Your frequent questions answered by the experts at Nationwide Children's Hospital

Q: My friend just delivered prematurely and her baby is now in a NICU. What is a NICU and why do preemies need to stay there? Why can't they just come home? A: Despite significant advances in the treatment and care of premature infants, prematurity remains the leading cause of neonatal death in our community. A Neonatal Intensive Care Unit (NICU) provides a stress-free, clean environment where premature infants can grow and develop. Preemies are more likely to acquire general infections than full-term infants because their immune systems are immature, so it's critical to prevent exposure to germs. Preemies can't maintain their body temperature due to their small size and body composition, so they live in incubators to keep warm, decrease exposure to germs and infection, and to limit water loss. They also need to be fed through a tube as they are not yet able to breast- or bottle-feed. There are certain illnesses and conditions that affect premature infants disproportionately. One is apnea, which is when a baby stops breathing for a period of time because the part of their brain that drives breathing is still very immature and may not function reliably. Another illness affecting premature infants is Necrotizing Enterocolitis (NEC), which causes destruction of all or part of the intestine. It is the most serious gastrointestinal disorder among hospitalized preemies and is often fatal. Specialized treatment and sometimes major surgery is necessary to halt the progression of NEC. After their stay in the NICU, preemies need the same regular well-baby checkups and immunizations that all infants receive as well as periodic hearing and eye examinations. Special attention is paid to the development of the nervous system and motor skills like smiling, sitting and walking. Many infants require speech or physical therapy as they grow. -Dr. Edward Shepherd is the Section Chief of Neonatology at Nation Children's Hospital and an Assistant Professor of Clinical Pediatrics at The Ohio State University.