This is not intended as medical advice. If you have questions about newborn care, contact your child’s pediatrician.

When our daughter was first admitted to the NICU for prematurity, a lot of the terminology and abbreviations that the medical team used were foreign to us. Over time, we learned the meaning of these words and acronyms used in the NICU:

A’s and B’s or A/B Spells

Refers to apnea and bradycardia, which often occur together in preemies. See the “Apnea of Prematurity” and “Brady Spell” sections below.

AoP (Apnea of Prematurity)

Apnea, stopping breathing for at least 20 seconds, is very common among premature infants due to their developing nervous systems. In a NICU, respiratory sensors monitor the infant’s breathing to help nurses watch for apnea. Sometimes, infants will start breathing again on their own, and other times a nurse will need to help the infant to breathe, by stimulating them. This usually just involves touching them, such as rubbing their chest or back briefly until they start breathing again on their own.

Apnea can cause bradycardia, an abnormally low heart rate (see “Brady Spell” below), and often results in decreased blood oxygen saturation (see “Sats” below). If the medical team determines that an infant’s apnea requires treatment, they may either administer caffeine or use CPAP (see “CPAP” below).

See also “Brady Spell,” “CPAP,” “Sats,” and “Stim” below.

Bilirubin or “bili”

Medical staff sometimes use the abbreviation “bili” for bilirubin, a yellow-colored pigment that is released when old red blood cells are broken down. You may hear the term in relation to lab tests because “t-bili” (bilirubin total) and “d-bili” (bilirubin direct) are blood tests for bilirubin levels.

It’s pretty common for newborns to have high bilirubin levels, causing a condition called jaundice. If untreated, it can lead to brain damage. Luckily, treatment is easy. To treat jaundice, a newborn is placed under a special phototherapy blue light and is given a mask for eye protection. This “bili light” emits a specific wavelength of light that helps the body break down and eliminate bilirubin. Follow-up blood tests will be used to confirm that the bilirubin levels are within the expected range.

Brady Spell or Bradycardia

Bradycardia is an abnormally low heart rate. In premature infants, bradycardia is often caused by apnea (a pause in breathing). Since apnea and bradycardia often occur together in preemies, you may hear medical staff call them “A’s and B’s” or “A/B Spells.”

In a NICU, infant heart rate is monitored, so nurses can check whether there is a bradycardia event.

Corrected Age or Adjusted Age

Preemies (babies who are born prematurely, before 37 weeks of pregnancy) often need some extra time to meet their development goals vs. babies who are born at term (37 weeks or later). For example, if a 1-month milestone for a term baby were to briefly make eye contact, a term baby might start intentionally making eye contact around one month after birth, but a baby born one month early might not reach that milestone until about two months of age.

To account for that difference in development, it’s common to refer to preemies by their corrected age/adjusted age rather than the actual time since their birthday.

This “corrected age” or “adjusted age” is the age since the baby’s due date (or the age since the baby would have reached 40 weeks of gestational age). You can think of it this way:

corrected age = number of weeks since birthday – number of weeks the baby was premature

For example, here’s how you can calculate the corrected age for an infant born at 30 weeks, assuming it’s been 15 weeks since the infant was born:

corrected age = 15 weeks since birthday – 10 weeks premature corrected age = 5 weeks

In this example, the infant’s corrected age would be 5 weeks because 15 weeks have elapsed since their birthday, and they were born 10 weeks premature (30 weeks is 10 weeks before 40 weeks of gestation).

CPAP

“CPAP” stands for “continuous positive air pressure.” CPAP provides a stream of air directly into the baby’s nose to support breathing. The air that it delivers may be room air (21% oxygen, just like we normally breathe) or may have a higher percentage of oxygen if needed. The air is humidified so that it does not dry out the infant’s nasal passages.

CPAP is used for a variety of respiratory challenges among infants in the NICU. CPAP may be used for infants with apnea of prematurity (see “Apnea of Prematurity” section above). It may also be used for other forms of respiratory distress when the condition is not sufficiently acute to require a ventilator.

A side effect of CPAP is that it can cause increased air in the stomach and a bubbly mouth. The extra air in the stomach can be uncomfortable for the baby and can lead to flatulence.

Emesis

“Emesis” means “vomiting.” In the NICU, the medical team will monitor for emesis. Among otherwise healthy premature newborns, emesis may be caused by feeding too fast, in which case food may be administered over a longer time period (see “Pump Feed” below). The color of the vomit may help with determining the cause.

EMM

“EMM” stands for “expressed mother’s milk,” meaning “breast milk.” Since most premature infants are unable to eat by mouth until a later age, it’s common to pump breast milk to feed them via a gavage feed. See the “Gavage Feed” section below.

Feeder-Grower

Patients may be in the NICU for a variety of reasons. Those patients who were born prematurely and don’t have complications aside from learning to eat by mouth (see “PO” below) are sometimes called “feeder-growers” because their reason for remaining in the NICU is to learn to eat by mouth (e.g. bottle feed and/or breastfeed) and continue growing.

Fortified Feed

Many premature newborns require a higher level of nutrition than term newborns. As a result, they may be given fortified feeds. A fortified feed is human breast milk that is mixed with a fortifier, commonly infant formula powder, to increase the nutrient density of the feed.

In some babies, fortified feeds can lead to constipation or lower frequency of stooling (though the stool may still be a loose consistency).

G Tube

A “G tube,” which stands for “gastrostomy tube,” is installed through the abdomen. It’s used for providing nutrients and, if needed, medications.

See also “Gavage Feed.”

Gavage Feed

Many premature infants are not yet able to eat by mouth, so they require gavage feeding: the use of a feeding tube. This may be either a G tube or NG tube. Food may be provided either by gravity feed (i.e. a container of liquid food is hung, and the force of gravity draws the liquid down the tube) or via a pump.

See also “Pump Feed.”

NG Tube

“NG tube” stands for “Nasogastric tube.” It’s a flexible tube that is inserted through the nose into the stomach. In the NICU, it is commonly used as a feeding tube, especially among premature infants who are unable to eat by mouth. See also: “G Tube” and “Gavage Feed.”

PICC

“PICC” stands for “peripherally inserted central catheter.” It is similar to an IV and is used to administer medications or nutrition. As opposed to an IV, which can stay in for several days, a PICC is more durable and can stay in place for a couple months or more.

PICU

Ok, so you probably already know that “NICU” stands for “Neonatal Intensive Care Unit.” A PICU, “Pediatric Intensive Care Unit,” is generally for older kids, as opposed to newborns.

PO

“PO” stands for “per oral” and means “consuming by mouth.” A medication that is administered “PO” is one that is given by mouth (as opposed to via an IV, for example).

Most premature infants are not yet able to eat all their food by mouth (PO), so they require a feeding tube initially. See also “Gavage Feed.”

Pulse Ox

Short for “pulse oximeter,” a pulse ox is a sensor that measures blood oxygen saturation (SpO2). In the NICU, this is often worn on the infant’s foot.

See also “Apnea of Prematurity.”

Pump Feed

Babies in the NICU who aren’t yet able to eat all their food by mouth (see “PO” above) require a feeding tube. A feeding tube may either be gravity fed, or food may be pushed through a feeding tube by a pump. A pump is typically used for patients who require food to be administered at a controlled rate. For example, if a patient needs 50 ml of food over 60 minutes, a pump could be used.

Note that a pump may be used for medications or food.

RA

In medical notes, “RA” stands for “room air.” A patient who is on “room air” is not receiving supplemental oxygen (i.e. they’re on 21% oxygen).

Rounds

Each day, the medical team gathers at the bedside of a patient to discuss the latest status of the patient and make decisions about their care. They will usually review any new lab results, measurements (e.g. weight), and notes from nurses. Parents are often encouraged to be present for the daily rounds to get the latest updates and ask questions.

“Sats”

A vital sign that’s measured for NICU patients is the blood oxygen saturation, which medical staff may refer to as “sats” (short for “saturation readings”). Blood oxygen saturation is abbreviated as SpO2. A pulse oximeter is used for measuring blood oxygen saturation.

See “Pulse Ox” above.

SLP / Speech Therapist

“SLP” stands for “speech-language pathologist” and is the same as a speech therapist. In the NICU, SLPs help babies develop the skills needed to eat milk by mouth (see “PO” above). They can assess sucking and swallowing challenges and help patients develop those skills. They may also provide guidance to caregivers about how to safely feed the baby.

Stim

Medical staff may use the term “stim” to refer to “stimulation.” In the NICU, it’s often used in the context of a premature baby having an apneic spell (see “Apnea of Prematurity” above). In that context, a nurse may “stim” an infant by rubbing their chest or feet, which can “remind” the infant to start breathing again.

Thin Liquids

Some infants have a condition called “dysphagia,” which means that they have trouble swallowing. A medical professional may recommend that they use a feed thickener to change the viscosity of the milk so that the baby is able to swallow it better. In that case, the milk would be thickened. Non-thickened milk would be a “thin liquid.” Medical notes may say that a patient is on “thin liquids” to indicate that they do not require a feed thickener.

Voiding and Stooling

“Stooling,” as you probably know, means “pooping.” However, “voiding” was a term we hadn’t heard before our daughter was in the NICU. “Voiding” means “urinating.”