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Infant Special Care Unit (ISCU)

  • The Infant Special Care Unit (ISCU) at Evanston Hospital is a level III nursery providing infants with highly specialized care in a healing environment.
  • The Division of Neonatology in the ISCU provides family-centered care for over 500 premature and special needs infants each year.
  • Neonatologists are on the unit 24 hours a day, seven days a week in order to provide immediate care to sick and premature infants.

Participating in your baby’s care 

  • You are welcome to be with your baby anytime of the day or night.  You may bring other visitors over the age of 18.  All visitors must be accompanied by a parent, and only two people are permitted at the bedside at a time.
  • You and your visitors will have to step out during nursing change of shift hours which are:
    • 7:00-8:00 a.m.
    • 3:00-4:00 p.m.
    • 7:00-8:00 p.m.
    • 11:00 p.m.-12:00 a.m.
  • Parent rooms
    • During the hours of 8:00 a.m. – 10:00 p.m., parent rooms are available for one hour intervals.
    • Please ask the unit concierge to sign you up for the time that you would like to use the parent room.
    • If you baby is stable in an open crib, they may come to the parent room with you for more privacy.  Please discuss this with your nurse. 

Who’s who and what they do 

  • Doctors
    • Neonatologist: 12 board certified pediatricians who specializes in the care of premature, low-birth weight and sick newborn babies.
    • Neonatal Fellow: A doctor who has finished pediatric training and is receiving additional training to become a neonatologist.
    • Pediatric Resident: A doctor receiving special training to become a pediatrician who works under the direction of the neonatologist
  • Nurses
    • Nurse Manager: A registered nurse who oversees all unit operations.
    • Neonatal Nurse Practitioner: A registered nurse who has received additional, specialized training to perform specific procedures and develop patient focused care plans.
    • Clinical Coordinator: A registered nurse who assists the nurse manager in overseeing unit operations.
    • Neonatal Bedside Nurse: A registered nurse who specializes in the care of sick and premature infants in the ISCU.
    • Discharge Coordinator: A registered nurse who assists with preparations to help parents take their infants home.
  • Technical Support
    • Respiratory Therapist: A health team member with special knowledge of breathing problems, treatment and equipment.
    • Physical Therapist: A health team member with specialized training in physical therapy for infants.
  • Social Support
    • Social Worker: A health team member trained to help families cope with problems related to their baby’s hospitalization.
    • Chaplains, ministers, priests and rabbis who are available to families anytime for spiritual support.
    • Cuddler Program Volunteers: Specially trained hospital volunteers who hold infants who may need extra TLC when parents cannot be there.

Feeding your baby in the ISCU 

  • Breast milk provides many health benefits for infants and is the optimal source of nutrition. Breast milk provides the following benefits:
    • Helps your baby’s intestines to grow and develop
    • Helps your baby to better tolerate feedings so that feeding volumes can be increased to maximize nutrition
    • Reduces the incidence and severity of infection
    • Protects your baby’s intestines from inflammation and Necrotizing Enterocolitis (NEC): a serious and sometimes fatal infection of the bowel
    • Helps the development of your baby’s eyes and brain
  • If you choose not to pump at all, or have insufficient milk to meet your baby’s needs, there are two feeding choices:
    • Pasteurized human donor milk
      • The American Academy of Pediatrics recommends pasteurized human donor milk when mother’s own milk is not available
      • Donors are carefully screened and cannot donate if they are taking medications or have any risk factors for disease
    • Commercial Formula
  • How your baby will be fed in the ISCU
    • IV: a premature baby may require special fluids that run into their veins. This fluid is called TPN and contains dextrose, proteins, fats, vitamins, and minerals. TPN is used until your baby is big enough to tolerate breast milk and/or formula feedings
    • Enteral Feedings: Your baby may have a small tube inserted through the nose (NG) or mouth (OG) that leads into the stomach. This allows breast milk or formula to be administered directly into the stomach to feed your baby. These tubes are generally for short term use and are removed once your baby is taking all of their bottles by mouth.
  • Breastfeeding in the ISCU
    • While your baby is in the ISCU, the Breastfeeding Resource Nurse may be available to answer any questions you may have regarding your milk volume, pumping, and/or breastfeeding.
    • Every Wednesday at 3:00 p.m., the Mother’s Milk Group is held in the ISCU conference room. This is led by a board certified lactation consultant, and is a great opportunity to meet other moms who are currently pumping in the ISCU.

Tests and Treatments in the ISCU 

  • Prematurity
  • Hypoglycemia
  • Respiratory Distress Syndrome (RDS)
  • Antibiotic Therapy
  • Chest tube placements
  • Echocardiogram
  • Blood Transfusions
  • Palliative Care
  • PCVC Placement
  • Umbilical Line Placement
  • Pre- and Post- Operative Care
  • Ventilator management
  • Nitric Oxide Treatment
  • High Frequency Ventilation
  • Whole Body Cooling

Common things you might hear in the ISCU 

  • Phototherapy
    • Your baby may require phototherapy for jaundice, which refers to increased bilirubin levels. Your baby’s skin will be exposed to a white or blue light, which helps reduce the high bilirubin level that is common in premature infants.
  • Blood Gas
    • If your baby is receiving respiratory support, the neonatologist may order a blood gas. This is a test that looks at the oxygenation level in a baby’s blood. It is a common test in the ISCU and requires just a few drops of blood from your baby’s heel or umbilical line.
  • CBC
    • One of the most common blood tests in the ISCU.  It is obtained to evaluate for anemia and infection, and it provides a lot of clinical information in just a few drops of blood.

 Kangaroo Care in the ISCU 

  • What is kangaroo care?
    • Holding your baby closely with skin to skin contact.  Many mother and fathers describe a special closeness and attachment to their bay when providing kangaroo care.
  • What are the benefits?
    • Research has shown that premature babies who experience kangaroo care may gain weight faster, may have more restful sleep period and fewer breathing problems.
    • Babies maintain a stable body temperature. Your body heat helps keep them nice and warm.
  • Is my baby eligible for kangaroo care?
    • You and your nurse can plan for kangaroo care. Kangaroo care is encouraged for babies, both premature and full term, who are stable in the following conditions:
      • babies on ventilators
      • babies on oxygen
      • babies breathing room air
      • babies who maintain their temperature while being held skin to skin
  • It is recommended that the amount of time you and your baby kangaroo is at least one hour and no more than three hours at a time.
  • Most infants will tolerate kangaroo care very well and are comforted by the skin to skin contact.
  • If you are interested in kangaroo care, please ask your nurse.

Common medications in the ISCU 

  • Ampicillin: An antibiotic that is used to treat possible infections right after birth.
  • Cefotaxime: An antibiotic that is usually given with ampicillin, that is used to treat possible infections after birth.
  • Caffeine: Stimulates breathing and is used to treat apnea of prematurity.
  • Multivitamins: Multivitamins may or may not contain iron. Premature infants have a higher nutritional need for vitamins, and will usually receive multivitamins 1-2 times per day
  • Iron: Helps prevent anemia in premature babies.

Preparing for discharge 

  • Screening and follow up appointments
    • You will need to make a pediatricians appointment within 2-3 days after your infant is discharged from the ISCU.
    • Hearing and vision screening: All babies born in the state of Illinois will have a newborn hearing screen called an Auditory Brainstem Response (ABR).
      • All babies born under 30 weeks or less than 1500 grams will have their eyes checked by the eye specialist to examine the blood vessels of the retina.
      • The hearing and vision screening are both done at the baby’s bedside.
    • ISCU Follow up Clinic
      • Starting at about 3 months after discharge, some babies will be seen in the ISCU development follow up clinic. These appointments keep a close look at your baby’s development, especially during the first 3 years.
      • The discharge coordinator will discuss the developmental follow up appointments with you.
  • Car seat safety:
    • Always use a car seat when transporting the baby in the car.
    • Never place the car seat in the front seat.
    • Practice adjusting the shoulder straps, putting the car belt on and releasing the car seat from the base.
    • The base needs to be buckled tightly into the car at all times
    • The American Academy of Pediatrics advises to keep infants and toddlers in rear-facing car seats until age 2 or until they reach the maximum height and weight for their car seat.
    • Prior to discharge, you will be asked to bring in the car seat. We will test your infant to see if they tolerate sitting in the car seat; this is referred to as a car seat test.
  • What to bring on discharge day
    • Car seat
    • Appropriate clothing and additional blankets, hats, and socks
    • A container to pack the extra breast milk stored in the ISCU

Additional Resources 

  • CPR class
    • Held at 7:30 p.m. every Tuesday in the ISCU conference room. This class is led by a CPR certified ISCU nurse.
  • Discharge Class
    • Held at 7:30 p.m. every other Monday in the ISCU conference room.
    • All parents are encouraged to go to the discharge and CPR classes before discharge. If interested in these classes, please let the nurse or unit concierge know and they will sign you up.
  • NorthShoreConnect
    • You can view updated information on your baby from home on your computer. NorthShoreConnect gives you the ability to see daily weights, feedings, and current medications. You will be able to send messages to your baby’s doctors and nurses; messages will be answered within 24 hours. If you are interested, please speak with you baby’s nurse of the unit concierge at the front desk.
  • ISCU Picnic
    • Each summer, former infants and families are invited to celebrate at the ISCU reunion picnic. Families and infants will unite with the doctors, nurses and staff from the ISCU who cared for them during a critical time and gave them a healthy start in life.

Helpful Links 

If you have any further questions or concerns, please call the ISCU at 847.570.2244.