Caring for your baby

You are welcome to be with your baby at any time; day or night. We work together with you to care for your baby. It’s important to be around as much as possible so you can help care for your baby, attend ward round discussions, have skin to skin and establish feeding routines. We will support you to be as involved in your baby’s daily care as you wish. This will help you to get to know each other and create that lifelong bond.

Premature babies usually go home at, or slightly before, the date they were due to be born. This means that if your baby is born six weeks early, it could be six weeks until he or she goes home. By the time they go home, babies will be feeding well, gaining weight, maintaining their own body temperature and sleeping in a cot.

Visitors

Only parents and/or the support person of the baby have open access to the unit. If there are special circumstances this must be agreed with the nurse in charge. Very sick or premature babies are at increased risk of infection. We may limit the number of visitors you have and how much your baby is handled by other people to reduce this risk. Please check the individual unit’s policy for more information.

Please do not come to the unit if you have COVID or flu-like symptoms, vomiting or diarrhoea. Contact the unit to speak to the nurse looking after your baby if you feel unwell, and tell your visitors to follow this also.

Hand Hygiene

Please wash your hands at the sink when you enter the nursery and use the alcohol gel by the bed before and after you touch your baby or their surroundings. If your hands look dirty please go back to the sink and wash with warm water and soap. When you leave the nursery please use the sink to wash your hands.

To protect your baby, please remove rings (especially those with stones), bracelets, watches and false nails. Please keep your nails clean and short. Everyone within a clinical area must adhere to the Trusts ‘bare below the elbow’ policy.

Keeping your baby’s bed tidy

Balloons, flowers and banners are not allowed on the unit. A small machine washable toy is allowed if your baby is in an unheated cot. Toys are not allowed in or around the incubators. As your baby grows we will suggest suitable toys for their development to use during your neonatal stay.

We clean your baby’s bed space regularly. Please keep your baby’s bed tidy and clear of personal belongings and take any dirty clothes away with you after each visit. There is space for you to store baby’s items and your own personal items at the cot-side. If you would like to help with cleaning and changing your baby’s bed, please speak to the nurse.

Mobile phones and cameras

Mobile phones can be covered in bacteria and viruses. If you bring your phone into the nursery, please wipe it with an antibacterial wipe before and after your visit. Please remember to use hand gel after handling your phone and before touching your baby. You are welcome to take photographs, or to video your baby, but please respect other family’s privacy.

Please don’t answer phone calls or video calls in the nursery due to noise levels. If you need to take a call please go to the parent’s area or out of the neonatal unit.

Food and drink

Each unit has a small kitchen for you to use, equipped with a microwave, kettle and toaster. You will find limited supplies of tea, coffee, milk, bread and butter. Please don’t take hot drinks or food into the nurseries. Please ask your local unit for more information about buying or preparing food and drink.

Respecting privacy

Having a baby on the unit can be a very anxious and upsetting time for parents. Please respect the privacy of other parents and babies on the unit.

To ensure confidentiality, we cannot give any information about your baby to your visitors. Your visitors must be with you at all times whilst on the neonatal unit. We will not give information about your baby to your relatives over the telephone.

To respect the privacy of other families on the unit, please don’t look at, approach, or ask questions about other babies. Please be mindful when you take photographs of your baby to not include other patients or visitors in them.

Clothes and nappies

Your baby may be very small, and you may not have been prepared if they arrived early. We have a large selection of baby clothes, so don’t worry if you don’t have any that fit. If you do want to bring your own clothes, please label them. Use the laundry bag at the end of the incubator/cot so you can take them home to wash.  Clothes and bedding should be washed at 65 degrees during their stay on the neonatal unit.

We supply nappies, cotton wool and cotton buds to help you for the first few days of your baby’s stay. Please bring in supplies for your baby longer term. Your nurse will be able to tell you which nappy size to buy.

Positive touch and developmental care

You may feel frightened to touch your baby at first, but we will support you in learning how to do this until you feel confident. The type of touch must be adapted to your baby’s response, their medical condition and how premature they are.

To prepare your baby for handling, we recommend doing some comfort-holding, for example before and after you change their nappy. Please remember to warm and clean your hands before touching or comfort-holding your baby. If you use alcohol gel to clean your hands then please wait a few seconds for the strong smell to disappear.

We follow cue-based care, which is an easy to follow ‘traffic light system’. This means following the signs your baby is giving you so you can see whether they are managing or if they need help to settle.

Even small babies benefit from the close contact a parent can provide. We may suggest you hold your baby in the ‘kangaroo-care’ position by placing your baby’s body against your skin (also called skin-to-skin).

These cuddles help your baby regulate their own heart rate, breathing rate and temperature. It’s also a great bonding experience for you both. It can also help increase your milk supply and promote more exclusive breast/chest feeding when it is safe for your baby to do so.

We encourage babies to have skin-to-skin cuddles as much as possible, but this must be balanced with the calories your baby uses to come out of their incubator or cot. As a general rule, we say a minimum of one hour for skin-to-skin. You can do this for longer if both you and your baby are comfortable.

To stay comfortable during Kangaroo Care make sure you have eaten, gone to the loo, have water available and are sat in a reclining chair. You may also like to have a book to read to your baby.

Feeding

Breast milk

Breast milk is the best food a baby can have – it has important ingredients that encourage growth and help fight infection. The birth parent of a premature baby produces appropriate milk for their baby. Even if your baby needs to be fed by a drip or by tube at first, they should still be able to breastfeed eventually. We will encourage you to express breast milk for your baby, as it clearly reduces the risk of serious infections and bowel problems.

You may find it difficult to express milk at first, especially if you are worried about your baby, but it’s important to do this as soon as you can. Your milk can be stored in the unit’s freezer until your baby is ready to feed.

Expressed breast milk

Your baby may not be able to suck very well at first, so we would encourage you to express your breast milk until he or she is able to do so. We supply breast pumps for use whilst you are visiting your baby on the unit. Breast pumps may be hired from outside companies for home use, or you may choose to buy your own – please speak to the nurse looking after your baby or the infant feeding lead for details.

Pasteurised donor expressed breast milk

You might struggle to produce a certain amount of breast milk at the beginning. If your baby is at high risk for developing feeding related gut problems, we may consider using donor expressed breast milk. We will ask for your consent before doing so.

Donor expressed breast milk comes from a donor breast milk bank. The milk bank receives expressed breast milk from donors who are recruited on neonatal units. Donors are screened for infection and the breast milk is pasteurised. The benefit of the milk bank is to make donor breast milk available for preterm and sick babies when birth parent breast milk is not available.

Sucking

Your baby may not be able to suck very well at first, so breast or bottle feeding may be difficult, but as they become stronger and with practice, this will become easier for both of you. The unit also has a speech and language therapist to support your baby with feeding. We may also recommend non-nutritive sucking (NNS) practice. Non-nutritive sucking can be offered during tube feeds by using a dummy or gloved finger. When suitable, we can start completing ‘dummy/finger dips’ with baby’s milk. By doing this baby gets to taste the milk and practice their sucking and swallowing skills.

Tube feeding

Until your baby can feed orally, they can be fed through a small tube, which passes through the mouth or nose and down into the stomach. We will teach you how to feed your baby via the feeding tube when you feel comfortable.

Bottle-feeding

If you are unable to breast feed or express breast milk, manufactured milks are available on the unit. If your baby is preterm and/or weighs less than 2kg we may use specially formulated milk.

Intravenous feeding

If your baby cannot tolerate milk feeds, it may be necessary for your baby to be fed via a drip. We call this parenteral nutrition (PN).

Going home

If your baby was born before you had the chance to prepare your home, you may want to use the time before discharge to do this. If you feel unsure about what to prepare, please ask the nurse looking after your baby, who will be happy to advise you.

To help you prepare for going home, we may suggest you stay overnight and gain confidence in caring for your baby on your own with support nearby if you need it.

We also offer a basic resuscitation skills session to all families before discharge, which involves practical training.

You must register your baby with your GP before they are discharged from hospital. We notify both the health visitor and your GP when your baby goes home so that they are up to date with your baby’s progress in case you need advice.

Following discharge, your family health visitor will visit you at home. They will be able to answer questions about your baby’s health and development, as well as carry out developmental assessments at key stages. If your baby needs follow-up care, this will be discussed with you before your baby is discharged.