Babies Who Need Special Care

Some babies need special care in hospital, sometimes on the ordinary postnatal ward and sometimes in a Neonatal Unit (NNU), also known as a Special Care Baby Unit (SCBU) or Neonatal Intensive Care Unit (NICU). Babies who may need special care include:

babies who are born early - babies born earlier than 34 weeks may need extra help breathing, feeding and keeping warm, and the earlier they are born the more help they are likely to need;

babies who are very small or who have life-threatening conditions, usually affecting their breathing, heart and circulation;

babies born to diabetic mothers, or babies where the delivery has been very difficult, may need to be kept under close observation for a time;

babies with very marked jaundice;

babies awaiting or recovering from complex surgery.

Contact with your baby

All babies need cuddling and touching, whether they are in the ward close by you or in an NNU. If your baby is in an NNU, you and your partner should try to be with your baby as much as possible. Encourage other members of your family to visit too, to get to know the baby, if this is possible. When you first go into the NNU you may be put off by all the machines and apparatus. Ask the nurse to explain what everything is for and to show you how to handle your baby.

Feeding

Feeding is especially important for premature babies. Those who get some of their mother's milk do better, so think seriously about breastfeeding. Even if you can't stay with your baby all the time, you can express milk for the nurses to give while you are away. Some small babies can't suck properly at first and are fed by a fine tube which is passed through the nose or mouth into the stomach. You and your partner can still touch and probably hold your baby. The tube isn't painful, so you needn't worry about it being in the way or hurting your baby.

Incubators

Babies who are very tiny are nursed in incubators rather than cots to keep them warm. But you can still have a lot of contact with your baby. Some incubators have open tops but, if not, you can put your hands through the holes in the side of the incubator to stroke and touch your baby. You can talk to your baby too. This is important for both of you. You may be asked to wear a gown and mask. Carefully wash and thoroughly dry your hands before touching your baby.

Newborn babies with jaundice

Jaundice in newborn babies is common because their livers are immature. Severely jaundiced babies may be treated by phototherapy.

The baby is undressed and put under a very bright light, usually with a soft mask over the eyes. It may be possible for your baby to have phototherapy by your bed so that you don't have to be separated. This treatment may continue for several days, with breaks for feeds, before the jaundice clears up. In some cases, if the jaundice gets worse, an exchange transfusion of blood may be needed. Some babies have jaundice because of liver disease and need different treatment. A blood test before phototherapy is started checks for liver disease.

Babies with jaundice after two weeks

Many babies are jaundiced for up to two weeks following birth. This is common in breastfed babies and usually it's normal and does no harm. It is not a reason to stop breastfeeding. But it's important to ensure that all is well if your baby is still jaundiced after two weeks. You should see your doctor within a day or two. This is particularly important if your baby's stools are pale. A simple urine test will distinguish between 'breast milk' jaundice, which will resolve itself, or jaundice which may need urgent treatment.

A baby with disabilities

If your baby is disabled in some way, you will be coping with a muddle of different feelings - love mixed with fear, pity mixed with anger. You will also need to cope with the feelings of others - your partner, relations and friends - as they come to terms with the fact that your baby is different. More than anything else at this time you will need to have a person or people to whom you can talk about how you feel and information about your baby's immediate and future prospects.

There are a number of people to whom you can turn for help - your own GP, a paediatrician at your hospital, or your health visitor. Once you are at home you can contact your social services department for information about local voluntary or statutory organisations. Many are self-help groups run by parents. Talking to other parents with similar experiences can often be the most effective help

Worries and explanations

Always ask about the treatment your baby is being given and why, if it's not explained to you. It is important that you understand what is happening so that you can work together with hospital staff to ensure that your baby receives the best possible care. It is natural to feel anxious if your baby is having special care. Talk over any fears or worries with the staff caring for your baby.

The consultant paediatrician will probably arrange to see you, but you can also ask for an appointment if you wish. The hospital social worker may be able to help with practical problems.

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