If your baby is discharged with medical equipment, learn how to use it and practice using it before she leaves the hospital. Usually the company that provides the equipment will send someone to the NICU or to your home to show you how to use it properly.

The three most common types of equipment that babies go home with are an apnea monitor, a feeding tube and oxygen.

The Apnea Monitor
Many babies have episodes of apnea (a periodic interruption of breathing). If a baby hasn't outgrown the problem in the hospital, she may temporarily need an apnea monitor at home.

The monitor is connected to the baby by soft, sticky patches or by a soft belt that goes around her chest. If the baby stops breathing or if her heartbeat is too fast or too slow, the monitor sounds an alarm.

Parents use the monitor when the baby is sleeping or when they aren't watching the baby. Before your baby leaves the hospital, you will learn:

• What to do when the alarm goes off

• When you should call your baby's health care provider

Sometimes the alarm goes off when there is nothing wrong with your baby. You will learn how to recognize these false alarms and what to do to help avoid them.

Feeding Tubes and Syringe
Some babies can't suck or swallow well enough to take in enough nutrients for healthy growth. These include babies with problems involving the heart, lungs, mouth, esophagus, airways or central nervous system.

When these babies go home, they may need to continue to be fed breastmilk or formula through a tube (called gavage feeding). The tube is inserted through the baby's nose or mouth, down the back of the throat, through the esophagus, and into the stomach. (The esophagus is the tube that connects the mouth and the stomach.) This tube usually stays in place between feedings and doesn't bother the baby.

You feed your baby by pouring breastmilk or formula into a syringe and inserting it into your baby's feeding tube. If your baby is not able to take in enough food by mouth for an extended period, she may need to be fed through an opening in her stomach (gastrostomy). This opening has a small plastic feeding tube attached to it.

Oxygen
Most babies are breathing on their own before they leave the NICU. But a few need extra oxygen for a while. The lungs often heal over the first two years of life.

The most common reasons babies need oxygen at home is a lung disorder called bronchopulmonary dysplasia (BPD). Babies at risk for BPD include those who:

• Have had severe respiratory distress syndrome (RDS)

• Have needed long treatment with mechanical ventilation and oxygen

If your baby needs oxygen, you will need:

• Stationary oxygen tanks (the tanks stay in one place and don't move)

• Portable oxygen tanks (you can move the tanks or take them with you)

• Nasal cannula (soft plastic tubing that goes around the baby's head

The hospital may arrange for a home health nurse to visit your home to check on the baby. He or she may also be on call to answer your questions or concerns. If this isn't arranged, speak to the NICU social worker or your baby's health care provider to see if you can get this service.

Over time, the baby's lungs heal and breathing becomes easier. The amount of oxygen is gradually cut back, then stopped altogether. Most babies need oxygen for less than six months.

If your baby goes home on oxygen, you must observe several safety measures. Oxygen can catch fire easily. Even a small spark can start a big fire. Do not allow smoking, a burning fire, sparks or gas stoves in the same room as the oxygen tank.

September 2007