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About us

The Neonatal Unit has 24 cots which enable us to provide specialised care

Neonate Aboutus 2

for babies from around 24 weeks of pregnancy. Many of the babies we care for are born early (premature). However some babies born around the time they are due (term) can have problems too, some requiring a brief stay with us and others a more intensive, longer stay.

Our approach is caring, holistic, individualised and with an emphasis on family. We provide research based care and strive to keep abreast with the latest research and medical technology. We consider the psychological, physiological, social and spiritual needs of baby and family.

Parents, grandparents, family and friends are shocked and upset when a baby needs to be cared for by us. We try to keep parents as informed as possible, allaying fears and worries when we can and enabling them to relay baby's progress to their family and friends.

Photographs are taken as soon as possible after birth so Dad and Mum can show family and friends their baby.

Our priority is to stabilise and investigate baby's condition as quickly as possible. Our aim is to provide expert care proficiently and to keep parents as included as we can during the admission of baby and ongoing care. We strive to be supportive to parents enabling them to gain confidence in caring for their baby.

We often explain to parents that their baby's progress may be something of a 'rollercoaster journey' - two steps forward, one step back, and that there will be good days and bad days but we shall be travelling with them.

There are many people involved in the care of your baby so if you wish to find out more about us please go to the team section for a brief insight into some of the staff and their roles.

 

Visiting
  • Parents, brothers and sisters are welcome to visit whenever they wish
  • Other visitors should be accompanied by at least one parent unless you have previously informed staff about who will be visiting your baby.
  • Only your own children may visit.
  • If you are unable to visit daily please keep in touch by telephone. You may take photographs of your baby at any time.
Parents Facilities

The Neonatal Unit was refurbished in 2007.

The Neonatal Unit is now evolving into a Level 3 Intensive Care Unit which means that we can care for babies from 24 weeks. Babies may be transferred to us from other parts of the UK beyond the Wirral, Merseyside and Cheshire.

Quiet Room
There is a Quiet Room on the Neonatal Unit where parents can spend time with their baby away from the ward. Here, mothers can express their milk and have private discussions with staff and family.

Parents Room
This room can also be used during the day by parents wishing to have private time alone or for breast feeding/bottle feeding. There is an emergency buzzer in the room and a telephone if you need assistance from a nurse or doctor.

Telephones
Telephone are available at each bedside on the ward and a public telephone phone is available on the first floor. There is a direct parent phoneline to the Neonatal Unit so parents can speak to nursing staff directly. Please do not use your mobile phone in the hospital. If you need to use a phone urgently, a memebr of the nursing staff will direct you to the nearest available teelphone.

General
Please do not use your mobile phone in the hospital. There is a pay phone available on the first floor. Ask your nurse if you need to use a phone urgently and she will advise you of the nearest available.

In the main hospital there are cafeterias serving hot and cold food:

  • Annabelles on the ground floor of the main hospital
  • Bowmans restaurant on the lower ground between the two sites.
  • There are shops and a bank on the ground floor.
  • There is a reception desk to guide you to all facilities within the hospital, information is available for travelling within the Wirral and taxis are available to hire.

There is a hairdressers available for patients and visitors:
'Arroweheads' open Monday and Wednesday 9am-5pm
Thursday and Friday 9am -7pm
Saturdays 9am -3pm

Contact via switch board 01512 678 5111 ext 2170.

Aromatherapy and massage is available for patients and visitors via 'Body and Soul' contact through the hospital switch board 0151 604 7108 ext 4009.

Health Advice
Breast Feeding

Mothers in the Neonatal Unit may be faced with extra challenges and the following practices help them achieve a successful breast feeding outcome:

  • There is a breast feeding policy which all staff adhere to. Staff are trained in management of breast feeding preterm babies
  • Staff will help mothers to establish 'skin to skin' contact as soon as baby's medical condition allows

Staff can provide information and support needed to:

  • Start milk expression soon after birth
  • Maintain lactation
  • Breast feeding process of an early (preterm) baby

Mothers should be informed on best techniques (breast massage, nipple stimulation, hand expressing, use of breast pumps). Breast milk should be expressed at least 6 times in 24 hours if the baby is too small/ill to feed. Dual pumping (using 2 collection sets together) increases milk volume and saves time.

  • The neonatal feeding policy supports breast milk feeding for all babies admitted to the unit
  • Pasteurised and banked donor milk is considered if mothers breast milk is unavailable
  • Staff encourage 'breast feeding practice' as soon as baby's condition allows ie. contact between breast and baby's mouth, becoming acquainted by smelling, licking and tasting. Transferring gradually from scheduled feeds to demand feeding

(In the period of transition from tube feeding to breastfeeding, a short period of levelling weight gain is common.)

  • Avoidance of use of bottles until the baby has established good suckling ability at the breast. During tube feeding the baby can be stimulated with breast or other oral stimulation. There is evidence that use of teats may confuse oral function in breastfeeding babies
  • All guidelines and procedures consider the individual baby's needs. In the Neonatal Unit there will always be babies who for one reason or another are not able to breast feed and who need to be fed with a bottle to thrive, because of longer periods of hospitalisation or who may need a dummy for comfort
  • Parents are encouraged to 'room in' prior to baby's discharge and to assist the transition to exclusive breast feeding
  • Community neonatal staff are trained to give continued breastfeeding support following discharge from the Neonatal Unit
  • There is breast feeding support in the community. (Please see useful links in the contact section of the website.)

Your premature/sick baby will be more able to digest breast milk than formula milk and it will help them to recover more quickly. Therefore, you will be encouraged to provide your breast milk for them. Help and support will be given to enable you to express your breast milk and progress to direct breast feeding if you wish. Breast pumps are freely available for loan.

If you are unable to provide your own breast milk, donated breast milk may be available. (This is breast milk which has been donated and pasteurised. Strict screening processes are in place for donors and milk.

The Neonatal Unit feeding advisor is available to discuss any feeding issues.

If you are discharged home and your baby remains on the Unit, arrangements can be made for the loan of one of our breast pumps. Please ask the nursing staff for details. Expressed breast milk can be frozen and transported to the Unit. The staff will be happy to give you advice and any further information if required.

Unicef the babyfriendly intiative website

 

Bottle Feeding

Breast feeding your baby for the first 6 months allows for the best start in life as per the recommendation from the World Health Organisation. 

However when baby has been born early and/or born very poorly, breast feeding can be challenging to start and prolong. Your baby needs milk for energy and growth and can be offered donor breast milk given by nasogastric tube, cup or bottle.

Modern manufacturing techniques have improved and been researched in order to try and emulate mothers milk. Careful preperation of those milks is required so please read the instructions very carefully.

If you are going to bottle feed it is important to use the teats your baby will use at home before you are discharged. Please discuss bottles and teats with the nurses on the Neonatal Unit and with the infant feeding advisor to help you decide which teat is most appropriate for your baby.

Head Scan

Your baby may have a head scan whilst on the Neonatal Unit. For further information on head scans please read the following information leaflet for parents.

Further investigations that can be done on a baby are MRI and CT scanning. Sometimes these are done to look in more depth at a problem identified during a head scan, helping to give a better diagnosis. MRI and CT scans can be used for other problems for example, to investigate abnormal tissue.

The medical nursing staff within the Neonatal Unit are always ready to speak to you about any concerns you may have about any test your baby is having.

Transfer of Babies

 

Transferbabies2 Transferbabies3 Transferbabies1

 

If your baby was born in the labour ward room or theatre and needed some assistance he/she will have been transported to the unit in a warm snug bed. The labour ward and theatres are not far away from the Neonatal Unit and are on the same floor.

This bed is soft and filled with water set at a warm temperature 37°C and has soft supportive sides. Your baby is wrapped up and kept warm with a hat and given oxygen if needed. He/she is then taken through to the Neonatal unit for assessment and observation and transferred into an incubator or cot. 

Hopefully you have been able to see or hold your baby before he/she was moved. Your baby is stabilised first, given medical support and medication if needed. Two photographs are taken as soon as possible and brought to you with booklets about the unit and care (provided by Bliss and the Neonatal Unit)

A larger incubator is used to transfer babies to other hospitals. This incubator is set at the required temperature for your baby and can supply oxygen and fluids to baby and a kit to help your baby if an emergency should occur during transfer from hospital to hospital.

 

Infections

Protecting your baby from infection

Always wash your hands thoroughly using warm soapy water before touching your baby and also after you have changed your baby's nappy wash. Please use the pedal on the bin so you keep your hands clean, having dried them well with the paper towels provided. Please close the bin quietly so that it does not wake the babies within the room.

You should also remove your jewellery as bacteria can linger on watch straps and under rings. It's advisable not to wear nail varnish or false nails for the same reason.

Download a short video on the correct procedure for washing hands

Hand gel is  available at your baby’s cot side and is extremely effective for removal of lingering bacteria on hands that look clean. After washing, use the gel covering all areas of your hands and fingers.

At home you would not usually use gel but because of the risks of hospital born bacteria it is particularly important to be vigilant in your hand hygiene. Please ask your visitors to observe the signs about hand washing too.

Hand gel should be used on entering and leaving the Neonatal Unit to reduce the risk of infection being brought into the unit and also maintain cleanliness when you leave.

Baby's toys and cards

Your baby is welcome to have toys in his/her cot but when there is moisture (humidity) in the incubator it is advisable to limit the toys to something washable like a muslin cloth/cloth doll which can be replaced each day, as moisture and warmth provide a breeding ground for bacteria. Other toys can be placed near the incubator but just a washable comfort toy/cloth with baby. As baby gets bigger and is no longer in humidified air/oxygen a few small toys in his/her cot will provide company. Swop with clean dry toys every three days or so, ensuring for your baby a clean environment which remains bacteria free. There is space for cards and these can be placed near baby's cot side.

 

Touch

Touch, containment, skin to skin, positioning of baby are all aspects of developmental care. 

Touch

Holding your baby is extremely important for you as a parent and for your baby and expressing love of your baby through holding is instinctive without you realising it. Sometimes when a baby has arrived unexpectedly or is ill, some of those instincts are put on hold for a period of time (due to separation of mother and baby, shock of the delivery) and it is not unusual for a parent to say initially that they don’t want to touch their baby, that they feel frightened in case they hurt their baby or disturb him/her particularly when they are in an incubator and/or on a breathing machine. 

Touch is extremely important to promote the connection between you and your baby. Touch is personal, the Neonatal staff are touching baby gently often wearing gloves or during painful procedures whereas your touch as parents is kind and loving and babies can tell the difference. 

The Neonatal staff will encourage you to touch and hold your baby even when baby is poorly and they will help guide you, suggesting where best to place your hands if baby has many wires/tubes attached. They will help you to read baby’s cues/signals and provide you with a small leaflet about approaching behaviours baby may show and about behaviours baby may show when stressed. 

A baby with smooth regular breathing, pink stable colour, smooth movements, hands clasped, finger holding, bringing hand to mouth, sucking, tucking in arms and legs to his/her body, holding his/her hand, frowning, cooing, smiling, actively turning to sounds, bright eyed highlight the characteristics. 

This baby will respond to being held and touched. This baby is well organised and able to spend time looking and being bright and stimulated. 

When baby becomes tired he/she will begin to fuss, cry, his/her colour will change and he/she may need other strategies to calm him/her, for instance a term aged baby maybe telling you he/she wants a nappy change or a feed. 

An early baby has possibly just had enough and cannot get comfortable and begins to tell you this through the body signals, eyes beginning to droop, body tone lowering and becoming limp, face grimacing, eyes go glassy, has a weak cry, hands are just sitting in mid air above the baby, holding fists tight, becomes very fidgety, may cough, sneeze, sigh, have a panicked look on face, move rapidly from being asleep to awake back again to sleep. 

Stopping the activity you are doing whether it is talking/stroking/changing nappy might help. Still hands will usually help a baby, bringing the body into a tucked position, hand on head /chest and hand holding arms and hands together, positioning a roll around baby to support them and help gain composure, covering with a blanket and resting. He/she may also need a nappy change and a feed so you must observe baby well to know what they are asking for. 

The medical nursing staff caring for your baby with the developmental specialist who has assessed baby can help you with this. 

Sitting alongside your baby you will be able to observe a lot and tell the staff what he/she likes or dislikes where they like to be touched, if he/she can tolerate stroking what he/she does when their temperature is measured under the arm etc.

When your baby is stable the nurses will suggest to both of you to have some skin- to-skin time with baby, often called Kangaroo care. This can seem quite scary when baby has been small and sick but the medical and nursing staff are able to help you with this. They will make sure there is space around the incubator or cot for a comfortable chair and a screen, they will have mentioned to you that baby is getting near to the time for kangaroo care and have asked you to wear or bring suitable clothing. 

Please view the following presentation used to train the staff, so that you can enjoy the skin-to-skin time with your baby. Dads love it too and being in a very feminine environment may feel inhibited initially but once you try it you will want to do it again. It is good for parents and baby. It will also help with your milk production if you are expressing. It is a diary moment. 

However, its ok if you don’t feel ready for kangaroo care. You can get to know your baby in other ways and wait until your baby is bigger or feel you want to do this when you stay overnight or when you get home. 

 

Time for Home

We are all sad to see you go, but that has been our aim from the moment you entered the Neonatal unit, to support you and your baby to go home.

We have been preparing you for home from the time your baby came to us, so you should now be becoming familiar with bathing, feeding etc. We ask you to take part in resuscitation training and to learn how to give medicines to baby if they are necessary.

We will make a date with you for going home. Providing your baby progresses well and you, the doctors, the staff on the unit and the community staff are happy, your baby will be discharged on this day.

A follow up visit is made for your baby to come and see the doctor 4-6 weeks after discharge in our children’s outpatients clinic.

The first night home can be a bit daunting so the Community Neonatal Midwives will visit you the next day to check everything has gone well and answer any of your questions.

Your GP and health visitor are sent a letter from the doctor about your baby’s diagnosis and care. The nurses also forward a letter to your health visitor regarding blood tests (PKU) and immunisations.

Download the 'time for home' leaflet
Download the 'time for home on o2' leaflet
 

Congratulations

A few more tips!!
Your baby will take a few days to get used to different sounds, lighting and activities. This may mean that your baby is more fussy than usual, may change sleeping, waking or eating patterns.

Don't panic, you may ring us over the next few days on the Neonatal unit and we will offer our advice.

The community Neonatal staff will visit and liaise with you for future visits as you need them.

Try to keep the family schedule simple at this time eg. not too many visitors to entertain.

Write out medications and times and check them off as you give them.

Write down all follow up appointments on your calendar/diary.

Make notes of questions as they arise, so you can ask your community Neonatal Midwife/GP/Health Visitor.

Accept all offers of help regarding washing ironing and shopping so you can spend time with your baby.

When you feel ready prepare for a simple trip out with baby to build your confidence.

Enjoy parenthood....... its a long road........ 

Temperature

There should be no need to try to imitate the extremely high temperatures of the Unit, as you are aware your baby has progressed from the Intensive nursery, which is kept a consistently high temperature, to the more acceptable levels of the outside nurseries. An ideal room temperature for your baby is about 19 C.

Do not be deceived by baby’s cool hands and feet, the ideal places to check for warmth are the back of the neck or the tummy with your warm hand. A baby’s normal temperature is 36.7 C or 37 C.

This is the most accurate way of finding out if the room temperature is right for your baby, if you find they are hot and sweaty and otherwise well, they may have been overdressed or over wrapped.

Alternatively if they feel cool then they may need more layers of clothing . If the room is too cold, make sure their cot or pram is kept out of draughts.

A baby that is too hot will feel hot and will sweat, especially from the face and head, will be irritable and may breathe faster than usual. In this case remove one or two layers of clothing or blankets.

If very hot, undress and cover with one sheet, call your Health Visitor for advice or your GP .

A baby that is too cold will be lethargic, their arms and legs may appear very pink but will be cool to the touch and they may not want to feed. Dress them more warmly and heat the room. Cover them with an extra blanket and check that they are starting to warm in about 15 to 30 minutes. If they do not seem to be warming up quickly, call your GP for advice.

Following the guide-lines from the Department of Health we do not recommend sheepskin blankets for babies to sleep on, or the use of duvets or baby nests for a baby to sleep in, all three can lead to overheating which has been linked to cot death

We recommend that babies be nursed on their back, this is to lower the risk of overheating (the baby can lose heat from their face more easily  and also if they are sick the baby will usually turn their head, the milk will soak into the sheet with no risk of them breathing it in.

To try to avoid the risk of cot death we also recommend, not smoking in the same room as your baby, not overheating them, not allowing them to become too cool, also to breastfeed if possible, should you require further information please ask for a leaflet from your Midwife or Health Visitor.

As a general guide a three month old baby (regardless of whether they are full term or premature). will feel as hot or as cold as an adult does. Therefore if you feel cool in a room your baby will, but if you feel hot make sure your baby is not overheating by being over wrapped or having too many clothes on. 

Clothing

Indoors 

During the day you should keep baby warm by putting a vest, babygro and cardigan on, a few layers trap air between them and this helps to keep your baby warm, with two blankets and perhaps a flannelette sheet to cover them.

In summer months a cardigan may not be necessary, or alternatively leave their vests off. Loose cotton clothing is a suitable alternative

Outdoors

Winter 
A further cardigan or woollen suit can be added, plus bonnet. Wrap baby (not too tightly) in a blanket with a further two blankets over them. (A blanket folded double counts as two blankets.) Remember to unwrap your baby and remove waterproof covers when you get indoors otherwise they will overheat.

Summer 
At first you may still need to cover baby’s head with a bonnet, however you should be guided by the outdoor temperature before putting too many layers over your baby. It is as well to remember that chilly breezes can be around on certain summer days, keep the hood of the pram up if this is the case, otherwise leave the hood down but protect your baby from the sun with a canopy or shade.

 

When to go out?

Give your baby time to adjust to your home temperature, we recommend waiting about four to seven days depending on your baby’s weight and the time of the year, e.g. summer or winter, this will depend on their weight as well, please ask your Community Neonatal Nurse or Health Visitor for advice.

Obviously in the summertime you may only need to wait a few days.

Make the first few outings short, try not to visit many crowded areas where your baby could be exposed to a lot of smoke or infections form others. e.g. Baby clinics, GP waiting rooms, crowded shopping areas etc.

Avoid damp, foggy or bitterly cold frosty days if you can, journeys in the car from one warm environment to another are ideal.

Make sure your car is safe, there are many car safety seats on the market suitable for small babies, a folded blanket under your baby’s bottom is often all that is needed to ensure the snug fitting of the safety straps (you should only be able to put one finger under the safety strap for a safe fit.) Also a rolled blanket around your baby’s head and sides will keep their head upright and prevent rolling.

Outdoors

Winter
A further cardigan or woollen suit can be added, plus bonnet. Wrap baby (not too tightly) in a blanket with a further two blankets over them. (A blanket folded double counts as two blankets.) Remember to unwrap your baby and remove waterproof covers when you get indoors otherwise they will overheat.

Summer
At first you may still need to cover baby’s head with a bonnet, however you should be guided by the outdoor temperature before putting too many layers over your baby. It is as well to remember that chilly breezes can be around on certain summer days, keep the hood of the pram up if this is the case, otherwise leave the hood down but protect your baby from the sun with a canopy or shade.

When to bath?

In the first few weeks there is no need to bath your baby more frequently than once or twice a week, especially in the winter months, topping and tailing is acceptable and keeps your baby warmer.

When you do bath them make sure the room is warm, approximately 22 °C (room temperature) and free from draughts, that the water is at the right temperature 30 °C (tested with your elbow), and all the essentials you need are at hand, the clothing ready (if necessary warming too). Ignore the 'phone' and front door bell once you have started to bath your baby, the risk of them getting cold far outweigh the importance of the person at the door on the 'phone'

 

Bath Baby3 1

Vitamins and Medication

Most babies gain their vitamin and iron stores in the last twelve weeks or so of pregnancy, therefore a baby born before 32 weeks needs supplements until he/she is established onto mixed feeding.

Vitamins are essential for normal growth and nutrition, the iron and folic acid are needed to help make red blood cells and help to prevent your baby becoming anaemic. A full term baby who has been ill may also need iron and folic acid. These supplements usually continue until your baby is 6 months of age, once mixed feeding has been established, or when your Consultant or GP recommends.

You will have been shown how to give your baby's medication. Mix it with a little milk (breast milk or formula) and give this via bottle prior to the feed. Keep a bib or tissue handy as the medication can stain clothing.

If it seems to cause any vomiting try dividing the dose over a few feeds, giving it in the middle of a feed or mixing it with more milk. Iron drops will usually turn the baby’s stools green or grey but do not cause constipation.
 

 

 

Immunisations

Our consultants usually recommend a full course of vaccinations from 8 weeks of age, if for any reason they feel your baby should not receive a certain vaccine they will usually let your GP and Health Visitor know. If you have any doubts please ask.

Development

As the Consultant has probably told you, we correct premature babies ages to allow them to catch up with their developmental milestones. This means that if your baby was 10 weeks early he will be expected to do what a 6 week old baby can at 16 weeks. Try not to compare your baby with a full term new born, he will take a little longer to do things.

You can look for what a week old baby should be able to do and follow your baby’s progress.

  • Baby will stop crying when picked up
  • Turn to look at the person who is talking
  • Be startled by a sudden noise
  • Respond, by quieting, to a soothing voice
  • Turn towards the light
  • Stares at your face
  • Begins to smile
  • Begins to be able to control his head

They may be followed up by their Paediatric Consultant until they are 2 years of age, approximately, they will have developmental assessments at your local clinic to make sure they are catching up.

By the time they are 2 years old they will have caught up, but some children who are born prematurely do remain smaller than average. It is not unusual to be followed up by the Community Physiotherapist and/or Occupational Therapist.

Back to sleep

'Back to sleep' 'Feet to Foot'

Why is this so important?

Over the past twenty years there has been a gradual reduction in the numbers of babies suddenly dying in their cots and this has been explained by investigations into babies sleeping patterns and identified risk factors eg. baby sleeping on their front, parents sleeping with baby, smoking in baby's room.

These are the recommendations to lessen the risk of sudden infant death syndrome (when a baby dies with no cause found, SIDS).

  • Don't cover baby with extra blankets or cloths.
  • Place baby on their back with their feet at the bottom of the cot, covered by two blankets tucked in at the sides.
  • Always place baby on their back to sleep, for naps and at night.
  • Place baby on a firm mattress, safety approved and covered by a fitted sheet.
  • New baby, new mattress
  • Keep soft objects, toys and loose bedding out of your baby's sleep area.
  • Do not smoke or allow smoke around your baby.
  • Don't share your bed with your baby during sleep.
  • Keep your baby's sleep area close but separate from where you and others sleep. It is recommended for you to have your baby in a cot within your room for up to 6 months.
  • Don't allow your baby to get too hot during sleep. Have a thermometer within the room and set to 18-20'C. To check your baby's temperature feel his tummy which should be warm to touch, not hot.
  • Avoid too much time in car seats, bouncers and carriers.
  • Provide tummy time to avoid flattened areas on baby's head. This also promotes normal development and tone in the baby's shoulders and thighs.
  • Observe baby clearing his airway by turning his head and trying to crawl. Consider doing this at each nappy change.
  • Tummy time should only be when baby is awake and when someone is observing the baby.
  • Discuss use of baby monitors as these on their own will not reduce the risk of SIDS.

The Foundation for the Study of Infant Deaths (FSID) is the UK's leading baby charity working to prevent sudden deaths and promote health. www.sids.org.uk

Further information provided by the Department of Health on reducing the risk of cot death.

Common Feeding problems

Slow to Feed
This includes falling asleep before taking their required amount, taking more than half an hour to finish their feed, or taking part of a feed and waking a short time later ready to finish it.

Usually changing to a medium flow teat will solve the problem, these teats allow the baby to take the milk at a faster rate, they will be able to finish the feed without being too tired. Please ask your Midwife or Health Visitor for advice.

You may find your baby still likes to have a nap before finishing the feed, but do not reheat the milk or re-use an hour after starting the feed.

If your baby has taken a lot of air into their stomach whilst feeding, this will make them feel full so they may fall asleep. You may need to wind them, or change their nappy in the middle of the feed (being careful to wash your hands before feeding again) in order to let them finish their bottle.

If your baby is lethargic or reluctant to feed and has taken less than half the normal amount of feed in 24 hours, or more, you should immediately consult your GP to rule out illness.

Frequent Feeding
This may include waking early for a feed or not being satisfied after finishing a feed. Usually making up an extra 30mls (or one ounce) at the next feed will satisfy your baby, as if they are draining each bottle this is an indication that they need a little more milk.

Check that you are making up the feeds correctly, if you are making the feeds too weak by adding extra water this will make your baby hungry. On the other hand if you are making their feeds thicker by adding extra scoops of powder this is extremely dangerous as you are making them thirsty by dehydrating your baby and putting them at risk of kidney damage. If you are having a problem ask your Midwife or Health Visitor to advise you. 

Weaning Premature Infants

What is weaning?
Weaning is the change from milk to solid food. As babies grow their nutritional needs change and are no longer met by breast or bottle alone. At this time a mixed diet is required. Weaning also helps babies to progress from sucking to biting and chewing.

When to wean?
There are no clear guidelines about when to wean premature babies but generally the earlier the baby was born the later we recommend weaning. We suggest you start offering your baby solids between 4 and 7 months after birth. The reasons we recommend this are: -

  • Before 4 months your baby’s gut is unlikely to be ready to cope with different foods and textures
  • It seems that around 4—7 months, babies are quite receptive to new flavours. After this time they may become increasingly suspicious of new foods.
  • Milk alone is not sufficient after about 6 months. Please discuss when to start weaning with either your Health Visitor, Children’s Nurse or Dietician. However if you have a family history of allergy, or your baby has had gut surgery, please discuss weaning with your Dietician
Infant Resuscitiation

For First Aid advice for babies (1 year old and under) you will be provided on discharge with a dvd by the Bliss Charity.

Choking Infant

If at any stage the infant becomes unconscious, open the airway, check breathing and, if necessary, begin rescue breaths. If you cannot achieve effective breaths, you must immediately begin giving chest compressions to try to relieve the obstruction quickly

GIVE UP TO FIVE BACK SLAPS
Check the mouth and remove any obvious obstruction.Back Slap

 

 

 

If the obstruction is still present
GIVE UP TO FIVE CHEST THRUSTS
Check the mouth; remove any obvious obstructionChest Press

 

 


If the obstruction does not clear after three cycles of backslaps and chest thrusts
DIAL 999 FOR AN AMBULACE
continue until help arrives

Parents' Support

Parents are the most important people in their child’s life. Share your experiences with other families. We can all learn together.

Tips for parents whilst your baby is in the Neonatal unit

Sleep promotes weight gain and healing so promote sleep and rest for your baby, let a sleeping baby sleep.

While your baby is sleeping spend time at the bedside looking lovingly at your baby. This will help you to get to know your baby. Watch activities and expressions and get to know baby's personality.

  • Provide containment holding during and after treatments and/or procedures. This is where you hold your left hand on baby's head and your right hand is resting on baby's chest or feet and supporting baby.
  • Discuss with your baby's nurse a schedule to have regular time with your baby, ringing in the morning to find out how baby has been and what time the feeds are likely to be.
  • Set up a phone routine to speak with your baby's nurse if you cannot get in for any reason. You may phone the unit at any time of course but being aware of the times of your baby's feeds and cares and the nurses shift patterns will help you get a working schedule going.
  • Take pictures and videos and share them with your family.
  • Use the parent sitting room to read, watch television and chat with other parents.
  • Visit the shops, cafeteria or go for a walk in the grounds of the park. This will help you to occupy your time, refresh yourself and promote your milk production if you are expressing.
  • We encourage you to have visitors but try not to have too many at once and also try not to pass baby around. Sleep promotes weight gain and healing.

As a new Mum you do need to rest and Dads need to support Mum and to get to know their baby. Some Dads take time off when your baby is born, others return to work so they can have time off when your baby goes home. This is an individual choice and has to be weighed up within each couple and family. There is no right or wrong way to come to this decision. Often employers are sympathetic to this situation and negotiation at this time with employers is best.

Neonatal chaplaincy
When a baby or infant is a patient in the Neonatal unit this can be a stressful and difficult experience for all parents. The hospital chaplaincy team consists of volunteers (male and female) and is available to all parents of children in the unit to give support by listening, prayer and being alongside. Baptisms and blessings of babies can be conducted in the unit if parents request this service.

Parents are welcome to visit the chaplains 'quiet area' in the sitting room on ward 52 where there is a prayer request book. There is also the chapel on the 1st floor in the main hospital. This is open all the time and there are services on Sundays at 10.30am and 3pm. Out of normal hours the switchboard can contact the duty on call chaplain

Baby Bounty Pack

This is given for free to every Mum. The contents may vary.
(We have avoided mentioning product names)

Typical bag content are small samples of:

  • Washing powder samples
  • Nappy sacks
  • Cream for baby's bottom
  • Nappy wipes and nappies
  • Fabric softener
  • Antiseptic cleaning product
  • Toothpaste
  • Advice information about pain relief
  • DVD sampler on playing with your child
  • Catalogues and information on the Child Trust Fund and Child Benefit
  • CD about baby massage
  • A Bounty booklet with helpful information about your baby.
  • We suggest you bring the nappy cream to the Neonatal unit.

There is a photo service available Monday to Friday. Tel: 0845 7660665 (local rate call). All other enquiries Tel: 0800 3169341

 

Bereavement Support

Bereavement Snowdrops

 

 

 

 

 

 

 

 

 

'The death of a baby is like a stone cast into the stillness of a quiet pool: the ripples of despair sweep out in all directions, affecting many, many people.' 

De Fraun 1991

Privacy
We have a quiet area away from the immediate clinical situation where you can spend time with your baby. We are available if you need us. During this time your baby can be held, bathed and dressed, visited by family and if you wish you can  take your baby home.

We will liaise with all religious and cultural organisations. There is a 24hour on call system for members of the hospital clergy to visit. Parents may use their own chaplain if they wish. Baptisms can be celebrated on the Neonatal unit.

We try to help you to preserve some memories of your baby by taking photographs; hand and footprints and when possible a lock of hair. These are kept and given to parents at an appropriate time. A camera and video are available for your use or with assistance from staff.

Follow up support
The staff on the Neonatal Unit will support you as much as they can as will your midwife and doctors and, on going home, your GP and health visitor.

We have close links with the team at general office who are able to guide you through the sensitive issues around registration of the death and planning the funeral. The team are very approachable.

The doctor (Neonatalogist) who has been caring for your baby will contact you to arrange a meeting to discuss any issues and offer support for the future.

Useful Contacts:

Child Bereavement Trust
Leaflets and books for bereaved families. 
Aston House, 
The High Street, 
West Wycombe,
Bucks
HP14 3AG

Child Death Helpline
A helpful line for all those affected by the death of a child. It is confidential and operated from Great Ormond Street and Alder Hey Children's Hospital.
Freephone 0800 282986 
Every evening from 7pm-10pm. Monday, Wednesday, Friday from 10am-1pm

Alder Hey Royal Liverpool Children's NHS Trust
Alder Hey
Eaton Road
Liverpool
L12 2AP

Telephone 0151 228 4811 (daytime)
Helpline 0151 228 9759 (evening)

Leaflets from the Stillbirth and Neonatal Death Society (SANDS)
Telephone counselling and groups for bereaved families
28 Portland Place
London
W1B 1LY

Helpline: 020 7436 5881


www.UK-Sands.org

Family and Baby Support Service

We understand that having a baby on a neonatal unit can be a very stressful time for families.

While your baby is in hospital and following discharge home you may like some extra support. This can be provided through the Family and baby Support Service which is a supportive, non-judgemental service, aiming to support families at this challenging time.

The service is for all families who live within the Wirral area that have a baby admitted to the neonatal Unit. Families can also be assisted whose infant has been transferred into the unit from outside the Wirral area.

The service and how it works
Support can be offered in a variety of ways to fit in with your family’s individual needs. The service is tailored to meet the unique needs of each family admitted to the Neonatal unit.
Support can include:

  • Emotional Support
  • Preparing for bringing your baby home
  • Signposting to other relevant agencies.
  • Offering advice and assistance in budgeting and seeking financial help
  • Helping parents to network and make friends.
  • Ongoing support once home.

For further information please contact:  0151 334 1381
 

Registering Baby's Birth

Your baby's birth must be registered within 42days of birth. (If you fail to do so you can be fined).

In order to register your baby's birth you need to telephone to make an appointment by calling 0151 606 2020.

Opening Hours 

Monday to Friday 9.00am – 4.00pm (Thursday 10.00am – 4.00pm)
For further information please go to the Wirral Goverment website.

For Information on child benefit please go to the Direct Gov website.
Telephone no. 0845-302-1444
 

Meet the Team

All care of babies is a team effort and the aim of the team is to provide the best care for your baby and family.

Consultants

The consultants are the most senior members of the Neonatal medical team, who are highly specialised in Neonatal medicine, with broad past experience in general paediatrics and individual areas of expertise. They each rotate for a week at a time. In addition there are other consultants for community and paediatric wards.

The consultant has overall responsibility in the care and management of each baby admitted to Neonatal Unit and they provide support to parents as required through full discussion of more complicated issues relating to the health needs of the child.

The consultants review the health and development of babies following discharge from Neonatal Unit according to their individual needs ensuring there is appropriate support and advice for the families of babies admitted to Neonatal Unit, both during admission and following discharge.

Dr David Lacey and Dr Lil Breen follow up babies who are on oxygen and lead ward rounds on the Neonatal Unit. Dr Russell Austen and Dr Todd care for babies on the post natal wards, in paediatric wards, on the community.

Each consultant has a team of registrars and senior house officers working for them.

Registrars
The Registrars who have at least two years experience of paediatric and Neonatal medicine give 24 hour on-call presence to supervise ongoing care of all babies on Neonatal Unit. They offer ongoing support, training and education to Senior House Officers. The registrars communicate with parents about individual issues concerning the health of their baby as it develops. They perform and supervise complicated procedures and investigations.

Senior House Officers (SHOs)
SHOs are qualified junior doctors from a range of specialities including paediatrics, obstetrics and surgery. They hold a daily review of all babies admitted to the Neonatal Unit including physical examinations, review of results and tests in discussion with nursing staff. They will attend complicated deliveries on the Labour Ward where risks to the health of the newborn may occur.

24 hour support for review of all babies on the Neonatal Unit where new problems or concerns have been identified by parents and Nursing Staff. The SHOs with the nursing staff ensure that GPs and Community Teams are informed of all problems and health issues relating to babies by letter or fax, and that all referrals to specialist consultants such as Cardiology and Orthopaedics are made as required.

Nurses/Midwives

Some or all of the following staff will be involved in the care of your baby - and their families - in the neonatal unit. A brief description of their roles is included.

Advanced Neonatal Nurse Practitioner/Educator 
Responsible for overseeing the day to day care of all babies on the unit. 

Advanced Neonatal Midwives and Nurses
Responsible for assisting medical staff with emergency and anticipated neonatal problems on the delivery suite and for liaising with postnatal ward staff. 

Senior Neonatal Midwives and Nurses
Senior Neonatal Midwives and Nurses often co-ordinate the unit and may have a special interest within neonatal care eg running the eye clinic, breast feeding, infection control, transfer of babies.

Midwives
Your midwife will continue to care for you during your stay in the hospital and at home. Your Midwife can do post natal checks on the neonatal unit or you can arrange to meet her on the post natal wards. Your midwife will liaise with our community neonatal midwives about follow up care for you when baby goes home.

Neonatal Nurses
Responsible for providing direct nursing care to babies on the neonatal unit and looking after the babies from admission to going home. They support the parents with feeding, explanations of baby's condition, assisting and teaching parents in the care of their baby - aiming to assist to a smooth transition to home.

Co-ordinator on the Neonatal Unit (NNU)
The co-ordinator's role is to ensure the best care for babies and their parents -offering clinical neonatal care, developmental care and emotional support, so the babies on the unit reach their maximum potential. Click here to view a full description.

The Nursery Nurse/Assistant Practitioner
Responsible for the care of babies within the low and high dependency areas of the neonatal unit. Supports parents in all aspects of care.

Health Care Assistants
Support the nursing and medical staff. To ensure all the supplies are stocked and ordered and to help coordinate many of the clinics within the department and take on specific tasks within their job role e.g. Milk bank work.

Medical and nursing students
Training is essential for all health professionals so there are opportunities for students to learn about the speciality of neonatal care; if you do not wish your baby to be involved you may do so without adversely affecting his/her care please inform the manager/ nurse caring for your baby.

Infection control nurses
There are identified nurses on the neonatal unit who act as a link with the infection control team at the hospital. 
 

Community

Some or all of the following staff will be involved in the care of your baby - and their families - in the neonatal unit. A brief description of their roles is included.

Neonatal Community Team
Follow up all the babies on the neonatal unit and babies who have feeding problems or are referred by the consultants from the post natal wards. The team see parents the day after discharge to chat about any concerns.

Hospital/Community midwife
Continues to provide care to Mum for up to 28 days, visiting at home or by arrangement via the communication room on Ext 2428.

Health Visitor
Will visit soon after baby is born, advising on the baby's development, weaning etc and will assist parents for up to five years. Provides parents with a health record book (Red book) which we suggest is brought into the neonatal unit so parents or staff can record the baby's weight.

General Practitioners
They are contacted by letter following a baby's admission to the neonatal unit and are kept informed by letter on the baby's condition, a discharge letter is sent to them and they receive letters from the consultants on any follow up visits from many of the health professionals involved in the baby's care.

Paediatric Oxygen Nurses 
Offer support and advice on the care of your baby receiving oxygen when the neonatal staff have handed over care to them. Initially, they will usually visit the parents weekly and liaise with the baby's health visitor , GP, physiotherapist and dietician. 

Health Professionals

Some or all of the following staff will be involved in the care of your baby - and their families - in the neonatal unit. A brief description of their roles is included.

Heart specialist (cardiologist) 
The consultant to whom babies with a heart problem are referred to for assessment and treatment.

Hearing specialist (audiologist) 
Responsible for screening all babies for hearing problems as early intervention, if required is important. Click here for more information on hearing screening.

Eye specialist (ophthalmologist)
Responsible for examining a baby's eyes for signs of retinopathy of prematurity. Please see retinopathy of prematurity in the FAQ section of the website.

Physiotherapist
The role of the physiotherapist is to ensure your baby is referred on to the community physiotherapist, who will continue to treat and advise once your baby is discharged from the neonatal unit.

ITU/HDU based in the hospital
Mothers sometimes need further specialised treatment after the birth of their babies and are transferred to consultant care within the adult intensive care ward or adult high dependency unit. Everything will be done to maintain communication between medical staff caring for the mother and those caring for the baby, and the family.

Infant feeding adviser
Breast feeding support is a major part of the adviser's role. Human milk provides many health advantages to sick and preterm babies and all mothers are encouraged and supported with breast feeding and milk expressing.
Breast feeding video

Milk bank coordinator
The milk bank co-ordinator manages the service, ensuring stocks of pasteurised donor milk are maintained within the neonatal unit and is responsible for the donor recruitment programme. The Milkbank follows strict policies and guidelines recommended by United Kingdom Association of Milkbanks (UKAMB) ensuring safety of milk at all times.

Developmental care specialists
Responsible for interacting with the baby observing how he/she behaves, assessing what may influence and promote baby's further development, helping parents and staff to provide the best care for baby.

Pharmacists
Provide the medicines needed for your baby.

Microbiologists
Look for infections in samples of tissue or fluids and recommend suitable treatment.

Biochemists
Screen blood to check the components within it are correct and inform neonatal staff of any abnormalities.

Haematologists
Screen blood and provide blood products in order to correct any problems eg blood transfusion.

Radiologists
Responsible for providing images of the body in a non invasive way for investigation, diagnosis and treatment eg MRI, X-rays Ultrasound.

Radiographer
A person qualified to take X-rays and/or to carry out specialised procedures eg MRI ultrasound and CT scanning.

Dietician
Discusses the nutritional needs of baby with parents and the medical team Some babies require follow up by the community dietician at home. More information can be downloaded here

Speech therapist
Discusses feeding difficulties and offers support to parents and staff during a baby's progression to feed. Early intervention with feeding difficulties can help prevent potential feeding and speech difficulties later in life.

Social Workers
Are available to offer assistance to the family - in particular over financial and housing difficulties. They can also be involved if there are any difficulties over the care of children eg another sibling needing a place in a crèche to allow parents to visit baby whilst he or she is sick in hospital. 
 

Contact Us

To find out more information about your baby in the Neonatal Unit please phone 0151 604 7108.

Other Useful Phone Numbers:

The Neonatal Community Staff
 - via the Neonatal Unit: 0151 604 7108
 - Parents direct line phone number: 0151 604 7622
 - Mobile Phones (08.30 - 16.30 hrs Mon to Fri): 07900212964 / 07710481057

Paediatric Nurse Specialists for Home Oxygen
 - via Ward 11: 0151 678 5111 ext 2179 or long range bleep: 07659506130
 - Mobile Phone: 07789938701

Physiotherapists Clatterbridge School: 0151 678 5111 ext 5237

Dieticians: 0151 678 5111 ext 2914

Pharmacy Helpline (9.00 - 17.00 hrs Mon to Fri): 0151 604 7100

Wirral Mothers Milk Bank: 0151 334 4000 ext 5000

Birth Registration Office: 0151 647 7000

BOC Gases Customer Services: 0800 111 333

BLISS Free phone parents support: 0500 618 140

Twins and Multiple Births Association: 0151 348 0020

Breastfeeding Support Line: 0870 900 8787

The National Childbirth Trust: 0870 444 8708

La Leche League: 020 7242 1278

FAQ
Why has my baby been admitted to The Neonatal Unit?

There are many reasons why a baby is admitted to the Unit. 
The most common is if a baby is born too early (premature, before 37 weeks gestation).

Babies that are born early often require closer observation of their breathing and temperature control. Often this can only be done on the Neonatal Unit where there are the staff and appropriate equipment to enable this to happen.

Each baby is assessed individually after delivery by a Paediatrician and the nursing staff, a decision is then made depending on the baby`s weight and general condition as to whether admission is necessary. These findings are discussed with parents.

Another reason for admission is if mum has had ruptured membranes prior to delivery and has developed an infection. The baby may need to be admitted for investigations and a course of antibiotics.

Sometimes if there have been any problems around the delivery, the baby may need to be admitted for observation.

Sometimes there may be problems with baby's feeding and his/her blood sugar (glucose) levels are low and need constant monitoring eg. the baby of a diabetic mum.

So where does my baby go?

The Neonatal Unit is located close to Delivery Suite and comprises of several rooms known as nurseries. The most common room for admission is the Intensive Room/Hot Room. This is the largest of all the nurseries and can accommodate up to 7 babies. It has the most equipment necessary for close observation of your baby.

What happens after admission to the unit?

Your baby`s condition is assessed and he/she is admitted to the room most appropriate to suit their condition. After admission, the baby will be weighed to give staff a baseline weight to work from. Even if the baby has been weighed on labour ward we will still weigh the baby again as often scales can give differing weights. The baby may be then nursed in an incubator. Incubators have a dual purpose, to keep baby warm and allow a good view of the baby.

What observations do you do?

We do what are known as baseline observations such as temperature, heart beat, breathing rates and blood pressure. These are recorded so that we can assess whether there is any deviation from the normal values. We listen for any noises that the baby makes whilst breathing. Obviously babies can cry!! But sometimes they can make a "grunting" type noise which can indicate that the baby has some distress with their breathing. Quite often just by allowing the baby to rest this problem will resolve.

Babie's breathing problems seem to respond better by being nursed on their tummy(prone). Do not be alarmed if you see this, because as soon as their condition allows they will be nursed on their back and they are only nursed on their tummy whilst being monitored.

Occasionally, some babies will need help from extra oxygen into the incubator. More technical support from a nasal continuous positive airway pressure machine (NCPAP) may sometimes be used. This allows oxygen/air under pressure into the nose assisting their breathing by holding the air sacs open, helping baby not to get tpo tired.

A breathing machine (ventilator) may be used. This involves a tube being passed into the lungs via the mouth (endotracheal tube) and then connected to the breathing machine that allows oxygen and air in measured amounts, the number of breathes at a measured time and pressure, to breath for your baby. The ventilator can allow baby to breath with assistance from the machine or to do all the work of breathing for his/her dependant on baby's condition.

How will you continue to monitor my baby?

This can be done in several ways - monitors or blood samples. You may think your baby is covered in "wires" when you first meet, but they all serve a purpose and allow staff to monitor the baby without having to constantly disturb them.

The most common monitors are heart beat and oxygen saturation monitors. The heart monitor requires 3 wires with stickers/sensors attached to baby giving a continuous read out of the baby`s heart rate and breathing. The sensors are a soft jelly type pad at one end and gentle to the skin. The oxygen saturation monitor has a probe which is generally wrapped around the foot or hand of the baby with a soft foam cover. This has a red light shining through the skin, which records the oxygen level in the baby's blood.

We often attach a skin probe to the baby to monitor their temperature. We also check baby's temperature by placing a thermometer under their arm at regular intervals. This will help us to vary the incubator temperature to maintain baby's temperature correctly.

A baby`s blood pressure is recorded by using a small blood pressure cuff (similar to the one used during your pregnancy but very small) around the arm or leg.

A frequent test measured by blood sample is blood sugar (blood glucose). Often the blood sugar can be low which indicates baby needs feeding. This may require the baby to have a tube inserted into the vein commonly called a drip or IV (intravenous infusion) to give extra fluids. This may be done if staff feel that the baby is not well enough to have oral feeds. If baby is unable to manage feeding on his/her own, by breast or bottle a tube can be passed into the tummy via the mouth (orogastric tube)or nose (naso gastric tube) and milk given via the tube directly into the tummy. The tube is gently stuck onto the face with tape that is like a second skin, soft and pliable…see the picture on About us.

Another test is a blood gas. This can be done with the blood sugar test and tells us whether baby is coping with his breathing and helps the Neonatal staff to make decisions about the care baby needs.

Will I have to wait long to see my baby?

Neonatal staff are very sensitive to the needs of parents following admission of a baby to the Unit so we try to make this transition as smooth as possible.

Parents are obviously kept aware and informed of the need to admit baby to the unit and parents can visit as soon as possible. They often come with baby depending on the reason for baby being admitted to the Neonatal unit.

Often though baby's admission is straight from birth and mum is being transferred up to the Postnatal Ward. If mum is too ill to visit we will go to see her. As soon as baby is well enough he/she will be taken to stay with mum for a short while if she is unable to visit.

Parents can stay with their baby as long as they need to. Grandparents can visit with consent from the parents. Other visitors are as per parent's wishes and two at a time. Only brothers and sisters of the baby are allowed to visit as young children often carry infections and we try to keep these risks down to a minimum.

Occasionally, the visit to the unit may have to be delayed if the baby is poorly and needs a lot of attention. Neonatal staff try to liaise with labour ward staff during these circumstances so that parents are aware of the situation.

As part of our care of the family we take photographs of your baby to keep. We also provide an introductory booklet which tells you a lot about the day to day running of the unit. There is also information supplied by Bliss which is a group that offers support for parents

We always put name bands on the baby and a cot card is placed at the end of the incubator or cot with the baby's name and date of birth.

Each baby has a named consultant who is responsible for the medical care your baby receives in the Neonatal Unit and also for follow up when discharged. The name of the consultant is written on a card alongside the space where your baby is.

The name of the nurse caring for your baby is on a board either within the room or outside the room depending on where your baby is situated.

There are four rooms: the intensive nursery, high dependency nursery, middle nursery and end nursery /going home nursery. If your baby is moved we will let you know and baby's first name will be on a board within the nursery or outside again depending on which room baby is in.

Why does my baby need a lumbar puncture?

If your baby is at risk of infection (for example if your baby is premature or the waters broke around baby at least 24 hours before delivery) or he/she is unwell, a lumbar puncture may be included as part of the infection screen.

A lumbar puncture is typically done to look for meningitis, an infection of the membranes covering the brain and spinal cord. Although meningitis is a rare occurrence it is important to detect and treat the condition as soon as possible.

A lumbar puncture is a procedure in which a small amount of fluid that surrounds the brain and spinal cord, called the cerebrospinal fluid (CSF) is removed and examined.

Fluid collected from a lumbar puncture is immediately sent to the laboratory and analysed for evidence of an infection. Initial results are available within 2-3 hours although the final results are not ready for at least 48 hours.

During this time your baby will receive antibiotics for at least 48 hours until all the results are available and a decision can be made about continuation of antibiotic therapy.

If you have any other questions or concerns about your baby having a lumbar puncture, the medical and nursing staff will be happy to answer your questions. 

Why does my baby need Vitamin K?

The Department of Health recommends that all babies receive Vitamin K to prevent Vitamin K Deficiency Bleeding (VKDB) or Haemorrhagic Disease of the Newborn (HDN). This is a rare but serious disease which can affect 1 in 10,000 babies if they are not given Vitamin K. Vitamin K is found in low amounts in some babies and is essential for helping blood to clot (stop bleeding). 

Half of all babies who do bleed will do so into their brain (intracranial bleeding) and this can cause damage to the brain and sometimes can result in the death of the baby. 

Some babies are more at risk than others but this sometimes does not show itself until the damage is done, which is why it is advisable for all babies to receive Vitamin K. 

By 6 months old, a baby can manufacture enough Vitamin K to not require any further treatment. 

Babies brought to the Neonatal Unit from labour ward will be given Vitamin K with mum’s consent into the muscle of the leg or directly into the bloodstream if the baby has a line in its blood vessels (intravenous cannula). If coming from the Post Natal Ward the Neonatal nurse will check that the baby has received Vitamin K already. 

Signs of bleeding around the umbilical cord, blood in stools and urine are observed for in all babies. Prolonged yellow skin (jaundice) is always investigated as this can occasionally be due to HDN. 

If you have any questions, please ask the nurse, midwife or doctor caring for your baby. 

Further information is available at www.doh.gov.uk Search for Vitamin K.

Question about colic?
What are the chances of my baby developing eye problems in relation to prematurity?
Why is my baby's skin yellow?

Phototherapy

Why is my baby having blood tests?

There are many reasons. Here is a list of some of the common blood tests your baby may have and the reasons required.

FBC (full blood count)
A count of particles contained in blood, red blood cells, white blood cells and platelets which are checked for anaemia, infection and clotting of the blood.

Blood glucose/blood sugar
Shows whether baby has had enough food/fluid to provide energy. 

U&E (Urea and Electrolytes) 
Salts contained in blood which need to be kept balanced depending on the amount of food/fluid baby receives and from the result can be altered with more or less food or fluid. Essential minerals found in blood. Cal&Mag. (Calcium and magnesium)

Blood gas
Indicates the amount of oxygen and carbon dioxide in the blood (measures effectiveness of breathing).

CRP (C-reactive protein)
Indicator of inflammation in the body.

SBR (Serum bilirubin)
Measure of the amount of bilirubin in the blood which indicates jaundice. See Q11 jaundice.

Blood cultures
Blood is placed in a medium which can grow bugs (bacteria) if they are present and the microbiologist can tell us if baby needs treatment with antibiotics.

How is the blood taken?
Blood may be taken by the following ways:

  • Heel prick (capillary sample)
  • Venous sample from vein
  • Arterial line in the umbilicus ( UAC Umbilical Arterial Catheter)
  • Arterial line which may be in the hand or leg
Why should my baby have the Newborn Blood Spot Screening test?

This test is offered to all babies within the first week of life. It identifies babies who may have rare but serious conditions. Most babies screened will not have any  conditions but, for the small numbers that do, the benefits of screening are enormous. Early treatment can improve their health and prevent severe disability or even death. 

Phenylketonuria (PKU) 
About 1 in 10,000 babies born in the UK has Phenylketonuria. Babies with this inherited condition are unable to process phenylanine, a substance in the blood and if not treated by a special diet very early in life, could lead to irreversible mental disability. If not screened and the condition is discovered later in life, the special diet will not make a difference. 

Congenital hypothyroidism 
About 1 in 4,000 babies born in the UK has congenital hypothyroidism (CHT). They do not have enough of the hormone called thyroxine which is essential for growth and can lead to serious, permanent physical and mental disability. 

Sickle cell disorders 
About 1 in 2,500 babies has (SCD) which is an inherited blood disorder of the red blood cells. The blood of babies with this disorder can change the shape of a sickle and become stuck in the small blood vessels. This can cause pain and damge to the baby’s body. 
Screening means that baby can receive early treatment, including immunisations and antibiotics which will help his/her to lead a healthier life, preventing serious illness and helping the parents to know what to look for through eduction. 

Cystic fibrosis 
About 1 in 2,500 babies born in the UK has cystic fibrosis (CF). This is also an inherited condition which affects the digestion and lungs. Babies with this condition may not gain weight well and have frequent chest infections. 

Following screening can have a high energy diet, medicines and physiotherapy 
Further information is available at http://www.newbornscreening-bloodspot.org.uk 

Is it better for me to breastfeed my early (premature) baby?

Breast milk

  • Protects against germs
  • Helps baby grow
  • Is easy to digest
  • Skin contact
  • Good for you too

The body manufactures specialised proteins called antibodies to fight off infections. Mothers transfer these protective antibodies to their babies through the placenta, during the last 3 months of the pregnancy. This process is interrupted when a baby is born early. For this reason, premature babies are especially vulnerable to infection. The good news is that mothers also give their babies antibodies in breast milk. Breastfeeding your baby provides an extra line of defence against infection. Premature breast milk is extra rich in antibodies and growth factors, which are vital to normal development. Breast milk is very easy to digest and is absorbed more easily than formula. It has been observed that babies spend less time crying and more time in deep sleep as a result of skin to skin contact with their parents. It will take time to establish breastfeeding but once you have achieved this, your baby will benefit from the extra cuddles at feeding time.

Breastfeeding is good for your health too, it helps you to:

  • regain your pre pregnancy figure, since extra fat stored by the body during pregnancy is used as energy to produce milk
  • may help reduce the risk of breast and ovarian cancer

Breast milk can be given in various ways if you are unable to directly breast feed through tube feeding, cup feeding and by bottle.

When I take my baby home, how early can I take him/her swimming?

Babies under 3 months old or weighing less than 5.5 kilos need to be in water with a temperature of at least 32°C which will probably mean a hydrotherapy pool.

For older babies, the water needs to be at least 30°C.

Swimming provides free movement and a physical workout helping with coordination, eating and sleeping patterns. It also increases baby's awareness and understanding as well as being fun and socialable for yourself and baby, helping you all to play as a family. 

Common Terminology
Anaemia

Having too few red blood cells which carry oxygen in the blood.

Antibiotics

Medication used to treat bacterial infection without harming good bacteria within the body.

Apnoea of prematurity (Apnoea means no breathing)

Pathways within the brain are not fully formed causing lack of control over his/her breathing.

Blood gas

This may be taken from the heel prick or direct from an artery (blood vessel which carries oxygen). The blood gas tells us baby's respiratory condition. Commonly in small early babies a line is put into the arterial blood vessel in baby's umbilical cord (tummy button) called an umbilical arterial catheter. Baby's blood pressure can be monitored via this and blood samples taken without disturbing baby.

Umbilical arterial catheter

This measures your baby's blood pressure and blood samples can be taken without disturbing baby.

Blood transfusion

Blood transfusions are sometimes required. Transfusions are performed to replace blood that babies have not been able to produce.

Brady, bradycardia, dips

The baby's heart beat has slowed down. A cardiorator will be used to record the heart beat via three sensors two on the chest and the other on a leg.

Medication is given to help support the breathing and heart rate when born below 32 weeks. The medication of choice is caffeine (a bit like us having a strong black coffee in the morning.) This is given daily.

Bronchopulmonary dysplasia (BPD) - Chronic lung disease

A complex disorder of the lungs which resulted from the premature baby needing support from a ventilator in the first few weeks of life.

Continuous positive airway pressure (CPAP)

Air and oxygen are given under pressure into the nose via small tubes attached to a hat. This allows baby to breathe with assistance because the air sacs within the lungs do not fully collapse making the exchange of carbon dioxide and oxygen easier.

Desats, desaturation

The blood oxygen levels have dropped below a normal amount. The nurses or doctors will set an alarm depending on baby's gestational age. This helps them to decide if baby needs extra oxygen.

EBM

Expressed breast milk.

Donor EBM

Breast milk that has been collected, tested and pasteurised from another mother and made available for other babies to use.

Electrolytes

Minerals that are present in the blood eg. calcium, sodium and potassium which are essential for life and need to be balanced.

Endotracheal tube (ET tube)

A soft tube that is introduced into the mouth and leads into the lungs, connected to a ventilator.

Haemoglobin

The oxygen carrying part of the red blood cell.

Hypoglycaemia

Lack of glucose in the blood which is needed for energy.

Incubator

A clear plastic box bed with drawers below allowing baby to be kept warm. It supports the lines and leads attached to baby. Parents and medical staff care for baby through small doorways called portholes.

Intravenous lines, IV and Drips

These are very thin tubes inserted into the blood vessel in an arm or leg, allowing nutritious fluid to be given.

Jaundice

The breakdown of excess red blood cells after birth which lay down bile salts in the skin.  A Phototherapy light is usually used to treat the yellow colouring.

Kangaroo care (KC)

Skin to skin holding which all parents are encouraged to do once baby is stable. The baby will rest onto mum or dads bare chest and both are covered by a blanket.

Meconium

The first poo/stool, produced during the pregnancy usually a green black colour and very sticky.

Nasal cannula/nasal prongs

A measured amount of oxygen will be given into the nose via small tubes in the nasal nares.

Oedema

Extra fluid collected beneath the skin which leads to swelling.

PDA, patent ductus arteriosus

The ductus arteriosus is open during the pregnancy and the placenta supplies the foetus(baby) with oxygen. Normally within 24hours of birth when baby is breathing for himself the ductus arteriosus closes. When this flap does not close it is called a patent ductus arteriosus. It can correct itself over the next few months but may require medication or surgery to close it.

Platelets

Particles that float around in the blood and help blood to clot.

Pyrexial

When the baby’s temperature is measuring higher than normal. The nurse will use a hand held thermometer or a sensor on the body. Monitoring the temperature is very important, a low temperature also indicate a problem. The aim is to keep babies temperature between 36.6°C and 37.2°C

Respiratory distress syndrome

A lung disorder that affects premature babies due to their lungs being immature and not producing sufficient surfactant.

SB, bili, bilirubin level

These refer to the blood test levels of bilirubin in the blood which makes baby look yellow ie. jaundiced.

Surfactant

A chemical in the lungs of term babies and adults which helps keep their airway open.

Tube feeding

A tube can be inserted into the stomach via the nose or mouth in order to give milk.

Umbilical venous catheter

A line/tube into the vein in the umbilical cord which allows nutritious fluid to be given.

Urea

A waste product removed from the body in urine.

Vent/ventilator

A breathing machine which can be controlled by the doctors and nurses giving measured amounts of oxygen allowing baby to breathe with the machine inflating and deflating the lungs. The breathing may be quite fast initially and as baby improves the machine will do less and baby will do more of the breathing. This is weaning baby off the vent.

Vital Signs

Heart beat, temperature, blood oxygen level, blood pressure.

Heart beat/rate

The number of times the heart is contracting to push blood carrying oxygen to the brain, lungs and rest of body. Your baby's heart rate can vary from 120-160 beats per minute.

Blood oxygen level

The amount of oxygen present in the baby's blood.

Blood pressure (BP)

This is measured with a small cuff (baby sized version of the one you had during your pregnancy) or directly via the umbilical arterial line and tells us how much pressure is being used to pump the blood around baby.

Support Neonatal

With our services becoming increasingly busy and now covering a much wider area, there is a real need for public donation and support for neonatal care.

We rely on the generosity of people to raise money to help buy pieces of equipment and support training and research that will improve the quality of care we provide to tiny and delicate babies. Donations also help us to provide comfortable surroundings for the parents, some of whom spend many months visiting their baby in very difficult circumstances whilst they are cared for on the unit.

Every penny donated directly contributes towards our life-saving work with special care babies.

To make a donation please contact our Head of Fundraising via:

Fundraising Office

Willow House

Clatterbridge Hospital

Bebington

Wirral

CH63 4JY

Telephone: 0151 482 7788

Email: wuth.charity@nhs.net

 

 

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#PROUD to care for you