No parent ever expects the Neonatal Intensive Care Unit, or NICU, to be a part of their baby's birth story. Glenn Waterkotte, M.D., medical director for the NICU at Cardon Children's Medical Center has cared for some of Arizona's tiniest citizens for more than 35 years. His goal is to get newborns well enough to go home as quickly as possible so the families can start their lives together.

Following is the transcript of our Feb. 18 Twitter chat with Dr. Waterkotte.

RAKmagazine: I’d like to start with your background at Cardon Children’s. How long have you been working with neonatal intensive care unit (NICU) babies?

Dr. Waterkotte: 34 years in the Valley. As a young pediatrician, this [NICU] was the newest field of pediatrics.

RAKmagazine: Why did you decide to work with at-risk babies and pregnancies as opposed to other areas of OB/GYN?

Dr. Waterkotte: Caring for babies this size was something I was good at and enjoyed doing.

RAKmagazine: What are some of the reasons a baby ends up in the NICU?

Dr. Waterkotte: Babies end up in the NICU due to prematurity, birth defects, infections and birth-related stress.

RAKmagazine: Can you elaborate on the term "birth-related stress"?

Dr. Waterkotte: Injuries or high-intensity stress related to difficulties in delivery and labor.

RAKmagazine: What kind of medical support can be provided for a baby in the NICU that can't be done in a hospital nursery?

Dr. Waterkotte: A NICU provides breathing support, special IV access, special feeding techniques, specially certified staff, etc.

RAKmagazine: To work in a NICU, what specialized training must you go through? Does it take longer than other specialties?

Dr. Waterkotte: Doctors must first become a pediatrician, plus three more years of training. For nurses, it's nursing school, then six-months of emergent education in a specialized area.

RAKmagazine: What are your primary tools for healing NICU babies?

Dr. Waterkotte: Specialized breathing machines, IV pumps, and the best nursing staff on the planet! Most NICU babies sleep in an isolette to stay warm and grow faster.

RAKmagazine: Are NICU babies primarily premature births? Do all premature births lead to time in the unit?

Dr. Waterkotte: Most NICU babies are premature, but not all premature babies need intensive care.

RAKmagazine: How have advances in NICU technology affected survival rates for premature babies?

Dr. Waterkotte: New medications, breathing machines, isolettes and nutrition have tripled survival in the last 34 years.

RAKmagazine: What is the life expectancy of a premature baby today?

Dr. Waterkotte: We expect all babies to live a normal life. We expect 80-year survivors! 25-years ago, more premature babies were at risk. We did not have the tools to help many premature babies back then.

RAKmagazine: How does staff attempt to provide a human (comfort) element to the healing process for a baby in the high-tech NICU?

Dr. Waterkotte: Our staff is very aggressive in implementing skin-to-skin care with parents and the baby, even for very sick babies.

RAKmagazine: Having a baby in NICU must be frightening for parents. What is done to provide emotional support to parents?

Dr. Waterkotte: Everything from nurses to doctors, social work and case managers reach out to answer their needs. Any one of us could be sitting in that parent's chair. We ask, 'How would we want to be treated?'

RAKmagazine: What is the average length of a NICU stay?

Dr. Waterkotte: The average stay is 10-14 days. The longest is five months.

RAKmagazine: Are parents allowed to visit their baby in the NICU? How often? Are they allowed to touch or hold their baby?

Dr. Waterkotte: The nursery is open 24/7. Parents are welcome to hold the baby any time as deemed medically safe. Now, we have private rooms for the same purpose.

RAKmagazine: Should an expectant parent learn about options for NICU care even if the pregnancy is low-risk?

Dr. Waterkotte: Parents should only recognize that their baby may require intensive care.

RAKmagazine: (question from audience) Is fetal surgery having an impact on your area of expertise?

Dr. Waterkotte: Some fetal surgeries can reduce a problem, but there are very few fetal surgical cures.

RAKmagazine: What kind of training do parents receive in preparation for taking their baby home from the NICU?

Dr. Waterkotte: We offer classes, CPR training, car-seat safety, bedside feeding training, and parent support meetings. We have a Facebook page for NICU alumni.

RAKmagazine: Is there ongoing support once the baby is home (i.e. can parents call the NICU if they have questions or concerns)?

Dr. Waterkotte: We do follow up phone calls to every parent and take calls from any parent with a question.

RAKmagazine: How have pregnancy and birth changed over the 34-years you’ve been in medicine?

Dr. Waterkotte: Labor pain management and the father’s involvement makes this [birth] a much more pleasant social experience. 

Visit the Cardon Children's NICU and listen to Valley parents Sandra (pictured above) and David Ampha talk about their daughter's stay. Watch RAK Video.