What is a Neonatal Network
A Network consists of hospitals with different types of neonatal Units. The purpose of each Network is to ensure, with only a limited number of exceptions, that mothers and babies receive their care within their Network, or very occasionally an adjacent Network. Mothers should receive care as near to home as possible and to know in advance should a problem arise with their baby where and how care will be provided. They should offer families the greatest opportunity for local birth and also minimize transfers for intensive care to those which are necessary. For babies transferred for longer term intensive care, Networks would facilitate early return to a local hospital.
Each Neonatal Unit within the Network has been designated to provide different levels of care i.e. some Units would only provide special care (SC), most would provide high dependency (HD) and limited intensive care (IC) and some the full range of intensive care.
Why are some babies admitted to the NICU/Special Care Baby Unit?
NICU stands for Neonatal Intensive Care Unit and babies are admitted to the NICU for a variety of reasons, including if they:
- Are born before 36 weeks gestation (the normal full-term gestation is 40 weeks)
- Have difficulties with their breathing that require support
- Are born with problems that require surgical intervention
- Are at risk of feeding problems
- Have a suspected infection
- Just require close observation for a short while, sometimes for just a matter of hours
- Have other medical conditions requiring treatment
Some babies are transferred to us other from other neonatal Units because we have the staff, expertise and capacity to care for very sick babies.
What is IC, HD and SC?
The levels of care will be classified as either Intensive Care, High Dependency Care or Special Care:
Intensive Care – this provides the full range of medical neonatal care, but not necessarily all specialist services such as neonatal surgery.
High Dependency – this care involves the continuation of some breathing support and intravenous nutrition, together with some other care needs that babies have.
Special Care – This may involve tube-feeding, some additional oxygen support and light therapy (phototherapy) for babies needing this particular type of care.
Who will be caring for our baby?
The Senior Nurse and Sisters are in charge of the nursing staff, which includes nurses of all grades, some of whom are in training. The medical staff consist of Consultants, Registrars and Senior House Officers (SHOs). If your baby requires surgery a Paediatric Consultant Surgeon will also be involved in your baby's care. Other staff who you may see visiting the unit include: Physiotherapists, Radiographers, Pharmacists, Dieticians and Social Workers. The Social Workers help parents in practical ways, and can advise about benefits and maternity rights.
How long will our baby be on the unit?
It is very difficult to say exactly how long your baby will be on the neonatal Unit as this will depend on his/her condition. However as a rough guide it would be fair to say that if born pre-term your baby will be on the Unit until the original due date i.e. until your baby has reached term.
When can we bring our baby home?
All parents are naturally anxious to get their baby home as soon as possible. We do, however, need to balance this with the best interest of the baby from a medical point of view.
If your baby was born early but is otherwise healthy, he/she can usually go home at about the time that they would have been 'term' i.e. the due date. This can, however, vary depending on your baby's strength and growth.
If you would like to know more about your baby's condition and when he/she might be ready to return home, please ask your nurse or doctor on the Unit.
What is all the equipment caring for my baby?
Most of the equipment can seem very frightening when you first come into the Unit. Please see the section on equipment for more information of the individual equipment used.
What can we do for our baby during the first days of the visit?
During the initial stages of your baby's admission to the Unit, it is important that you can just be with them as often as possible.
When your baby starts to recognise your voice, we know they become reassured. You should, however, balance this with your own needs for sufficient rest and sleep.
If you have chosen to breastfeed, you can start to express milk which the Unit can store until your baby can tolerate milk feeds. Staff on the Unit will help and advise you with this.
Will we be able to touch our baby?
There may be times when it is safer for your baby to stay in the inclubator, in this case Comfort holding is one of many ways for you and your baby to get to know each other. Comfort holding is 'still touch'. Cradling your baby with still, resting hands can be more comforting than stroking or massage. Always speak to your nurse before you try comfort holding, they can show you how to do this.
Can we take photos of our baby?
When the baby is first admitted, a nurse on the Unit will take a photo and will give you a copy as soon as possible.
You are welcome to bring your own camera to the Unit and take further photos of your baby, but do not take any pictures of other babies in the room. The camera flash does not seem to harm babies but please try to limit its use as pre-term babies need undisturbed sleep to help them grow.
To prevent accidental loss, please take care not to leave your camera unattended.
We are worried that our baby is very fragile, and that we might do something wrong?
Please be reassured that experienced nurses will be on hand in the Unit to help you. They will show you how to take care of your baby. Many parents are anxious at first but all of them become very good at caring for even the tiniest babies.
Can I breastfeed if my baby is in an incubator?
Please see the feeding section on this website for more information.
What can we do for our baby in the Unit later on?
As your baby begins to get stronger and healthier, you will be encouraged to take an increasing part in your baby's care; this can help you gain confidence before you return home as a family.
Can we bring anything into the Unit for our baby?
Parents and visitors usually want to personalise their baby's incubator. This is fine, but please bear the following in mind:
- The Unit is very busy and does not have a lot of space
- Please only bring in small things
- If you have a lot of things, please bring them in one or two at a time
- If they are lots of toys in the incubator, they might get lost or dropped
- If you have a lot at home, rotate your selection of toys
- Sick babies on the Unit are vulnerable to infections, which might be carried in on soft toys.
If you want to bring in a soft toy, please make sure it is either new or recently washed. The nurses will spray it with an antiseptic spray before putting it in the baby's cot or incubator. You will find that the nurses are often grateful for soft toys because they can help support the baby's tubing or pacifiers (dummy).
Can we bring in clothes for our baby?
Most babies that are admitted to NICU are initially unwell. At this time, they are best cared for in the incubator unclothed, which helps staff to observe their progress closely.
Once your baby is getting stronger, staff can start to cloth him/her. Some parents like to bring their own baby clothes, which is fine but there is no need to do this because there are baby clothes on the Unit, which are laundered. If you bring your own baby clothes, it is safest to prevent losses by taking them home to launder – please also mark them in some way so that they can be identified.
When can we visit our baby?
Most Units have open visiting for parents but please see Units individual pages on this website for more information.
What are the visiting times and facilities for us and our family/friends?
Please see Units individual pages on this website for more information.
How many visitors can come to see our baby at a time?
Most Units will only allow two adult visitors by your baby's cot at any one time. One of these must be mum or dad. This aims to reduce the risk of any infection being spread in the unit and because the rooms get crowded. If a large family wants to visit, they can take it in turns to come in with either of you.
Are our baby's brother/sister allowed to visit?
Most units welcome visits from the baby's siblings – just as long as they do not have obvious signs of having a cold or other infectious diseases. In particular they should not visit if they have had recent contact with children who have chicken pox (varicella zoster) or shingles. If you have any questions or concerns about infections, please discuss them with the nurse caring for your baby.
Units acknowledge it is a good idea for the baby's brothers/sisters to come visit their new brother and/or sister. It is important that they don't feel excluded from what is happening at this time to prevent relationship problems in the future.
We are worried our other child/children will be frightened by the experience..
Children actually tend to 'accept' the machinery and tubing that is on the NICU much more easily than adults do.
Very young children will need careful supervision. Short, frequent visits are usually preferable to a single long visit; this helps prevent them getting bored and restless.
Can our visitors' children also come to the Unit?
Only the brothers and sisters of the baby (the parents' children) may visit. This is to minimise the risk of infection to this group of vulnerable babies.
We need to travel to the Unit every day, how can we reduce parking costs?
Most units will be able to help with long term parking tickets. Please see Units individual pages on this website for more information.
What should we wear to visit the Unit?
All visitors entering the Unit must remove their outdoor clothing (e.g. coats etc). Because of all the equipment generating heat, the rooms can get very hot so we advise you to wear only light clothing.
When your baby is ready to be handled outside the incubator, you are both encouraged to hold the baby skin-to-skin on your chest. This is good for both of you. Mothers can usually start to breast feed at this time. Both of you will find it easier to wear a short (or top) that opens down the front to give your baby easy access to your chest skin.
Why do we need to wash our hands?
All visitors to the Unit must wash their hands when they enter the Unit and when they leave. This is because babies are both vulnerable to infections and more susceptible to having major reactions to simple colds than older infants.
Always wash and dry your hands and wrists thoroughly before touching your baby, and please use the alcohol hand rub.
Before touching your baby, if possible, remove any rings and watches that you are wearing. Again, this is to minimise the risk of carrying infection to the baby.
Can we, as the baby's parents, phone the unit to ask about his/her progress?
Parents are usually given the direct number of the Unit and may call any time of the day or night. Units would prefer you to call to reassure yourselves rather than sit at home worrying. For practical reasons, staff will limit the amount of information given over the phone, and will only give information over to yourselves.
Can other people phone the Unit?
To limit the disturbance of the staff on the Unit, relatives or friends should ask you, as parents, for current updates.
Depending on the circumstances, you may wish a relative or friend to act as your support person. As long you give permission and let the Unit know, staff can share information by phone with the nominated contact person.
How and when can we speak to a Consultant?
The best time to speak with a Consultant is usually at the end of a ward round. However it may be worth checking with the nurses to see if this is convenient of whether it would be better to book an appointment.
Where can we get more information?
We hope that the website will provide most of your information needs however there are links to numerous other relevant websites.