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Tube feeding your baby on the Neonatal Unit

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Tube feeding your baby on the Neonatal Unit

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Activities and information for siblings of neonatal babies. Available on the unit or can be printed off for you :-)

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Join the outreach team and Jo from the chaplaincy team to meet other parents in a safe and understanding setting who have also experienced neonatal care. All are welcome, whether you spent days, weeks or months in NICU.

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Financial support, information and practical help

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We know how tough it can feel when your baby is in hospital and you are worried about your finances. We're here to support you. Choose where you live to...

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Find out more about additional leave to maternity and paternity leave as well as extra pay.

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Neonatal Care Leave and Pay: Guidance and FAQs | Bliss

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The Neonatal Care (Leave and Pay) Act 2023 – a new leave and pay entitlement for parents with a baby in neonatal care – comes into effect in England, Scotland and Wales on 6 April 2025.

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All things to know when your baby is almost ready for home. Please feel free to ask any questions to a member of our team.

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Going home from the neonatal unit | Bliss

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You may have a lot to think about when you go home from the neonatal unit with your premature or sick baby. Find out more about preparing to go home, and what support is avaliable.

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Words you might hear used on NICU

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This page contains a guide to help you understand some of the common words and terms you might hear while on a neonatal unit.

When you are new to the neonatal unit, it can feel like you hear many new words. You might hear medical words, or shortened or abbreviated words which you have not heard before. This can feel confusing and overwhelming at a difficult time.

You have the right to understand the care your baby is getting and how they are doing. The neonatal team will work to make sure they explain things in a way that you understand.

If you are ever unsure about your baby's care, or you do not know what some words mean, let the staff know. They will be happy to explain things in a different way for you, and explain anything you are unsure about.

To find the term you are interested in, scroll through the alphabetical list below.

A

Acidosis (pronounced ass-sid-oh-sis) A high level of natural acid in the blood. This can be because the lungs are not working well, or because not enough oxygen is reaching parts of the body. It can be a combination of both. Sometimes, the body produces too much acid, or the kidneys do not remove the acids from the blood. This is called metabolic acidosis.

Anaemia (pronounced anne-eem-me-ah) Too little haemoglobin in the blood (see 'Haemoglobin').

Apgar score A simple way of checking a baby's health immediately after birth, by scoring 'points' for heart rate, breathing, skin colour, tone and the baby's reactions.

Apnoea (pronounced app-knee-ah) A pause in breathing for 20 seconds or longer.

Apnoea of prematurity Premature babies may have an apnoea because of being the part of the brain that controls breathing is not developed yet. Often the baby starts breathing on their own, but might need to be gently helped by moving them slightly. Caffeine is often given to help with this. Apnoeas in premature babies might happen more than once. Most babies will grow out of apnoea of prematurity by the time they are around 36 weeks.

Apnoea alarms or monitors A monitor that checks that a baby is breathing regularly. These set off an alarm if the baby pauses for 20 seconds or longer between breaths.

Asphyxia (pronounced ass-fix-ee-ya) A condition where there is too little oxygen and too little blood flow in the body. This can cause injury to the brain and other organs in the body. The most common time for asphyxia to happen is during labour (whilst the baby is being born) or at birth.

Aspirate (pronounced ass-pi-rate) This word is used in different ways in the neonatal unit:

1. Doctors and nurses might talk about 'checking the aspirate' before putting a milk feed down a nasogastric or orogastric tube. This means that a syringe is attached to the end of the feeding tube to get a small amount of the baby's stomach contents. It will be tested by using a pH paper or stick to make sure that the tube is in the stomach and it is safe for feeding. This aspirate will be checked regularly.

2. You might hear the word 'aspirate' used when something other than air (eg. meconium) is inhaled into a baby's lungs before the baby has been fully born. This is called meconium aspiration, which can be a serious, although rare, condition (see 'Meconium' and 'Meconium aspiration' for further information).

3. Milk aspiration is when the baby inhales small amounts of milk when feeding. This can happen if they are premature and have not yet developed some skills needed for feeding.

Audiology (hearing) tests There are two ways of assessing a baby's hearing. Both involve placing earphones over the baby's ears to deliver a series of clicks. The baby's responses to the clicks are then analysed.

B

Bagging Putting a mask connected to a squeezable bag or pressure device over the baby's nose and mouth to help breathing.

Bilirubin (pronounced billy-roo-bin) A yellow part in the blood that gives a yellow colouring to the skin. High levels can be dangerous, and cause jaundice.

Blood cultures If doctors think that a baby may have an infection, a small blood sample is taken and added to and sent to the laboratory for testing. Results are available after 48 hours. When it is known what bacteria are in the baby's body, the team can check that the baby is on the right antibiotics to kill that bacteria.

Blood gases This is a test done in a laboratory to find out the levels of oxygen and carbon dioxide gases and acids in the blood. Medical staff do this to work out how well the lungs and circulation are functioning, and to make sure any breathing help they are getting is working well. The number of gases that need to be checked will depend on the problems the baby is having. Some blood gas tests also measure the amount of salt (often called sodium) in a baby's blood.

Blood pressure This is the pressure generated in the body's arteries by the pumping of the heart. It is often monitored in babies who are unwell. They can do this using a cuff on the baby's leg or arm, or a line in their vein. If the blood pressure is too low, the baby may be treated with medicine.

Blood transfusion This is when extra blood is given from a donor. A blood transfusion might be needed to treat severe anaemia (a serious lack of red blood cells), low blood pressure, or during or after an operation.

Bradycardia (brad-ee-card-ee-ah) This is when the heart rate slows down for a period of time. This is common in premature babies. It is usually part of apnoea of prematurity (see above). The baby usual recovers on their own. Sometimes, the staff might need to stimulate the baby to make them respond. Bradycardia usually stops after about 36 weeks' gestation.

Breast pump Piece of equipment used forexpressing breast milk. They can be manual (done by hand) or electric.

Broncho Pulmonary Dysplasia (pronounced bron-co pul-mon-air-ree dis-play-zee-a) See 'Chronic lung disease'.

C

Candida (pronounced can-di-dah) A yeast infection (where fungus grows) of the skin, mouth, gut, groin or inside parts of the genitals).

Cannula (pronounced can-you-la) A very small, short, soft plastic tube that is put into a baby's vein to give fluids or medicines straight into the bloodstream without having to keep using needles. Veins in the arms and legs are usually used, although sometimes the veins in the baby's scalp have to be used. A cannula can last for several days but can also need to be changed every few hours.

Cannulae (pronounced can-you-lee)

Soft plastic prongs which go into the nose to send oxygen into the lungs.

Centile charts (pronounced sen-tile) Graphs showing the normal ranges of body measurements at different ages, like weight and the size of the baby's head.

Cerebrospinal fluid (sometimes called CSF, and pronounced se-ree-bro-spy-nal) Fluid made within the parts of the brain which flow down and around the spinal cord. If anything gets in the way of this flow, fluid can't be removed and the pressure rises. This can cause the parts of the brain to get bigger, which can lead to a condition called hydrocephalus.

Cerebral Function Monitor (sometimes called CFM)

A machine that looks at the background electrical activity in the brain. It can tell if a baby might have a fit. This is often used for babies born at term (near their due date) who might have asphyxia (see above) and are being treated on a cooling mattress.

Chest drain A tube passed through the chest wall into the space between the lungs and the outside of the chest to drain off air or fluid leaking from the lung.

Chronic lung disease (CLD) A condition of the lung that may happen because the baby has been on a ventilator for a long time. With CLD, the baby needs more oxygen and may find breathing difficult. This can take some time to improve. CLD is also known as broncho pulmonary dysplasia (BPD, see above).

Chronological age (pronounced cron-a-lodge-ick-al) A baby's age from their date of birth.

Cooling mattress A cooling mattress is used to treat hypoxic ischaemic encephalopathy (HIE, see below). The mattress cools the baby to prevent damage to the brain.

Corrected age The age a premature baby would be if they had been born on their due date.

Continuous positive airway pressure (CPAP) A type of treatment used to help a baby's breathing and helping them have fewer moments of apnoea. Using a CPAP machine, the lungs are expanded by applying a small amount of pressure (oxygen or air) through small prongs just inside the nose or by a small mask over the nose. In some cases a premature baby may be on and off CPAP for several weeks.

CT scanner This is a special type of X-ray machine that is more detailed than a normal X-ray. In babies, it is usually used to look in detail at parts of the brain or sometimes the chest.

Cyanosis (pronounced sigh-an-oh-sis) When there is not enough oxygen in the blood. It can make the skin, lips, the tongue and nails appear a blue, dusky colour.

D

Developmental care This is about making the baby's surroundings as free of stress as possible to help improve how your baby develops over time. This is done in several ways, by:

Reducing the amount of light and noise that the baby is exposed to. The staff might cover the incubator with a sheet or specially-made cover

Creating a 'nest' to nurse a baby, which makes them feel more comfortable and secure

Changing how your baby is disturbed

Massaging your baby

Involving babies in caring for their baby on the unit - for example Kangaroo Care.

Dysmorphic When the doctors and nurses see some features in a baby that are unusual. In many cases, the features turn out to be normal and cause no concern. If there is a problem, a number of tests will be carried out and, if necessary, other specialists may be asked to look at your baby and give an opinion.

Drip When fluids or blood are passed into a vein or artery using a needle or plastic tube. The word drip is sometimes used instead of Cannula.

E

Electrocardiogram (sometimes called ECG, and pronounced ee-leck-tro-car-dee-oh-gram) A test to look at the heart's electrical activity.

Electroencephalogram (sometimes called EEG and pronounced ee-leck-tro-en-seph-la-gram) A test to look at the brain's electrical activity. This is often done in a different unit of the hospital.

Extracorporeal membrane oxygenation (sometimes called ECMO, and pronounced ex-tra-corp-or-ree-al mem-brain ox-i-gin-a-shon) This machine puts oxygen into the blood when a baby born at term is not able to do this using their heart and lungs. It might be used in very sick babies when treatment with a ventilator has not worked. As this is a special machine, babies might need to be moved to another hospital for this treatment.

Electrolytes (pronounced E-leck-tro-lites) Salts in the body (which can be measured in blood tests) that are essential for the body to work.

Endotracheal tube (sometimes called an ET tube, and pronounced en-doe-track-eel) Soft plastic tube put through the mouth or nose into the windpipe (trachea), which is attached to a ventilator to help breathing. It is often called a tracheal or ET tube.

Exchange transfusion Replacing a baby's blood with blood from an adult donor. This is done if a baby's jaundice level (see below) is very high and they are not getting better with treatment.

Expressed breast milk (EBM) Expressing breast milk means to use a pump, hands or both to get milk from the mum's breasts. The milk can be stored in a fridge or freezer or given directly to the baby.

Extremely low birthweight A baby born weighing less than 1000g.

Extubate (pronounced ex-tube-ate) Removing the endotracheal tube (see above) from the windpipe.

F

Fontanelle (pronounced fon-tan-el) Soft spots on a baby's head that disappear by 18 months, as the skull bones grow and join together.

Family-centred care This means involving families in the care of their baby on the unit. Find out moreinformation about family-centred care.

Family-integrated care This is a care model, which is an extension of the principles of family-centred care. This model can be used by neonatal units.

G

Gases and Gas monitor See 'Blood gases'.

Gestational age (pronounced jest-a-shon-al) The number of weeks the baby has been in the womb is known as the gestation. Being born at term means being born after 37 full weeks in the womb but before 42 weeks. If a baby is born before 37 weeks gestation, they are considered to be premature (sometimes called preterm by medical staff).

Glucose monitor This is a machine that can measure the amount of glucose (sugars) in the blood.

Grunting A noise made by a baby with breathing difficulty.

H

Haemoglobin (pronounced hee-ma-glow-bin) Carries oxygen around the body. It is found in the red blood cells.

Head circumference (pronounced sir-come-for-ence) Measurement of the biggest distance around the baby's head.

Heat shield Clear plastic shell placed over the baby to prevent heat loss.

Heated, humidified high-flow nasal cannula (HHHFNC, or high-flow) Where warm, moist air flows into your baby's lungs through small tubes in their nose.

High dependency unit (HDU) Another way to describe the level of care babies get in a local neonatal unit. Babies who need a higher level of medical and nursing support than provided in a special care baby unit (SCBU) are cared for here.

High frequency oscillatory ventilation A type of ventilator. With most ventilators, you can see the baby's chest rise and fall at the breathing speed that has been set, which looks like regular breathing. Oscillators use very fast speeds, so the baby's chest appears to vibrate. This may look alarming, but this type of ventilation works extremely well for some of the lung conditions that babies may have.

Humidity To prevent premature babies losing too much water through their skin, they are often looked after in warm, humidified incubators. This is why there is sometimes mist on incubators. Humidity (water) is also added to the gases the baby breathes through the ventilator, CPAP or high-flow machines (see above).

Hyaline membrane disease (HMD) A breathing problem in which the lungs are stiff and collapse instead of staying filled with air. This is also known as respiratory distress syndrome (RDS).

Hydrocephalus (pronounced high-dro-keff-al-uss) When too much fluid is present inside the parts of the brain. The increased pressure in the brain might cause the head size to increase very quickly.

Hypocalcaemia (pronounced high-po-cal-sea-me-a) A low blood calcium level.

Hypoglycaemia (pronounced high-po-gly-sea-me-a) A low blood glucose level.

Hypothermia (pronounced high-po-ther-me-a) A body temperature of below 35.5°C (95°F).

Hypoxia (pronounced high-pox-ee-a) A low amount of oxygen in the body tissues.

I

Incubator A heated bed covered by a clear plastic box that allows the baby to be kept warm without clothes so that they can be monitored very closely. Humidity and extra oxygen can be run into the incubator if needed. The levels of oxygen can be very closely controlled and monitored.

Incubator cover A special cover that is made to fit over an incubator to shield the baby from light and noise.

Infusion pump Like a syringe, and provides fluids, medicine or nutrients directly into the blood or gut. These can be given over a set period of time.

Inotrope A medicine used to support blood pressure

Intra-ventricular haemorrhage (sometimes called IVH, and pronounced in-tra-ven-trick-you-la hem-or-ridge) This is a common in premature babies where there is bleeding into the fluid chambers (ventricles) of the brain. IVHs are graded 1-4, according to their size, and are found on an ultrasound scan. Grade 1 bleeds are quite common in premature babies and tend to have no long-term consequences. Grade 4 bleeds (the biggest) means that there is bleeding into the brain tissue and may mean the baby has difficulties as they develop and grow.

Intravenous (IV) lines Fine tubes (cannula) that are sometimes put into a blood vessel - usually in a hand, foot, arm or leg - in order to give fluid or medicine directly into the blood.

Intravenous (IV) nutrition A way of supplying all the most important nutrients directly into the blood through an IV line (see above).

J

Jaundice (pronounced jawn-dis) A yellowness of the skin and/or whites of the eyes caused by a high level of bilirubin (see above) in the blood. It is very common in babies, and is caused by the normal breakdown of the baby's red blood cells. However, high levels can be dangerous and phototherapy (shining blue light onto the baby's skin) may be needed to prevent high levels.

Jejunal feeding (pronounced ju-jew-nal) Putting milk, using a special soft tube through the nostrils, into the jejunum (part of the small intestine). This is not as common as other types of tube feeding.

L

Long line This is a longer cannula that is put into a vein in the arm, leg or head, with the end of the line lying close to the heart. It is also sometimes called a central line. These lines are used to give the baby IV nutrition directly into a vein when the starting of milk feeds has to be delayed. They can also be used for medication.

Low birth weight (LBW) There are three categories of low birth weight:

Low birth weight (LBW) - a weight at birth of less than 2500g

Very low birth weight (VLBW) - a weight at birth of less than 1500g

Extremely low birth weight (ELBW) - a weight at birth of less than 1000g

Low flow oxygen A way of giving small amounts of oxygen to babies

Lumbar puncture (LP) or Lumbar tap Meningitis is a very bad infection around the outside layers (called membranes) of their brain and spinal cord. If doctors are worried your baby might be getting this condition, they will take action quickly, as it can become serious. The doctor or nurse practitioner will put a small needle into one of the spaces low down in your baby's back, take some of the fluid and send it for testing. The team will offer your baby things like expressed breast milk to help ease any pain.

M

Magnetic resonance imaging (MRI) scans Scans that can give a very useful computer-generated picture of the organs inside a baby without harming them. If your baby has an MRI scan, they will be placed in a special incubator that keeps them safe and warm while inside the scanner. MRI images are very useful for checking for any brain damage, and can help see how a brain is maturing. In most hospitals, the MRI unit will be in a different part of the hospital, so the baby will need to be well enough to travel there.

Meconium (pronounced mew-co-knee-um) A dark greenish sticky solid that builds up in the baby's digestive system before they are born. It usually starts being passed as bowel movements within 24 hours after birth.

Meconium aspiration (pronounced mew-co-knee-um ass-pir-ray-shon) A baby who becomes distressed during labour and before they are born may pass meconium while they are still in the womb. If the baby then breathes the fluid which is surrounding them in, the sticky material can block part of the airways. This can cause inflammation in the lung, and mean the baby finds it hard to breathe soon after they are born.

Morphine (pronounced more-feen) A drug used to reduce the discomfort and stress that babies might experience from some of the treatments they need. It can reduce their own breathing, and so the drug is usually reduced or stopped when a baby is taken off a ventilator. If a baby has needed it for quite a long time, they might become jittery when it is stopped, due to not having the drug in their system anymore.

N

Nasal cannula (pronounced nase-al can-you-la) Small tube put into the nostrils to give a baby oxygen.

Nasogastric feeds (sometimes called NG feeds, and pronounced nase-oh-gas-trick) Nutrition fed using a fine, soft tube passed through the nose into the stomach.

Nasogastric tube (sometimes called an NG tube) A long, thin, soft plastic tube that is passed through a baby's nose into their stomach. This tube is used to give milk to a baby until they are strong enough to take milk from the breast or a bottle.

Neonate The first four weeks of a baby's life (up to 28 days).

Necrotising enterocolitis (sometimes called NEC, and pronounced neck-crot-tize-ing ent-er-co-light-is) A serious condition, where tissue in the bowel (small and large intestines) becomes inflamed. NEC can make a baby temporarily unable to take milk, and at its worst it can cause parts of the bowel to become so damaged that tissue within it dies. NEC can affect just a small part of the bowel, or sometimes the whole bowel can be affected. It is common

NICU This stands for the neonatal intensive care unit.

Nitric oxide This is normally made in the body to relax blood vessels. It means blood can flow to all parts of the body. When the blood vessels to the lungs stay narrow, nitric oxide is sometimes given in the air and oxygen given to a baby to cause them to relax and allow blood flow to the lungs.

NNU This stands for the neonatal unit.

O

Oedema (pronounced oh-deem-a) Swelling caused by too much fluid in the tissues under the skin.

Open cots When a baby can keep their own body temperature stable, they can be transferred from an incubator into a cot without a roof.

Orogastric tube A fine tube passed through the mouth and into the stomach. It is used to give milk to the baby. Sometimes this is done instead of passing the tube through the nose (see Nasogastric tube above)

Oxygen saturation This is measured by placing a special probe on the hand or foot of the baby. This can measure the amount of oxygen flowing through the baby's blood vessels. If the oxygen level drops, the alarm will alert the nurse. If the baby is moving around a lot, sometimes the reading is not lower than it actually is.

P

Parenteral nutrition Nutrition given directly into the bloodstream. It is often called total parenteral nutritionor TPN. The liquid contains sugars, proteins, fats and vitamins - everything the baby needs to grow. Parenteral feeding solutions are often given through a long line.

Patent ductus arteriosus (sometimes called PDA, and pronounced pa-tent duck-tuss art-ear-ree-oh-sis) Where the small connection between the vessels supplying the lungs with blood, and the vessels supplying blood to the body, stays open. This is a very common problem for very premature babies.

Patent ductus arteriosus (PDA) ligation An operation which mends a PDA (see above).

Peak Inspiratory Pressure (PIP) The pressure applied by the ventilator to inflate the lungs (breathing in).

PEEP (positive end expiratory pressure) Pressure applied during breathing out. This helps to stop the lungs from collapsing while the baby is on the ventilator (see hyaline membrane disease above).

Periodic breathing When a baby pauses breathing for up to 10 seconds.

Periventricular leukomalacia (sometimes called PVL, and pronounced perry-ven-trick-you-la luke-oh-mal-a-zee-a) This is where the brain doesn't get enough oxygen and blood flow when it is developing, and the brain cells may die and be replaced with fluid cysts. These can be seen in ultrasound scans of a baby's brain. Depending on the area affected, PVL may show possible future problems with development.

Persistent pulmonary hypertension of the newborn (sometimes called persistent fetal circulation, and pronounced pur-sis-tant pul-mon-air-ree high-per-ten-shon) Before birth, the blood vessels of the lungs are narrow. If the blood vessels do not relax after birth, lungs can't get enough blood flow. Oxygen, ventilation, and sometimes nitric oxide and drugs, are given to open the narrow vessels.

pH The acidity (low pH value) or alkalinity (raised pH value) of the blood. A value close to 7.3 is normal for a baby's arterial blood (blood which comes from the heart and to the rest of the body).

Phototherapy Using blue (not ultraviolet) light to reduce the bilirubin level in babies with jaundice (see above).

Physiotherapy Special treatment to help a baby's development in their movement and behaviour. This might include advice on positioning and stretching exercises, as well as treatments for their chest.

Platelets A part of the blood that helps with clotting. If levels are low, platelets can be given in a blood transfusion.

Pneumothorax (pronounced new-mo-thor-axe) When the lung has leaked air between the lung and chest wall (rib cage). This makes it hard for the lungs to expand and take in air. The air can be removed using a chest drain (see above).

Posset When the baby brings up a small amount of milk after feeding.

Pre-eclampsia This condition is quite common in pregnancies and can cause the baby to be born prematurely. It can be dangerous, particularly if it develops quickly. The main symptoms are headaches and swollen feet, which are linked to having high blood pressure. Bed-rest can help, but sometimes the only way to stop pre-eclampsia is to deliver the baby early.

Preterm baby A word used by health professionals to describe a premature baby, born before reaching 37 in the womb.

Pulse oximeter This measures oxygen saturation levels (see above).

R

Resuscitate The help given to babies (usually at birth but sometimes during their stay in the neonatal unit) when they need urgent help with their breathing and circulation.

Retinopathy of prematurity (ROP) Damage to the retina (back) area of the eye that is sensitive to light. Premature babies and those born with a very low birth weight are at a higher risk of this condition. It is linked to the amount of oxygen in the blood reaching the retina. It is most common in premature babies born before 32 week's gestation, or babies born weighing under 1500g at birth. These babies are regularly checked for retinopathy of prematurity by a specialist ophthalmologist (a doctor who is an expert in the eyes).

Respiratory syncytial virus (sometimes called RSV, and pronounced res-pir-a-tor-ree sink-ee-tal vi-russ) This virus causes cold-like symptoms, and affects a lot of babies. can make it harder to breathe if the lungs are affected. If your baby was born prematurely, gets a lot of lung infections, or was born with a congenital heart problem, they could become more poorly than other babies if they catch RSV. Very high risk babies might be given a vaccination against the virus.

S

Saturation monitor (prounounced sat-ture-a-shon) See 'Pulse oximeter'.

Scans (ultrasound) The ultrasound scan used on the neonatal unit is similar scans done on pregnant women. The most common scan is on the brain. This is done with a small probe on the fontanelle (see above). There can be lots of reasons for doing scans, but usually it will be to monitor a premature baby's brain, as they are at risk of bleeding into the brain. Other parts of the body that might need ultrasound scanning are the tummy or the heart. A scan of the heart is often called an echocardiograph, shortened to an 'echo'.

SCBU This stands for special care baby unit.

Small for gestational age (SGA) A baby whose birth weight is lower than that of 90% of babies of the same gestational age (see above).

Sleep study This is a test done on babies who have been on oxygen for a long time. It is often done a short time before the baby is due to go home. The test sees whether the baby can keep their own oxygen levels in a safe range. If the baby is to going to go home on oxygen, then the test is used to set the amount of oxygen that the baby will need. Usually the sleep study will happen over a period of 12 hours and must include a period when the baby is in quiet sleep, as this is the time that the body's oxygen levels are usually at their lowest.

Steroids Steroids (or corticosteriods) are used in several ways. They can be:

Given to mums before the baby is born, when the birth seems likely to happen early. The drug crosses the placenta and causes the baby's lungs to mature, ready for breathing.

Given in the first week or so after birth to babies getting intensive care, to improve the blood pressure in babies with very low blood pressure, where other medication is not working

Given to babies with chronic lung disease (see above), as it may be difficult for the baby to come off the breathing machine. Low doses of steroids can reduce any inflammation (swelling) in the lung.

Stridor A harsh noise made by a baby on breathing in, because of a blockage in the upper airway.

Surfactant (pronounced sir-fact-ant) A mixture of chemicals that stop the lungs from collapsing when the baby breathes out. The lungs start making this at about 24 weeks' gestation, but is not well developed before 36 weeks'. This can be the cause of respiratory distress syndrome (RDS - see above). Replacement surfactant can be given as a liquid into the lungs of the premature baby soon after birth.

Syringe driver See infusion pump above.

T

Tachycardia (pronounced tack-ee-card-ee-ya) A rapid heartbeat. Sometimes health professionals might say a baby is 'tachy' if they have a fast heart rate.

Tachypnoea (pronounced tack-ip-knee-a) Rapid breathing rate.

Temperature skin probe A small device that is put on the skin to measure the baby's temperature.

Total parenteral nutrition (TPN) See 'Parenteral Nutrition' above.

Transcutaneous monitors (pronounced trans-cue-tain-ee-uss) This is a monitoring device that is put on the skin to measure the blood oxygen or carbon dioxide levels.

Transient tachypnoea of the newborn (TTN).

This affects babies born at term. In the womb, babies have their lungs full of fluid (amniotic fluid) which is very important for lung growth. When they are born, the baby takes a few deep breaths and pushes the fluid out into their circulation. If the baby does not take enough deep breaths, the lungs keep some of the fluid.

Transport incubators This is a special incubator that is used if the baby needs to be transferred to another hospital or a different part of the hospital. to another hospital or a different part of the hospital.

Trophic feeds Very small volume tube feeds that are given to prepare the gut at the start of feeding.

Tube feeding When the baby is fed through a small, fine tube that runs from the nose or mouth straight into the stomach. It is mainly used when a baby is too unwell or premature to feed by themselves.

U

Ultrasound scan See 'Scans' above.

Umbilical catheter A plastic tube put through one an umbilical artery or vein. A catheter in the artery is used to take blood samples and to measure blood pressure. A catheter in the vein is used to give fluids and drugs.

V

Ventilation is mechanical support with breathing, so that the baby will be able to have normal levels of oxygen and carbon dioxide in their blood when unable to achieve them for themselves. There are several different types of ventilation.

Ventricle (cardiac) - pronounced ven-trick-al

The pumping chamber of the heart.

Ventricle (brain) Space within the brain filled with cerebrospinal fluid (see above). This is where bleeding most commonly occurs in premature babies (see intra-ventricular haemorrhage above).

Ventricular tap (pronounced ven-trick-you-la) After an intra-ventricular haemorrhage (see above) a quick build-up of cerebrospinal fluid may happen, causing the head to grow too quickly (hydrocephalus, see above). This can be temporarily treated by putting a needle through the fontanelle (see above) and taking out some of the excess cerebrospinal fluid.
Ventriculo-peritoneal (VP) shunt (pronounced ven-trick-you-lo perry-ton-eel)
This is a tube with one end put into the ventricles in the brain, and the other into the abdominal cavity (in the tummy) to drain cerebrospinal fluid. This is used as a treatment for hydrocephalus (see above).

Very low birth weight (VLBW) A baby born that is less than 1500g.

Vital signs monitor A monitor that measures important signs like blood pressure, heart rate and oxygen saturation levels.

Vitamin K A naturally-occurring vitamin that is important for the clotting of blood. Newborn babies often don't have enough vitamin K and are given it to stop them from bleeding too much.

The information in this section is due for review November 2025

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Words you might hear on the neonatal unit | Bliss

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This page contains a guide to help you understand some of the common words and terms you might hear while on a neonatal unit.

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Parents share their experiences of being involved in medical procedures

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This page explains some of the tests, scans and care given to babies in a neonatal unit.

For any test or treatment your baby may need, health professionals will talk to you and answer your questions.

It is likely that your baby will have different tests whilst they are in the unit. This is so that your baby's needs can be met as they change. They allow the neonatal team to see how they are responding to their care.

This helps with making decisions about whether to continue with a treatment, try something new, and whether your baby needs to be moved to a different hospital for more specialist care.

During these procedures you may be able to comfort your baby to reduce their discomfort. This can be done through comfort holding (cradling their hands and feet), skin-to-skin or giving them a dummy and some expressed milk.

Tests and procedures will only be done when your baby needs them. The neonatal staff will always try to reduce pain, discomfort and the disturbance caused to your baby.

There are some common tests and procedures you might come across. You can read more about the tests and care your baby may receive on this page.

The nurses were lovely and so much more than nurses! Although NICU is so hard and you are constantly worrying when a beep goes off, I couldn't have felt like I was in more caring hands.

Samantha, mum to Bowie and Honey

Blood is the body's transport system, moving oxygen, nutrients, waste products and chemical messages to all the right places. Your baby's blood does many jobs, including fighting infection. Because of this, blood tests can show how your baby is progressing.

Most blood samples are taken by pricking the skin to get blood from the back of your baby's hand or heel.

The team might check the following things:

Sugar levels

Blood carries energy in the form of sugar. This test tells the doctors whether your baby's blood sugar levels are being properly controlled.

There are many reasons why your baby may need their blood sugar monitored. Most commonly, babies born to mums with diabetes (a condition which causes blood sugar levels to be too high) or babies born with a very low birthweight will be monitored more closely.

This is because they may have problems keeping a healthy blood sugar level.

Blood gases

As well as carrying oxygen from the lungs, blood also carries carbon dioxide back to the lungs so we can breathe it out as waste gas.

Measuring the levels of carbon dioxide, as well as other waste chemicals carried by the blood, can give information about how your baby is breathing. Blood gases can also help tell how other organs, such as kidneys, are working.

Platelets

These are important for controlling bleeding. In premature and sick babies, the platelet count can be too low. This is why it is monitored. If the level does get too low, your baby might need a platelet transfusion.

Haemoglobin (pronounced hee-mo-glow-bin)

This chemical helps blood to transport oxygen. It is carried by red blood cells. If your baby does not have enough red blood cells, the body may not get enough oxygen. This is called being 'anaemic' (pronounced an-ee-mick).

If your baby's haemoglobin gets very low, they might need a blood transfusion.

White blood cells

These cells play a big role in fighting infections. You may hear your care team talking about 'C-reactive protein' or 'CRP'. These are part of your immune system and their levels go up with infection. Checking these levels helps to see how well your baby is fighting an infection, or if an infection is starting.

Multiple tests

Sometimes, your baby might need to have multiple blood samples taken over a short period of time. This might mean that they need a blood transfusion to replace the blood that is used for testing.

This is nothing to worry about and you can ask the care team about comfort holding and other forms of parental touch to help soothe your baby during these procedures.

Scans can help doctors to see inside your baby's body. Your baby may have one or more of the following types of scan:

X-ray

X-rays are often used to look at your baby's chest, especially when they are having breathing support. They are also sometimes used to check for problems in the gut if your baby is not feeding well.

X-rays use tiny amounts of radiation, so they are only used when they are really needed. You might need to leave the room when the X-ray is taking place but they are not harmful to your baby.

Ultrasound

This type of scan uses ultrasound waves to build a picture of inside the body. A common use of these scans is to see if there is bleeding or other problems on your baby's brain. You can stay with your baby when they have an ultrasound scan.

Magnetic resonance imaging (MRI)

Many units have access to an MRI scanner, which uses a magnetic field to show pictures of your baby's internal organs. These scanners are usually in a different part of the hospital from the neonatal unit.

Sometimes they may be in a different hospital altogether and your baby will need to be transferred. This means your baby might have to wait until they are ready to be moved.

Sometimes, your baby might need to be sedated for their scan to make sure they stay still enough for the scanner to work.

I struggled with seeing my baby boy in an incubator in the first few days. However, talking to the nurses really helped.

Claire, mum to Joshua

All babies will have vision and hearing tests after they are born. Babies who are born prematurely are more likely to have problems with their sight and hearing, so they may have some extra tests.

Some babies with particular medical conditions may also have their sight and hearing tested whilst on the neonatal unit.

Babies born before 31 weeks' gestation or below 1500g of weight at birth will be screened for a condition called 'retinopathy of prematurity', or 'ROP'. This can be a serious eye condition if it isn't picked up and treated quickly.

Babies who are at risk are screened as soon as their eyes have developed enough. The specialist doctors who carry out these tests, called ophthalmologists (optal-molo-gists) can also look for other eye problems.

Babies born prematurely or with other medical conditions can also be at higher risk of hearing problems. Their hearing will be tested before they leave hospital.

Screening for genetic conditions

Sometimes, the neonatal team might want to check to see if your baby could have a condition they were born with. These can be passed on genetically - which means they are passed down from parents to their children. They can also develop on their own for other reasons that are not genetic. The doctors will talk to you about these tests, if they think they are needed.

Lumbar puncture

Some babies can get a very bad infection around the outside layers (called meninges) of their brain and spinal cord. This infection is called meningitis. If doctors are worried your baby might be getting this condition, they will take action quickly, as it can become serious.

In a lumbar puncture, the liquid around the spinal cord is taken and sent for testing. To do a lumbar puncture, the doctor or nurse will gently put your baby in a curled position on their side - this helps to make the space between the bones in their spine bigger.

Then, whilst a nurse is watching your baby closely, a doctor or nurse practitioner will put a small needle into one of the spaces low down in your baby's back. The team will offer your baby things like expressed breast milk to help ease any pain.

Emergency resuscitation (pronounced ree-sus-a-tay-shon)

It is possible that your baby might need urgent help with their breathing if they are not breathing by themselves. If your baby can't breathe for themselves, this can mean that their heart stops beating properly. This can happen straight after they are born, or during their time on the unit (if they have a serious infection, for example).

Resuscitation is where doctors help your baby to start breathing again and for their heart to start beating properly. This is usually done with equipment on the unit which focusses on your baby's airway and breathing.

Sometimes, doctors might press on your baby's chest in a special rhythm which can help start their heart again. These are called cardiac (pronounced car-dee-ack) compressions.

Important to remember

If you think that your baby has stopped breathing, there will be a red button somewhere around their incubator or cot that you should press. This will sound an alarm that immediately calls the care team to come to your baby.

The best way to help in this situation is to make sure you give the care team space to work. This can be extremely difficult but it is vital to allow space for them to help your baby.

The information in this section is due for review November 2025

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Tests and care your baby might be given | Bliss

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This page explains some of the tests, scans and care given to babies in a neonatal unit. For any test or treatment your baby may need, health professionals will talk to you and answer your questions.

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Understand what you can do to become involved in your baby's care whilst on the NICU.

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Get older brothers and sisters involved with a fun activity pack. Please ask a member of staff to print for sibling fun!

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A free app to support neonatal siblings.

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Please feel free to discuss this with a member of our team.

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Introducing you to the different ways you can

support your baby before, during and after procedures on the NICU.

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Past parents of NICU kindly took part in making this video with the Yorkshire and Humber ODN to show what 24 hours can look like in a Neonatal Unit.

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Y&H Neonatal Parent and Family Engagement 

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Understanding how different environments can affect your baby's development.

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Follow our page and keep up to date with events, our NICU family and updates from previous babies and their families.

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Welcome back to Instagram. Sign in to check out what your friends, family & interests have been capturing & sharing around the world.

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Charities and support groups for families and neonatal units.

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NICU support community

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Hello, we are Frankie and Georgie, two parts of Miracle Moon. A place of psychological support for NICU parents, past, present and future.

We both have lived experience of having our babies in neonatal care after being born prematurely at 31 weeks. We connected online, became friends and then business partners, developing Miracle Moon together, and have since provided online support for the NICU community through one-to-one therapy and social media.

Frankie, as a Clinical Psychologist, has been responsible for the educational & supportive content on our social media and works alongside Georgie as a graphic designer to bring meaningful and supportive content to our audience. We are passionate about bringing humanity, kindness, understanding and advocating for NICU parents. Our mission is to connect with as many people who have been through neonatal care as possible, to validate and support, so that no one feels alone in their feelings and experiences.

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Hello, we are Frankie and Georgie, two parts of Miracle Moon. A place of psychological support for NICU parents, past, present and future. We both have lived experience of having our babies in neonatal care after being born prematurely at 31 weeks.

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A free app for new mums offering evidence-based coping techniques.

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Support for families experiencing HIE

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What Is Hypoxic-Ischaemic Encephalopathy (HIE)? | Peeps HIE Charity

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HIE stands for hypoxic-ischaemic encephalopathy. In simple terms HIE is a lack of oxygen to the brain that occurs before, during, or shortly after labour.

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Counselling and support specialists in perinatal mental health

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Perinatal Mental Health Specialists | PND counselling | House of Light

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Perinatal mental health specialists offering counselling and support to women affected by Antenatal and Postnatal Depression, and Anxiety.

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Home-Start Hull is a voluntary organisation offering both practical and emotional support to families with at least one child under five living in Hull.

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Support for families who have experienced NICU

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Hello

Welcome to The Smallest Things, a registered charity promoting the good health of premature babies and their families. We're really glad you found us. Whether you're a parent or family member looking for support, an employer wanting to help your staff, or a health professional looking for information, you're in the right place.

Following its #NotMatLeave campaign, The Smallest Things was delighted when the government announced in March 2020 that parents of babies admitted to neonatal care would receive paid time off work.

Plans for 2022/23 were recently made public and once again the government has failed to include neonatal leave. This is despite Prime Minister Boris Johnson assuring us in November 2021 that legislation would be brought forward ''one way or another''.

Neonatal families have been forgotten and continue to be kept apart by work and financial pressures at a time they need to be together most.

About us
The Smallest Things exists because we don't believe there's enough understanding of the unique needs of families of premature babies.
Going home from the hospital is far from the end of the journey through neonatal care. Many babies have longer-term needs and lots of parents struggle mentally, practically and financially following the trauma of NICU. We're here for them.

From signing the petition to extend parental leave to making a donation or hosting a picnic, there are lots of ways you can support The Smallest Things...

Fundraise for us
Fancy getting your trainers on and running 10K? Or perhaps coffee and cake are more your thing? There are lots of ways to raise money for The Smallest Things and we'll support you every step of the way.

Ask your employer
In February 2018, with no sign of new legislation on the cards, we launched our Employer with Heart charter, asking businesses to extend parental leave for staff who have babies born early. Has your workplace signed up to our charter yet?

Make a donation
We're a tiny charity run entirely by volunteers so every penny really does count. Your donations help us to raise awareness, carry out research, host events, consult with government officials and launch schemes such as our 'preemie proud' red book stickers.

Sign the petition
More than 350,000 people have signed our petition asking Kelly Tolhurst MP and government colleagues to recognise the significant and unique needs of families with children born prematurely and to extend statutory leave accordingly. Is your name on the list?

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The Smallest Things exists because we don't believe there's enough understanding of the unique needs of families of premature babies. Going home from the hospital is far from the end of the journey through neonatal care. Many babies have longer-term needs and lots of parents struggle mentally, practically and financially following the trauma of NICU.

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Y&H Neonatal Parent and Family Engagement 

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Transferring between neonatal units in Yorkshire and Humber

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Reasons why your baby might be transferred

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Reasons why your baby might be transferred

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Y&H Neonatal Parent and Family Engagement 

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Reasons why your baby might transfer between neonatal units

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Y&H Neonatal Parent and Family Engagement 

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Y&H Neonatal Parent and Family Engagement 

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What is the Yorkshire and Humber Neonatal Network?

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What levels of care do different neonatal units provide?

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What levels of care do different neonatal units provide?

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Y&H Neonatal Parent and Family Engagement 

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Different levels of neonatal units and what they provide

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Understanding the importance of skin to skin and kangaroo care, and what it can do for you and your baby.

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Positive touch is a way of communicating your love and reassurance to your baby and hearing your baby's needs in return. Babies do communicate, and by watching and listening to your baby you can learn what kind of touch to use and when it is appropriate, safe and pleasurable for your baby.

It's harder for your baby to communicate when exposed to too much noise, too much light, too much cool air, or an uncomfortable lying position. See whether the environment can be calmed down first. In time, you will get to know your baby's individual ways and you may find your baby responding more often and for longer.

Comfort holding

Comfort holding is one of many ways for you and your baby to get to know each other. Your baby may be more comfortable lying in the incubator than being held. In this case, the staff may suggest that you try comfort holding if they think your baby is well enough. Comfort holding is 'still touch'. Cradling your baby with still, resting hands can be more comforting than stroking or massage, which are more stimulating.

Comfort holding can:

soothe your baby during uncomfortable procedures.

settle a restless baby.

help your baby to get back to sleep after feeds and care.

encourage your baby to be quietly awake and responsive.

Comfort holding is a way to experience loving touch when your baby is not ready to be held.

Talk to your baby's nurse about comfort holding. Together you can watch for signs from your baby that will guide you as to when and how to do it.

Be careful to:

Remove watches and jewellery, pull your sleeves up to the elbows, and wash your hands and lower arms. This reduces the risk of infection inside the incubator.

Always make sure that your hands are warm before touching your baby.

If your baby has difficulty keeping warm, make sure there is a layer of fabric (a hat, vest or blanket) between you.

Speak to your baby before touching, so that they are aware of your presence before you start.

Cradle one or both hands around your baby's feet, head or body, and keep them still. Your baby may also like to grasp one of your fingers.

Wait and watch for signs that tell you that your baby is relaxed.

You can continue for as long as you are both comfortable. When you finish comfort holding, move your hands away from your baby very slowly.

Kangaroo Care

Kangaroo Care is skin-to-skin contact when a baby is placed against the parent's chest. Benefits include improvements with lactation and with establishing breastfeeding, and better weight gain for the baby. In the longer term, it helps parents to feel closer to their babies and more confident in caring for them. Kangaroo Care can be used with babies with high medical needs, but this will require careful planning and collaboration with the neonatal staff.

Talk to staff and plan a good time and comfortable place for you to try Kangaroo Care.

While Kangaroo Care is based on direct skin-to-skin contact, removing your baby's clothes is not vital if this is upsetting for him or her. A hat and a blanket for extra warmth might be necessary for very small babies.

Hold your baby chest-to-chest tucked inside your clothes, enclosing him/her to keep his/her temperature stable. Check that the head is well supported and if you can't see your baby easily, try using a hand mirror.

Explore what you both like to enjoy together. Some babies like to have their eyes shielded, others like to be sung to softly or while having a tube feed. Allow time for your baby to settle and get the full benefit.

If you baby is happy, you can cuddle for as long as you are both comfortable. Lie back, relax and enjoy.

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Premature and sick babies undergo many medical procedures that can cause them some discomfort. As your baby's parents, you are the best people to balance this with a positive, reassuring touch.

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Psychological support for families on the Hull Neonatal Unit

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Common feelings and reactions in NICU families

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Washing your hands with soap and water is vital for protecting your baby and other babies on the unit. We ask you to stick to your own baby's area and not approach other cot sides.

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If you are unsure on any of the points on your checklist please speak to a member of staff.

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Moving from tube feeding to bottle feeding video.

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Moving from tube feeding to bottle feeding video.

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A beautiful video about supporting your baby to transition from tube feeding to bottle feeding and how to know when they are ready.

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Moving from tube feeding to Breastfeeding video

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Moving from tube feeding to Breastfeeding video

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A beautiful video about the transition to breastfeeding for premature babies. The video talks about the gradual approach and the feeding cues to look for.

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Your voice matters! Please complete our feedback form. Department 'Hull Neonatal Unit'. Make sure you tell us what section of the unit your experience was on. Areas: Intensive Care, High Dependency, SCBU and Transitional Care.

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Northern Lincolnshire and Goole NHS Foundation Trust

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We use some essential cookies to make this website work. We'd like to set additional cookies to understand how you use www.nlg.nhs.uk, remember your settings and improve our services. We also use cookies set by other sites to help us deliver content from their services.

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Feedback form - Northern Lincolnshire and Goole NHS Foundation Trust

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Whether you have a compliment to share or a concern to raise - you can leave your feedback via our online form

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Is there someone you want to say thank you to for the care you received? Send a Shining Light to a person or team to show your appreciation :)

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Shining Lights: Nominate someone today! – NHS Humber Health Partnership Forms

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Steps to responsive bottle feeding your baby

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Steps to responsive bottle feeding your baby

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On NICU we may use the term "modified responsive feeding". This is for babies who are not yet ready to take full oral feeds and require frequent feeding with nasogastric tube support. Please ask your NICU Nurse for support.

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Bottle feeding and formula preparation leaflet

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Bottle feeding and formula preparation leaflet

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A brilliant best practice guide to the safest method of bottle feeding and infant powdered formula preparation.

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This is a really useful tool to help with breastfeeding and topping up your baby via their feeding tube on the Neonatal Unit. You can also use this at home with the Neonatal Outreach Team.

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Video on how to position and attach your baby to breastfeed

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Video on how to position and attach your baby to breastfeed

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A great video on positioning your baby to breastfeed. Please ask your Nurse to support you with breastfeeding your baby on NICU.

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Unicef UK Baby Friendly Initiative | Positioning and attachment

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Some great advice for getting an effective latch and signs your baby is getting enough

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Helpful information about expressing your milk

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Helpful information about expressing your milk

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Y&H Neonatal Parent and Family Engagement 

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Helpful information about expressing milk

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Y&H Neonatal Parent and Family Engagement 

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ARDO - pump parts and putting your pump together

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ARDO - pump parts and putting your pump together

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Y&H Neonatal Parent and Family Engagement 

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Pump parts and putting the pump together -Ardo

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Understanding feeding options for your baby and the benefits of breast milk.

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Storing your expressed milk in hospital 

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Storing your expressed milk in hospital 

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Y&H Neonatal Parent and Family Engagement 

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Screening, tests and immunisations your baby may be exposed to whilst on the NICU.

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Get to know the routines and what you are likely to expect throughout your baby's journey on the NICU.

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Information on what to expect during your child's NIPE.

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All parents are offered a thorough physical examination for their baby within 72 hours of giving birth.
The examination includes screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, testicles (testes).

What is the newborn physical examination?

The newborn physical examination is usually carried out in hospital before you go home.

Sometimes it's done at a hospital or community clinic, GP surgery, children's centre or at home. Ideally, both parents should be there when the examination is done.

The healthcare professional doing the examination should explain what it involves. This could be a doctor, midwife, nurse or health visitor who's been trained to do the examination.

Some parts of the examination may be a bit uncomfortable for your baby, but it will not cause them any pain.

The aim is to spot any problems early so treatment can be started as soon as possible. Usually, nothing of concern is found.

If the healthcare professional doing the examination does find a possible problem, they may refer your baby for more tests.

You'll be offered another physical examination for your baby at 6 to 8 weeks, as some of the conditions it screens for can take a while to develop.

This 2nd examination is usually done at your GP surgery.

How is the newborn physical examination done?

The healthcare professional will give your baby a thorough physical examination.

They'll also ask you questions about how your baby is feeding, how alert they are, and about their general wellbeing.

Your baby will need to be undressed for part of the examination.

During the examination, the healthcare professional will also:

look into your baby's eyes with a special torch to check how their eyes look and move

listen to your baby's heart to check their heart sounds

examine their hips to check the joints

examine baby boys to see if their testicles have descended into the scrotum

What does the newborn physical examination check for?

The examination includes an overall physical check, plus 4 different screening tests.

Eyes

The health professional will check the appearance and movement of your baby's eyes.

They're looking for cataracts, which is a clouding of the transparent lens inside the eye, and other conditions.

About 2 or 3 in 10,000 babies are born with cataracts in one or both eyes that need treatment.

But the examination cannot tell you how well your baby can see.
Find out more about childhood cataracts
Heart

The healthcare professional will check your baby's heart. This is done by observing your baby, feeling your baby's pulses, and listening to their heart with a stethoscope.

Sometimes heart murmurs are picked up. A heart murmur is where the heartbeat has an extra or unusual sound caused by a disturbed blood flow through the heart.

Heart murmurs are common in babies. The heart is normal in almost all cases where a murmur is heard.

But about 8 in 1,000 babies have congenital heart disease that needs treatment.
Find out more about congenital heart disease
Hips

Some newborns have hip joints that are not formed properly. This is known as developmental dysplasia of the hip (DDH).

Left untreated, DDH can cause a limp or joint problems.

About 1 or 2 in 1,000 babies have hip problems that need to be treated.
Find out more about developmental dysplasia of the hip
Testicles

Baby boys are checked to make sure their testicles are in the right place.

During pregnancy, the testicles form inside the baby's body. They may not drop down into the scrotum until a few months after birth.

Around 2 to 6 in 100 baby boys have testicles that descend partially or not at all.

This needs to be treated to prevent possible problems later in life, such as reduced fertility.
Find out more about undescended testicles

Does my baby have to have the examination?

The aim of the examination is to identify any of the problems early so treatment can be started as soon as possible.

It's strongly recommended for your baby, but not compulsory.

You can decide to have your baby examined and screened for any or all of the conditions.

If you have any concerns, you should talk to your midwife or the healthcare professional offering the examination.

When will we get the results?

The healthcare professional who does the examination will give you the results straight away.

If your baby needs to be referred for more tests, they'll discuss this with you there and then, too.

The results will be recorded in your baby's personal child health record (red book).

You'll need to keep this safe and have it to hand whenever your baby sees a healthcare professional.

If you have any concerns, you can discuss them with your midwife or the healthcare professional who does the examination.
Download a leaflet about screening tests for you and your baby from GOV.UK

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All new parents are offered a newborn physical examination for their baby. Your baby's eyes, heart, hips and, in boys, testicles will be checked.

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Understanding jaundice symptoms and treatments.

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Find out more about what jaundice is, the signs to look out for in your baby, and the treatment available.

Jaundice (jawn-diss) is the name for yellowing of the skin and the whites of the eyes. It is very common for newborn babies to get jaundice. In most cases it is harmless and goes away without needing treatment by the time your baby is about two weeks old.

Sometimes jaundice can be serious and may be caused by a medical problem. Serious cases of newborn jaundice are more common in babies born premature. Because it can sometimes be serious, your midwife or baby's doctor needs to know if they have jaundice. Your baby can then get any treatment they need quickly.

What causes jaundice?

The yellow colour is caused by a build-up of a substance called bilirubin (billy-roo-bin).

Bilirubin is a normal body chemical, which is produced when red blood cells are broken down and replaced by fresh cells. Bilirubin is then processed by the liver and leaves the body in urine (pee) and stools (poo).

Jaundice is common in newborn babies because the baby's liver is not developed enough in the first few days to process all the bilirubin that is produced. Bilirubin then builds up in the blood, which causes jaundice.

Doctors call this ' physiological jaundice ', which means it is not caused by a medical problem. This is the most common type of jaundice and starts at about two days after birth, but is usually gone by about two weeks.

Other types of jaundice

Other types of jaundice may be caused by serious medical problems. Jaundice that occurs within the first 24 hours of life, which doctors call ' early jaundice', could be caused by conditions such as:

There is also a type of jaundice which causes babies to be jaundiced for longer (after they are around two weeks old). This is called ' prolonged jaundice '. It can also be referred to as 'breastmilk jaundice' because it is much more common in babies who are fed with their mother's milk.

Doctors are not sure why this happens, but it does not harm the baby and will go away without treatment. This type of jaundice can sometimes carry on for up to 12 weeks, but this does not mean that feeding with breast milk should stop.

Prolonged jaundice is usually harmless, but may occasionally be caused by more serious medical problems. Babies with prolonged jaundice will usually have some extra blood tests to look for any medical problems. This is often at a clinic in the hospital or may be done at home by a community midwife in some areas.

In most cases, no medical condition is found and the jaundice gradually goes away without needing treatment, but occasionally important medical problems are picked up by these tests.

Which babies are most likely to get newborn jaundice?

Jaundice in newborn babies is very common, but in most cases is not severe enough to need treatment. There are some things which make a baby more likely to have jaundice that needs treating:

Being born premature (less than 38 weeks) - the earlier a baby is born, the more likely they are to need treatment for jaundice.

Having a low birth weight.

Being male.

Being from an Asian or black family.

Getting jaundice in the first 24 hours after birth.

Having a brother or sister who needed treatment for jaundice after birth.

Being only fed with breastmilk.

Babies born prematurely are more likely to get jaundice. If they have jaundice, it is more likely to be severe and tends to last longer than in full term babies.

After your baby is born, they will be examined, both in hospital and at home. Every time your baby is examined, your care team will be checking for jaundice. You will be encouraged to check your baby too, especially after you take them home. If your baby has jaundice, their skin and the whites of their eyes will appear yellowish.

Signs of jaundice in babies with darker skin tones

It can be more difficult to tell if a baby has jaundice if they have darker skin, because the yellowing may be less obvious. Gently pressing on the tip of their nose or on their forehead can make it easier to see any yellowing.

The whites of the eyes should normally always be white, no matter how dark your baby's skin. So checking your baby's eyes is a good way to look for jaundice. It is best to check your baby in bright light, preferably daylight.

Tell your midwife, health visitor, or GP the same day if you think your baby has jaundice.

Jaundice on the neonatal unit

Jaundice is commonly seen on the neonatal unit, especially with preterm babies. Around 80% of preterm babies develop jaundice. The liver of a preterm baby is still developing, and is not yet able to process bilirubin as easily as term babies.

Preterm babies are also more sensitive to the potential complications of jaundice, so treatment often starts earlier than in babies born at full-term.

Jaundice is also more common in babies who are born at full-term but unwell, for example with an infection, or who have other risk factors. Their care team will know what to look out for and will check your baby's bilirubin level, but if you think your baby looks like they have jaundice, please mention this to them.

If you notice your baby has jaundice

If you think your baby may have jaundice, tell your midwife, health visitor or doctor straight away. Jaundice is not usually a serious problem, but it is best to get your baby checked.

If your baby's jaundice does not go away (prolonged jaundice)

In full-term babies, jaundice usually goes away on its own by the time your baby is two weeks old, or three weeks if they were premature. If the jaundice does not go away, it might mean that there is an underlying medical problem.

If your baby has jaundice for more than two weeks, tell your midwife, health visitor or GP the same day. Prolonged jaundice is usually harmless, but it is important to have your baby checked in case they need treatment for a medical problem.

Pale stools (poo) and dark urine

A newborn baby's stool should be yellowy orange and their urine should normally be colourless or yellow. If they are not, that can be a sign of a problem which needs to be investigated. If your baby has pale (cream or white coloured) stools then you should inform your Community Midwife, GP or Health Visitor immediately, and tests should be arranged that day.

Useful guide to baby stool colour.

When your baby needs immediate medical help

Get immediate medical help by contacting your GP or going to the hospital Accident and Emergency department if your baby:

Has jaundice in the first 24 hours after they are born.

Has jaundice and is unwell, becoming more drowsy or not feeding.

Is becoming more and more yellow.

What tests might my baby have?

To accurately check whether your baby has jaundice, the level of bilirubin in their blood needs to be measured. Your midwife may be able to do this test at home, or you may need to take your baby to the hospital. If you are on a neonatal unit, doctors and nurses will check your baby's bilirubin level regularly.

The two main ways to check your baby's bilirubin level are:

By using a small device called a bilirubinometer (billy-roo-bin-ometer), which shines a light onto your baby's skin.

With a blood test from a heel prick. This may be needed depending on the results of the bilirubinometer test and the age of your baby.

The results of the test are used to see whether your baby needs any treatment. The doctor may also recommend further tests to look for other causes of jaundice. If so, they will explain what these tests involve.

Most babies with newborn jaundice do not need treatment. If your baby does need treatment, this will usually be given in hospital, but sometimes it can be given at home. Some people believe that sunlight is a good treatment for newborn jaundice but this is not correct.

The main treatment for newborn jaundice is called phototherapy. This is where your baby lies in an incubator with a blue light source above them. Some babies may be able to have phototherapy by lying on a special light-up blanket (called a 'biliblanket') instead. The blue light changes the bilirubin into a form that your baby's body can more easily process.

You will usually still be able to feed your baby, change their nappies, and give them a cuddle. Find guidance on how you can be more involved in your baby's care on the unit.

Preterm babies may need multiple treatments over a number of days and sometimes weeks. The more preterm your baby is, the more likely it is they will need phototherapy. Once treatment has stopped, your baby's bilirubin level will be checked again as they may require more phototherapy.

Very occasionally, a baby with jaundice needs a treatment called exchange transfusion. This is where your baby's blood is slowly replaced with blood from a blood donor, to remove the bilirubin. This treatment will happen in a neonatal unit and will only be done if your baby's bilirubin level is very high, or if phototherapy has not worked.

Your baby may need other treatments if they have a medical condition causing their jaundice. You can ask your nurses or doctors to explain what these involve.

Are there any short-term or long-term effects from having newborn jaundice?

Most newborn babies who have jaundice are not ill, and the jaundice goes away on its own in a few weeks without causing any problems.

But high levels of bilirubin can be harmful. That is why some babies need treatment. Fortunately, treatment usually works well to bring down the high level of bilirubin before it causes harm.

In a small number of babies, levels of bilirubin go very high. This can affect the brain and cause a condition called kernicterus (ker-nic-ter-us). Babies with this condition will be very unwell and will need care in the neonatal intensive care unit (NICU). Signs of kernicterus include:

Being overly sleepy

Being irritable

Being floppy, or stiff with an arched back

Having pauses in breathing (apnoea)

Having unusual movements (seizures)

Kernicterus can lead to long-term problems for babies. These include seizures (fits), learning difficulties, and hearing problems. If your baby has had kernicterus, they will have follow up appointments to check their development.

If jaundice is caused by a baby having a different blood type to their mother ( Rhesus disease), this can also cause the baby to develop anaemia (ah-nee-mee-ya), which is when they have less healthy red blood cells.

Where can I get more help and support?

It is natural to feel worried if something seems wrong with your baby. Your midwife, health visitor, or your baby's doctor will be able to talk to you about newborn jaundice. In most cases they will be able to reassure you that your baby's jaundice will get better without causing problems.

If your baby needs treatment, you can talk to the nurses and doctors in the hospital. If you are unsure about any part of your baby's diagnosis, treatment or care, just ask.

If you feel like you are struggling, we have lots of information and tips on how you can look after yourself and find support.

If your baby is found to have an underlying liver problem, you may find it helpful to visit the website of the Children's Liver Disease Foundation. We also have some other links to charities and organisations who can provide support.

If you need someone to talk to, you can contact us on hello@bliss.org.uk or arrange a video call with one of our volunteers.

If you have any feedback about this page, please email: information@bliss.org.uk

Last reviewed: April 2022

Next review date: April 2025

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Find out more about what jaundice is, the signs to look out for in your baby, and the treatment available.

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Understanding your baby's heart and a diagnosis of PDA.

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What is a patent ductus arteriosus (PDA)?

The ductus arteriosus is an extra blood vessel which all babies have in the womb. It connects the two main blood vessels leaving the heart. These are called the aorta and pulmonary artery. Before a baby is born, the ductus arteriosus diverts blood from the lungs to the rest of the body.

After your baby is born, their lungs will fill with air, and blood will flow to their lungs. The ductus arteriosus is then not needed, and usually closes over the first few days of life.

In some babies, particularly babies born premature, the ductus arteriosus may not close properly. If it stays open (patent), it is called a patent ductus arteriosus (PDA). You may hear this being called persistent ductal arteriosus.

Although PDAs are more common in babies born premature, they can also occur in babies born at term.

What are the signs of a PDA?

Your baby is likely to be diagnosed with a PDA on the neonatal unit.

Doctors may suspect a PDA in your baby if they have had difficulty coming off a mechanical ventilator or continuous positive airway pressure (CPAP) machine. Your baby may have needed one of these treatments if they had experienced respiratory (breathing) distress shortly after birth.

If your baby's doctor suspects that your baby has a PDA, they detect it by using a device that is used to listen to the heart called a stethoscope.

The most common sign of a PDA is a heart murmur. This is an extra or unusual sound that is made by your baby's heart. Other signs that your baby might have a PDA include:

having a fast heart rate

low blood pressure

low blood oxygen levels

pauses in breathing (apnoea)

poor feeding or poor weight gain

chest infections.

The signs that your baby will have will depend on the size of the PDA. A baby who has a small PDA may have no signs at all.

What tests might my baby have?

Your baby will have an echocardiogram (ECHO). This is an ultrasound scan that uses waves to look at the heart and nearby blood vessels. It is used to confirm a diagnosis of a PDA and to look at its size.

What treatment is available for PDA?

The treatment that is used to treat the PDA will depend on its size. Possible treatments include the following:

Monitoring

Doctors may monitor the PDA to see if it closes on its own before starting treatment.

Your baby may be discharged from the neonatal unit during this time, but will have follow-up appointments to monitor the progress of the PDA.

You know your baby best. You should speak to someone if you are worried about your baby when you are at home, such as your GP or health visitor.
If, when your baby is at home, they show signs of shortness of breath, long pauses in their breathing or go pale or blue, call 999 straight away.
Medication

If the PDA is large, doctors may give your baby a water medicine called a diuretic. Diuretics help to reduce the amount of fluid on the lungs. This should help your baby to breathe more comfortably.

If, after some time, the PDA does not close and your baby has difficulty coming off breathing support, medication such as ibuprofen is used to try to close it. This is given intravenously (into a vein). Other medications may be used if your baby is unable to take ibuprofen.

Your doctor will explain the benefits and risks of any medications to you. If you have any questions or there is anything you do not understand, ask your doctor to explain it again or in a different way. They are there to help and answer any questions you have.

Surgery

If medication does not close the PDA, doctors may suggest surgery. There are two types of surgery that are used to close a PDA:

Keyhole surgery

Most PDAs are small, so can be successfully closed using keyhole surgery. This surgery involves passing a long thin tube (catheter) through a vein or artery in the heart. The ductus arteriosus is then sealed using a small stainless-steel coil or plug.

Surgical ligation

This may be needed if your baby has a large PDA. During this surgery, a surgeon will make a small cut on the left side of your baby's chest. They will then put a metal clip around the ductus arteriosus to close it.

For both types of surgery, your baby will be put under general anaesthetic (put to sleep).

The idea of your baby having surgery may seem like a scary thought. But surgery to treat a PDA is usually successful and many babies recover quickly. The surgeons will explain what they plan to do before surgery and talk about what will happen and any risks with you.

The British Heart Foundation has a factsheet about PDA which includes more information about these types of surgery.

Are there any short or long-term effects from having a PDA?

Most babies who have a PDA will need no further treatment once it is closed successfully and will have no ongoing health problems.

If the ductus arteriosus is large and is left untreated, this can cause pulmonary hypertension (high blood pressure in the lungs). It can also increase the risk of developing a condition called necrotising enterocolitis (NEC).

Babies who need surgery to close the ductus arteriosus may already have existing conditions that are linked to their prematurity. This might mean that there is a higher risk of them developing problems with their lungs such as chronic lung disease (CLD).

If you have any questions or concerns about any effects of having a PDA, speak to your baby's healthcare team. They are there to help and answer any questions you have.

Where can I get more help and support?

In a survey we conducted of 190 parents, 86% of parents had never heard of or knew little about PDA before their baby had it.

If your baby has a condition that you don't know much about or is new to you, you may feel overwhelmed and worried. How you feel and process what has happened to you might be different to others who face these challenges.

If you are unsure about any part of your baby's diagnosis, treatment or care, the staff on the unit will help you in any way they can. It is okay to ask again if you need information repeated or made clearer. The team will understand and want to support you.

We have included some links to charities and organisations who can provide more support.

Social media websites such as Facebook may also be able to provide information about local support groups and charities where you can talk to other parents who have a baby with a condition such as a PDA.

Your unit may also be able to provide you with this information. If you need someone to talk to, you can also contact us on hello@bliss.org.uk or arrange a video call with one of our volunteers.

British Heart Foundation (BHF) funds research into heart and circulatory diseases and provides information and support. They have a helpline and email support service, and a factsheet on their website for parents with a baby with a PDA. Call 0300 330 3311, weekdays, 9am to 5pm or email hearthelpline@bhf.org.uk

Children's Heart Foundation (CHF) provides information and support for children with heart conditions and their families and has a factsheet on PDA. You can call their Infoline on 0300 561 0065, email info@chfed.org.uk, or visit chfed.org.uk

Tiny Tickers works to improve the early detection and care of babies with heart conditions and has a fact sheet on PDA. Visit tinytickers.org for more support and information.

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Find out more about what PDA is, the signs to look out for in your baby, and the treatment available.

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Every bead tells a story of strength, honour and hope. Please ask a member of our team for more details.

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Understanding the various modes of breathing support your baby may need whilst on the NICU.

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Understanding medical terms that you may hear whilst on the NICU.

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Become familiar with medications your baby may need whilst on the NICU.

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A range of medications your baby may need whilst on the NICU and when discharged home.

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A video demonstrating how to perform CPR on your baby once discharged from the NICU. Please feel free to ask any questions to a member of our team.

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How to give a baby CPR - Resuscitation Council UK

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A short video and information regarding resuscitation of a baby.

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A short video demonstrating the maneuver to perform if your child is choking.

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St John Ambulance The Chokeables advert: save a choking baby - Extended version

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Information on reasons why your baby may be crying and how to cope in difficult situations.

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Babies cry, you can cope When babies cry it can be stressful and overwhelming. Help is out there and all you need to do is ask. Latest news Testimonials

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Information on how to position your baby safely when sleeping.

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The safest cot is a clear cot

The safest cot for a baby is a clear cot. That means removing anything that isn't essential. Babies need just two items in their cot:

It's important to remove anything that isn't essential because items such as toys, blankets and bumpers could cover their face and obstruct their breathing.

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

No products designed to keep your baby in one sleeping position, such as wedges or straps

No pods or nests, rolled up towels or anything soft placed on top of the mattress.

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Safer sleep overview - The Lullaby Trust

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An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

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Helping you understand the job roles in the hospital.

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Understanding your baby's eyes and a diagnosis of ROP.

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NEC UK is the first charity in the UK exclusively for the condition Necrotising Enterocolitis (NEC).

Follow this link to find out more.

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Necrotising Enterocolitis | Nec Uk | England

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NEC UK A UK Charity for the condition Necrotising Enterocolitis- What is NEC, nec support, family support. Raise awareness of necrotising enterocolitis.

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Understanding what vaccinations your child will receive.

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Hull and East Riding Breastfeeding support

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Hull and East Riding Breastfeeding support

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Contacts for breastfeeding support after discharge from the Neonatal Unit.

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2 short stories from mothers who continued to breastfeed their babies into childhood.

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Unicef UK Baby Friendly Initiative | Continued breastfeeding

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Donor Human Milk for your baby on the Neonatal Unit

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Donor Human Milk for your baby on the Neonatal Unit

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We are proud to have access to Human Donor Milk.

Did you know you can donate your expressed milk too? If you have a lot of supply that may not get used, visit The Milk Bank at Chester

and sign up to be a Donor. The Milk Bank at Chester

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Understanding feeding options for your baby and the benefits of breast milk.

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A great guide to using infant formula and knowing what formula to use. Note: not all milk is proven to help the symptoms they claim to help.

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Caring for your baby at night and when sleeping.

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Caring for your baby at night and when sleeping.

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We do not recommend bed sharing with a baby who is born premature (before 37 weeks gestation) or low birth weight.

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Even though all children develop at their own pace, some parents may become concerned about their child's development. In this section we focus on some of the issues that may affect children who were born prematurely as they continue to grow and start their school life.

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Even though all children develop at their own pace, some parents may become concerned about their child's development. In this section we focus on some of the issues that may affect children who were born prematurely as they continue to grow and start their school life.

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What is PALS (Patient Advice and Liaison Service)?

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Find out more about the Patient Advice and Liaison Service (PALS), which offers confidential advice, support and information on health-related matters.

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Support for families that have a baby born premature or sick

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For babies born premature or sick | Bliss

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Our vision is that every baby born premature or sick in the UK has the best chance of survival and quality of life.