 Namaste viewers, welcome you all to the episode 5 of NICU Diaries and to answer to your queries I have Dr. Ravi Swami and I have Dr. Sanjeeva Reddy here. The first question is about what all the protocols that we use in our NICU to prevent infections and how do we manage when they occur? Infections are the most common problem what we see in NICU because the babies have got very minimal defense but the simplest thing which we enforce for all parents or all the health care professionals are to wash their hands. So just even before you enter the NICU you will see that we are quite strict on washing your hands, wearing a separate gowns, changing your footwear and stuff. This itself is more than sufficient to reduce most of the infections in NICU. So these are the usual ways how we limit and prevent infections. What would be any adverse effects that we can see in NICU care of babies? NICU per se we cannot generalise the adverse effects it all depends on why a particular baby is admitted to NICU. So if a baby is admitted for infection treatment the adverse effects will relate to the medications that we use and sometimes if the baby is admitted for treatment of jaundice the effects will depend on the treatment that we use, the phototherapy light and also the complications of the jaundice itself but NICU per se will not leave any adverse effects as such. Babies admitted in NICU will they have a healthy life later or do they have any long term complications that could stay? So this has been well studied so we are always interested in looking at the long term neurodevelopmental outcomes for babies usually between 18 months to 24 months depending on the condition most of the premature babies that's the most common admission to the NICU preterm babies if you say you have about 100 babies in NICU 80 to 85 should not have any issues depending again on gestation but remaining 15 percent we do look into complications especially in their motor problems like they able to walk and whether they're able to use their hands and so on similarly we do see issues with their speech and in their behaviour. How do we support the parents and families during their stay is there any different way that we do or how do we support them? So NICU environment is very unique only patient is allowed to stay inside the unit but again there is key differences between adult ICU and NICU for example whereas adult patient is cared for in a normal kind of a bed for babies we may have a cot which is suited for the size of the baby or we may have a special incubator which helps in maintaining the temperature of the baby. So parents may find it a little bit difficult to have access to babies all the time but we will try and do our best to allow the visiting hours unrestricted access to stay with the baby for as long as it's possible but we have a feeding room next to the unit where they can sit and rest for as long as they want and more importantly we provide information on a regular basis so they are updated about what's going on with the baby and they can kind of feel relaxed about what's going on inside. How do you approach pain management and comfort measures for infants in NICU? Okay so again depending on what the problem is we can decide so the most commonest ways how we manage pain in babies who are undergoing any form of procedures for example we're doing any blood test or we're putting a canal or something then it's well well proven beyond or that sucrose which is a sugary water does help in pain relief. So yeah depending on the threshold for pain we decide on the medicines what we need to use. Thank you so much viewers for watching we'll see you again in the episode 6.