Frequently Asked Questions

Why has my baby been admitted to the neonatal unit?

There are a variety of problems in pregnancy which increase the risk of a baby being admitted to the neonatal unit:

• Premature labour (before around 36 weeks)
• Intrauterine Growth Restriction (IUGR). This means that a fetus is small for his / her gestational age and can be due to the placenta not functioning as well as it should.
• Pre-eclampsia (raised blood pressure). This can increase the chances of a premature delivery.
• Maternal diabetes . Babies of diabetic mothers (gestational or normal) may have difficulty maintaining their blood sugar level, or possibly have breathing difficulties.

Some of the common reasons why babies are admitted to the neonatal unit are:

• Prematurity (under around 35 weeks)
• Low birthweight (under around 1.8kg, or 4lbs)
• Breathing difficulties
• Low blood sugar
• Jaundice
• Poor feeding
• Infection
• Any unusual behaviour or findings which require further investigation or treatment

How can I find out what is happening to my baby?

When you visit the unit for the first time, nurses will be happy to explain what care your baby is needing and why. If there is a doctor on the unit at this time, they may also speak to you to give you more detail.

Whenever you visit the unit, staff will update you on any changes and will always be happy to explain anything or answer questions, so please do not be afraid to ask. Remember, there are no silly questions!

You can telephone the unit at any time to see how your baby is by calling Intensive Care (01895279447) or Special Care (01895279109) and asking for the nurse looking after your baby.

Why is my baby in an incubator?

We place premature or sick babies inside an incubator, or in a heated cot, to help them maintain their temperature. They may also have humidity inside the temperature as an additional source of heat as well as a preventative measure to decrease water losses and skin breakdown. Although your baby is in an incubator, this does not mean that he or she cannot come out for a cuddle. Practising kangaroo care will help to keep your baby warm when he or she is out of the incubator.

Why does my baby need help breathing?

In the womb, babies receive all oxygen from the mother via the placenta. When they are born, they have to adapt very quickly to breathing in the outside world. This can be a problem for premature babies because their lungs may not be fully developed, or they may be too weak to breathe on their own. The three levels of respiratory support that babies can require are Ventilation, CPAP and oxygen therapy.

Why isn't my baby being fed yet?

The digestive systems of premature babies are often not yet mature enough to tolerate food when they are born. Breast milk must be introduced very slowly starting with small amounts. During this time, these babies may receive either intravenous (IV) glucose solution or IV total parenteral nutrition (TPN). 'Parenteral' means 'into the blood stream', and TPN is a mixture of nutrients (such as glucose, salts, amino acids, fats and vitamins) that can be given to babies through a fine tube in a vein.

When babies are well enough and old enough, they can start to be given milk feeds into their stomach, starting with a small amount at first. However, most babies' sucking reflex starts to develop at around 33 weeks, so until they can suck well enough to breast or bottle feed completely, they will need to be fed by a small tube passed through the nose, or the mouth, and into the stomach. This is called a naso-gastric (if through the nose) or oro-gastric (through the mouth) tube.

Breast milk is best for all babies, however it is particularly vital for premature and sick babies. Mums will be encouraged to express milk so that we can give this via the feeding tube. Giving breast milk early helps to protect babies against infection, and stimulate gut activity. This is especially important as premature and sick babies are at an increased risk of serious infections and gut problems. Breast milk is much more easily digested than formula milk, and also provides essential nutrients and hormones to help baby grow and develop.

As babies mature, they can then start to be put to the breast and practice suckling. This helps the baby learn how to feed properly, and can also aid digestion.

Even if you do not wish to breastfeed, we would still request that you express breastmilk for a little while if possible, as this can protect premature and sick babies from different illnesses.

When will you weigh my baby?

All babies are weighed on admission to the unit. Thereafter babies in the intensive care area may be weighed daily, or twice weekly, and babies in special care are usually weighed once or twice weekly. Babies will usually lose up to 10% of their birth weight in the first few days as the result of fluid loss from their body post-delivery and through the passing of meconium, their first bowel movements.

How much can my baby see and hear?

Even term babies do not have completely developed eyesight, and it is thought that for the first 2-3 months babies can only see in black and white. The shapes they see may be blurred, but they are naturally drawn to the shape of a face.

Hearing develops earlier than eyesight and babies born at term can hear very well. Babies born earlier can hear but may be sensitive to the noises of a busy nursery. Sharp, loud noises may cause stress to a premature baby.

In our nurseries we try to minimise disturbances caused to the baby by excessive light and noise by placing a cover over the incubator. However, the voice of a parents can be very soothing to a premature baby, even if they are very ill. So, don't be afraid to speak to your baby, talk about your day, sing or read a story!

What can I do to help?

Even if a baby is very ill, parents can do alot to help. Although you may not be able to hold your baby, you could try containment holding and talking softly to him or her. Speak to the nurse looking after your baby about opening the incubator doors or side panel.

You will meet many different nurses and doctors on the unit and there will me many changes in your baby's care which you will be kept informed of. You are therefore an important source of reference to members of staff who may not have looked after him or her before.

Breast milk is very important for sick or premature babies. Even if you don't wish to breast feed at home, we would ask mums to consider expressing breast milk as every little bit will help your baby in the early stages!

What medications is my baby on and why?

You can see what medications your baby is on by looking at his or her drug chart (or asking one of the nurses). The medications that your baby is receiving may include some of the following:

Antibiotics

Many babies in the neonatal unit will receive intravenous (IV) antibiotics for a time. On the baby's drug chart you will see these (there are many different types) written as such things as: Gentamicin, Vancomycin, Amoxicillin, Ceftriaxone, Ceftazidime and Flucloxicillin.

Caffeine

Caffeine is a stimulant and encourages babies to keep breathing. Nearly all babies born before around 34 weeks will experience some degree of 'apnoea of prematurity' where they will pause for a little too long between breaths and this will result in a drop in their heart rate (bradycardia - or brady) and / or a drop in their oxygen saturations (desaturations - or desats). Caffeine can be given intravenously initially and then changed to orally when your baby is having more milk.

Sytron

Babies born before around 34 weeks or weighing less than about 1.8 kg are prone to iron deficiency as most of the body's stores of iron are laid down in the last trimester of pregnancy. Systron is an iron supplement and this is useful in preventing anaemia as it is important in the production of red blood cells. Treatment starts at 28 days of age if babies are on full milk feeds.

Dalivit (also called Abidec)

These drops are given to premature and low birthweight babies when they are on full milk feeds as they are at risk of a deficiency in vitamins A,D and C.

Folic Acid

Preterm babies routinely have folic acid supplementation to prevent folate deficiency and reduce their incidence of anaemia.

Can my other children visit the baby? Will they be frightened?

Yes, we would encourage you to bring siblings to visit their new baby brother or sister. Children can deal with situations better than you may think, and may understand what is happening much more if they can see the baby.

Can my visitor's children also come to the unit?

We would ask that brothers and sisters of the baby are the only children that you bring to the unit for reasons of infection control.

What should I wear when I visit?

When you arrive on the unit you will need to remove your outdoor jacket. If you are a workman etc. we would ask that you change out of dusty / dirty / paintcovered etc. clothes before visiting. If you are practising kangaroo care, you should wear a loose shirt / blouse, preferably one which buttons / zips at the front.

When can I cuddle my baby?

When your baby is well enough, he or she will be able to come out of the incubator for a cuddle. Ask the nurse looking after your baby, and she will be glad to take the baby out for you, or if not, to explain why your baby would be more comfortable in the incubator for now. Kangaroo Care is an excellent way to hold your baby.

Can I bring things to the unit for my baby?

You are welcome to bring items in to make your baby's cot / incubator area feel more homely, such as pictures drawn by siblings, cuddly toys, photos of the family etc. We ask that cuddly toys be placed around or on top of the incubator for infection control reasons (sometimes the incubator can be very warm and humid) but you are welcome to put these things into a cot when they reach this stage.

We have a wardrobe of babygros, vests, hats etc. for premature to term babies. This is situated in Jasmine special care nursery. You are very welcome to use these clothes to dress your baby (wires & lines permitting) or if you prefer you may bring in your own clothes. If you use our clothes, these are then placed in the orange laundry bag in Orchid nursery when they are dirty. If you are using your own clothes, these should be taken home and washed by yourselves as otherwise they will become mixed in with our clothes!

How can I reduce my parking costs?

Ask one of the nurses for a parking permit form. Unfortunately you will still need to pay for parking (and hunt for a space!) but it will be a little cheaper for you. Once you have this form, you will have a choice of purchasing a weekly permit for £12.00 or a monthly permit for £25.00.

When can I take my baby home?

Premature babies do not always need to stay on the unit until their due dates. If they are feeding well, gaining weight and have no other problems, they may be well enough to be discharged a little earlier.

Term or slightly premature babies admitted to the unit will go home when the reason for their admission has been investigated, resolved, or if necessary, treated.

Some babies stay in hospital for more time if they need longer term help with feeding, breathing or have other medical problems.

To be considered for discharge from the unit, your baby must be:

• Medically stable
• Breast or bottle-feeding successfully (unless other arrangements have been agreed)
• Gaining weight steadily
• Able to maintain a normal body temperature in an open cot