The Unit has been purpose built and provides care for up to 15 babies. Two of the cots are dedicated for intensive care; the remainder are used for high dependency and the special care needs of the babies in their care.
The care is provided by a Consultant-directed team of expert medical and nursing specialists trained in this field of medicine. Other supporting members of the team included physiotherapists, technicians from the x-ray, hearing and eye departments, pharmacists, volunteers the hospital chaplain and the Special Care Support Group members.
Surgery is not performed in this hospital on babies. If this is required it will be undertaken at one of the local regional units by a paediatric surgeon.
The philosophy is to maintain a safe environment, and one which encourages the highest of skilled and compassionate care for your baby.
An environment which encourages the relationship between parents and their baby and the promotion of the family unit.
REASONS FOR ADMISSION
The majority of babies admitted to SCBU are premature (born early).
There are other reasons which may also require your baby to be admitted, for example:
- Babies whose birth weight is less than 2.4kg (5lbs 4oz)
- Babies who have breathing problems or appear unwell at birth and who may require oxygen therapy and/or assistance with breathing from a ventilator or flow driver
- Babies where there is a risk of infection, most commonly when the membranes have ruptured (“waters have broken”) more than 24 hours before delivery
- Babies whose jaundice requires further investigation and/or specific treatment
- Babies with feeding problems, including a low blood sugar result
- Any baby on the delivery or post-natal wards whose condition is a cause for concern and who may require further investigation and treatment.
THE EARLY DAYS
Whilst your baby is on SCBU you are encouraged to be involved in your baby’s care as early as possible. Early attachment to all the family is important, and so talking to and touching your baby is essential. It is amazing how tiny babies react to their parents, and your nervousness in handling them will soon disappear.
Parents are often taken aback by the appearance of their baby. Premature babies are often tiny, thin and frail-looking. The large head and tummy may look out of proportion with the skinny chest, arms and legs. Their skin may also look wrinkled because the baby has not yet developed baby fat, and may be covered in fine hair.
As your baby grows he/she will lose their body hair, and become round and chubby. Your baby may be quite sleepy and quiet initially, but this is common.
Parents are often quite anxious about their baby’s weight; it is normal for newborn babies to lose weight in the first week to ten days. Babies are routinely weighed on the Unit twice a week, and you will be kept informed of their progress.
The majority of the babies are initially nursed in incubators. As they grow, mature and become more stable, they will be transferred into a cot.
The medical staff may need to perform necessary tests on your baby from time to time. These tests could include blood tests, hearing and eye tests, x-rays, and other specialised tests. These tests will be discussed with you, prior to them being carried out.
The Unit provides a large range of baby clothes for you to choose from, or you can provide your own. Premature baby clothes can be expensive, it is amazing how quickly your baby will grow. Please feel free to use cameras and video cameras.
REGISTERING YOUR BABY
When your baby is born the hospital staff send a Birth Notification to the Registrar. You will then need to make an appointment with the office to register your baby’s birth. There is a six week time scale to register your baby. A leaflet explaining the process is available on the Unit.
One of the most frightening aspects of the Special Care Baby Unit is the amount of equipment that can surround your baby. The staff are happy to explain its purpose and the reasons why it is being used. Please do not hesitate to ask questions – your fears can be greatly reduced with an understanding of what the “dials and bleeps” mean.
CARE OF YOUR BABY
Your baby has been protected in a dark, warm womb and is suddenly exposed to bright lights, noise and possibly painful procedures, and may no longer feel protected and secure.
We try to keep the lighting in the nurseries subdued; just using the dimmer switches and lamps. You may also notice that your baby’s incubator is covered with a cover to create some shade.
The Unit can be a noisy place but we do try and keep noise to a minimum, especially during rest periods. Talk gently and quietly to your baby. Try and close incubator doors and bin lids quietly. Don’t worry though if you have a lively toddler with you – your baby will have to get used to having them around!
Babies like to feel cozy and secure and we find that by providing boundaries or nesting for the babies in their incubators or cots with blankets or sheets they are more settled and rested. The nurses will show you how to do this.
There are a few things that you can do to help both calm and stimulate your baby.
- talking, singing, saying nursery rhymes, telling stories
- playing cd’s of gentle music, nursery rhymes or lullabies
- cuddling stroking, rocking and holding
- kangaroo care, skin to skin and baby massage
- you could put something that smells of you or your home in the incubator or cot e.g. scarf or special blanket
- photographs of you, or the baby’s brother or sister can be placed inside or beside the incubator or cot
- pictures, drawing or small toys can be placed near their bedside
You may be given a chart to fill in your baby’s like and dislikes as you get to know him or her. The Unit also likes you to fill in the chart with the times that you will be visiting your baby once you have gone home.
Finally remember – YOU are the constant factor in your baby’s life, and you do contribute so much to your baby’s well being. The Unit could not manage without you.
FEEDING YOUR SPECIAL CARE BABY
The nutritional needs of the premature baby are different from those of a full term infant. During the last weeks of pregnancy the growth rate of the unborn baby is almost twice that of the full term infant in the first few weeks of life. Sucking and swallowing reflexes are absent or poorly coordinated in babies of 33 weeks gestation, so specialised feeding may be required.
Mothers are given support and guidance with whatever method they choose to feed their baby by.
Some babies are strong enough to suck from the breast or bottle from birth. If this is not possible then your baby may need feeding by a tube, which is passed through the baby’s nose and goes into the stomach. This is called naso-gastric feeding. Mother’s breast milk or formula milk may be given this way. The nursing staff perform naso-gastric feed, but you may be taught how to do this if your baby is on the Unit for a length of time.
Very small or sick babies may not be able to tolerate naso-gastric feeds. Nourishment is therefore given continuously through an artery or a vein. It is know as intravenous feeding. If this method of feeding is necessary then breast milk can be frozen and saved until your baby is strong enough to tolerate milk. Humilactors (electric breast pumps) can be borrowed from SCBU whilst your baby is still on the Unit.
Babies often need Vitamin supplements whilst on the Unit and after discharge, to help promote growth. This will be discussed with you.
Vitamin K is given to every baby at birth, (with your permission).
A heel prick blood test is routinely performed on all babies as part of the National Metabolic Screening Programme when they reach 5 days of age. This is to exclude some rare conditions such as phenylketonuria. A leaflet will be given to you prior to the test.
All babies will have a hearing test (audiology) in their first few weeks of life as part of the NHS Newborn Hearing Screening Programme.
Some babies may also need their eyes checking for Retinopathy Of The Newborn, again this will be discussed with you by the nursing staff.
Parents are of vital importance to the well-being of their baby and so are welcome on the Unit day or night. The brothers and sisters of the baby are welcome as well, but please do not bring children except the baby’s siblings. Other visitors are welcome to visit between 2pm to 3.30pm and also between 6.30pm to 8pm.
All visitors must be accompanied by at least one of the parents – a maximum of 2 visitors (plus parents) at any one visiting time with no swapping over of visitors (ask the staff to explain this). This is to avoid overcrowding and extra noise on the unit. If your baby is in the intensive care nursery (Nursery 1) then please discuss visiting with the nurse caring for your baby.
There may be occasions when you are not able to go into the nursery straight away – the nursing staff will explain to you why at the time.
Each day between 1 pm and 2 pm there is a designated ‘quiet period’ At this time the lights are dimmed and noise activity in the area near the babies is kept to a minimum, with the exception where very ill babies require continuous care and attention.
On the Unit there are a selection of toys to entertain your children when they visit. The Unit does request that your children are supervised at all times whilst visiting, by either yourselves or a member of your family.
For your comfort it is advisable for you and your family to wear loose and comfortable clothing as the Unit us a very warm environment.
Small sick babies are very susceptible to infection and therefore the Unit asks that you wash your hands before you touch your baby
The Unit also requests that you do not touch any other baby on the Unit as this can put that baby at risk from cross-infection.
If any of your visitors are unwell, then please ask them not to visit the unit until they are well (anyone who has had a stomach bug must be symptom free for at least 48hrs before they visit).
During the past few years, York Hospitals NHS Trust has increased security throughout the hospital. In the area of the Maternity Unit and SCBU, closed circuit TV is in operation 24 hours a day.
All babies have a security tag on and access to the Special Care Baby Unit is restricted and monitored.
The entrance to the Unit is via an intercom/camera system.
Parking within the hospital car parks has proved difficult in recent times. Parking permits are available to parents of babies in the intensive care nursery and you can park free in the designated area close to the maternity unit entrance. Other parents are asked to park in the multi-storey car park this is again free but you should bring your car park ticket with you to the unit so that it can be validated. Once validated you have 30 minutes to leave the car park so only validate it when you are ready to leave
Parking in any other areas of the car Park will incur a fine and/or wheel clamping.
Although we would prefer that these are not used on the unit we appreciate that many parents do use them. Please do not use them in Nursery 1 & 2 and wherever possible please use them away from the nurseries and keep them on silent at all times.
A ‘No Smoking Policy’ is enforced throughout the hospital grounds.
ACCOMMODATION AND REFRESHMENTS
During your stay on the Special Care Baby Unit, you are welcome to use the facilities provided and funded by the SCBU Support Group. They include a kitchen which has tea and coffee making facilities and the use of a fridge and microwave. There is also a sitting room that has a TV and DVDs where you can take a break from the Unit. Your baby may also be able to join you for short periods when their condition is stable enough.
As the Unit is very warm you are encouraged to help yourselves to cold water at any time. Hot drinks are not allowed in the nursery areas. Sandwiches and drinks are available from the shops in the Main Entrance and meals can also be obtained from the hospital’s Mallard Restaurant. Please feel free to use the sitting room rather than taking food into the nurseries.
GETTING READY FOR HOME
The most important thing that any parent wishes to know when your baby is on SCBU is ‘when can we take him/her home?’ As your baby may be quite small he/she will usually have to stay in hospital for a while after you have gone home. When your baby is maintaining his/her temperature, feeding well by breast/bottle, and gaining weight he/she will be discharged from hospital.
Before your baby is discharged the nurses on the Unit will go through a few procedures with you e.g. bathing your baby and the giving of any medicines they may need. Some babies may also require oxygen therapy on discharge. The nursing staff and Community Special Care Sister will give guidance and support to you if this happens.
As your baby is near the end of their stay on SCBU you may be invited to stay in one of the purpose built bedsits. The Unit has a single and a double bedroom where you can stay with your baby to get used to looking after them independently.
Your baby may need their first course of vaccinations before going home from SCBU. This will be discussed with you by the doctor, and your written consent obtained prior to the procedure. Your baby will be closely observed and given pain relief if necessary. Information leaflets are available on the Unit.
When you take your baby home the house needs to be kept at a constant draught free temperature of 18-20 degrees centigrade.
If you are taking your baby home in the car, please practice with your car seat before collecting your baby.
- not all car seats fit every car
- never use a second hand car seat unless you can guarantee it has not been involved in an accident
It is important that you follow the rules laid down by the Foundation of the Study of Infant Deaths (FSID) when putting your baby to bed. These rules are implemented on SCBU when your baby is almost ready for home and include;
- put your baby to sleep on their back
- do not let them get too hot
- provided a smoke free environment
- place your baby in the feet to foot position in bed
- get medical advice if your baby appears unwell
If you have any questions regarding this, please do not hesitate to ask.
Taking your baby home can be frightening as well as exciting for you. You can easily become exhausted and irritable, and it is very important that you get adequate rest.
It is tempting to want to show your baby off, but please keep visitors to a minimum in the first few weeks.
Above all, enjoy your baby – they are not babies for long!
SUPPORT AT HOME
Once you have taken your baby home, please don’t feel abandoned. If you are worried, do not hesitate to phone the Unit. Your Midwife, Health Visitor or Community Neonatal outreach will be visiting you at home. The Unit has two neonatal outreach sisters who work in the community.
Understandably they cannot visit everyone, so it is normally the very premature or vulnerable babies who need there support.
FOLLOW UP CARE
Some babies will need to be seen at the follow up clinic in the Child Development Centre at the hospital nearest to your home. This is to keep a check on your baby’s progress and an appointment will be given to you before your baby’s discharge. Other appointments may also be necessary for some babies.