other advanced technologies in the Penn State Health Children’s Hospital NICU include:

• Bubble continuous positive airway pressure (CPAP), a non-invasive method of ventilation for premature babies that do not need to be on a ventilator
• High-frequency jet ventilation for extremely immature newborns with respiratory failure
• High-frequency oscillatory ventilation for babies with severe respiratory failure
• Nitric oxide, a special gas that relaxes pulmonary arteries in babies with pulmonary hypertension
• Sophisticated brain assessment through continuous electroencephalogram (EEG) monitoring
• Therapeutic hypothermia, a cooling treatment that may help reduce the risk of brain injury in babies who have been deprived of oxygen

Babies with congenital heart defects have access to Penn State Health Children’s Heart Group, a regional center of excellence in the care of children with heart disease. Newborns with congenital defects of the lungs, intestines, kidneys, and other organs and newborns with surgical problems, have around-the-clock access to Pediatric Surgeons.

Our commitment to care continues long after your child leaves the NICU at Penn State Health Children’s Hospital. We are one of the few programs in the region with a NICU Neurodevelopmental follow-up clinic that tracks the developmental progress of former high-risk NICU patients. The clinic’s goal is to provide early identification and referral for early intervention to address the neurodevelopmental and neurobehavioral problems associated with a NICU stay.

Babies who receive neonatal intensive care are at risk for developmental delay. Our NICU Neurodevelopmental clinic specializes in identifying neurodevelopmental problems early to provide timely intervention and therapies to reduce long-term developmental issues. We review the growth and progress of:

• Cognitive function
• Fine and gross motor skills
• Growth
• Hearing
• Language development
• Play skills (cognitive development)
• Social-adaptive behavior

Our team of neonatologists, clinic coordinators (a neonatal nurse practitioner and a neonatal physician assistant), neonatal-perinatal medicine fellows, occupational therapists, pediatricians and a neuropsychologist care for your child as they grow. Care begins in early infancy with evaluations through age two years. Infants are typically seen three times after NICU discharge:

• 4 months after their due date
• 9 months after their due date
• 18-24 months after their due date

All patients are seen by an occupational therapist who assesses motor development and tone. Patients who are 18-24 months are also seen in conjunction with a neuropsychologist who assesses language, cognitive function and social-adaptive behavior. At the end of these assessments, the team will meet to discuss the patient and the care coordinator will help arrange follow up and referrals. The care team will then counsel the family and provide them with a report card summarizing this information. Later, they will compile a letter inclusive of all parties’ assessments and recommendations to send to the primary care physician. Most appointments last 1-2 hours.

As the child grows and develops, the care team provides monitoring and age-appropriate support, follow-up screening, reevaluation and assists with recommended treatments.

The NICU Neurodevelopmental follow-up clinic is located at our Penn State Health Pediatric Specialties.

Additional Resources

We want to make sure patients and families have the resources they need.  Whether it is lodging for out of town visitors, post-operative care for the patient, support groups for the family or financial support, we are here as your resource. If you have any questions please call our office at 717-531-8413.

NICU Advisory Council

The NICU Advisory Council is comprised of parents whose children spent time in the NICU and multidisciplinary staff members from both the NICU and Women’s Health units. Together, the group works on projects and initiatives to improve the NICU environment and the relationships among patients, families and staff. The NICU Advisory Council meets quarterly throughout the year at the hospital and meetings are facilitated by elected staff and parent co-chairs. Some projects and initiatives the council has worked on include:

• Created an electronic ”Wall of Hope” within the NICU showing photos of infants while in the NICU alongside a more current photo showing their progress following discharge
• Created milestone cards that can be posted at an infant’s bedside and/or kept by parents to explain a variety of big moments in a patient’s admission (e.g., extubation, weight goals, a feeding tube coming out, coming out of the incubator and first outfit)
• Helped with deciding on the décor (pictures, color schemes, etc.) for the new NICU
• Provided input on NICU processes such as discharge, volunteers and various support services
• Renovated the NICU breast pumping room

If you are interested in learning more about joining NICU Advisory Council, please email [email protected] or complete the application here, specifying your interest in the NICU Family Advisory Council.

Family Care Conferences in the NICU

Our providers and staff believe in family-centered care. This means we partner with our families to make sure they are involved in all aspects of care for their babies at the level they choose.

One way we encourage our families to be involved is having family care conferences at certain points during your baby’s stay. These are opportunities for our families to meet the care team away from the bedside to ask questions and understand the plan of care.

If you would like to schedule a family care conference, please ask your bedside nurse, social worker or care coordinator.

NICU Parent Support Program

The NICU Parent Support Program provides support to families with children that have special needs.

We work with Parent to Parent of Pennsylvania, which connects families who currently have a baby in the NICU with other families who previously have had a baby in the NICU.

When you have a baby in the NICU, it is difficult and overwhelming. Having someone who has been through similar circumstances can help.

All NICU Parent Supporters have received extensive training on a variety of topics including how to be a great mentor. They stand by to support new parents through this challenging time.

If you are interested in being matched to a NICU Parent Supporter, call Parent to Parent of PA at 888-727-2706. When you call, a regional coordinator will ask you questions about your baby and family needs. Based on this information, the coordinator determines which NICU Parent Supporter would be most helpful to you. You should expect a call within 48 hours. It is that simple. Together, you and the NICU Parent Supporter will determine future contacts. Each match is unique and the number of contacts preferred by one caller may be different than that preferred by another caller. Sometimes, lifelong friendships develop.

Financial Support

• Children's Miracle Network
• Ronald McDonald House

As part of our integrated neonatal care services, we provide support for referring physicians and their newborn patients:

• Communication - our staff keeps you informed about your patients and care team members will update you on progress, providing consultation and sharing outreach services. We also keep families informed and involved in the family centered care approach
• Consultation - neonatal attending physicians provide telephone consultation (717-531-8941) 24 hours-a-day, seven-days-a-week
• Direct connection - just one call connects you directly with the specialized neonatal services. 24-hour neonatal consultations and transports: 717-531-8941
• Easy access and parking: opportunities to stay at the Ronald McDonald home close by
• Expertise - experienced allied health professionals including nutritionists, occupational therapists, physical therapists, feeding team therapists, respiratory therapists and pharmacists offer advice and support
• Follow-up - high-risk patients are followed after discharge for up to two years
• Neonatal transport - air and ground transport to Penn State Health Children’s Hospital; highly skilled specialized transport teams return infants to “home” hospitals when additional hospitalization is required following discharge from Penn State Health Children’s Hospital
• NICU - 56-bed Level IV neonatal intensive care unit
• Perinatal Program Services - coordinated multidisciplinary prenatal and postnatal services for prospective parents of infants with prenatally identified congenital abnormalities