Ventriculoperitoneal Shunt Surgery: After Your Newborn's Surgery

The doctor placed a ventriculoperitoneal (VP) shunt under your baby’s skin. A VP shunt is made of two thin tubes (catheters) connected by a valve. The shunt drains extra fluid out of your baby’s brain and into their belly. Your baby's body can take in the extra fluid without harm.

After surgery, your baby’s neck or belly may be tender. But your baby should not have much pain. You may notice that the swelling of your baby’s head lessens right away. There will be a lump on your baby’s head where the valve is. In some cases, the shunt can't be felt under the skin. The area around the stitches or staples may be tender for a week or so. If needed, the doctor will remove your baby’s stitches or staples.

While your baby is recovering from the surgery, they will stay in the neonatal intensive care unit (NICU). Your baby may stay several weeks or longer. The doctor will let you know when your baby can go home.

The NICU care team will watch for signs of infection or signs that the shunt is not working right. These include a bulging soft spot (fontanelle), fast head growth, irritability, poor feeding, vomiting, and unusual sleepiness (lethargy).

If your baby’s shunt gets infected or stops working well, it may need to be removed or replaced. Without problems, your baby’s shunt may be left in place for years.

• Your baby will be well cared for in the NICU. The NICU staff are specially trained. Your baby's care team may include your baby's doctor, a doctor who specializes in treating newborns (neonatologist), other specialists, nurses, and support staff like technicians and social workers. Your baby’s NICU care team will do everything they can to help. And they will answer any questions you may have.
• You can visit your baby in the NICU. You will need to wash your hands each time you enter the NICU. Depending on your baby's condition, you may also have to wear a mask or disposable gown.
• You may see tubes and wires attached to your baby. The tubes supply air, fluid, medicines, and nutrition to your baby. The wires are connected to machines that help the doctor keep track of your baby's vital signs.
• It may seem that your baby is getting lots of tests. All of these tests help the doctor keep track of your baby's condition and give the best treatment possible.
• The NICU care team will teach you how to hold your baby. You may need to hold your baby’s head at a certain angle for the first few weeks.
• As your baby grows stronger, you'll be able to take on more caregiving tasks, from feeding to changing diapers and bathing.
• You can provide breast milk for tube-feeding. This reduces your baby's risk of infection.
• If you need it, ask the NICU care team about counseling and support. Also ask friends and family for support.

• Someone from the NICU care team will help plan your baby's discharge from the hospital. They will answer your questions about what will happen before and after your baby leaves the NICU.
• The NICU care team will teach you how to care for your baby at home. You will learn how to:
  • Feed your baby at home. This may include a feeding schedule.
  • Do infant cardiopulmonary resuscitation (CPR).
  • Safely transport your baby in the car.
  • Set up any special equipment your baby may need.
  • Give your baby medicines.
  • Bathe your baby.
• You will meet with the hospital's discharge planner, the doctor, and the NICU care team. You'll discuss a medical care plan. The plan will include checkups, specialist care, and ongoing tests.
• This is a good time to make an appointment with your baby’s regular doctor. The first doctor visit should be a few days after your baby comes home.

Some babies may be ready to go home earlier than others. Depending on when your baby goes home, the doctor may give you special instructions for activity, diet, medicines, and incision care. These may include:

• Activity
  • Let your baby rest as much as possible. Sleeping will help your baby recover.
  • You can handle your baby as you normally would. It is okay to hold and cuddle your baby.
  • Do not push on the valve on top of your baby’s head.
  • Do not put tight hats on your baby.
  • The doctor will tell you when it’s okay for your baby to lie on the side of the head that has the shunt.
  • Do not let your baby do anything that could cause them to hit their head.
  • You can give your baby a sponge bath. The doctor will tell you when it’s okay to shampoo your baby’s head.
  • Do not let your baby swim or bathe until the stitches or staples are removed.
  • Check with your doctor about when it is safe for your baby to travel by plane.
  • Know the type of shunt device that your baby has. If it is a programmable shunt, make sure that you do not use other magnetic devices, like cell phones, near your baby’s head.
  • Watch for possible problems as your baby's brain develops. These could include delayed learning, problems with motor skills, and speech problems. Talk to your doctor about new problems or changes you see.
• Diet
  • The tubing in your baby’s belly will not affect how your baby digests food. Your baby can eat as usual.
• Medicines
  • The doctor will give you instructions about your baby taking any medicines.
  • If your doctor prescribed antibiotics, be sure your baby takes them as directed. Don't stop giving them just because your baby feels better. Your baby needs to take all the antibiotics.
  • Your doctor may recommend giving your baby acetaminophen (Tylenol) to help with pain after the procedure. Be safe with medicines. Read and follow all instructions on the label.
  • Do not give your baby two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Incision care
  • If your baby has strips of tape on the cuts (incisions) the doctor made, leave the tape on until it falls off.
  • Wash your hands before and after touching your baby's incisions.
  • Wash your baby’s incision areas daily with warm, soapy water, and gently pat them dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the areas with gauze bandages if they ooze fluid or rub against clothing. Change the bandages every day.
  • Keep the areas clean and dry.