Neonatal care after surgery

After surgery, infants and children will return to the intensive care unit (ICU) to be closely monitored during recovery period. The course of every child after surgery is different, but there are some consistent trends.

Children generally arrive in the ICU on a ventilator with a breathing tube.

  • Children who have “straightforward” surgeries are generally extubated within 24 hours
  • Children who have more complicated surgeries are on the ventilator for days or, in some cases, weeks.
Each child’s recovery happens at a different pace. Your child will be kept as comfortable as possible with several different medications, some which relieve pain, and some which relieve anxiety. The staff will also be asking for your input as to how best to soothe and comfort your child. 

Nurses in this unit are trained to manage patients that are moving towards going home. Your child will have vital signs monitored every 4 hours and will still have all intake (drinks/formula/food) and output (diapers/urine/stool) measured and recorded.  Children in the children’s special care unit will be allowed to visit the play room and are encouraged to begin their home routines. 

Infants who spent a lot of time on a ventilator, or who were fairly ill while in the ICU, may have trouble feeding initially. These babies may have an oral aversion, in which they may equate something placed in the mouth, such as a pacifier or bottle, with a less pleasant sensation such as being on the ventilator. Some infants are just tired, and need to build their strength up before they will be able to learn to bottle-feed. Strategies used to help infants with nutrition include the following:

  • Supplemental tube feedings:  Feedings given through a small, flexible tube that passes through the nose, down the esophagus, and into the stomach can either supplement or take the place of bottle feedings. Infants who can drink part of their bottle but not all may be fed the remainder through the feeding tube. Infants who are too tired to bottle feed at all may receive their formula or breast milk through the feeding tube alone.
  • High-calorie formula or breast milk:  Special nutritional supplements may be added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow.