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SPECIAL CARE BABIES

special care babies
Beth Kitt
Medically reviewed by
11th Sep 2022
 

Around 1 in every 7 newborn babies spend time in a neonatal unit. This may be because they have arrived too early (before 37 weeks) or because they are sick. Knowing what will happen if your baby needs special care can make the experience less frightening.

Sometimes special care babies can remain on the postnatal ward if it is felt that the treatment they need can be safely carried out there.

Other times babies are placed in a special neonatal unit; a ward that has specially trained staff and the equipment to care for premature and sick babies. 

Why babies need special care

The most common reason for babies needing specialist care is being born weeks or even months before their due date.

Other reasons include low birth weight, breathing, circulation or other life threatening problems, severe jaundice after the birth, a difficult delivery or the need for surgery.

What happens in a neonatal unit

What happens in a neonatal unit depends on the amount of support your baby needs. There are different rooms in a neonatal unit that reflect this, with Neonatal Intensive Care Unit being the area where baby’s need the most support. Most baby’s, when they are first admitted to neonatal unit start in the NICU. As they get better they then transfer to the other areas in the neonatal unit, this could be the high dependency area, transitional care or the nursery. 

On first sight, these units can appear very scary, especially the NICU. There is a lot of complicated equipment which is used to monitor your baby, control her environment and assist her bodily functions, such as breathing, as well as supplying her with drugs, fluids and nutrients. These machines often bleep, this is nothing to be alarmed about and doesn’t mean that something is wrong.

Ask the staff to explain what the equipment is for and how it is helping your baby. The staff in these units have been specially trained to look after your baby and will be happy to discuss any concerns you have. 

If your baby is in there for breathing difficulties or low oxygen saturations then your baby will be having some kind of support for breathing. This could be a CPAP machine, oxygen through little tubes in the nostrils or another kind of breathing machine. 

It is very common for all babies in NICU to have a cannula in their hand. A cannula being a small tube going into a vein, to provide them with antibiotics, sugary fluids or other medication they may need.

All babies in NICU will also be having their heart rate, oxygen saturations and breathing measured constantly. This is done by a strap round their foot and/or stickers on their chest. This is often the source of the bleeping, as even the slightest fluctuation out of the set limits will cause a bleep.

Neonatal Unit Rules

On entering the neonatal unit, you will be expected to wash your hands, and when you leave too. You and your partner (baby’s parents) are able to visit baby at any time of day or night. The unit is open to you 24/7. For siblings of baby and other visitors that you may want to visit your baby, there will be strict timings. There is often limits on 2 visitors per cot at one time. You will be told your own hospitals visiting times and limits when your baby is admitted to neonatal.

Caring for your baby

All baby’s in NICU will be in an incubator rather than a cot as this will keep baby warm. These incubators have arm holes where you can put your arms through and hold baby’s hand, talk to her or change her nappy without taking her out. You can also, take her out by lifting the top for feeding or skin to skin. If baby has drips or wires on her you will need some help in getting her out, the neonatal nurses are there to support you with this. 

Skin to skin is very important for your newborn baby. Skin to skin will help your baby regulate her temperature, heart rate and breathing rate. It is also great for bonding with your baby, as it increases your oxytocin hormone. It is very normal to feel a little disconnected from your baby during these early days. Skin to skin can help with this. If you can’t do skin to skin with baby in the first day or 2 because you or baby is poorly then do not fret. Skin to skin is something that can be done with a baby of any age and will help you feel closer to your baby. If you are feeling disconnected to baby for longer than a few days or, it is getting you down, then seek support from your neonatal team and they will be able to offer you reassurance and help you bond with baby.

You will be encouraged to breastfeed or express your milk as the benefits from breastfeeding are particularly important for pre-term and sick babies. The first milk you will produce is called colostrum and has many good properties and nutrients in that will be of great benefit to your baby.

You should begin expressing your milk as soon as possible after the birth, your milk can then be stored until your baby needs it. The neonatal nurses will be able to support you with hand expressing colostrum, latching baby to the breast or bottle feeding your baby.

It is very common for premature babies to struggle to coordinate all of the muscles needed for sucking and swallowing. So a tube may be passed through their nose (a naso-gastric tube) and their mouth into their stomach to help them feed.

Although it looks uncomfortable, being fed through the tube doesn't hurt your baby.  

Going home without your baby

Before your baby can go home she will need to be feeding well and putting on weight. If your baby has to remain in hospital for weeks, or even months, it is likely that you will have to go home leaving her in the baby unit.

This can be very hard to do and it's quite natural to feel torn between wanting to be with your baby and the needs of the rest of your family. The staff will be able to reassure you and tell you what is best for you and your baby.

If you do have to leave your baby in the hospital you will be able to visit every day. While you are with her you will be able to hold her, have skin to skin, feed her (the team can teach you how to doo this if it’s with a tube) and change her nappy. 

Remember, you can’t put from an empty cup. Looking after yourself is the first step in order for you to care for your baby. You too would have been through a lot from birth, you need your time to recover as well.

 

Approved by healthcare team







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