Northumbria Healthcare NHS Foundation Trust

Special Care Baby Unit(SCBU) Explanatorybooklet for parents

Issued by the Maternity Department

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Welcome to our unit. The purpose of this leaflet is to provide you with information about The Special Care Baby Unit (SCBU). This is based at the Northumbria in Cramlington and has 12 cots. It is also intended to answer some of the common questions which arise if your baby is receiving treatment within the SCBU, based on those asked by parents who have been through the same experience.

We aim to deliver a high standard of care for you and your baby at all times. Whilst for the majority of people their baby’s birth is a straightforward event with no complications, for some, it can involve the baby requiring treatment within the SCBU for days, weeks or (in rare cases) months.

If your baby does require more intensive care once stabilised they will be transferred to a regional unit such as the Royal Victoria Infirmary (RVI). When he/she no longer requires intensive care they will return to the Northumbria depending on the availability of cot spaces.

The reasons for treatment within the SCBU are varied and can include premature birth, jaundice, breathing difficulties etc. This booklet attempts to explain the type of staff involved in the baby’s care, the equipment involved and some of the technical terms which are used. It is an emotional and exhausting time for you and your family following an unexpected admission to SCBU. In addition it is important that you rest between your baby’s care time and visiting. Initially it may seem like the nursing staff are providing more of the care for your baby than you, and this can be a frustrating time.

However once your baby is stable staff will guide and support you in caring for your baby. Baby nappies and clothing are supplied on the unit and washed to hospital standards. You are welcome to use your own baby clothing, but please inform the staff when doing so.

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Since the leaflet is intended to be general in nature, it cannot cover every case which may arise. If you have any queries or anxieties, please ask the nursing staff as they are always willing to explain the treatment your baby receives.

There is a birth reflection service for mothers who deliver at NSECH. Please ask a member of the nursing team if you would like information about this.

The Staff Nursing The unit is led by a Ward Manager, Neonatal Nurse Consultant & Advanced Neonatal Nurse Practitioners. All of the qualified nursing staff have undergone specialist training in the care of premature and newborn babies. They will be able to help and advise you on the care of your baby, we also have healthcare assistants. Because of confidentiality any information about your baby is only given to the parents. No information will be given to other family members we would appreciate if you could pass this on to your family, to avoid any upset.

Medical Staff Medical cover is provided by Paediatricians 24 hours/7 days a week based here at the Northumbria. They attend the unit for ward rounds and also hold outpatient clinics at North Tyneside General Hospital and Wansbeck General Hospital following discharge. You may speak to a Doctor, Ward Manager, our Neonatal Nurse Consultant or ANNP at any time.

Domestic Staff We have our own domestic staff who strive to maintain a high standard of cleanliness within the unit.

Hearing Screeners Before discharge your baby will have a hearing test performed by a hearing screener, you may already have consented to this after delivery and if not the hearing screener will explain the test prior to obtaining consent on the unit.

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Prevention of Infection The prevention of infection is paramount to the wellbeing of our vulnerable babies.

Research shows that careful hand washing for all staff and visitors is one of the most important routines to reduce the risk of infection. We ask that you use the alcohol gel provided at the door before entering the unit.

Before touching your baby please remove all wrist watches, and jewellery. Then wash your hands with soap and water. We would recommend that handling of your baby is limited to parents whilst the baby is in special care to minimize the chance of your baby picking up an infection.

Environment We aim to reduce noise, activity and lighting around each cot space to ensure that the environment is pleasant for nurturing and improving your baby’s well-being. This can sometimes be quite difficult to organize but babies need as much rest as possible in order to develop and grow. Research has shown that over stimulation and handling can have a negative impact eg. poor weight gain, or temperature instability.

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Visiting The unit has a security entry system for the protection of the babies. It is important that the staff know who is coming in and out of the unit and because of this we would ask that you do not let anyone into the unit.

Parents are welcome to visit their baby at any time. Visiting for other friends or relatives is from 14:00hrs - 19:30hrs. This is to promote adequate peace and rest for all the babies on the unit. Please make family aware of the times they can come to the unit to avoid any disappointment.

For safety reasons only 4 people can visit the baby at one time, one of these must be a parent. Other visitors can wait in the waiting area and take turns to come in.

Babies in special care are at risk of picking up infections and because of this no children under the age of 16 are able to visit unless they are brother or sister to the baby. Further visiting restrictions may be enforced over the winter season to reduce infections to our vulnerable infants.

Unfortunately we do not have the facilities for siblings to be left to play unsupervised during visiting.

Parents and visitors are encouraged to wash their hands when they come to the ward.

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Facilities There is a parent’s sitting room on the unit where you can help yourself to tea and coffee. There is a dishwasher, fridge and a microwave for you to use so that you can bring food in with you when you come to visit your baby. On the ground floor next to the main entrance there is a café/shop run by our Hospital Volunteer Service where you can get snacks and hot drinks as well as newspapers and magazines. The restaurant is situated on the ground floor which serves a selection of both hot and cold refreshments. There are water coolers and vending machines available for drinks and light refreshments. All opening times are available at the hospital main reception.

Meals are provided for mums and dads whilst in resident in our parents’ rooms on SCBU prior to discharge.

There is a toilet on SCBU for parents. Visitor toilets can be found on the main corridor outside SCBU, opposite the lifts.

We ask that all outdoor garments, coats/hats are removed on entering SCBU and placed on the coat hanger to the left through the double doors as you enter the unit, in the waiting area. Please do not leave any valuables unattended; lockers are available for use during your visits which are situated next to the coat hanger in the waiting area.

We have 2 rooms with en-suite facilities which you are invited to come and stay in with your baby before they are discharged. This gives you the opportunity to look after your baby with the support of the staff to build your confidence before your baby goes home. We appreciate that nurseries can be busy during visiting; one of our parents rooms if vacant can also be used as a private room for breastfeeding. Depending on the wellbeing of your baby, or for expressing your breast milk, please ask a member of staff should you wish to use this facility.

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We have a separate milk kitchen where you can store your breast milk if you are expressing it for your baby. This is where you will find breast pumps for you to use so you can express milk while you are sitting by your baby. There are also breast pumps which can be loaned from the breast feeding support teams/ or health visitor in the community whilst your baby is in SCBU.

Please ask a member of staff to place your breast milk in or take it out of the fridge.

Breast feeding support is available on SCBU. Support is also available in the Community following discharge; please refer to contact numbers on back of this booklet, an interpreting service is available.

It is important to register your baby with your GP prior to discharge, if you fail to do this it may delay your baby being seen if you have a problem after discharge.

Please refer to our welcome to our ward information. There is an array of information to help you understand your infant’s admission and care on the unit. Should you require help with transport please mention this.

Car parking permits are given free for non-resident mothers. Please ask a member of staff for this.

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The equipment The equipment and monitors can be very frightening when you see them. The nurses will explain them to you, in detail, but here is a very brief explanation of some of the equipment you may see in SCBU: Incubator This looks like a large see-through plastic box, it enables us to maintain a constant temperature, in which to keep your baby nice and warm, whilst observing them. If necessary it also enables us to deliver oxygen. Babies may wear clothes while in the incubator (we have a large selection of baby clothes).

You will still be able to touch your baby and have him/her out for skin to skin contact. The length of time your baby will need to stay in the incubator may vary from a few hours to several weeks.

Apnoea Monitor This is usually a soft disc which is stuck to your baby’s abdomen or may be a mat which is placed under your baby’s sheet and attached to a small box, which makes a clicking noise. It picks up the breathing movement.

Babies who are born early occasionally forget to take a breath and this is a safety precaution, in case we need to remind them.

Pulse Oximeter This is a small probe which wraps around your baby’s foot; it measures oxygen in the blood and tells us the baby’s heart rate.

Phototherapy light/bilibed/biliblanket Your baby may become jaundiced (which is very common in premature babies) and require the phototherapy light, which looks like a “sun bed” (no harmful rays).

This is pushed over the incubator or cot, your baby will need to wear eye protectors to shield their eyes from the bright light.

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The alternative treatment is a “bilibed”. This is placed in the cot and your baby lies on this inside a special towelling suit.

The biliblanket is useful for those mothers who are breastfeeding as it is a type of blanket that wraps around the baby so feeding is easier.

CPAP/HIFLOW

This consists of two small tubes inserted into your baby’s nose, which helps to deliver oxygen under pressure to assist with breathing, if your baby becomes tired.

Ventilator

Sometimes very premature babies have difficulty breathing on their own, because of immature lungs and may need assistance with breathing. The ventilator is a machine which delivers oxygen under pressure via a small tube which is inserted into the baby’s windpipe. If your baby required this treatment it may be established in our unit, before being transferred to an intensive care unit (usually RVI) or to other regional neonatal intensive care units.

Intravenous Drip

Often small or sick babies are not able to tolerate or digest milk feeds in the first few days, and it may be necessary to feed them using an intravenous drip. This consists of a small plastic tube inserted into a vein in your baby’s hand, arm or foot. Then, clear fluid is fed into the vein via a small infusion pump.

Tube Feeding

You will see lots of babies in SCBU being fed by this method. A fine tube goes up your baby’s nose and down into the stomach. It is fixed to the side of the face with a small piece of tape. It is necessary to feed like this until your baby is able to suck, either the breast or bottle.

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Going home – frequently asked questions Q. Will my baby be allowed home if still undergoing treatment?

Yes. You will be advised of any medications which your baby needs to take at home, and how they are to be given.

Q. Is there a required weight my baby should reach before he/she is allowed home?

There are no set rules, since individual babies vary. However, when your baby is able to breast or bottle feed normally and to keep warm and gain weight without extra help then he/she will be allowed home.

Q. What is my baby’s age, will he/she develop as quickly as a full term baby?

If your baby was born early you may have heard two ages mentioned:

Real age – This is the actual time since your baby was born.

Corrected age – This is the time from when your baby was due.

E.g. Katy was due on 5th June but was born on 5th April and it is now 5th October, Katy’s real age is 6 months but her corrected age is 4 months.

As your baby grows older, the importance of the ‘missing’ weeks becomes less obvious. For the first couple of years of your baby’s development it is worth keeping both dates in mind and trying not to compare with other babies of the same age. All babies are individuals and will develop at their own pace.

Follow-up visits to the baby clinic will be arranged and you are always welcome to call back to the SCBU for a chat about your baby’s progress.

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Q. What support will I get from the hospital, midwife, health visitor etc.?

A date for the first follow-up appointment will be made when your baby is discharged. It is important to keep these appointments so that the doctors can assess your baby’s progress.

Support is available from SCBU, a member of the team will ring you 48 hours following discharge. In addition, your midwife, health visitor or GP may call on you at home to see how your baby is progressing and to give you details of your local baby clinic.

Q. Will the same problems occur if I have further children?

Not necessarily. Your individual circumstances will be discussed with you by the medical staff.

Q. When I take my baby home can I take him/her outside?

You may take your baby out as soon as you wish making sure that baby is appropriately clothed depending on the weather. However until your baby is bigger it is best to avoid crowded places where people may have coughs and colds.

Sometimes babies who are born early are more prone to chest infections.

Q. How warm does it need to be at home?

It is not necessary to have your home as warm as the SCBU, a room temperature of 15-20°C. 60-70°F is warm enough.

It is important not to over-heat your baby with too many clothes/blankets. Quilts and cot bumpers are not recommended for babies under one year old.

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Q. Should my baby be immunised?

Most doctors will recommend that babies begin a course of immunisations at two months old, as this is when their natural immunity is low and they are less resistant to infections. This is no different for your baby, sometimes the first dose may be given whilst your baby is in the unit, or your health visitor will arrange an appointment at your baby clinic.

Q. What should I feed my baby?

If you are breastfeeding there is support available in the community, which can be arranged prior to discharge.

You will be advised before discharge which formula to use if you are not breastfeeding. Some babies will be discharged on a special formula called ‘Nutiprem’ this is for pre- term/small for dates babies and is available on prescription.

It is usually advised that your baby will stay on this until weaned, however this may be reviewed at any-time. Your health visitor will give you advice about weaning.

Q. What is the best sleeping position?

Cigarette smoke will irritate and possibly damage your baby’s lungs so avoid smokey areas. Smoking at home should also be avoided in any rooms where your baby might be. This is also in line with the Department of Health guidelines on The Prevention of Cot Death.

Q. Car Safety

Your baby should always be in a suitable restraint when travelling in a car. The safest type of baby seat is a rear- facing infant carrier. There are several different types available which can be used from birth.

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If your car is fitted with passenger or side air-bags they must be deactivated. If you are unable to do this your baby must always travel in the rear of the car.

We hope that we have answered some of your questions, if you have any queries please do not hesitate to contact the unit.

We endeavour to maintain our high standard of service. In order to help us we would appreciate that you complete a parent’s survey prior to discharge.

Contact information Should you have any other questions or need further advice please contact SCBU: 0191 6072017

Bliss Helpline Support,

Advice and Confidential Information 0500 618 140

National breastfeeding helpline 0300 100 0212

Breastfeedingnorthumberland.co.uk

NHS Northern Neonatal Network App – which you can access via the App Store (search NNN) and download to your mobile phone. It provides information for families of premature and sick babies. Follow the links to Cramlington Emergency Care Hospital – Ward Information – Neonatal Unit.

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Notes

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Notes

PIN 453/V1

Review date: September 2021