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, a patient affairs officer, medical social workers, 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.

UNIT PHILOSOPHY

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), at least 36 weeks gestation.

There are other reasons which may also require your baby to be admitted, for example:-

• Babies whose birth weight is less than 2.4kg (5ibs 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
• Babies of diabetic mums who are on insulin
• 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 babies 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 hearing and eye tests, x-rays, and other specialised tests. Routine blood tests are performed weekly on all the babies. 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.

EQUIPMENT

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 it's 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.

This is one of the two Intensive Care cots on the Unit.

INCUBATOR

This is a transparent cot used to control and maintain your babies temperature and to allow maximum observation by the nurses and doctors.

INFUSION DEVICES

When babies are too ill or too immature to feed, their nourishment is given by way of an infusion, or 'drip' as it is more commonly called.

MONITORS

Monitors vary in size and shape but their purpose remains the same. They display the heart rate, breathing rate, blood pressure. oxygen saturation and/or temperature of your baby, and are attached by adhesive pads to the chest and limbs.

OXYGEN

Should your baby require oxygen this may be administered directly into the incubator or via nasal prongs. Some babies may require extra help with their breathing with the aid of a mechanical breathing machine called a ventilator.

PORTABLE ULTRASOUND SCANNER

This is kept on the Unit and is used as an aid for the medical team to view internal organs.

X-RAY MACHINE

The unit has it's own portable x-ray machine. This allows x-rays to be done quickly and efficiently when required.

PHOTOTHERAPY UNIT

This consists of a mobile frame supporting a canopy which houses 4 florescent tubes and is used to reduce the bilirubin level of a jaundiced baby (the yellow discoloration of the skin).

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 small sheet 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.

These include

• 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 with 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 babies 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.

VISITING

Parents are of vital importance to the well-being of their baby and so are welcome on the Unit day or night. Open visiting is available for brothers, sisters (siblings) and grandparents (accompanied by a parent). 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. We suggest that just parents and siblings visit at this time. This is an ideal opportunity to get to know your baby in a quiet peaceful environment.

On the Unit there are a selection of toys and books 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.

Other relatives and friends can visit the Unit between 7pm and 8pm. Because the nurseries can be very busy the Unit asks that only two people visit at any one time accompanied by yourselves. If you have close family or friends who have travelled a long way or find it difficult to visit at those times please speak with the member of staff that is looking after your baby.

VISITING RESTRICTIONS

There are some restrictions that are necessary in order to protect your baby from infection.

• persons under the age of 16 years are not allowed to visit the Unit except for brothers and sisters.

Small sick babies are very susceptible to infection and therefore the Unit asks that you wash your hands before you touch your baby and ensure that siblings, relations and friends all do so as well.

The passing round of your baby to too many people to cuddle increases the risk of infection.

The Unit also requests that you do not touch any other baby on the Unit as this can put that baby at rink from cross-infection.

If you or any other person have an infection or are feeling un-well please discuss this with the nurse who is looking after your baby before visiting.

SECURITY

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. For reasons of security the Unit does not permit any relative or friends to visit any baby when a parent is not present, unless prior arrangements have been made.

PARKING

Parking within the hospital car parks has proved difficult in recent times. Parking permits are available to parents on the Unit and can be obtained from a member of staff. The permit does not automatically guarantee a designated parking place, but if a space is available then you only need pay the discounted price of £2.00.

Parking in any area of the hospital other than the Main Car Park will incur a fine and/or wheel clamping.

MOBILE PHONES

Mobile phones must be switched off before entering the Unit because they may interfere with the medical equipment that is in use on SCBU.

NO SMOKING

A 'No Smoking Policy' is enforced throughout the hospital grounds.

ACCOMODATION 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 video 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.

NB The kitchen has recently been refurbished and the rest of the area is due to be refurbished in the very near future.

A cold water dispenser is located on the Unit with a variety of flavoured fruit juices. As the Unit is very warm you are encouraged to help yourselves to cold drinks 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.

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.

NB The bedrooms are also due to be refurbished by the Support Group in the near future.

VACCINATIONS

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.

AT HOME

When you take your baby home the house needs to be kept at a constant draught free temperature of 16-20 degrees centigrade.

If you are taking your baby home in the car, please practice with your car seat before collecting your baby.

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;

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 Special Care Sister will be visiting you at home. The Unit has two Special Care 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.

This information was taken from the booklet that is given to all parents who have a baby admitted on the SCBU and was funded by the Support Group - thank you!