When you first enter the neonatal unit (NNU) you will see a lot of equipment and hear a lot of unfamiliar sounds. This equipment is there to give your baby the best possible chance of survival and a healthy future.

Equipment in the NNU is designed to keep your baby warm, monitor many of their body’s functions (heart rate, blood pressure, body temperature, oxygen saturation, etc.), and help with their breathing, if necessary.  The medical staff will explain the function of all the equipment that surrounds your baby.  Below is a list of some of the most commonly used equipment in the NNU.

Baby in incubator

Bag and Mask

Your baby will have its own ‘Bag and Mask’.  Should the need arise; your baby will be given oxygen via the mask by their nurse as an initial support.   This emergency support will be given by either using the mask to create a seal over your baby’s face or by blowing oxygen over their face.   Bag and Masks are located on the wall behind each baby’s cot.  If your baby is in an incubator, this form of initial support may be given via a ‘neopuff system’ attached to their incubator.  The neopuff system works on the same principle as for the bag and mask. 

Gastric Tubes/Feeding Tubes

Often, preterm and sick babies cannot feed normally, for a variety of reasons.  For the first few weeks, these babies feed through special feeding tubes placed in one of the nostrils or in the mouth.  These tubes are very small, and run directly to the stomach. 


Premature (and sometimes term) babies can have trouble keeping their body temperature at the correct level as they have little body fat for insulation. An incubator will be used to keep your baby warm.  Your baby’s temperature will be monitored by placing a small sensor on their skin; the temperature recorded by the sensor will be shown on the screen beside their incubator.  If the sensor falls off their skin or your baby’s temperature goes outside a pre-set range, it will start an alarm.  Their nurse will adjust the temperature inside the incubator so your baby stays comfortable.

Your baby’s incubator will also control the moisture and oxygen levels in the air that surrounds them; this prevents water loss from their thin skin and supports their breathing.  The incubator will protect your baby from the noise of the busy NNU environment.

There are two types of incubators; closed-box and open-top.  The closed-box incubator has two hand-sized ports on the sides, and has devices to circulate inside air and humidity.  The open-top incubator - or babytherm - allows greater access to the baby, and has an overhead heater to keep them warm.  As your baby gets better and becomes more stable, they may progress from being placed in a closed-box incubator to an open-top incubator and finally to a cot. 

Infusion Pump

This is used to control the rate at which fluids, feeds, and medication are given to your baby. It may also have a syringe pump or syringe driver.

NICU comfort holding

Fluids and medications can be given in various ways

Intravenous Lines 

Babies in the NNU get their fluids and medications through intravenous (IV) lines.  An IV line, or ‘line’, is a fine tube inserted into a baby’s veins.  Generally, IV lines are inserted into a vein in the arm, leg, or scalp.

Pain relief, such as sucrose, is given during the insertion of the IV line.  Once inserted, the IV line does not cause pain.  However, if dislodged from the vein, it can cause pain.  Your baby’s nurse will keep an eye on the IV lines insertion site to prevent the IV line from dislodging.

When an IV line must stay in a vein for a longer period, it is inserted into a deep vein.  This is called a ‘Percutaneously Inserted Central Catheter (PICC) line’ or ‘long line’.  When a baby is given food and nutrients through an IV line it is called ‘total parental nutrition’ (TPN). 

Pulse Oximeter/Blood Saturation Monitor 

A pulse oximeter measures the amount of oxygen in the blood.  It consists of a monitor and an infra-red sensor.  The pulse oximeter shines red light through the skin onto the sensor strapped to the baby’s foot or hand.  This device can be very sensitive to movement; if the alarm starts, it does not necessarily mean that there is an emergency.

Umbilical Catheters

There are two types of umbilical catheters, umbilical artery catheter and umbilical vein catheter.  Some preterm babies have their umbilical cord clamp removed and have a soft tube inserted into the blood vessels of their umbilical cord.  An artery catheter is for monitoring blood pressure and sampling blood gases.  A vein catheter is for giving nutrition and medications.  Mostly, umbilical catheters are used in the first few days after birth. 


Baby feet in incubator

Alarms on equipment do not always mean there is an emergency


A ventilator helps a baby to breathe or completely takes over their breathing.  It keeps the correct amount of oxygen and carbon dioxide gases in their blood.  This machine gently pushes warmed, moist air down into their lungs.  This air passes through a soft plastic tube (endotracheal tube) placed in the baby’s windpipe (trachea).  This action of passing a tube into the windpipe is called ‘intubation’. 

The level of support the ventilator will give to your baby will regularly change to meet their changing needs.  As your baby gets stronger, they will wean off the ventilator, as they will need less support to breathe.  Weaning off the ventilator can last from a few hours to a few weeks; each baby is different. 

The first time your baby is taken off the ventilator, they may breathe well for a while, but then may become tired.  If this occurs, your baby maybe intubated again or a less invasive form of breathing support maybe given to them.  Please do not worry if this occurs, as this is typical of the weaning process.  If your baby catches an infection when they have come off the ventilator, they may need re-intubation until the infection has cleared up.

Sometimes special types of ventilation called ‘high frequency oscillator ventilation’ and ‘nitric oxide ventilation’ are used.  High frequency oscillator ventilation delivers very fast, small amounts of air to the baby’s lungs, seen as very fast small, breaths.  Their chest appears to vibrate.  These vibrations may look alarming when seen first, but rest assured this type of ventilation works very well to overcome breathing difficulties in very sick babies, and does not cause any pain or distress.  Nitric oxide ventilation uses nitric oxide gas to expand the blood vessels in the lungs, improving the baby’s breathing.

Continuous Positive Airway Pressure Driver

Continuous Positive Airway Pressure (CPAP) is a less invasive form of respiratory support than the ventilator.  It does not require an intubated baby; instead, it is given through ‘nasal prongs’ or a ‘face mask’.  The prongs, or mask, stay in place using a cap with ties. 

CPAP provides a pressurised flow of warmed, moist air into the baby’s lungs which helps keep their lungs inflated.  Sometimes, extra oxygen is added to this warmed air for more breathing assistance.  During CPAP, the baby is doing all the breathing, but CPAP prevents their lungs from emptying completely.  This makes breathing easier for the baby.

CPAP is used to wean a baby off the ventilator to breathing unaided.  Do not be alarmed if your baby needs CPAP assistance after a period of time of breathing unassisted.  This is normal for many babies.

Bi-Level Positive Airway Pressure

This is similar to CPAP and works in the same way, but it delivers a slightly higher pressure on inspiration, i.e. when the baby takes a breath.

Baby with breathing mask

Your baby may need help with their breathing

High Flow Oxygen

High flow oxygen is another form of respiratory support used as an alternative to CPAP.  Similar to CPAP, it provides an air and oxygen mixture that is pressurised, warmed, and humidified.  Like CPAP, it is provided through nasal prongs rather than needing an intubated baby as with the ventilator.  Unlike CPAP, the baby is not in control of the breathing.  Instead, the ‘flow’ of the air/oxygen mixture is regulated according to the baby’s needs and as the baby gets stronger is gradually reduced.

Low Flow Oxygen

Low flow oxygen can be used to wean a baby off CPAP or high flow oxygen.  Babies on low flow oxygen are breathing themselves, but need a little support in the form of oxygen-rich air supplied at minimum pressure.  Low flow oxygen is delivered using nasal prongs.  It differs from ‘high flow oxygen’ as it is not warmed or humidified, and is supplied at a lower pressure.

Some babies require ‘low flow oxygen’ for a long period.  On occasion, a baby is sent home with nasal oxygen.  Babies sent home ‘on oxygen’ usually, but not always, have a condition called ‘chronic lung disease’ due to prematurity.  If your baby requires oxygen at home, the medical team in the NNU will make sure that you are confident with the use of oxygen and will organise its installation into you home prior to discharge. 

Vital Signs Monitor

All babies in the neonatal intensive care unit are connected to their own vital signs monitor, 24 hours a day.  This monitor displays your baby’s vital signs.  Vital signs include blood pressure, heart rate, breathing rate, body’s temperature, and oxygen levels.

Vital signs are monitored using small pads, placed on the baby’s chest.  These pads have thin cables running to the vital signs monitor.  These monitors are very sensitive and will alarm if your baby’s heart rate and breathing rate fall outside the range of values suitable for your baby.  Sometimes, the alarm starts because the pads get displaced by the baby’s movement, and does not necessarily mean there is an emergency.