Instagram story viewer> @thenicudoc> Posts

70.3K

followers

1160

following

Your daily dose of NICU
Education. With clips, teaching, and quizzes. For nurses, trainees, and others
UNC,DUKE,UAB
No medical advice.
Opinions-my own

POSTS STORIES REELS

Some even younger ⤵️

At first, the eyes can have a light grey to brown hue. Then by about 3-6 months, the biggest eye color change will happen. The pigment that makes up your eyes will begin to fill up enough that you can have an idea. However, it isn't until about 1 year of age where most baby's eyes will have solidified enough pigment to determine an adult color.
Some babies with light eyes can still shift slightly in shade up to 3 years, but this won't be a dramatic color change.

I apologize. Not a remix. Thank you for sharing your beauty to the world
@herewe_grow

Did you guess your baby's color right from the start?

#fyp #inspiration #eyecolor #beauty #newborn #baby #infant #viral by @thenicudoc

Ever REALLY thought about it?

I hear this ask the time "I started Lasix to bring the swelling down."
Now, let's look at the physiology and evidence of this.

When a baby develops inflammation, whether after surgery or from certain lung conditions, blood vessels can become leaky. Fluid escapes into the surrounding tissues, causing edema.

Here's the irony: a baby can look fluid overloaded but actually have LOW circulating blood volume, specially if edema is from infection.

So, does Lasix help?

The argument FOR it: Lasix helps the kidneys eliminate sodium and water. If there is pulmonary edema, it can improve respiratory mechanics. Studies in babies with BPD have demonstrated short-term improvements in lung compliance and oxygenation.

The argument AGAINST it: If the swelling is primarily from inflammation and capillary leak, Lasix doesn't fix the underlying problem. And if the baby is already intravascularly depleted, diuresis could worsen perfusion, hypotension, electrolyte disturbances, or kidney injury.

But what does the evidence say?

A 2022 Cochrane review found that furosemide can temporarily improve pulmonary function in some infants with chronic lung disease, but there's insufficient evidence that routine use improves tissue edema.

The American Thoracic Society also recommends against routine diuretic use in children with post-prematurity respiratory disease.

So perhaps the real question isn't whether Lasix makes babies pee.

It's whether the baby actually needs to lose tissue fluid quickly in the first place or just let time do it's job.

What's your thoughts on diuretics for tissue edema?

#edema #pulmonaryedema #kidneydisease #infection #diuretic by @thenicudoc

You won't believe the end

True story. I both busted out laughing and started tearing up.
It took this dad that connection with his baby girl to suddenly become a big teddy bear.
He did skin-to-skin every single day until discharge.
Gave me the biggest huh when they left.
Sometimes parents surprise you.

This month I'm gonna share some crazy, funny, and some sad stories for #prematurityawareness month.

Follow to hear them all.

#preemies #prematurity #preemiestrong #nicu by @thenicudoc

Are you going?

I'm excited to attend one of my favorite meetings in a couple of weeks.
If you're in Neonatology, this is such a great conference.
And this year they are celebrating 50 years!
Register if you haven't done so already. It's not too late.
⤵️
https://events.miami.edu/event/ConferenceRegistration2026

I get nothing out of this but the satisfaction of seeing you there

Don't forget to come say hi and we can get a pic if you like

See you soon!

#miamineonatologyconference #miamineo2026 #conference #miami #neonatology by @thenicudoc

Might look cute, BUT...

Watch out for these little ones.
I didn't mean to keep her. Just want what's best for these little ones, but she sure told me how she felt!

Is it me or do these babies have a little attitude? 🤭

#revengeissweet #revenge #funnystory #funnybaby by @thenicudoc

Babies have fun too!

Here some of the collection through the years of some fun costumes shown in NICUs around the US.

Which one is your favorite?

#happyhalloween #halloweenbabies #halloween2026 #cutebabies #nicu by @thenicudoc

Do you know the diagnosis? ⤵️

It's Transposition of the great arteries (TGA).
In TGA, the aorta comes off the right ventricle and the pulmonary artery comes off the left. That means two parallel circuits instead of one loop. Blue blood goes back to the body, and red blood goes back to the lungs.
NO BUENO

Why the metabolic acidosis?

The only way oxygenated blood reaches the body is through mixing at the PFO, PDA, or a VSD. If mixing is poor, the tissues starve, switch to anaerobic metabolism, and you get lactate and a metabolic acidosis.

What's with the weird CXR?

The famous "egg on a string" CXR
The heart is egg-shaped, and the mediastinum is narrow because the great vessels sit front to back instead of side by side. Lungs are often clear. It's a classic, but plenty of TGA babies have a normal film, so don't let a normal CXR talk you out of it.

What do I do?
Start PGE1 to keep the ductus open and improve mixing. Typical starting doses are 0.01 to 0.05 mcg/kg/min. Be ready for apnea, so have an airway plan before starting or transport. Then get cardiology involved and plan for the arterial switch in the first couple of weeks of life, where the great vessels are moved to the correct ventricles and the coronaries are reimplanted. Outcomes are excellent when we catch it early.

👨‍⚕️Pearl: Oxygen won't fix it. A failed hyperoxia test should send you straight to PGE1 and an echo.

Now, would you think INTACT septum or NO, has some shunting?

#tga #neonatology #chd #medicaleducation #pediatrics by @thenicudoc

It's just a baby kidney

Preterm baby with a persistent non-gap metabolic acidosis and you're wondering why the bicarb just won't budge? Let's talk RTA type 2! This causes the bicarbonate to be "normally" around 14-18 in preterm infants.

Think of the preterm proximal tubule as it's still growing. It's immature, so it can't reabsorb bicarb like it will later on. So it spills in the first part of the kidney, the proximal convoluted tubule.

What you'll see:
-Hyperchloremic, normal anion gap metabolic acidosis
-Low serum bicarb
-Urine pH that can basic or still drop below 5.5 if distal tubule is more mature
-Poor growth if it goes unaddressed

What to do:
-Check lytes, urine pH, and your anion gap
-Replace bicarb or citrate in fluids or external if needed.
-Review meds that can contribute, like diuretics

The hopeful part: for most of our preemies, this is transient. As those tubules mature, the bicarb leak settles down.

Save this one for your next acidosis workup, and tag a NICU friend who needs the refresher!

#rta #renaltubularacidosis #kidney #medicine #resident by @thenicudoc

$Gotta know your ABCDEs Ever wondered how doctors systematically read a chest X-ray? One simple trick is remembering the ABCDEs of chest X-rays! A, Airway: Is the trachea midline? Is the endotracheal tube positioned correctly, any defects? B, Bones: Look for fractures or other bony abnormalities. C, Cardiac: Evaluate the heart size and shape or surrounding air. D, Diaphragm: Check the position of both hemidiaphragms and the costophrenic angles. E, Everything Else: Examine the lungs, pleural spaces, soft tissues, and any lines or tubes. In the medicine, having a systematic approach helps us avoid missing important findings! Save this ABCDE checklist for your next chest X-ray and share with a colleague #xrays #neonatology #chestxray #medicaleducation #pediatrics by @thenicudoc$

I really am learning!

The way science advances, you have to attend conferences to keep up with the latest.

BUT...it is also a great way to network.
If you're in training or starting out your career, make sure to save time to attend your favorite conferences.

You can thank me later!

I know you've been there...🤫

#conference #aap2026 #naspghan #nursing #pediatrics by @thenicudoc

…and thats how you know rounds are done🥲

#nicu #nicunurse #preemiestrong #nicubaby #neonatology by @thenicudoc

What do you think?

I've seen all kinds of baby births, but never seen anything like this.
Either this is one cool nonchalant baby boss or some artistic neo was having fun.

Still, fun to see this going viral

#viralreels #nonchalantbaby #coolbaby #newborn by @thenicudoc

Prem Fort

@thenicudoc