Neonatal Unit- Information booklet 2018 (9)

NEONATAL
U  NIT Information

for parents

YOUR BABY AND
TRANSITIONAL
CARE

Dear Parent,

Congratulations on the birth of your baby
or babies!

Your baby/babies require transitional
care on the postnatal ward.  This usually
means that your baby was either:

Born early

Smaller than we had expected

Has spent time on the neonatal unit (special care baby unit)

Is receiving antibiotics into their vein because we suspect (or
know) that they have an infection
Or that we feel we need to observe your baby.

As a result, you and your baby may have to stay in hospital a bit longer
than you had expected.  However the aim of transitional care is to keep
mother & baby together which will assist with bonding and help to
establish feeding.

Occasionally your baby will require a longer stay in hospital, perhaps you
need to get home to other children.  In which case your baby will be
admitted to the nursery on the Neonatal Unit.  You can come to the
neonatal unit to be with your baby as much as you are able to until they
are ready to go home.

WHAT DOES THIS
MEAN TO YOUR
BABY?

A lot of the babies who require transitional care are small and this means
they need to be fed more regularly (i.e. every 3 hours). They will be seen by
a member of the neonatal medical team every day and by a member of
the neonatal nursing team twice the day and night, their care will be
planned with you and the midwifery team staff.

Because some babies who are small for their gestational age (the number
of weeks they were born at) or are premature have reduced stores of fat,
they are more at risk of becoming cold (hypothermic). Their temperature
will be checked regularly and your baby may require a special heated
mattress to help them to stay warm.  Skin-to-skin is encouraged as this is
a good way to maintain their temperature and promote bonding.

Another potential problem is that your baby could use up their energy
quickly and develop hypoglycaemia (low blood sugar) by trying to keep
warm, feeding etc. We assess your baby’s energy levels by checking their
blood sugar. We do this by taking a drop of blood from their heel. There
are many ways to treat hypoglycaemia, these include feeding your baby
more often or giving them a small amount of dextrose gel (a sugary
solution). These treatment methods will be discussed with you at the
time.

CAN I FEED
MY BABY?

We encourage all mums to breast feed as there is so much research
proving its benefit to both mother & baby. Sometimes babies on
transitional care are too tired to feed well, so we need to help them by
using a nasogastric tube (a small tube passed up your baby’s nose and
down into their stomach).

A feeding plan will be created for your baby after discussion between you,
the neonatal staff and midwifery staff. This may include you expressing
breast milk for your baby, occasionally some babies may require formula
milk as a supplement to breast milk as a temporary measure. This will be
discussed with you and will only be given with your permission. We will
encourage and support you to feed your baby by your chosen method
whether that be breast or bottle

WHO WILL BE
LOOKING

AFTER US?

A midwife will look after you, assisted by midwifery support workers and
health care support workers. Your baby will also be seen by the neonatal
medical and nursing teams. We will plan your baby’s care with you and
we will encourage you to take an active role in the care of your baby.  Your
baby will be reviewed twice a day by a neonatal nurse and once a day by
a neonatal doctor.  Extra reviews of your baby can happen if you or the
midwifery team are concerned about your baby.

Your baby may need to spend some time on the neonatal unit for tests to
be carried out or medications to be administered.  We will always discuss
this with you and explain why it is necessary.

WHEN CAN WE
GO HOME?

Transitional care babies need to be discharged by a member of the
neonatal medical team.  Sometimes your baby may be discharged from
transitional care, but isn’t yet ready to go home.  For example if your baby
has had antibiotics which have been stopped, but they haven’t yet
managed to establish full feeding by mouth.

In order to go home your baby needs to be:

Taking all their feeds by mouth (or have a plan in place to give
nasogastric tube feeds at home, in which case your care will be
taken over by the neonatal outreach nursing team)

Maintaining their temperature in a normal cot

At a safe weight to be discharged (if your baby was very small
when they were born then we may require them to be gaining
weight before we are happy for them to go home)

There may be times where your baby is discharged from Transitional Care
but there is a midwifery/obstetric/social reason why Mum isn’t quite ready
to leave hospital in which case your baby will remain on the postnatal
ward until the midwifery discharge can take place.

THANK YOU

We hope this leaflet has been useful.  If you have any further questions or
concerns, please ask a member of staff, they will be pleased to help you.
The telephone number for transitional care is...................