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This leaflet is designed to give parents comfort and confidence in the care of their sick or premature baby.

This leaflet covers a wide range of issues and provides a useful tool to help conversations with parents on the neonatal unit.

Printed copies are available for £15 per pack (1-9 packs) or £11 per pack (10 or more packs). There are 50 leaflets per pack and this price includes P&P within UK. Order using the Baby Friendly Resources order form, which you can download from our Resources page.

Public Health Wales have produced a version of the You and Your Baby neonatal leaflet in Welsh, which is free to download.
Orders for UK delivery only, and include postage and packaging costs. Orders may take up to 7 working days to process. The Baby Friendly Initiative reserve the right to re-print items at any time. If you are looking to order audit tools or e-learning, please use our digital resources order form.

You and Your Baby: Supporting Love and Nurture on the Neonatal Unit leaflet

More neonatal resources to support you

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You and your baby leaflet - Baby Friendly Initiative

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This leaflet covers a wide range of issues and provides a useful tool to help conversations with parents on the neonatal unit.

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Welcome to Warrington NNU!

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Find out more about our unit here...

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Dads Do NICU Too - The Smallest Things Charity link for support of Dads on NICU.

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Information for your first few days in the neonatal unit. Read about what to expect, finding your feet, and how to get more support.

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We hope this reassures you that there is not one, straightforward feeding experience, and that every parent's journey is different.

On this page, we will talk about the different types of nutrition that your baby might be fed in neonatal care. Breast milk provides the best nutrition and protection for your baby, but there are also reasons why your baby may need to be fed with other types of nutrition or need more support with feeding during their stay in neonatal care and beyond.

How to know if your baby is getting enough nutrition

You can be sure that your baby is getting enough nutrition if they:

Have plenty of wet and dirty nappies (the consistency and amount will change as babies get older and depending on what they are fed)

Are growing and gaining weight

Are mostly settled and calm between feeds, if they are fed by tube, or are breastfeeding or bottle feeding.

Steady weight gain is a good way of showing that your baby is feeding and growing well. But all babies will gain weight at a different rate. This will be monitored during your baby's stay on the neonatal unit and when you get home. Always talk to a member of staff on the neonatal unit if you have any concerns.

Parenteral nutrition (PN)

Some babies born very premature or sick will not be able to have milk straight away.

Parenteral nutrition (PN) is nutrition in a liquid form that is given directly into your baby's bloodstream intravenously (through a vein). The solution has nutrients such as vitamins, minerals, carbohydrates, proteins and fats. It is called total parenteral nutrition (TPN) where it is used as the only source of nutrition.

Colostrum and first milk

The first milk that mothers produce is called colostrum. Colostrum is often thicker and more yellow in colour than breastmilk. It contains a rich mix of proteins, including antibodies that can help protect against infections. Colostrum comes in small amounts, but this will increase the more times you express. Some research has shown that introducing colostrum as early as possible to babies born premature or sick can reduce the time it takes for them to be able to feed successfully, and can reduce the risk of infections.

Breast milk

Breast milk is the best milk for nutrition, growth and development for all infants. It has many benefits, including the following:

It boosts your baby's immune system and protects against infections, such as gut and chest infections.

It has antibodies from the mother that can protect your baby against bacteria and viruses.

It can reduce the risk of your baby developing necrotising enterocolitis (NEC), a serious condition that can happen in babies born premature.

It provides other nutrients, growth factors and hormones that help your baby grow and develop during the vital early months after birth.

It improves brain development.

It is very easy to digest and is absorbed more easily than formula milks.

Your baby may not be well enough or strong enough to breastfeed straight away. If this is the case, the staff at the hospital will help you to express (collect) your breast milk, as soon as possible after the baby's birth. You can do this by hand or with a breast pump. There are other reasons why parents may express milk for their baby.

After expressing your breast milk, the milk can be frozen and stored until your baby is ready to feed. Expressed milk can also be given to your baby directly into their stomach using a feeding tube, which is useful if they are too unwell to feed from a breast or bottle. Breast milk can be given by bottle once your baby has learned to suck, swallow, and breathe on their own.

Expressing breast milk can take time to learn, and the staff looking after your baby will give you positive support and practical help with this. Try not to worry if you are not expressing a lot of milk at first. Speak to your midwife or feeding specialist on the neonatal unit for more support.

Supplements and fortifiers

Babies born premature or sick may also need extra vitamins and minerals for growth, so your baby may be given supplements to breast milk. Your baby's doctor may prescribe a breast milk fortifier (which is usually a powder made from cow's milk) which can be added to breast milk. This can help with growth and bone development.

If your baby needs more milk than is available, your baby's doctor may prescribe donor breast milk or a formula (see below) for preterm babies, to be taken alongside your milk.

We have more detailed information about expressing milk and breastfeeding.

Donor milk

If you have a low supply of milk, or are unable to breastfeed, some hospitals can provide donated breast milk for your baby. Donor milk may be used for a baby who is at a high risk of necrotising enterocolitis (NEC), because they are very premature, or at a very low birthweight. This is because there is some evidence that donor milk can reduce the risk of NEC in premature babies when compared to formula milk. This makes it a good alternative to breast milk for these babies. However, donor milk is not as effective as mother's own milk.

Speak to unit staff for more information, or if you have any concerns about receiving donor milk. They can also give you information about what to do if you have extra milk.

For more information about donor milk, visit the United Kingdom Association for Milk Banking (UKAMB) or The Human Milk Foundation website.

Formula

If you decide not to breastfeed or express your milk, your baby may be prescribed a special preterm formula designed especially for their nutritional needs.

This may be given by a feeding tube at first, but can be given by bottle once your baby has learned to suck, swallow, and breathe on their own. Your doctor will talk to you if they think your baby will benefit from a preterm formula milk. If needed, your doctor may prescribe your baby a preterm formula milk to be used at home.

Some parents may choose to feed their baby using a first infant formula. These do not contain the additional nutrients of preterm formula, but sometimes preterm formula is not needed or recommended. Formulas do not have the same benefits as breast milk for your baby, and does not provide protection from infection. Formula milk is also not as easy for your baby to digest as breast milk. However, formula may be the right choice for some families for other reasons.

If you feed your baby using formula, staff on the neonatal unit should show you how to make up feeds safely before you go home from the unit. The NHS website also has some information about this. On some units, staff may ask you to bring in your chosen formula (if not prescribed), but will supply you with sterile bottles and teats at first. In time, you may want to bring in your own bottles so your baby can start to get used to them.

We have more information about bottle feeding your baby.

Combination feeding

Some parents may feed their baby through a combination of breast milk and formula. This is often known as combination feeding. Combination feeding may be used if you are unable to produce enough milk, or are finding it difficult to breastfeed. Some parents choose to combination feed so that they can share feeds between them. Combination feeding may be something you had planned to do. But if this is not the case, don't be hard on yourself if you combination feed for other reasons. Talk to a feeding specialist, your midwife or health visitor if you have any questions or concerns about combination feeding.

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Babies born premature or sick often have different nutritional needs. Find out more about the different types of nutrition that your baby might be fed in neonatal care.

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Going home can feel huge after a NICU stay. Bliss have created a tailor-made support link for families preparing for discharge.

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Parents might experience a range of unexpected emotions when they are getting ready to go home from the neonatal unit. While it is an exciting time to be at home and starting life with your new baby, you may also have some uncertainty about not having the support of the unit staff at home. You can speak to the unit staff about any worries you have. They will be happy to help and most neonatal units will allow you to contact them if you have any concerns or want some advice when you are home. This should be explained to you as part of the discharge process.

Parents often tell us that even though they were excited to go home with their baby, being at home can also feel like an isolating and overwhelming experience. Others say they didn't feel as confident as they wanted to be, and missed the support of the neonatal unit and the reassurance of staff. Some parents describe feeling a 'whirlwind' or 'rollercoaster' of different emotions. It is important to remember that there is no right or wrong way to feel, and it is normal to experience lots of different emotions while you adjust to life at home with your baby.

You may find it helpful to talk to your health visitor or community neonatal nurse about how you are feeling.

How can I get support with my mental health?

Having a baby born premature or sick can make you feel sad and low at times. But if these feelings start to impact on your everyday life, you may be experiencing symptoms of depression. Postnatal depression is a type of depression that parents can experience after having a baby, and affects fathers as well as mothers. If you are worried about how you are feeling, are experiencing persistent low mood or other symptoms associated with postnatal depression, you may need some more support. You can talk to your GP, health visitor or community neonatal nurse about how you are feeling.

You may also find it helps to talk about your concerns with a friend, family member or someone else you trust. It can be easy to forget about looking after yourself when you have a baby to look after, but it is important to reach out if you need help.

It is important to remember that you are not alone. In a survey we carried out of around 600 parents, over 80% said their mental health got worse after their time on the neonatal unit.

We have lots of information about where you can get support with your mental health, including details of other organisations that may be helpful.

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How you might feel when you go home | Bliss

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Parents might experience a range of unexpected emotions when they are getting ready to go home from the neonatal unit. While it is an exciting time to be at home and starting life with your new baby, you may also have some uncertainty about not having the support of the unit staff at home.

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Where possible, we will always discuss your baby's care with you and gain your consent for any significant procedures or events.

We will always aim to involve you in your baby's care - in emergency circumstances, we will always prioritise your baby's best interests.

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This is a short animation that helps to explain what a neonatal unit is...

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Neonatal Animation: A guide for parents on what to expect when on a neonatal unit

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Unit contact number:

01925 662278

Please note that nursing handover takes place between 7am-7:30am and 7pm-7.30pm. During these times a nurse may not be available to answer the telephone.

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Support from your family and friends

Family and friends can be an important source of support when you come home from the neonatal unit. Often they may want to help, but may not know what to say or how to approach the subject with you. There may be times when you do want someone to listen, or you may not be ready to talk about how you are feeling, and that is okay.

It might be helpful to think about what kind of support and help you might need when you come home. Sometimes, help with practical tasks can be more helpful than emotional support. If you are feeling overwhelmed, you can ask family and friends to help with practical tasks, such as:

cooking meals to put in the freezer for when you need them

driving or coming with you to follow-up appointments

helping with laundry or food shopping

helping with school or nursery pick-ups if you have other children.

When you get home, you may have family members and friends asking questions and wanting to know more about you and your baby's health. It is natural for them to be interested, but this may feel quite overwhelming. You may want to ask one family member or friend who you trust to be the first point of contact. They can then be responsible for updating other family members or friends with any news or information. This can help to take any pressure off you.

Support with your finances

Having a baby born premature or sick can have an impact on your finances. Going to and from hospital for regular follow-up appointments can be expensive and it may be more difficult to pay your bills. A social worker at the neonatal unit may be able to help with practical issues, such as advice on travel costs or finances.

We have more information about how having a premature or sick baby can affect your finances, and what support is available.

If you are a single parent, looking after a premature or sick baby at home can be difficult. You may find it helpful to contact Gingerbread, a charity that supports single parent families.

Support from Bliss

Bliss offers support services for families. We have an email service that supports parents and families of premature and sick babies. You can email us at hello@bliss.org.uk and we'll get back to you.

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What support is available when you go home | Bliss

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When you come home from the neonatal unit with your premature or sick baby, you may not know where to go for support. Find out more here.

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What is parenteral nutrition (PN)?

Parenteral nutrition (PN) is nutrition in a liquid form that is given directly into your baby's bloodstream intravenously (through a vein). The solution has nutrients such as vitamins, minerals, carbohydrates, proteins and fats. It is called total parenteral nutrition (TPN) where it is used as the only source of nutrition.

How does PN work?

PN provides food to help your baby grow. An infusion pump is used to deliver the nutrition to your baby. This allows a stream of nutrients to flow into the bloodstream over a period of time. In newborn babies it is common for the vein in the baby's umbilical cord to be used for this.

A doctor or advanced neonatal nurse practitioner will insert a tube (catheter) into your baby's umbilical cord (tummy button). The nutrition passes through this into the bloodstream. After some time, if your baby still needs PN, they will place another tube (called a long line) into one of your baby's veins (usually the arms or legs). They will then remove the tube in the tummy button.

At first, this may be their only source of nutrition.

Why does my baby need to be fed using PN?

Although very premature and sick babies can have milk feeds, these often need to be introduced gradually so their gut can learn to cope with them. Very premature babies are usually fed using PN at first, as they have an immature digestive system that needs time to develop enough so they can tolerate enough milk to meet their nutritional needs. For both very premature and sick babies, PN can be used to make sure they get enough nutrition and can start to grow while they are gradually introduced to feeds.

We understand that seeing your baby being fed using PN can be quite scary. But it will allow your baby to feed without reducing their energy. It also enables them to absorb the nutrients required to grow.

When will my baby stop needing PN?

As your baby begins to grow and becomes stronger, a method called tube feeding will be introduced. This is so your baby can start to have milk. Tube feeding is where breast milk or formula is given through a tube passed into your baby's nose or mouth to their stomach. Milk feeds will be introduced as soon as possible alongside PN.

Once tube feeding has been established, PN will stop. Some babies need PN for a week or two, but others can take longer.

We have more information about tube feeding that you may find helpful.

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Parenteral nutrition, also known as PN, is used to feed extremely premature or very sick babies.

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What is tube feeding?

During tube feeding, breast milk or formula is given through a tube passed into your baby's nose or mouth to their stomach. Types of tube feeding include the following:

Nasogastric tube feeding (also called an NG tube) - This is when a baby is fed through a small soft tube, which is placed in the nose and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

Orogastric tube feeding - This is when a baby is fed through a small soft tube, which is placed in the mouth and runs down the back of the throat, through the food pipe (oesophagus) and into the stomach.

Babies who are very premature or sick may need to be fed using parenteral nutrition (PN) at first.

Why does my baby need to be fed using tube feeding?

Tube feeding is often used to feed premature and sick babies as they can be too small and sick to breastfeed or bottle feed at first. Babies born premature or sick have a low supply of energy and nutrients, so it is important that they are able to have small nutritional feeds often, without lowering their energy levels.

In babies born premature, the coordination of sucking, swallowing and breathing needed for effective feeding is usually not fully established until about 32 to 34 weeks' gestation (although this is different for different babies). Babies born at term and sick may also take longer to co-ordinate feeding. Tube feeding will help your baby receive enough nutrition to grow and develop.

Can I be involved in caring for my baby if they are being tube fed?

Yes, you can. Staff on the neonatal unit will encourage you to be as involved as possible in the care of your baby on the neonatal unit. If you feel comfortable doing so, they should show you and your partner how to give tube feeds. Staff on the neonatal unit will explain how tube feeding works and will teach you how to:

Check the tube is in the correct position before feeding

Prepare the milk and fill the syringe that is connected to the feeding tube

Position your baby correctly for tube feeds

Give the milk slowly to support comfortable digestion

Know what to look for during a feed.

This can feel quite scary at first, but with practice you should gain confidence. You will have the time to give the milk very slowly which helps your baby to digest more comfortably.

If your baby is well enough to come out of the incubator, you and your partner can also practice skin-to-skin contact with your baby while they are tube feeding. Skin-to-skin contact has lots of benefits for you and your baby, and helps parents to feel closer to their baby and more confident in caring for them.

When can my baby stop tube feeding?

In time, you may notice your baby demonstrating feeding cues during a tube feed. For example, they may open and close their mouth, put out their tongue or suck their fingers during a tube feed. This shows that they might be ready to practise breastfeeding or bottle feeding.

If you are planning to breastfeed and your baby is well enough to come out of the incubator, giving them lots of opportunities to be close to the breast may help them to learn to breastfeed. During a tube feed may be a good time to do this. When they are more mature and interested enough, some babies will start licking milk and in time practice sucking. As your baby starts to take more breast and bottle feeds, they will not need as many top-ups of milk from the feeding tube. This will depend on your baby's energy levels and their ability to coordinate sucking, swallowing and breathing.

Some parents have concerns about their baby changing from tube feeding to breastfeeding, as it is more difficult to measure how much milk their baby is having. Your baby will show signs that they are receiving enough milk, such as feeding cues and wet and dirty nappies. The healthcare team supporting you will monitor your baby's feeding and will manage any top-ups that might be needed. Talk to a member of staff on your unit if you have any concerns.

What will happen if my baby needs to go home from the neonatal unit with a feeding tube?

If your baby is going home with a feeding tube, a member of unit staff will show you how to feed and care for the tube yourself. It may be you or your community neonatal nurse who will replace the tube when you go home. This will depend on your baby's needs, your preferences, and the support the unit provides.

Support will always be available if you do not feel comfortable with replacing the tube yourself. If you have any questions or concerns, talk to the unit staff.

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Your baby may be fed using tube feeding while on the neonatal unit. Find out why this might be and information about caring for your baby while they are being tube fed.

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As part of our Infection Control and Prevention, we would ask each family to watch this video on how to wash your hands effectively to protect your baby.

This technique should be used when decontaminating your hands with either alcohol gel or soap and water.

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Washing your hands is one of the simplest ways you can protect yourself and others from illnesses such as food poisoning and flu.

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Your time on the NICU, and your visitors

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Your time on the NICU, and your visitors

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We do not regard parents as visitors - you are welcome 24 hours a day, 7 days per week!

Your other children also have open access to NNU but must always be accompanied by a parent.

Your visitors are welcome on the unit between 11am-6pm, and 8pm-10pm

Visitors must always be accompanied by a parent

No more than 3 people per cotside

Visitors must be over the age of 16 (baby's siblings are exempt from this rule)

Visitors must be free from contagious diseases, and will be asked to leave the unit if they appear unwell.

Please be aware and considerate of other families - at times we may ask visitors to step out if the nurseries become too crowded or if a clinical procedure is taking place.

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The Team photo board

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We always aim to maintain patient confidentiality.

We ask you to please also respect other baby/babies' and families' privacy, especially during private conversations at the bedside.

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Psychological support for families

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You're not alone, find out what emotional and practical support is available to you here.

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Support for Each Stage of Your NICU Journey

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Support for Each Stage of Your NICU Journey

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Having a baby born sick or premature can be overwhelming.

You might be expecting a baby at risk of being born premature or sick, on the neonatal unit, just arriving home, or looking after a baby who is growing up. Whatever your stage of the journey, having a baby born sick or premature can be overwhelming.

Our information and support tool will help you to quickly access the support and information you need, whatever you are going through.

Tell us what you need help with, and we'll point you in the right direction.

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Support for your stage of the journey | Bliss

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Having a baby born sick or premature can be overwhelming. You might be expecting a baby at risk of being born premature or sick, on the neonatal unit, just arriving home, or looking after a baby who is growing up. Whatever your stage of the journey, having a baby born sick or premature can be overwhelming.

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Getting involved in your babies care (Bliss)

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Getting involved in your babies care (Bliss)

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We ALWAYS want you to be involved in your baby's care - please ask our staff to help if you need us!

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Postnatal depression is a type of depression that many parents experience after having a baby.
It's a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners.

It's important to get help as soon as possible if you think you might be depressed, as your symptoms could last for months or get worse and have a significant impact on you, your baby and your family.

With the right support most people make a full recovery.

Depression during pregnancy

Depression in pregnancy (antenatal depression) is also common, affecting more than 1 in 10 women.

Other mental health symptoms that can occur during or after your pregnancy include anxiety, panic attacks and psychosis.
Read more about mental health in pregnancy

Symptoms of postnatal depression

Many women feel a bit down, tearful or anxious in the first week after giving birth.

This is often called the " baby blues" and is so common that it's considered normal.

The "baby blues" do not last for more than 2 weeks after giving birth.

If your symptoms last longer or start later, you could have postnatal depression.

Postnatal depression can start any time in the first year after giving birth.

Signs that you or someone you know might be depressed include:

a persistent feeling of sadness and low mood

lack of enjoyment and loss of interest in the wider world

lack of energy and feeling tired all the time

trouble sleeping at night and feeling sleepy during the day

finding it difficult to look after yourself and your baby

withdrawing from contact with other people

problems concentrating and making decisions

frightening thoughts - for example, about hurting your baby

Many women do not realise they have postnatal depression because it can develop gradually.

Speak to a GP, midwife or health visitor as soon as possible if:

you think you may be depressed

Many midwives and health visitors have been trained to recognise postnatal depression and have techniques that can help.

Remember that:

a range of help and support is available, including talking therapy

depression is an illness like any other

it's not your fault you're depressed - it can happen to anyone

being depressed does not mean you're a bad parent

it does not mean you're going mad

your baby will not be taken away from you - babies are only taken into care in very exceptional circumstances

Treatments for postnatal depression

Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available.

These include:

self-help - things you can try yourself include talking to your family and friends about your feelings and what they can do to help, making time for yourself to do things you enjoy, resting whenever you get the chance, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet

talking therapy - a GP may be able to recommend a self-help course or may refer you for a course of therapy, such as cognitive behavioural therapy (CBT)

antidepressants - these may be recommended if your depression is more severe or other treatments have not helped; your doctor can prescribe a medicine that's safe to take while breastfeeding

Local and national organisations, such as the Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS), can also be useful sources of help and advice.

Causes of postnatal depression

The cause of postnatal depression is not completely clear.

There are a number of things that may make you more likely to have postnatal depression. These include:

a history of mental health problems, particularly depression, earlier in life

a history of mental health problems during pregnancy

having no close family or friends to support you

a difficult relationship with your partner

recent stressful life events, such as a bereavement

physical or psychological trauma, such as domestic violence

Even if you do not have any of these, having a baby is a life-changing event that can sometimes trigger depression.

It often takes time to adapt to becoming a new parent. Looking after a baby can be stressful and exhausting.

Preventing postnatal depression

There are things you can do during pregnancy to help you keep well, such as maintaining a healthy lifestyle and having someone you can talk to and turn to for support.

Going to antenatal classes and making friends with other pregnant women or new parents can also be helpful.

If you are pregnant or thinking about getting pregnant, talk to a GP or your mental health team if:

you have a history of depression or mental health problems

someone in your family has had mental health problems after childbirth (for example, your mother or sister)

This is so they can offer you appropriate treatment.

You can also talk to a midwife, who can support you or refer you to specialist mental health services if needed. If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth.

The mental health team, maternity team and GP will work closely with you during your pregnancy and after you have given birth.

Myths about postnatal depression

Postnatal depression is often misunderstood and there are many myths surrounding it.

These include:

postnatal depression is less severe than other types of depression - in fact, it's as serious as other types of depression

postnatal depression is entirely caused by hormonal changes - it's actually caused by many different factors

postnatal depression will soon pass - unlike the "baby blues", postnatal depression can persist for months if left untreated and in a minority of cases it can become a long-term problem

postnatal depression only affects women - research has actually found that up to 1 in 10 new fathers become depressed after having a baby

These factors are equally true of antenatal depression.

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Postnatal depression is a type of depression that many parents experience after having a baby. It's a common problem. Depression in pregnancy (antenatal depression) is also common.

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Helpful Organisations

There are a wide range of organisations who provide tailored support for families of premature or sick babies.

LGBTQIA+ support

Find below organisations who provide support and advice, specifically for the LGBTQIA+ community:

Stonewall have some great information on parenting rights, including parental responsibility, family leave and pay, adopting, fostering, co-parenting, fertility treatment and surrogacy.

Switchboard LGBT+ Helpline provides a listening service for LGBT+ people over the phone, via email and online chat. It can provide you with contact details of an LGBT-friendly therapist.

Imaan is a charity that supports lesbian, gay, bisexual, trans, queer or questioning (LGBTQ) Muslims, providing an online forum where people can share experiences and ask for help.

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With over 90,000 babies born premature or sick and admitted to neonatal care every year in the UK, many families are touched by a neonatal experience. However, many LGBTQIA+ parents feel underrepresented in the neonatal support available.

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Parking is FREE whilst your baby is on the Neonatal Unit!

Please give your registration number to a member of nursing staff.

One vehicle per family

If you incur any parking fines whilst your baby is on NNU please let our ward clerk Rose know.

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Every baby is offered newborn blood spot screening, also known as the heel prick test, ideally when they're 5 days old.

What is the blood spot test?

Newborn blood spot screening involves taking a blood sample to find out if your baby has 1 of 9 rare but serious health conditions.

Most babies won't have any of these conditions but, for the few who do, the benefits of screening are enormous.

Early treatment can improve their health, and prevent severe disability or even death.

What does the blood spot test involve?

When your baby is 5 days old, a healthcare professional will prick their heel and collect 4 drops of blood on a special card.

You can ease any distress for your baby by cuddling and feeding them, and making sure they're warm and comfortable.

Occasionally, the sample may need to be taken when your baby is 6, 7 or 8 days old.

Sometimes a second blood spot sample is needed. The reason for this will be explained to you. It doesn't necessarily mean there's something wrong with your baby.

The test doesn't carry any known risks for your baby.

Which conditions is the blood spot test for?

The blood spot test screens for the following 9 rare but serious conditions.

If you, your partner or a family member already has one of these conditions (or a family history of it), tell your healthcare professional straight away.

Sickle cell disease

About 270 babies are born with sickle cell disease in the UK each year. This is a serious inherited blood disease.

Sickle cell disease affects haemoglobin, the iron-rich protein in red blood cells that carries oxygen around the body.

Babies who have this condition will need specialist care throughout their lives.

People with sickle cell disease can have attacks of severe pain and get serious, life-threatening infections. They're usually anaemic because their blood cells have difficulty carrying oxygen.

The blood spot screening test means that babies with sickle cell disease can receive early treatment to help them live healthier lives. This may include vaccinations and antibiotics to prevent serious illnesses.

Pregnant women are also routinely tested for sickle cell disease early in pregnancy.

Read more about sickle cell disease.
GOV.UK also has a factsheet about sickle cell disease
Cystic fibrosis

About 1 in 2,500 babies born in the UK has cystic fibrosis. This inherited condition affects the digestion and lungs.

Babies with cystic fibrosis may not gain weight well and are prone to chest infections.

Babies with the condition can be treated early with a high-energy diet, medicines and physiotherapy.

Although children with cystic fibrosis may still become very ill, early treatment can help them live longer, healthier lives.

Read more about cystic fibrosis.
GOV.UK also has a leaflet for parents whose baby has suspected cystic fibrosis
Congenital hypothyroidism

About 1 in every 2,000 to 3,000 babies born in the UK has congenital hypothyroidism. Babies with congenital hypothyroidism don't have enough of the hormone thyroxine.

Without thyroxine, babies don't grow properly and can develop learning disabilities.

Babies who have the condition can be treated early with thyroxine tablets, and this allows them to develop normally.
The British Thyroid Foundation has more information about congenital hypothyroidism
Inherited metabolic diseases

It's important to let your healthcare professional know if you have a family history of a metabolic disease (a disease that affects your metabolism).

Babies are screened for 6 inherited metabolic diseases. These are:

About 1 in 10,000 babies born in the UK has PKU or MCADD. The other conditions are rarer, occurring in 1 in 100,000 to 150,000 babies.

Without treatment, babies with inherited metabolic diseases can become suddenly and seriously ill. The diseases all have different symptoms.

Depending on which one affects your baby, the condition may be life threatening or cause severe developmental problems.

They can all be treated with a carefully managed diet and, in some cases, medicines as well.

Severe combined immunodeficiency (SCID)

In some areas of England, screening for a condition called severe combined immunodeficiency (SCID) is also being offered as part of the newborn blood spot test. This is to help the NHS decide if screening for SCID should be offered to all babies in England.

SCID causes problems with the immune system. It makes it very hard for a baby to fight off infections like meningitis and pneumonia, which can be life-threatening. About 14 babies born each year in England have SCID.

Ask your midwife if screening for SCID is being offered in your area.
Great Ormond Street Hospital for Children has more information on severe combined immunodeficiency

Does my baby have to have the blood spot test?

The blood spot test is not compulsory, but it's recommended because it could save your baby's life.

You can choose to have screening for sickle cell disease, cystic fibrosis or congenital hypothyroidism individually, but you can only choose to have screening for all 6 inherited metabolic diseases or none at all.

If you don't want your baby to be screened for any of these conditions, discuss it with your midwife.

You should be given information about the blood spot test and the diseases it screens for in advance so you can make an informed decision for your baby.

If you change your mind, babies can be screened up to the age of 12 months for all the conditions except cystic fibrosis. Cystic fibrosis can only be screened for up to 8 weeks of age.

If you have any concerns about the tests, speak to your midwife, health visitor or GP.

When will we get the results?

You should receive the results either by letter or from a healthcare professional by the time your baby is 6 to 8 weeks old.

The results should be recorded in your baby's personal child health record (red book). It's important to keep this safe and take it with you to all your baby's appointments.

If you haven't received your baby's results, speak to your health visitor or GP.

You'll be contacted sooner if your baby screens positive. This means they're more likely to have one of the conditions tested for.

You'll be contacted:

the day the result is available, or the next working day, if your baby is thought to have congenital hypothyroidism (CHT) - you'll be given an appointment to see a specialist

before your baby's 4 weeks old if they're thought to have cystic fibrosis

before your baby's 6 weeks old if they're thought to have sickle cell disease

Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing.

Screening for sickle cell disease also finds babies who are carriers of this or other red blood cell diseases.

Carriers are healthy, although they can experience problems in situations where their bodies aren't getting much oxygen - for example, if they're having an anaesthetic.

Parents of babies who are found to be carriers should be told by the time they're 6 to 8 weeks old.

What do the results mean?

Most babies will have a normal result, which means it's unlikely that they have any of the conditions.

A small number of babies will screen positive for one of the conditions. This doesn't mean they have the condition, but they're more likely to have it. They'll be referred to a specialist for more tests.

It's important to know that screening isn't 100% certain. A baby with a negative screening result may later turn out to have the disease screened for. This is known as a false negative.

Babies with a positive result sometimes turn out not to have the disease - what's known as a false positive.

Occasionally, other medical conditions are picked up by blood spot test screening. For example, babies with beta thalassaemia major, a serious blood disease, will usually be detected. These babies also need to be referred for early treatment.

More information

Take our survey

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Your guide to the newborn blood spot (heel prick) test, including which diseases it screens for and when to expect the results

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Unicef UK Baby Friendly Initiative | Hand expression

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Getting to know your baby - why you are so important. 

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Getting to know your baby - why you are so important. 

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Why you are important to your baby's care | Bliss

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Find out why you are a really important part of your baby's care on the neonatal unit

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Watch Small Wonders videos here
Supporting you when your baby is sick or premature
More than 1 in every 10 UK babies is born prematurely or sick. As well as professional support there's so much that only you as a parent can do to make a real difference to your baby's chances of growing up fit and strong.

It can be very distressing to be told when you're pregnant that your baby is likely to be born prematurely, however there are so many ways you can make a real difference to their health and wellbeing.

Small Wonders are 12 bite-size films following families and their journey in neo-natal units.
Topics covered:

Birth

First hours

Expressing breast milk

Holding your baby

Your time in hospital

Feeding independently

Preparing for home

First months at home

Twins and triplets

Bereavement

What is Small Wonders?
Seeing how other parents have coped in a similar situation can be comforting. Seeing them become involved in their baby's care can help you feel more confident to get involved in your own baby's care.

The films, endorsed by seven Royal Colleges and many charities, aim to support families of sick and premature babies through their experiences and form the heart of a National Change Programme.

Best Beginnings has supplied Small Wonders DVDs to around 150 neonatal units in hospitals across the UK. The films address sensitive situations, some of which may not be right for you at this time. If in doubt, ask the advice of your hospital staff before watching.

We have worked closely with over 200 families, experts and endorsing organisations to produce these films and the DVD has been endorsed by over 20 organisations, including UNICEF and RCPCH.
How do I watch Small Wonders?
For a quick look at the Small Wonders, click . You can also watch online on the Baby Buddy app , on our YouTube channel, and on the desktop version of Baby Buddy. You can buy copies of the Small Wonders DVD, which comes with the supporting booklet, from our online shop. If you are a parent of a sick or premature baby you can receive a copy of the DVD for free through your hospital.
Ways parents can participate in their baby's care:

Regular skin-to-skin/kangaroo care. Skin-to-skin contact reduces susceptibility to infection and can help to stabilise a baby's temperature and reduce the length of hospital stay. It also improves awareness and helps mother to produce milk

Providing and feeding breast milk to your baby, for example through expressing. Breast milk is very important because it reduces infections and advances mental and emotional development

Providing comforting touch and comfort holding. Time spent holding or touching your sick or premature baby allows you to bond, which increases your baby's responsiveness and lets you get to know one another

Day-to-day care such as nappy changing or bathing your baby

Best Beginnings collaborates with other organisations to ensure that families receive the best possible support. For more information regarding premature and sick babies, visit the Bliss website or call their Family Support Helpline for free on 0500 618140.
What mums and dads think of Small Wonders
"I found the films useful as I am in a similar situation as some of the parents and it gives a good idea of what to expect."

"I have had a premature baby but I learnt a lot from watching these films. There are a MUST for parents who haven't had previous experience of a neonatal unit. Really good!"

"Absolutely fantastic films. Very informative and a great insight into what's to come when having a premature baby. So glad that I got a chance to watch these as it really helped myself and my partner."
Want to know more about Small Wonders?
Visit the Small Wonders Impact and Evaluation page.
To find out how Best Beginnings can work with you in your are and use our Small Wonders resources email Nilu, our Head of Evaluation and Impact at [email protected]

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Supporting you when your baby is sick or premature. Small wonders project include 12 bite-size films following families and their journey in neo-natal units. Learn more here.

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Lullaby Trust- Safer Sleep for Premature Babies

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Lullaby Trust- Safer Sleep for Premature Babies

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Safer sleep advice for preterm and low birth weight babies.

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Read about how newborn hearing screening is carried out, what is screened for, and when you can expect to get the results.

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Quiet time on NICU occurs daily between 12 and 2pm - this is to support brain development and give babies a restful period without being disturbed.

During this time the lights will be turned down, curtains drawn, and noise kept to a minimum.

It can also be an opportunity for you to spend time with your baby, enjoy skin to skin cuddles or read to your baby.

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Top tips for those early days of parenthood

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#ReadyforParenthood campaign

Congratulations on becoming a new parent

Becoming a new parent is life-changing. It can also be in varying measures exhilarating, exhausting, and extremely challenging. Our #ReadyforParenthood campaign aims to support new parents and carers.

Hear firsthand from parents who've had particular challenges in early parenthood and how they managed to overcome them:

Our campaign covers a variety of different topics related to being a parent, with information and links to useful organisations that can help you. Click on the images below for further information:

Bonding with your new baby takes time. Your baby can hear from around 24 weeks of pregnancy so you can start talking to them before they are born. When your baby is born, you can start to get to know them by having skin-to-skin contact.

Even if they have to stay in hospital you can spend time bonding with them and be part of their care until they are ready to come home.

Holding your baby, making eye contact, smiling and talking to them when you're together or out and about helps them to feel secure and connected. You may not feel an immediate bond with your baby, but taking time to get to know them will build your relationship.

If you are feeling that life as a new parent is difficult, you can talk with friends and family, your midwife, the maternal mental health team or your health visitor for support.

Breastfeeding lowers the risk of breast cancer, osteoporosis and obesity. It naturally uses up around 500 calories a day, and it saves money - formula feeding can cost as much as £45 a month.

In the first few days after birth, breasts produce a golden yellow fluid called colostrum. It's the perfect combination of vitamins and nutrition for your baby, and much easier to digest than first infant formula.

If you need help or support with breastfeeding, ask your midwife or health visitor, or get in touch with your local breastfeeding support group.

If your baby is around six months and staying in a sitting position with steady head and is co-ordinating their eyes, hands and mouth, it may be time to introduce solids. It's important not to rush the process too quickly. Speak to your health visitor if you think your baby is ready.

Your baby should sleep in the same room as you, day and night, for at least the first six months so you can respond quickly if they need you. Babies can overheat with too much bedding or clothing, or if the room's too hot. The ideal room temperature is 16-20°C. Use one or more layers of lightweight blankets; a folded blanket counts as two blankets.

The safest way for your baby to sleep is lying on their back on a firm, flat mattress in a cot, crib or moses basket. Don't worry if they turn onto their tummy or side to sleep once they are old enough to roll over.

Some parents choose to share a bed with their baby. It is important to know how to do this safely and when this may be dangerous. Seek professional advice and follow the safer sleep advice from the Lullaby Trust.

Covid-19 and Influenza vaccinations are recommended in pregnancy to protect you and your baby from serious illness. Ask your midwife, GP or an immunisation nurse for more information.

You can have the Covid-19 vaccine if you are breastfeeding and getting both jabs offers the best protection. Vaccinated people are far less likely to become seriously ill.

Childhood vaccinations are offered free of charge by your GP. As well as protecting your own baby, you're also protecting other babies and children by preventing the spread of disease.

The environments we provide our children help shape their experiences. Try to make eating well and taking regular exercise a priority and it will help promote healthy behaviours to your children.

Exercise increases energy levels and helps you feel good. It doesn't have to mean joining a gym. Pushing the pram or buggy to the shops or in a park is a good way to get active. Some parks even have free green gyms you can use.

Build activity into your everyday. You can use the stairs rather than the lift, walk places instead of driving, walk briskly with your buggy, rather than slowly. You will soon start to feel the benefits.

You may find less time for shopping so preparing healthy meals in advance will help keep your energy up whilst you look after your child. You can prepare meals in bulk and freeze them.

Regular physical activity is great for our bodies and minds. Slower paced activities such as walking are good opportunities to connect with others. Make time to connect with family and friends, in a safe way and take notice of the world around you.

All babies cry, and some cry more than others. Crying is your baby's way of telling you they need comfort and care.

Think ICON: 'I' is for I nfant crying is normal. Every baby is different but after about 2-3 months they should start to cry less each week.

'C' is for C omforting methods can help soothe your baby. Try skin to skin cuddles, breastfeeding, singing to your baby or going for a walk together.

'O' is for O K to walk away if you've checked your baby's safe and the crying's upsetting you. After a few minutes when you're feeling calmer, go back to them.

'N' is for N ever, ever shake, hurt or shout at your baby. Shaking can cause lasting brain damage or death. If you're worried that your baby's unwell contact your GP or call NHS 111.

You are welcome to share this campaign content widely throughout your networks, please ensure the South East Maternity Team is credited wherever possible.

Download our easy read booklet:

Download our Gypsy, Roma and Traveller community version here.

Download our campaign booklet in the language of your choice:

Mini Polls

Please answers the questions below:

Download our #ReadyforParenthood evaluation report:

What is the fourth trimester? - a film by Tommy's

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ReadyforParenthood campaign Congratulations on becoming a new parent Becoming a new parent is life-changing. It can also be in varying measures exhilarating, exhausting, and extremely challenging. Our #ReadyforParenthood campaign aims to support new parents and carers.

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Lullaby Trust- Safer Sleep for Full Term Babies 

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Lullaby Trust- Safer Sleep for Full Term Babies 

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Safer Sleep for Full Term Babies

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Screening for retinopathy of prematurity - information for parents and carers

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You have been given this leaflet because your baby was born at less than 31 weeks of pregnancy (very premature birth) or had a birthweight under 1501 grams and is at risk of developing ROP. It will give you more information about ROP, clarify what happens during screening and how you can support your baby and explain what happens after screening.

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Treatment of Retinopathy of Prematurity (ROP)

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Treatment of Retinopathy of Prematurity (ROP)

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Information for parents regarding Treatment of Retinopathy of Prematurity - often called ROP.

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A useful checklist to ensure you are baby wearing in a safe and secure way.

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ICON - Babies cry you can cope - Advice and Support | ICON

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ICON - Advice and support for parents when babies are crying

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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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At Warrington NNU we use vCreate photo sharing service to send photos and videos of your baby to you during their stay. If you have not yet been signed up to vCreate please let a member of staff know.

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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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How can you be involved in your baby's care? 

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How can you be involved in your baby's care? 

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How can health professionals support my family to get involved?

The nurses, doctors and other health professionals on a neonatal unit can support you to feel more confident in caring for your baby.

They can help by talking through anything that might be stopping you being more involved.

You might like to ask a nurse of other health professional on the unit to support you by:

Showing you how to do your baby's daily cares, like changing nappies, washing them, and dressing them

Giving you clear information about your baby's care, in a way that you understand

Understanding your emotional needs and how staff can support you

Making sure you understand and agree to the treatment your baby needs - this is called consent

Giving you practical information about how the unit works and the policies they have

Giving you any financial help that's available for car parking, hospital food, or other expenses

Showing you where to find further financial support if needed

Showing you where to find support if you are having to travel a long way from home to see your baby

Supporting you to help them, by letting you be a part of life on the unit. For example, many units let parents be there for the health professionals' ward rounds

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Getting involved in your baby's care | Bliss

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Find out how you can be involved in caring for your baby during their stay on a neonatal unit.

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Warrington Neonatal Unit has a facebook page!

An page open to the public where many of our parents post updates about their babies after discharge.

This might be a good place for you to look for peer support from other parents who have had a neonatal journey.

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How does getting involved in your baby's care on the NICU help?

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How does getting involved in your baby's care on the NICU help?

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Research shows that parents being involved in their baby's care on the neonatal unit can have positive effects on them and their baby.

Being involved in your baby's care

Some research shows that being more involved can mean that:

Babies spend less time in hospital

Parents feel less stressed

Babies are more likely to gain weight

Parents feel happier with the care their baby is getting

Parents have more success with breastfeeding

Parents are more comfortable and confident when their baby goes home

Babies are less likely to be re-admitted to hospital after they go home

You might not be able to get as involved as you'd like straight away. This might be because you are recovering from the birth, or if you have to return to work.

Whatever your situation, the staff on the unit will work with you to get involved when you can, and in a way that is right for you and your family.

Some parents find that starting with one thing, and building up to take on more care can be a good way to begin.

Skin-to-skin

Research shows that doing skin-to-skin care can help to create connections between you and your baby. Being physically close can help you to feel emotionally close too.

Skin-to-skin care can also help:

Start breastmilk production and breastfeeding, if you've chosen to feed this way

Your baby to sleep better

For you to learn each other's smell, which can help with feeding and creating an emotional connection

For dads and partners to feel physically close to your baby too

There is also some evidence to show that doing skin-to-skin can help to calm your baby, and can reduce any stress or anxiety you feel as a parent, too. It can especially help to soothe them if your baby is having any painful or distressing procedures.

Some evidence also shows that in premature babies, those who had skin-to-skin care had better longer-term outcomes.

Staff on the neonatal unit are likely to ask if you'd like to try skin-to-skin care with your baby, if your baby is well enough. They will also help you to find the best way to do this, for you and your baby.

This means making sure you feel confident and comfortable, and that you take things at your own pace.

Speaking to your baby

Talking to your baby can help them, as well as help you feel more connected to them. Some research shows that parents speaking to their baby in hospital can increase how much oxygen is in your baby's blood, something which is very important to their overall health.

Some research also shows that your baby's heart rate can increase when hearing their mother's voice. You might like to try reading or singing softly to your baby. This is something that wider members of your family can get involved with too.

It is also something which is easy to do even if you aren't able to hold your baby. You might feel a bit self-conscious to begin with, but your baby knows your voice, and hearing it will let them know you are there.

Being physically and emotionally close

Researchers have looked into the differences between being physically close with your baby, and being emotionally close with them.

If you are able to be with them physically, and do things like skin-to-skin, this can help you feel more emotionally connected with your baby too. But the two might not always go hand in hand.

You might be physically close to your baby but find it hard to feel connected with them. Or, you might not be able to spend much time on the unit, but feel connected with them emotionally through photos or videos you've taken, or through clothing that smells of your baby.

It can be really hard to feel connected with your baby in both ways. Some parents feel a lot of pressure to bond, and can feel that their baby's stay in neonatal care is getting in the way of being able to do this.

You're not alone, and there is support for you. You might find it helpful to chat with the staff on the unit and tell them how you're feeling and what you're worried about.

They will be able to suggest ways you can feel closer with your baby, both physically and emotionally.

Getting used to holding your baby

Research looking at the experiences of first time parents whose baby was in hospital found that parents were often nervous or unsure when it came to holding their baby, because they were scared of hurting them.

But the research also showed that once parents in neonatal care did connect physically with their baby, the emotional connection really grew.

If you're unsure of how to hold your baby, or you're worried you might hurt them, you can speak to the neonatal staff. They will explain how best to handle your baby, and what is the safest and best way to do this.

Staff are also very used to these worries from parents, and will be able to reassure you.

We surveyed over 1,200 parents to find out more about how they felt when they arrived on the unit, how they got involved in their baby's care, and how this affected them and their baby.

The most empowering part of getting involved

The parents we surveyed told us that the most empowering parts of getting involved in their baby's care were:

Skin-to-skin

Holding them

Feeding them

Bathing them

Touching them

Clothing them

Talking to them

Reading to them

Singing to them

Watching them

Changing their nappy

Expressing milk

Being involved in ward rounds

There might be other things you would like to do with your baby. Staff on the unit will be able to talk through all the options with you, to help you be as involved as you'd like to be.

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How getting involved on the neonatal unit helps | Bliss

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We often hear that parents find it hard to know how to look after their baby on the neonatal unit. But what are the benefits of being involved? And what do other parents say?

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Quick guide to your baby's vaccinations

6-in-1 protects against:

Diphtheria - a highly contagious bacterial infection, spread by coughs and sneezes, or close contact with someone with diphtheria.

Hepatitis B - an infection of the liver caused by a virus spread through blood and bodily fluids.

Hib (haemophilus influenzae type b) - bacteria that can cause several serious conditions including meningitis, sepsis (a kind of blood poisoning) and cellulitis.

Polio - a viral infection that can cause paralysis.

Tetanus - bacteria that can enter the body through a wound like a cut or scrape.

Whooping cough (pertussis) - highly contagious bacterial infection of the lungs and airways.

PCV or pneumo jab protects against pneumococcal infections that can lead to pneumonia, sepsis and meningitis.

RV protects against rotavirus infection that can cause diarrhoea and vomiting.

MenB protects against meningitis and sepsis.

Hib/MenC protects against haemophilus influenzae (a bacterium that can cause different serious illnesses) and meningitis C.

MMR protects against measles, mumps and rubella (German measles).

Newborn screening tests

You will be offered newborn screening tests for your baby soon after they are born. These screening tests are recommended by the NHS. This is because results from these tests can help make sure that your baby is given appropriate treatment as quickly as possible if needed.

It is important to think carefully whether you want to have these screening tests. Your decisions will be respected, and health care professionals will support you. Ask your midwife or doctor for more information about newborn screening

The red book

Your baby's Personal Child Health Record is also known as the red book or PCHR. It's used to record your child's weight and height, vaccinations they've been given and other important health information. You can also add information yourself - it's a great way of keeping track of your child's progress. Remember to take it with you when your baby has appointments at the clinic, GP or hospital.

An online version - the eRedbook - is being trialled in some areas in the UK. Sign up via the link if you're interested in participating in the trial or being kept up-to-date with the developments.

Health and development checks

Your baby's health checks are very important - they are an opportunity to check that your baby is developing properly.

They are usually carried out by your health visitor either at home or in your GP surgery, baby clinic or children's centre. These development checks are also a good opportunity for you to raise any concerns you might have.

Your baby's very first health check takes place shortly after they are born, and they'll continue until your child is 2 to 2 1/2 years old.

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These are the routine vaccinations and immunisations your baby needs

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6-in-1 protects against: Diphtheria - a highly contagious bacterial infection, spread by coughs and sneezes, or close contact with someone with diphtheria. Hepatitis B - an infection of the liver caused by a virus spread through blood and bodily fluids.

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Some parents feed their premature or sick baby expressed milk or formula in a bottle. Some babies will transition to bottle feeding after being tube fed.

You may prefer to feed your baby expressed milk and/or formula in a bottle alongside breastfeeding. This is called mixed or combination feeding. If you are thinking about mixed or combination feeding, talk to your neonatal team, feeding specialist, midwife, health visitor or GP.

Like other types of feeding, it is important to recognise the signs that your baby is hungry (feeding cues) before bottle feeding. Your baby may demonstrate early feeding cues by putting their fingers into their mouth, making sucking motions (rooting) and becoming restless.

Your baby will want to be close to you while being bottle fed, so this is a great time to have skin-to-skin. When possible, it is best for you or your partner to give bottle feeds so that your baby can learn with you. Doing the following while bottle feeding your baby can help them to feed successfully and be more comfortable:

Make sure you are close to your baby and hold them in the best position suited to your baby, with their head supported. This may be upright or elevated on their side. Some units may advise you to try different positions.

Offer the bottle when your baby shows feeding cues.

Gently invite your baby to take the teat.

Avoid forcing your baby to take the teat or finish the feed.

If the milk comes too quickly, it can be difficult for your baby to coordinate their sucking, swallowing and breathing. A nurse or feeding specialist on the unit will show you teats, bottles and positions that can help your baby to do this more effectively.

Some babies have periods of low oxygen (desaturations) and/or low heart rate (bradycardia) when they are starting to bottle feed or breastfeed. This is normal in some cases and will improve with time, but can be a sign that your baby is not ready for feeding yet. If this happens, it may need to be looked at by a doctor or a speech and language therapist who specialises in swallowing.

Low oxygen and heart rate while feeding can also be a sign of reflux. Reflux happens when some of the partly digested milk or food in the stomach comes back up the tube from the mouth to the stomach (oesophagus). This is common in all babies, but is more common in babies born premature or sick. We have more information about reflux.

Staff on the neonatal unit should support you and show you how to make feeds and clean and sterilise your baby's bottles (see below). They could also encourage you to bring bottles in from home so that your baby can get used to them. For more help and support with bottle feeding, speak to your neonatal team, feeding specialist, midwife, health visitor or GP.

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Find out how to feed your premature or sick baby expressed milk or formula in a bottle.

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Ideas to make healthy eating easy for new parents: British Nutrition Foundation

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Ideas to make healthy eating easy for new parents: British Nutrition Foundation

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There are lots of healthy meals and snacks that you can make that are quick and easy to prepare.
Healthy meal ideas
Try to base your meals on a starchy food, choosing wholegrains or higher fibre varieties where possible, such as potatoes with their skins, wholegrain breads, brown rice or wholewheat pasta, and then add different vegetables and a source of protein (such as beans, pulses, fish, eggs or lean meat). Keep a list of healthy meal ideas that you like. This will make it easier when you shop. If you are struggling to find time to go to the supermarket, why not try shopping online?

Here are some healthy meal ideas to get you started:

Chicken and vegetable stir-fry with reduced salt soya sauce, and boiled brown rice or wholewheat noodles. Why not add garlic, ginger and plain cashew nuts?

Grilled or steamed fish with lemon and some pepper. Serve with steamed potatoes and vegetables.

Lentil and vegetable soup, served with crusty bread.

Spaghetti bolognese with added vegetables and lentils in the sauce (see recipe below).

Fishcakes made with mashed potatoes, tinned salmon and herby low-fat cream cheese (to save time you could use fresh ready-made mash). Serve with peas and sweetcorn.

Baked potato with baked beans and a small portion of grated cheese, with a side salad.

Eggs, scrambled with chopped onion, peppers and mushrooms, on wholemeal toast.

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Healthy eating for new parents - British Nutrition Foundation

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When it feels like you do not have any time between feeds and nappy changes to think about cooking, here are some tips to make healthy eating easier. There are lots of healthy meals and snacks that you can make that are quick and easy to prepare.

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This information is about introducing your premature baby to more solid foods, and the steps you can follow as your baby moves from milk to eventually only eating solids. This is called weaning.

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This information is about introducing your premature baby to more solid foods, and the steps you can follow as your baby moves from milk to eventually only eating solids. This is called weaning.

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We encourage all parents to attend and take part in ward round when possible!

Times of ward rounds - approx. 9am-11.30am

Every Thursday we have a Grand Round with a consultant paediatrician.

If you are not able to be present during the ward round but would like to speak to a doctor about your baby's care, please let your nurse know and we will facilitate a conversation or phone call.

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We hear from parents that the equipment on the neonatal unit can seem overwhelming when you first arrive.

In this page, we explain what some of the equipment looks like and what it does.

The NICU was a room that never slept - it was a sensory overload. It's crazy that today, at one year old, Leo's favourite things are flashing lights and saying 'beep'.

Destiny, mum to Leo

You might not have had any time with your baby after they were born and before they went to the unit.

Many parents tell us that seeing their baby in the incubator and attached to wires makes them feel distanced from them. There can also be sounds from equipment which can seem alarming at first. This can feel very upsetting.

Some parents find it helpful to know what the equipment does and how it helps to monitor and provide support for their baby. If you are ever unsure about the equipment used for your baby, ask the neonatal team - they will be happy to explain.

Incubators are clear boxes which help keep your baby warm. Premature or sick babies can struggle to stay warm on their own.

Some incubators are closed boxes with hand holes on the side. This helps keep the heat and humidity in the incubator, stopping too much moisture evaporating from your baby's fine skin.

Other incubators have open tops and an overhead heater or heated mattresses.

The temperature is controlled in two ways - either with controls or using an automatic sensor on your baby's skin. If the sensor falls off or is not working properly, an alarm sounds, and a nurse will check the temperature of the incubator.

Ventilators and breathing machines

Before your baby was born, they received all the oxygen they needed from their birth parent. The oxygen in the birth parent's blood passes across the placenta and into the umbilical cord (the cord that connects the baby to the placenta and which is cut at birth).

Once they are born, babies get their oxygen by breathing. If a baby is born prematurely or with a medical condition, they may struggle to breathe by themselves. Premature babies' lungs in particular might not be developed enough to manage breathing by themselves yet.

Depending on what your baby needs, they might be put on a machine called a ventilator - this helps your baby to breathe.

There are two types of basic ventilator:

Ventilators: These blow air with or without added oxygen (depending on what your baby needs) gently into your baby's lungs through a tube which is passed through their nose or mouth. This inflates your baby's lungs and is adjusted depending on what your baby needs.

High frequency oscillating ventilators: These blow small amounts of air, with or without added oxygen, (depending on what your baby needs) into the lungs very quickly, hundreds of times a minute. Your baby's chest will look like it is vibrating. This might look worrying, but it can work very well for some kinds of lung conditions.

Other breathing machines can include:

Continuous positive airway pressure (often shortened to 'CPAP')
These blow air, with or without oxygen, (depending on what your baby needs) through two thin tubes in your baby's nose, or through a small mask over their nose. CPAP slightly raises the pressure of the air, which helps keep your baby's lungs inflated.

Non-invasic positive pressure ventilations (also called BiPap)
This is given through a mask or a small tube in your baby's nose and helps to regulate their breathing.

Heated, humidified high-flow nasal cannula (also called 'high-flow' or 'optiflow')
Some babies need help with their breathing but do not need something as strong as a ventilator. High-flow is where warm, moist air with or without oxygen (depending on what your baby needs) flows into your baby's lungs through small tubes in their nose.

Endotracheal (pronounced en-doe-track-eel) tube

This is put down your baby's windpipe (called a trachea by health professionals) if they are on a ventilator. It is either put in through your baby's nose or mouth. It is the tube which passes the air into your baby's lungs from the ventilator.

Vital signs monitor

These machines pick up electrical signals given out from your baby's heart, and always check that it is beating properly. They can also pick up changes in your baby's breathing. These monitors pick up these signals through small pads put on your baby's chest. Wires run from the pads to the monitoring machine.

Oxygen saturation monitor

These monitors check the amount of oxygen in your baby's blood, by shining a light through their skin. The sensors are strapped gently to your baby's foot or hand.

Intravenous (pronounced in-tra-vee-nus, and sometimes shortened to IV) drip

Your baby might have thin tubes (sometimes called IVs, drips or cannulae) put into a tiny blood vessel. The IV is usually put in a hand, foot, arm or leg. Sometimes the staff might have to use one of the tiny veins on the surface of your baby's head. These tubes are there to give fluids or medication, like antibiotics.

Feeding tube

If your baby can't feed by themselves yet, they might be able to have breast milk or formula through a tube that goes down their mouth or nose and into their stomach. Doctors might use a nasogastric (pronounced nase-oh-gas-trick) or orogastric (pronounced or-oh-gas-trick) tube.

For more information about feeding, visit our page about being a parent on the neonatal unit.

As soon as you know what all the machinery does, and why they beep and alarm, you will feel more comfortable in this unfamiliar place. Ask questions - no one will judge you.

Annie, mum to Alfie

Umbilical catheter (pronounced umm-bill-like-al cath-it-er)

These long, soft tubes are put into the blood vessels in your baby's belly button. Umbilical catheters are mostly used in the first few days after birth.

There are two types - one goes into an artery (blood vessels which carry blood full of oxygen from the heart and to the rest of the body) and is used to measure blood pressure and to take blood samples to check levels of certain important gases.

The other kind goes into a vein (smaller blood vessels which take blood with less oxygen back to the heart) and gives your baby nutrition or medicine. These catheters can have one or more tubes, allowing for different tests to be taken at the same time and avoiding disturbing your baby.

Long lines

These are very thin tubes passed into one of your baby's larger veins. Long lines are often used for giving nutrition an certain medication. Placing these can be a fiddly procedure if your baby is very small, but it is non-invasive.

The procedure might be done in a sterile environment to protect your baby from infections, where you may not be able to join. Your care team will explain all of this to you.

Phototherapy lamp or light blanket

If your baby has jaundice, they may be treated with blue light lamps (called 'phototherapy lamps') or a special light blanket (called a 'bili-blanket'). Jaundice (pronounced '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.

For more information about jaundice, visit our page about jaundice.

The information in this section is due for review November 2025

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We hear from parents that the equipment on the neonatal unit can seem overwhelming when you first arrive. In this page, we explain what some of the equipment looks like and what it does.

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British Association of Perinatal Medicine

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Families | British Association of Perinatal Medicine

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Support for parents, carers and families spending time in the neonatal unit.

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What is a Health Visitor and how will they help you post discharge? 

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What is a Health Visitor and how will they help you post discharge? 

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Caring for Your Baby At Night Unicef Resource

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Caring for Your Baby At Night Unicef Resource

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Hear from parents who have experienced a preterm birth, and Neonatal Care.

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From preterm birth to thriving baby - How NHS staff ensured the best start for little Luna

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A useful leaflet by the Lullaby Trust. A guide to buying safer sleep essentials.

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