NICU consultants and support staff
Newborn intensive care unit - consultants and support staff; Neonatal intensive care unit - consultants and support staff
The NICU is a special unit in the hospital for babies born preterm, very early, or who have some other serious medical condition. Most babies born very early will need special care after birth.
This article discusses the consultants and support staff who may be involved in the care of your infant depending on your infant's specific medical needs.
If your newborn needs to be admitted to the neonatal intensive care unit, or NICU, a group of different medical professionals will be there to help. Here's a rundown of some of the consultants and support staff you can expect to meet in the NICU. Each person who works in the NICU has a different specialty: Your bedside NICU nurses work most closely with your baby, providing care and observing closely for important changes. A neonatologist specializes in the health problems of newborns. They supervise and coordinate care. A cardiologist is trained to diagnose and treat diseases of the heart and blood vessels. If a baby has a heart defect, a cardiovascular surgeon will perform the surgery to fix it. An infectious disease specialist treats babies who have serious infections, including infections of the blood, brain, or spinal cord. A neurologist diagnoses and treats conditions of the brain, nerves, and muscles. You might see a neurologist if your baby has seizures, or is born with a nervous system condition like spina bifida. When the problem needs to be corrected with surgery, a neurosurgeon will perform the operation. An endocrinologist diagnoses and treats hormone problems, such as diabetes. Gastroenterologists are expert at treating digestive problems of the stomach and intestines. A hematologist-oncologist treats blood disorders and cancer. An infant might see this type of doctor for a problem with blood clotting. A nephrologist focuses on diseases of the kidneys and urinary system. If your baby was born with a kidney problem, you will talk to this doctor about treatments, and possibly the need for surgery. Pulmonologists treat newborn lung problems, such as respiratory distress syndrome. You might see this doctor if your baby was born with a breathing condition. Then you'll work with a respiratory therapist to treat the problem. If you had a very high-risk pregnancy, you'll work with a maternal-fetal medicine specialist. This doctor can help if your baby was born prematurely, or you had twins or other multiples. Babies who are born with eye defects see an ophthalmologist, a doctor who diagnoses and treats eye problems. If your newborn needs x-rays, an x-ray technician will take the test, and a radiologist will read the results. Sometimes babies are born with or at risk for developmental delays. If that is the case, a developmental pediatrician will test your child, and help you find the right care once you leave the NICU. The pediatrician may recommend that you see an occupational or physical therapist to assess your baby's reflexes, movement, and feeding. While you're in the NICU, you'll also see a neonatal nurse practitioner. This specialist will work closely with your doctor to make sure your baby gets just the right care. Being in the NICU can feel scary and new at first. Don't be afraid to ask questions. Your NICU medical team is there to care for your baby, and to make sure you're prepared to take over that care once you get home.
An audiologist is trained to test a baby's hearing and provide follow-up care to those with hearing problems. Most newborns have their hearing screened before leaving the hospital. Your health care providers will determine which hearing test is best. Hearing tests may also be done after leaving the hospital.
A cardiologist is a doctor that has special training in the diagnosis and treatment of heart and blood vessel disease. Pediatric cardiologists are trained to deal with newborn heart problems. The cardiologist may examine the baby, order tests, and read test results. Tests to diagnose heart conditions may include:
- Electrocardiogram (ECG)
- Cardiac catheterization
If the structure of the heart is not normal due to a birth defect, a cardiologist might work with a cardiovascular surgeon to perform surgery on the heart.
A cardiovascular (heart) surgeon is a doctor who has special training in doing surgery to correct or treat defects of the heart. Pediatric cardiovascular surgeons are trained to deal with newborn heart problems.
Sometimes, surgery can correct a heart problem. Other times, complete correction is not possible and surgery is done just to make the heart work as best as possible. The surgeon will work closely with the cardiologist to care for the baby before and after surgery.
A dermatologist is a doctor who has special training in diseases and conditions of the skin, hair, and nails. Such a doctor might be asked to look at a rash or skin lesion on a baby in the hospital. In some cases, the dermatologist might take a sample of the skin, called a biopsy. The dermatologist might also work with the pathologist to read the biopsy results.
A developmental pediatrician is a doctor who has been specially trained to diagnose and care for infants who have trouble doing what other children their age can do. This type of doctor often evaluates babies who have already gone home from the NICU and will order or perform developmental tests. The doctor can also help you find resources near your home that provide therapies to help infants and children in meeting development milestones. Developmental pediatricians work closely with nurse practitioners, occupational therapists, physical therapists, and sometimes neurologists.
A dietitian has special training in nutritional support (feeding). This type of provider may also specialize in pediatric (children's) nutritional care. Dietitians help determine if your baby is getting enough nutrients, and may recommend some choices of nutrition that can be given through the blood or a feeding tube.
A pediatric endocrinologist is a doctor with special training in the diagnosis and treatment of infants with hormone problems. Endocrinologists might be asked to see babies who have problems with the level of salt or sugar in the body, or who have problems with the development of certain glands and sexual organs.
A pediatric gastroenterologist is a doctor with special training in the diagnosis and treatment of infants with problems of the digestive system (stomach and intestines) and liver. This type of doctor might be asked to see a baby who has digestive or liver problems. Tests, such as x-rays, liver function tests, or abdominal ultrasounds, might be done.
A geneticist is a doctor with special training in the diagnosis and treatment of infants with congenital (inherited) conditions, including chromosomal problems or syndromes. Tests, such as chromosome analysis, metabolic studies, and ultrasounds, may be done.
A pediatric hematologist-oncologist is a doctor with special training in the diagnosis and treatment of children with blood disorders and types of cancer. This type of doctor might be asked to see a person for bleeding problems due to low platelets or other clotting factors. Tests, such as a complete blood count or clotting studies, might be ordered.
INFECTIOUS DISEASE SPECIALIST
An infectious disease specialist is a doctor with special training in the diagnosis and treatment of infections. They might be asked to see a baby that develops unusual or serious infections. Infections in babies can include blood infections or infections of the brain and spinal cord.
MATERNAL-FETAL MEDICINE SPECIALIST
A maternal-fetal medicine doctor (perinatologist) is an obstetrician with special training in the care of high-risk pregnant women. High-risk means there is an increased chance of problems. This type of doctor can care for women who have premature labor, multiple gestations (twins or more), high blood pressure, or diabetes.
NEONATAL NURSE PRACTITIONER (NNP)
Neonatal nurse practitioners (NNP) are advanced practice nurses with extra experience in the care of newborn infants in addition to completing master's or doctoral level educational programs. The NNP works along with a neonatologist to diagnose and treat health problems in babies in the NICU. The NNP also performs procedures to help diagnose and manage certain conditions.
A pediatric nephrologist is a doctor with special training in diagnosing and treating children who have problems with the kidneys and urinary system. This type of doctor might be asked to see a baby who has problems in the development of the kidneys or to help care for a baby whose kidneys do not work properly. If a baby needs kidney surgery, the nephrologist will work with a surgeon or urologist.
A pediatric neurologist is a doctor with special training in the diagnosis and treatment of children with disorders of the brain, nerves, and muscles. This type of doctor might be asked to see a baby who has seizures or bleeding in the brain. If the infant needs surgery for a problem in the brain or spinal cord, the neurologist might work with a neurosurgeon.
A pediatric neurosurgeon is a doctor trained as a surgeon who operates on children's brains and spinal cords. This type of doctor might be asked to see a baby who has problems, such as spina bifida, skull fracture, or hydrocephalus.
An obstetrician is a doctor with special training in taking care of pregnant women. This type of doctor might also assist women who are trying to get pregnant and follow women with medical conditions, such as diabetes or decreased fetal growth.
A pediatric ophthalmologist is a doctor with special training in diagnosing and treating eye problems in children. This type of doctor might be asked to see a baby who has birth defects of the eye.
An ophthalmologist will look at the inside of the baby's eye to diagnose retinopathy of prematurity. In some cases, this type of doctor might perform laser or other corrective surgery on the eyes.
A pediatric orthopedic surgeon is a doctor with special training in the diagnosis and treatment of children who have conditions involving their bones. This type of doctor might be asked to see a baby who has birth defects of the arms or legs, hip dislocation (dysplasia), or fractures of the bones. To see the bones, orthopedic surgeons might order ultrasounds or x-rays. If needed, they can perform surgery or place casts.
An ostomy nurse is a nurse with special training in the care of skin wounds and openings in the belly area through which the end of the intestine or the collecting system of the kidney stick out. Such an opening is called an ostomy. Ostomies are the result of surgery needed to treat many intestinal problems, such as necrotizing enterocolitis. In some cases, ostomy nurses are consulted to help care for complicated wounds.
OTOLARYNGOLOGIST/EAR NOSE THROAT (ENT) SPECIALIST
A pediatric otolaryngologist is also called an ear, nose, and throat (ENT) specialist. This is a doctor with special training in the diagnosis and treatment of children with problems with the ear, nose, throat, and airways. This type of doctor might be asked to see a baby who has problems with breathing or a blockage of the nose.
OCCUPATIONAL/PHYSICAL/SPEECH THERAPISTS (OT/PT/ST)
Occupational and physical therapists (OT/PT) are professionals with advanced training in working with infants with developmental needs. This work includes neurobehavioral assessments (postural tone, reflexes, movement patterns, and responses to handling). In addition, the OT/PT professionals will help determine a baby's nipple-feeding readiness and oral-motor skills. Speech therapists will also help with feeding skills in some centers. These types of providers might also be asked to provide family education and support.
A pathologist is a doctor with special training in laboratory testing and examination of body tissues. They supervise the laboratory where many medical tests are performed. They also examine tissues under the microscope that are obtained during a surgery or an autopsy.
A pediatrician is a doctor with special training in the care of infants and children. This type of doctor might be asked to see a baby in the NICU, but is usually the primary care provider for a healthy newborn. A pediatrician also provides primary care for most babies after they leave the NICU.
A phlebotomist is a specially trained professional who takes your blood. This type of provider may take the blood from a vein or a baby's heel.
A pediatric pulmonologist is a doctor with special training in diagnosing and treating children with respiratory (breathing) conditions. Even though the neonatologist cares for many infants with respiratory problems, the pulmonologist might be asked to see or to help care for babies who have unusual conditions of the lung.
A radiologist is a doctor with special training in obtaining and reading x-rays and other imaging tests, such as barium enemas and ultrasounds. Pediatric radiologists have extra training in imaging for children.
RESPIRATORY THERAPIST (RT)
Respiratory therapists (RTs) are trained to deliver multiple treatments to the heart and lungs. RTs are actively involved with babies having breathing problems, such as respiratory distress syndrome or bronchopulmonary dysplasia. An RT might become an extracorporeal membrane oxygenation (ECMO) specialist with further training.
Social workers are professionals with special education and training to determine the psychosocial, emotional, and financial needs of families. They help families find and coordinate resources in the hospital and community that will help to meet their needs. Social workers also help with discharge planning.
A pediatric urologist is a doctor with special training in diagnosing and treating conditions involving the urinary system in children. This type of doctor might be asked to see a baby with conditions such as hydronephrosis or hypospadias. With some conditions, they will work closely with a nephrologist.
An x-ray technician is trained in taking x-rays. X-rays can be of the chest, stomach, or pelvis. Sometimes, solutions are used to make body parts easier to see, as with barium enemas. X-rays of bones are also commonly performed on babies for a variety of reasons.
Hendricks-Muñoz KD, Prendergast CC. Family-centered and developmental care in the neonatal intensive care unit. In: Polin RA, Spitzer AR, eds. Fetal and Neonatal Secrets. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4.
Kilbaugh TJ, Zwass MS, Ross P. Pediatric and neonatal critical care. In: Gropper MA, ed. Miller's Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 79.
Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine Diseases of the Fetus and Infant. 11th ed. Philadelphia, PA: Elsevier; 2020.
Last reviewed on: 10/2/2020
Reviewed by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.