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Psychology support for families post NNU discharge

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This video guides mothers on how to hand express and talks about the times when hand expression might be useful.

See the Breastfeeding Network website for FAQs and a leaflet all about expressing and storing breastmilk.

Problems viewing this video? Contact us.

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Hand expression video - Baby Friendly Initiative

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This video guides you through how to hand express, and talks about the times when hand expression might be useful for you.

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About your baby

For many families, having a baby admitted to a neonatal unit is a unique and frightening experience. For the majority, this situation is neither expected nor prepared for. Find out more information and about help and support that you can receive.

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For many families, having a baby admitted to a neonatal unit is a unique and frightening experience. For the majority, this situation is neither expected nor prepared for. Find out more information and about help and support that you can receive.

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You and your partner may be able to get paid time off work if your newborn baby is premature or sick and needs neonatal care. Please visit the Government website for more information

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Your Neonatal Care Leave and Statutory Neonatal Care Pay: what you can get, eligibility, how to claim and how to cancel.

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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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What the law says- Neonatal Care Leave and Pay 

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What the law says- Neonatal Care Leave and Pay 

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What the law says - Neonatal care leave and pay - Acas

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What neonatal care leave is, who is eligible and rights of parents who take it.

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Information on what happens straight after birth as well as the importance of giving vitamin K to your newborn.

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It's natural to focus on your baby's birth while you're pregnant. But it's a good idea to also know what to expect after labour.
Skin-to-skin contact really helps with bonding. It's a good idea to have your baby lifted onto you as soon as they're born and before the cord is cut so you can be close to each other straight away.

Either before, or just after the cord is clamped, your baby will be dried and then covered with a towel to stop them getting cold. You can continue to hold and cuddle your baby while this is done.

Your baby may have some of your blood on their skin and perhaps vernix, the greasy white substance that protects your baby's skin in the womb.

If you prefer, you can ask the midwife to dry your baby and wrap them in a blanket before your cuddle.

Mucus may need to be cleared out of your baby's nose and mouth.

Some babies need a bit of help to get their breathing established.

Your baby may be taken to another part of the room to have some oxygen. They'll be brought back to you as soon as possible.

Your baby will be examined by a midwife, neonatal nurse or paediatrician, then weighed and possibly measured, and given a wrist or ankle band with your name on.

Your midwife or maternity support worker will help you wash and freshen up before you go to the postnatal ward.

Vitamin K for newborn babies

You'll be offered an injection of vitamin K for your baby. This helps prevent a rare bleeding disorder called haemorrhagic disease of the newborn.

Your midwife should have discussed the injection with you while you were pregnant.

If you'd prefer for your baby not to have an injection, they can have vitamin K by mouth instead, but they'll need further doses.

Stitches for tears or cuts

Small tears and grazes are often left without stitches because they can usually heal without treatment.

If you need stitches or other treatments, you should be able to carry on cuddling your baby while this is being done.

If you have had a large tear or an episiotomy, you'll need stitches.

If you have already had an epidural, it can be topped up. If you haven't, you should be offered a local anaesthetic to numb the area.

Preventing bleeding after the birth

Postpartum haemorrhage (PPH) is a complication where you bleed heavily from the vagina after your baby's birth.

There are 2 types of PPH, depending on when the bleeding takes place:

primary or immediate - bleeding that happens within 24 hours of birth

secondary or delayed - bleeding that happens after the first 24 hours and up to 12 weeks after the birth

Sometimes PPH happens because your womb doesn't contract strongly enough after the birth.

It can also happen because part of the placenta has been left in your womb or you get an infection in the lining of the womb (endometritis).

To help prevent PPH, you'll be offered an injection of oxytocin as your baby is being born. This stimulates contractions and helps to push the placenta out.

Now read about you and your body after the birth.

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What to expect after your baby is born, including information on skin-to-skin contact, bonding, stitches and vitamin K injections.

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Information from the Lullaby Trust

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The screening tests that are offered to you and your baby

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The screening tests that are offered to you and your baby

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STFYAYB provides information about the screening tests offered during and after pregnancy.

Details

This information is about the screening tests you will be offered during your pregnancy and after your baby is born. It explains the different types of test and what the tests are looking for.

Easy read versions of this leaflet are available. Additional information is also available for parents of babies who are in a special care baby unit, neonatal intensive care unit or paediatric intensive care unit.

We hope this advice will help prepare you for discussions with your midwife or doctor so that you can ask the questions that are important to you.

It is your decision whether or not to have any of the tests described.

In this publication, we use the terms 'woman' and 'women' to refer to anyone able to become pregnant, including trans men. Trans men who are pregnant should be offered the same antenatal and newborn screening tests as other pregnant individuals.

The information is available in 12 other languages: Arabic, Bengali, Chinese, French, Latvian, Lithuanian, Polish, Portuguese, Punjabi, Romanian, Somali and Urdu.

See how to print digital leaflets if you want to print any sections of this guidance.

Free printed copies of this leaflet are also provided for local screening providers to give to women who cannot access the internet. Screening services can view the full PDF of the printed leaflet and order printed copies on the APS online ordering portal (requires login).

Contact the screening helpdesk with any queries about this publication, making sure you include its full title.

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Screening tests for you and your baby (STFYAYB)

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STFYAYB provides information about the screening tests offered during and after pregnancy.

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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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Special care baby unit (SCBU, SCU or low dependency) - Level 1

This is for babies who do not need intensive care. Often, this will be for babies born after 32 weeks' gestation.

Care can include:

Monitoring their breathing or heart rate

Giving them more oxygen

Treating low body temperature

Treating low blood sugar

Helping them feed, sometimes by using a tube

Helping babies who become unwell soon after birth

Sometimes, a baby might be admitted to a special care baby unit for phototherapy to treat jaundice. But sometimes, this condition is treated in transitional or postnatal care (see above).

Local neonatal unit (LNU) - Level 2

This is for babies who need a higher level of medical and nursing support. If your baby was, or will be, born between 27 and 31 weeks' gestation, you may be transferred to an LNU.

Care on an LNU might include:

Short-term intensive care (usually up to 48 hours)

Short-term ventilation, continuous positive airway pressure (called CPAP) or high flow therapy, for breathing support

Care during periods where their breathing pauses briefly, called 'apnoea' (pronounced ap-knee-ya)

Feeding through a drip in their vein (called parenteral nutrition)

Cooling treatment for babies who have had difficult births or are unwell soon after birth (before being transferred to a neonatal intensive care unit - see below)

Helping babies who become unwell soon after birth

Neonatal intensive care unit (NICU) - Level 3

This is for babies with the highest need for support lasting more than 48 hours. Often these babies will have been born before 28 weeks' gestation, or be very unwell after birth.

You might have been transferred to a different hospital which has a neonatal intensive care unit before your baby was born. This is usually because the staff feel your baby would benefit from this level of care, but that it is safer to transfer your baby before they are born.

Some of the reasons babies are cared for here are when they:

Need help with their breathing (called ventilation)

Need help with their heartbeat and blood pressure

Have a moderate to severe condition affecting their breathing (called respiratory distress)

Need longer-term feeding support through an intravenous (intra-venus) tube or general nutritional support

Need or have just had surgery - including cooling treatment for brain injuries

At a neonatal intensive care unit, all levels of care may also be given to babies from the local area.

Our friends at the Cambridge University Hospitals Trust and Rosie Maternity and Neonatal Voices Partnership have made a video about NICU, especially aimed at big brothers and sisters that helps to explain what NICU is.

I'm confused by the different levels of neonatal care

It can be confusing to understand your baby's level of care.

Sometimes babies might be treated in different types of units because their condition has changed. It might not be clear straight away what type of care your baby is getting.

For example, your baby could be in a neonatal intensive care unit, but getting special care. You can always ask the staff if you want more information about the level of care your baby is getting.

You might hear staff on the unit call the different levels of care by different names than we've used here. Have a look through our neonatal words for some other ways people talk about levels of care.

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It can be confusing to understand your baby's level of care. Here, we talk about the different levels of care neonatal units provide.

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Guide to Medela hospital grade electric breast pump

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Guide to Medela hospital grade electric breast pump

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Pumping with Symphony at the Hospital : A Guide | Medela

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Get started with Symphony at the hospital with our guide. Learn about breast shield selection, pump setup, and more—ideal for new mums!

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Skin-to-skin contact - Baby Friendly Initiative

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Skin-to-skin contact is important for babies and mothers to develop close, loving parent-infant relationships and to initiate breastfeeding.

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How to position your baby for breastfeeding

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How to position your baby for breastfeeding

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding.

Key to achieving the Baby Friendly standards is a workforce able to support mothers to breastfeed effectively. This video provides some guidance on this.

You can see more of the 'From Bump to Breastfeeding' DVD on the Best Beginnings website.

Video not working? Contact us

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Positioning and attachment video - Baby Friendly Initiativ

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In this video, a breastfeeding counsellor helps a mother with her positioning and attachment whilst breastfeeding. Watch to learn more.

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In this video, we explore how best to support new mothers with feeding.

Exclusive breastfeeding for the first six months ensures the best outcomes for babies, and mothers need support to get this off to the best start. Ongoing help with positioning, attachment and skin-to-skin contact help mothers to maintain their milk supply and avoids disruption to breastfeeding.

If mothers wish to bottle feed, the impact on milk supply should be discussed so that they can make informed choices. A sensitive, non-judgmental approach is key.

For more information:

Problems viewing this video? Contact us.

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Maximising breastmilk video - Baby Friendly Initiative

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In this video, we explore how best to support new mothers with feeding, including positioning, attachment and skin-to-skin contact.

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Feeding your baby on the neonatal unit can be different to what you had planned, but you can still find the best way of feeding for you and your baby. Find out more here.

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Transfer Closer to Home: The neonatal repatriation of your baby

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This is the transport team who are specialised in the retrieval and repatriation of you and your baby.

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The Southampton Oxford Neonatal Transfer service (SONeT) is a collaboration between two neonatal intensive care units (NICUs) in Oxford and Southampton. It provides emergency neonatal retrievals, planned transfers and repatriations in Thames Valley and Wessex Neonatal Network.

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Southampton Oxford Neonatal Transport (SONeT) is a collaboration between the two neonatal intensive care units (NICUs). It provides expert neonatal transport services for the Thames Valley and Wessex region.

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Video content with practical advice and support

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Best Beginnings - creators of Baby Buddy

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Best Beginnings - creators of Baby Buddy

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Best Beginnings is a national charity working to support all parents and caregivers in the UK to give their children the best start in life. We are the creators of the free-to-use, ad-free, multi award-winning Baby Buddy app - a virtual friend and baby expert that guides you through pregnancy and t…

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What is 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). It can sometimes reach the baby's throat and mouth.

The stomach contains acid that helps to digest food. The acidity of the food coming back up to the throat can cause some discomfort and burning sensations. This can be painful for babies and they may become irritable during and after feeding.

Why does reflux happen?

Reflux happens when the band of muscle between the food pipe and the stomach opening is weak and cannot close properly. This band usually opens when food is about to enter the stomach and closes so that food stays in the stomach.

Babies born premature or sick are more likely to experience reflux, but it is very common and affects nearly half of all babies in some way.

What are the signs of reflux in babies?

Signs of reflux in babies can include the following:

Bringing milk back up during or after feeds.

Vomiting that often shows no clear pattern in terms of timing or amount.

Persistent hiccups and coughing.

Fussiness, crying and restlessness.

Refusing feeds or only taking small amounts of food.

Choking or gagging.

If untreated, more severe complications of reflux can include the following:

Frequent chest infections.

Poor weight gain.

Difficulties with feeding, including a reluctance to feed.

If your baby is showing signs of reflux, talk to a medical professional such as your GP or health visitor.

What treatment is available for reflux?

Mild reflux usually improves on its own and gets better when your baby begins to wean onto solids. Treatment depends on the severity of the reflux. But there are ways you can help too. Here are some ways you can help your baby:

Give your baby skin-to-skin after a feed, to allow the food to settle.

For some babies it is helpful for them to be fed in different positions. You could try to feed your baby in a more upright position. Speak to staff on the neonatal unit if you have questions or need support with positioning your baby for feeding.

Keep your baby's head gently raised during the day, especially after a feed. Reflux is worse when a baby is lying flat on their back. Do not put anything directly under your baby's head, and never use a pillow with a baby under 12 months old.

Change your baby's nappy before feeding.

Feed your baby with smaller amounts of milk more often.

Wind your baby more frequently. To wind, rub rather than tap your baby.

Your GP may also give you some medications to help. These may include feed thickeners, which are added to your baby's milk to help reduce the effect of reflux. Thickeners work by making the food more solid once it is in the stomach and this makes it harder to bring back up. Other medications may help to stop your baby's stomach producing too much acid and speed up food passing through the stomach. Feed thickeners should only be used if they have been prescribed by a medical professional such as a GP.

Reflux usually gets better on its own, as babies' muscles develop. If treatments and medications do not help, then your baby may need to be referred to a specialist. They will be able to tell you if your baby needs any further tests.

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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). It can sometimes reach the baby's throat and mouth. The stomach contains acid that helps to digest food.

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At the heart of SSNAP’s support is our dedicated Family Care Team: Christine, Donna, and Lauren.

You’ll find them on the unit offering both emotional and practical support to families navigating the neonatal journey. Whether you need someone to talk to, help finding your way through hospital life, or just a listening ear and a little encouragement — they’re here for you, every step of the way.

If you are a parent on the unit then please pop into our office or say hello if you see us on the unit.

You can also visit our website SSNAP | Home

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On our neonatal unit, we promote the use of swaddle bathing for our babies. Check out this leaflet and scan the QR code for a video of it in action.

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How to wash and bath your baby.

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Read a step-by-step guide to washing and bathing your new baby, including how often to do it and how to top and tail.

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Little Ssnaplings - our very own baby and toddler groups for families who have spent time in the neonatal unit!

These groups are a place for families who have experienced a difficult start with their newborn. Where they can meet others who understand and have been there them selves.

You will be able to enjoy a FREE 2 hour group and enjoy baby massage, baby yoga and Ride on Time for our toddler group. Light refreshments will follow.

If you'd like any more information on our groups please contact Tash  tash@ssnap.org.uk visit the website (Little Ssnaplings | SSNAP) or speak to the SSNAP family care team!

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We love it when families who are discharged home, keep in touch! Simply put, we couldn't achieve all that we do without the support of people who go above and beyond to donate to raise money for SSNAP.

Why not visit the SSNAP website to read some amazing stories of those who have also been supported by SSNAP throughout their journey in the neo natal unit?

Stories | SSNAP

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SSNAP_Service_Leaflet.pdf

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Babies in hospital do not have baths straight away, when they are big enough they can have a bed bath. This video shows how to give your baby a bed bath - they use a "rag" or flannel in this video but in hospital you may be advised to use gauzes to clean your little one.

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We were taking home new friendships and endless stories from other parents, with different experiences but with whom we shared the same emotions. Those parents are the only ones who can understand what the NICU world really is. We’re taking home the value of celebrating every milestone with our babies, that we always must have hope and not take anything for granted.

Today I’m a proud member of SSNAP and I also ran the Oxford Half Marathon in 2022 as my way of saying thank you to everything SSNAP has done for us. Our story is our legacy and my hope is that one day Tessa and Thiago will be proud to share the story of how much love they received thanks to SSNAP.

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On 25 June 2021 I gave birth to my beautiful twins, Thiago and Tessa. At only 31 (30+6) weeks of pregnancy. Tiny and fragile, they were immediately moved to the NICU, at the John Radcliffe Hospital in Oxford - where an incubator became their new home for the following 37 days. Those were the longest and most difficult 37 days of our entire life.

My journey to becoming a mum started more than two years ago, when my partner and I decided to embark on the IVF journey. It took 2 failed cycles, a miscarriage, many tears, anxiety and pain, but at the beginning of 2021 we could finally see two heartbeats. "Pregnancy is no disease", I've been told, but what I went through in 7 long months was the most horrible and difficult experience of my entire life. Hyperemesis gravidarum (extreme pregnancy sickness) was one of the rare conditions I suffered from, very hard on the body and mentally very demanding. At 20 weeks I was diagnosed with placenta previa, which caused a series of very frightening big and unpredictable bleedings. When the first one happened I was at home on my own, and seeing a river of blood coming down my legs was frightening. Your mind starts to process many dark and scary thoughts, and one of them is death. After the second haemorrhage at 28 weeks, I was diagnosed with PPROM (Premature rupture of membranes), and started leaking amniotic fluid. That's when the doctors made the decision to keep me in until Tessa and Thiago's birth. I spent one month in the hospital surrounded by other women with similar or worse conditions. I saw women coming and going. I listened to other women's stories, empathised with most of them, and made friends. At night I could hear them crying and sobbing. Same as me. I cried every day.

My daily routine consisted of blood tests to check my infection levels, steroid and anticoagulant injections, transfusions, and meeting different doctors every day. 'We'll try to take you to 37 weeks of pregnancy', said one doctor. 'I think it'll be safer if we deliver at 34 weeks', I've been told by another doctor, after my third bleed.

After each bleed I experienced panic attacks, after each bleed my anxiety and fear to see blood again were mixed with compulsions and obsessive thoughts, as I had to check my pad every 10 minutes. I was scared to get up from the hospital bed, I was scared to go to the toilet on my own, I was scared to have a shower on my own. Luckily I have the most supportive and empathetic partner in the world, and he was next to me after each bleeding and anxiety episode.

On the morning of 25 June I had a fourth bleed. This time I tried to stay calm. 'It's just another bleed', I told myself. But this time it was different. 'We need to deliver now', my partner and I heard, 'and we need to make a decision pretty quickly'. Our mind went dark. What would've that meant for me, for my babies? Will they be okay? Will they be healthy? I had so many questions and fears flooding my mind. But waiting any longer could've meant risking mine and my babies' life. Thiago's placenta had already detached from my uterus and his heartbeat was dropping.

I was taken to the theatre. But I wasn't mentally prepared for that. My pregnancy that day was interrupted.

I wonder why a woman needs to stay awake during a C-section. It's a massive surgery and experiencing everything was traumatising. I remember being surrounded with many doctors, midwives and neonatologists, ready to provide care to my babies.

The fluids started entering my body, my mind became very dizzy, and my whole body numbed. I remember the pulling sensation and pressure when Tessa and Thiago came out, I remember hearing their weak cry. I saw them for just two minutes, as they were taken immediately to the NICU.

I lost nearly 3 litres of blood, I had two blood transfusions and my physical recovery was incredibly slow. But that was nothing compared to what I felt emotionally.

When the pain from the surgery eased off a bit and I was able to get out of bed, I went to visit my babies in the NICU. They were there, in two separate incubators, on the opposite side of the room. My two tiny babies were surrounded by wires and tubes, there were tubes inside their tiny bodies. My two tiny babies weren't able to breathe on their own. I cried all the tears I had. I felt guilty, I felt useless, I felt impotent, I felt like I was dying inside. That's when I was approached by two lovely ladies from SSNAP. 'We're here for you all', my partner and I heard. 'You can talk to us'', they said while offering a chocolate snack. I immediately felt so much warmth, so much compassion, so much kindness. A small gesture that made me feel slightly better. A SSNAP box was waiting for us, next to each of our baby's incubator, with information on what SSNAP is and what they do for parents whose babies are in the NICU. 'There are other mums like me', I thought. 'I'm not alone'. In each box we also found a little bear, that today, 2 years later, I still jealously cherish.

I suffered from PTSD and I experienced flashback memories for many weeks following the delivery. I wasn't able to stay in the NICU without crying, I wasn't able to touch my babies, I was scared to hurt them. But I wasn't on my own. Thanks to the SSNAP team who looked after me every day, I was able to overcome my fears, I was able to talk about my traumatic experience, hold my babies on my chest for the first time, and learn how to get involved into my babies' daily care. They were able to listen, to use kindness and empathy to approach a vulnerable me, they were able to respect my silence when I wanted to be silent. For 37 days they were there for myself and my family. SSNAP became my safe place.

Luckily my babies were doing well and THAT day finally arrived: we were going home. No more incubators, no more reliance on beeping monitors and their cary fluctuating numbers, no more feeding tubes down the throat and gastric aspirates, no more hospital schedules, no more painful procedures. We are leaving all this behind, but what we were taking home from the NICU World is the immense gratitude for all the support and help we've got from all the people who give their own time to look after all the premature and sick babies and their families, making sure they grow and thrive, people who gave us advice and helped us build our confidence as parents of premature babies, answering all our questions and guiding us through our journey in the NICU.

We were taking home new friendships and endless stories from other parents, with different experiences but with whom we shared the same emotions. Those parents are the only ones who can understand what the NICU world really is. We're taking home the value of celebrating every milestone with our babies, that we always must have hope and not take anything for granted.

Today I'm a proud member of SSNAP and I also ran the Oxford Half Marathon in 2022 as my way of saying thank you to everything SSNAP has done for us. Our story is our legacy and my hope is that one day Tessa and Thiago will be proud to share the story of how much love they received thanks to SSNAP.

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Our story is our legacy, my hope is that one day Tessa and Thiago will be proud to share the story of how much love they received thanks to SSNAP

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An illustrated, step-by-step process on how to complete a standing transfer for skin-to-skin.

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This information was created on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening.

This short video explains blood spot screening in newborn babies.
Newborn blood spot video
Blood spot screening is recommended by the NHS.

1. Purpose of screening

To find out if your baby has any of 9 rare but serious health conditions.

Early treatment can improve your baby's health and prevent severe disability or even death. If you, the baby's father, or a family member already has one of these conditions, please tell your health professional straight away.

2. About these conditions

2.1 Sickle cell disease

About 1 in 2,800 babies born in the UK has a sickle cell disease ( SCD). These are serious, inherited blood diseases. They affect haemoglobin, a part of the blood that carries oxygen around the body. Babies who have SCD will need specialist care throughout their lives.

People with SCD can have attacks of severe pain, get serious, life-threatening infections and are usually anaemic (their bodies have difficulty carrying oxygen). Babies with SCD can receive early treatment, including vaccinations and antibiotics, which, along with support from their parents, will help prevent serious illness and allow them to live a healthier life.

2.2 Cystic fibrosis

About 1 in 2,500 babies born in the UK has cystic fibrosis ( CF). This inherited condition affects the digestion and lungs. Babies with CF may not gain weight well and frequently have chest infections. Babies with CF can be treated early with a high-energy diet, medicines and physiotherapy. Although children with CF may still become very ill, early treatment can help them live longer, healthier lives.

2.3 Congenital hypothyroidism

About 1 in 2,000 babies born in the UK has congenital hypothyroidism ( CHT). Babies with CHT do not have enough of the hormone thyroxine. Without thyroxine babies do not grow properly and they can develop permanent serious physical problems and learning disabilities.

Babies with CHT can be treated early with thyroxine tablets and this will allow them to develop normally.

It is important to let your health professional know if you have a family history of a metabolic condition. Babies are screened for 6 inherited metabolic diseases (IMDs).

These are:

phenylketonuria (PKU)

medium-chain acyl-CoA dehydrogenase deficiency (MCADD)

maple syrup urine disease (MSUD)

isovaleric acidaemia (IVA)

glutaric aciduria type 1 (GA1)

homocystinuria (pyridoxine unresponsive) (HCU)

About 1 in 10,000 babies born in the UK has PKU or MCADD. The other conditions are rarer, occurring in 1 in 150,000 babies to 1 in 300,000 babies.

Babies with these inherited conditions cannot process certain substances in their food. Without treatment babies with some of these conditions can become suddenly and seriously ill. The symptoms of the conditions are different; some may be life threatening or lead to severe developmental problems.

They can all be treated by a carefully managed diet, which is different for each condition and may include additional medicines.

3. The screening test

When your baby is 5 days old the health professional will prick your baby's heel using a special device to collect some drops of blood onto a card. Occasionally this may be later than 5 days. The heel prick may be uncomfortable and your baby may cry. You can help by making sure your baby is warm and comfortable, and by cuddling and feeding them.

Sometimes, a second blood spot sample is required later on. If so, the reason will be explained. It does not necessarily mean there is something wrong with your baby.

4. Safety of the test

There are no known risks to your baby associated with having the test.

5. Screening is your choice

Screening your baby for all these conditions is recommended because it could save your baby's life but it is not compulsory. You can choose to have screening for SCD, CF or CHT individually but can only choose to have screening for all 6 IMDs or none at all. If you do not want your baby screened for any of the conditions or have any concerns about the test, please talk to your midwife.

Early screening is best as treatment can be started as soon as possible if needed. But if you choose not to have screening, your baby can have the test later if you change your mind. Babies can be screened up to 12 months of age for all the conditions except CF (only up to 8 weeks of age).

6. Possible results

Most babies will have normal results indicating that it is unlikely that they have any of the conditions. A small number of babies will screen positive for one of the conditions. This does not mean they have the condition but they are more likely to have it. They will be referred to a specialist for further tests.

Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing. Screening does not detect all carriers.

Occasionally, other medical conditions might be identified through these screening tests. For example, babies with beta thalassaemia major (a serious blood disease) will usually be detected. These children also need to be referred for lifelong treatment and care.

Screening for sickle cell disease also finds babies who are genetic carriers of these or other red blood cell diseases. Carriers are healthy although they can experience some problems in situations where their bodies might not get enough oxygen, for example, if they are having an anaesthetic.

7. Getting my results

You should receive the results from a health professional by the time your baby is 6 weeks old. The results should be recorded in your baby's personal child health record ('red book'). Please keep this safe and bring it with you to any further appointments. You will be contacted sooner if there is thought to be any problem with your baby.

8. My baby's blood spot card and data after screening

After screening blood spot cards are stored for at least 5 years and may be used:

to check the result or for other tests recommended by your doctor

to improve the screening programme

for research to help improve the health of babies and their families in the UK (this will not identify your baby and you will not be contacted)

In addition, there is a small chance that researchers may want to invite you or your child to take part in information gathering linked to the newborn blood spot screening programme. Researchers undertaking any additional studies would explain what is being done and you would then be asked if you wish to take part in that study. Please let your midwife know if you do not want to be contacted to discuss taking part in any additional information gathering.

All use of the blood spots is governed by the code of practice. Any research will have been approved by an independent research ethics committee.

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This information was created on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening. This short video explains blood spot screening in newborn babies. Newborn blood spot video Blood spot screening is recommended by the NHS.

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Changing your babies nappy who was born prematurely may need to be paced depending on your babies response to handling, ensuring that you do not raise their legs or feet and watching for cues from them on how they are coping with you changing them.

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Tips for changing your baby’s nappy | Bliss

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Changing your premature or sick baby’s nappy is a great way to be involved in their care on the neonatal unit.

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There is a useful video at the end of all the information on how to change a nappy - you do not always need to apply barrier cream if your babies private area is starting to look a bit pink then this is the optimum time to apply some cream.

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When to change a nappy

Babies need frequent nappy changes.

Babies have very delicate skin so their nappy needs to be changed as soon as they wet or poo themselves, otherwise their skin becomes sore and red.

Changing your baby's nappy as soon as possible after they've done a wee or poo will help prevent  nappy rash.

Young babies may need changing as many as 10 or 12 times a day, while older babies need to be changed around 6 to 8 times.

What you need for nappy changing

Before you change your baby's nappy, wash your hands and get everything you need in 1 place, including:

a changing mat or towel

cotton wool and a bowl of warm water, or fragrance and alcohol-free baby wipes

a plastic bag or bucket for the dirty nappy and dirty cotton wool or wipes

barrier cream to protect your baby's skin

a clean nappy (and liner and cover if you're using cloth nappies)

clean clothes

Where to change a nappy

The best place to change a nappy is on a changing mat or towel on the floor, particularly if you have more than one baby.

That way, if you need to see to another child for a moment, your baby can't fall. It's best done sitting down so you don't hurt your back.

If you're using a changing table, keep an eye on your baby at all times. You shouldn't rely on the straps to keep your baby secure. Never walk away or turn your back.

Older babies may try to wriggle away when you're changing them. You could give them a toy or use a mobile to distract them.

How to change a nappy

It's just as important to clean your baby fully whether they have wet themselves or done a poo.

If your baby's nappy is dirty, use the nappy to clean off most of the poo from their bottom.

Then use the cotton wool and plain warm water (or baby wipes) to remove the rest and get your baby really clean.

Clean the whole nappy area gently but thoroughly and make sure you clean inside the folds of skin.

Girls should be cleaned from front to back to avoid getting germs into their vagina.

Boys should be cleaned around the testicles (balls) and penis, but there's no need to pull back their foreskin.

If it's warm enough, let your baby lie on the changing mat without a nappy on for a while. Wearing a nappy all the time makes nappy rash more likely.

If you're using disposable nappies, take care not to get water or cream on the sticky tabs as they won't stick if you do.

If you're using cloth nappies, put in a nappy liner and then fasten the nappy. Adjust it to fit snugly round the waist and legs.

Chat to your baby while you're changing them. Pulling faces, smiling and laughing with your baby will help you bond and help their development.

Try not to show any disgust at what's in their nappy. You don't want your baby to learn that doing a poo is something unpleasant or negative.

Nappy hygiene

Disposable nappies can be rolled up and resealed using the tabs. Put them in a plastic bag kept only for nappies, then tie it up and put it in an outside bin.

Washable cloth nappies don't have to be soaked before they're washed, but you may choose to soak them to help get the stains off. Check the washing instructions first.

Cloth nappies can be machine washed at 60C, or you could use a local nappy laundry service.

There's no evidence that using washing powders with enzymes (bio powders) or fabric conditioners will irritate your baby's skin.

Wash nappies that are dirty with poo separately from your other washing.

To avoid infection, wash your hands after changing a nappy before you do anything else.

If your baby's old enough, they can wash their hands with you as it's a good habit to get into.
Learn how to wash your hands properly

What baby poo looks like

Your baby's first poo is called meconium. This is sticky and greenish-black.

Some babies may do this kind of poo during or after birth, or some time in the first 48 hours.

After a few days the poo will change to a yellow or mustard colour. Breastfed babies' poo is runny and doesn't smell. Formula-fed babies' poo is firmer, darker brown and more smelly.

Some infant formulas can also make your baby's poo dark green. If you change from breast to formula feeding, you'll find your baby's poos become darker and more paste-like.

If you have a girl, you may see a white discharge on her nappy for a few days after birth.

It's caused by hormones that have crossed the placenta to your baby, but these will soon disappear from her system.

These hormones can occasionally cause slight bleeding like a mini period, but in both cases it's nothing to worry about.

Read the NCT guide to newborn baby poo.

How often should my baby do a poo?

Babies do an average of 4 poos a day in the first week of life. This goes down to an average of 2 a day by the time they're 1 year old.

Newborn babies who are breastfed may poo at each feed in the early weeks, then, after about 6 weeks, not have a poo for several days.

Formula-fed babies may poo up to 5 times a day when newborn, but after a few months this can go down to once a day.

It's also normal for babies to strain or even cry when doing a poo.

Your baby isn't constipated as long as their poos are soft, even if they haven't done one for a few days.

Is it normal for my baby's poos to change?

From day to day or week to week, your baby's poos will probably vary.

If you notice a definite change of any kind, such as the poos becoming very smelly, very watery or harder (particularly if there's blood in them), you should talk to your doctor or health visitor.

If your baby's poos look pale, this can be a sign of liver disease.

Speak to your health visitor or GP if you notice this.

Disposable and washable cloth (reusable) nappies

Disposable and cloth nappies come in a range of shapes and sizes. The choice might be confusing at first, but with trial and error you'll be able to work out which nappies suit your baby best as they grow.

Disposable and cloth nappies have different pros and cons, so you'll need to consider things like cost, convenience and the impact on the environment when you choose what to buy.

For example, disposable nappies are very handy, but washable cloth nappies work out cheaper if you add up the costs over the years your baby's in nappies.

Some cloth nappy brands and local councils offer free samples for you to try out.

If you use cloth nappies, you may want to sign up to a nappy laundry service that'll take away the dirty nappies and deliver a fresh batch each week.

The 'Which?' consumer information website has more information and advice to help you decide which type of nappy is best for your baby, budget and lifestyle.

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Your guide to changing a nappy, what to do with dirty nappies, baby poo and different types of nappy

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This short video explains what neonatal units are and abit about neonatal care.

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

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A guide to performing a side-lying nappy change. This contains a useful QR code with a video of this in action.

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Sleeping resources

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Sleep and night time resources - Baby Friendly Initiative

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These resources by UNICEF UK and other organisations cover a range of issues around infant sleep and caring for babies at night.

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening.

This short video explains screening for eyes, heart, hips and testes in newborn babies.
Newborn and infant physical examination video
The newborn physical examination is recommended by the NHS.

1. Purpose of screening

Within 72 hours of giving birth, you will be offered a top-to-toe physical examination for your baby. This will include 4 specific screening tests to find out whether your baby has a suspected problem with their eyes, heart, hips or, in boys, their testes which would benefit from early investigation and possible treatment.

The screening tests are carried out again between 6 and 8 weeks of age as some conditions do not develop or become apparent until then.

2. About the conditions

Each part of the physical examination is looking for different conditions.

About 2 or 3 in 10,000 babies have problems with their eyes that need treatment. The examination checks the appearance and movement of the eyes. The main reason for screening is to identify a condition called cataracts (a clouding of the transparent lens inside the eye). The examination cannot tell how well your baby can see.

Around 8 per 1,000 babies will have a heart problem or condition. This could range from a heart murmur to a problem needing specialist care or treatment. A murmur is a noise made by the blood as it passes through the heart. In almost all cases when a murmur is heard, the heart is normal. Murmurs are common in babies and this does not always mean there is a problem.

Babies can be born with hip joints that are not formed properly and if untreated this can lead to a limp and to joint problems. About 1 or 2 in 1,000 babies have hip problems that need treatment.

Baby boys are checked to make sure their testes are in the right place. It can take several months for testes to drop down (descend) into the scrotum. About 1 in 100 baby boys have problems with undescended testes that need treatment to reduce the risk of problems later in life, such as reduced fertility.

3. The screening test

A trained health professional will carry out a physical examination of your baby and ask you questions about your baby's general wellbeing.

Your baby will need to be undressed for part of the examination. During the examination the health professional will:

look into your baby's eyes focusing on how their eyes look and move

listen to their heart using a stethoscope to detect heart sounds

examine their hips to ensure the joints are working properly

examine baby boys to check if their testes are in the right place

These screening tests are carried out within 72 hours of birth and again when your baby is between 6 and 8 weeks of age.

4. Safety of the test

There are no risks associated with having this test.

5. Screening is your choice

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

The general physical examination including this screening is therefore recommended for your baby.

6. Not having the test

You can decide to have your baby examined and screened for any or all of the conditions. If you have any concerns you should discuss them with your midwife and the health professional who offers the examination.

7. Possible results

Usually there will be nothing of concern found. If the health professional finds a possible problem, your baby will be referred for further assessment and tests if appropriate.

8. Getting my results

The health professional carrying out the examination will give you the results straight away. If a referral for further assessment is needed, this will also be discussed with you at the time of the examination.

The results will be recorded in your baby's case notes and personal child health record ('red book'). You will need to keep this record safe and make sure it is available whenever your baby sees a health professional.

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Eyes, heart, hips and testes (physical examination)

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Public Health England (PHE) created this information on behalf of the NHS. In this information, the word 'we' refers to the NHS service that provides screening. This short video explains screening for eyes, heart, hips and testes in newborn babies. Newborn and infant physical examination video The newborn physical examination is recommended by the NHS.

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Building relationships

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Relationship building resources - Baby Friendly Initiative

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These resources cover a range of issues around supporting close and loving relationships between parents and babies.

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This leaflet explains what repatriation is and the process of getting you and your baby back to your local neonatal unit.

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Handy tips for bottle feeding your baby, including hygiene, being prepared, how to wind your baby and how to keep them safe.

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A short video to explain getting ready to go home with your little one.

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Thames Valley and Wessex Neonatal Network 

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Thames Valley and Wessex Neonatal Network 

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These are the hospitals that are within the neonatal network that covers Thames Valley and Wessex regions.

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Resources that provide information about the neonatal unit, daily routines, staff as well as much more.

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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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Safe 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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Community Support for Breastfeeding- Oxfordshire Breastfeeding Support

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Community Support for Breastfeeding- Oxfordshire Breastfeeding Support

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We are delighted to be able to reopen some in person sessions, from Friday, July 2nd, 2021. Spaces are very limited and pre-booking is essential. Read more on our new in person support page. Virtual Zoom Group, virtual 1:1 consultations and virtual antenatal breastfeeding education sessions will continue alongside the in person sessions. If you are a student or visiting health professional see the page about observations for the latest news about what and where you can book with us.

Alongside our pre-booked in person sessions, OBS Facilitators are providing FREE 1 to 1 support by video or phone for more complex feeding issues. The first step is submitting a Help Request.

We run a group support session every second Thursday afternoon where you can get support from our specialist facilitators, trained volunteers and other mothers. Because we are now running some in person sessions (see above) we have reduced the frequency from weekly to every second week. Most weeks will have a themed break-out room on a popular topic. See our OBS Group page for details and the link to register.

The quickest way to get support from OBS is in our friendly, private Facebook group, which is closely moderated by our team.

Online Antenatal Sessions

Please see our Antenatal Sessions page for details and the link to register. You can say which date you prefer when you register.

Oxfordshire Breastfeeding Support provides local breastfeeding support in the community via 1:1 virtual support, virtual group support and antenatal breastfeeding education sessions for Oxfordshire families, facilitated by experienced IBCLCs and breastfeeding support workers, and supported by trained volunteers. We also run a friendly private Facebook group were you can quickly find support.

You can read about what to expect and how we've helped local families. Hope to see you soon!

Last updated June 2021

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oxfordshire breastfeeding drop-in community peer support maternity infant baby babies toddler child nursing breast feeding milk antenatal oxford pregnancy ibclc volunteer breastmilk support responsive parenting

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We are delighted to be able to reopen some in person sessions, from Friday, July 2nd, 2021. Spaces are very limited and pre-booking is essential. Read more on our new in person support page. Virtual Zoom Group, virtual 1:1 consultations and virtual antenatal breastfeeding education sessions will continue alongside the in person sessions.

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Log into Facebook to start sharing and connecting with your friends, family, and people you know.

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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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Helpful tips on how to sooth your baby and know when to get extra help.

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All babies cry, and some more than others. Crying is your baby's way of telling you they need comfort and care.
Sometimes it's easy to work out what they want, and sometimes it's not.

The most common reasons for crying are:

hunger

a dirty or wet nappy

tiredness

wanting a cuddle

wind

being too hot or too cold

boredom

overstimulation

There may be times of the day when your baby tends to cry a lot and cannot be comforted. Early evening is the most common time for this to happen.

This can be hard for you, as it's often the time when you're most tired and least able to cope.

The amount babies cry tends to peak when they're around 4 to 8 weeks old, then gradually tail off.

How to calm a crying baby

Try some of the following ways to comfort your baby. Some may work better than others:

If you're breastfeeding, let your baby suckle at your breast.

Having some gentle noise in the background may help distract your baby.

Some older babies like to use a bit of cloth or a blanket as a comforter.

Hold your baby or put them in a sling so they're close to you. Move about gently, sway and dance, talk to them and sing.

Rock your baby backwards and forwards in the pram, or go out for a walk or a drive. But limit how long your baby sleeps in a car seat to up to 30 minutes for newborns and up to 2 hours for babies. Even if they wake up again when you stop, at least you'll have had a break.

Find something for them to listen to or look at. This could be music on the radio, a CD, a rattle, or a mobile above the cot.

Try stroking your baby's back firmly and rhythmically, holding them against you or lying face downwards on your lap.

Undress your baby and massage them gently and firmly. Avoid using any oils or lotions until your baby's at least a month old. Talk soothingly as you do it and keep the room warm enough. Some health centres and clinics run baby massage courses. For information, ask your midwife or health visitor.

Try a warm bath. This calms some babies instantly, but makes others cry even more.

Sometimes too much rocking and singing can keep your baby awake. You might find lying them down after a feed will help.

Ask your health visitor for advice.

Crying during feeds

Some babies cry and seem unsettled around the time of a feed. If you're breastfeeding, you may find that improving your baby's positioning and attachment helps them settle.

You can go to a breastfeeding drop-in group and ask for help if there's one available in your local area.

The Breastfeeding Network's website can provide information on the nearest group to you.

You can also ask your health visitor for advice.

Crying during feeds can sometimes be a symptom of reflux, a common condition where babies bring back milk after feeds.

Speak to your health visitor or GP for more information and advice.

If your baby cries constantly

There are several reasons that can cause a baby to cry excessively.

It can be exhausting if you have tried everything and nothing seems to comfort your baby.

Colic

Excessive crying could be a sign that your baby has colic. Everyone agrees that colic exists, but nobody knows what causes it.

Some doctors think it's a kind of stomach cramp. The crying sounds miserable and distressed, and stops for a moment or two, then starts up again, which suggests it could be caused by waves of stomach pain.

The crying can go on for some hours. There may be little you can do except try to comfort your baby and wait for the crying to pass.
Get tips for coping with colic
Crying and illness

If your baby's crying constantly and you cannot console or distract them, or the cry does not sound like their normal cry, it can be a sign they're ill.

Or they may be ill if they're crying and have other symptoms, such as a high temperature. If this is the case, contact your health visitor, GP or call NHS 111.

Call 999 and ask for an ambulance if your baby:

has a fit (seizure or convulsion)

has blue, mottled, ashen (grey) or very pale skin

is unresponsive, floppy or not waking up as easily as usual

breathes rapidly or makes a throaty noise while breathing, or seems to be working hard to breathe, perhaps sucking in their stomach under their ribcage

is being violently sick a lot (projectile vomiting)

has a high temperature, but their hands and feet feel cold

has a spotty purple-red rash anywhere on the body - this could be a sign of meningitis

Find out the signs of serious illness in your baby
Trust your instincts. You know what's different or worrying behaviour in your baby.

Getting help with a crying baby

You can talk to a friend, your health visitor or GP, or contact the Cry-sis helpline free on 0800 448 0737. It is open 9am to 10pm, 7 days a week.

Cry-sis can put you in touch with other parents who have been in the same situation.

You can also visit the Cry-sis website for information on coping with crying babies.

If you decide to talk to your health visitor or GP, it can help to keep a record of how often and when your baby cries.

For example, this might be after every feed or during the evening. This can help your health visitor or GP to work out if there's a particular cause for the crying.

Keeping a record can also help you identify the times when you need extra support. You could think about possible changes to your routine.

There may be times when you're so tired and angry you feel like you cannot take any more. This happens to a lot of parents, so do not be ashamed to ask for help.

If you do not have anyone who can take care of your baby for a short time and the crying is making you stressed, put your baby in their cot or pram, make sure they're safe, close the door, go into another room and try to calm yourself down.

Set a time limit - for example, 10 minutes - then go back.

Never shake your baby

No matter how frustrated you feel, you must never shake your baby. Shaking moves their head violently and can cause brain damage.

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A crying baby can be exhausting and it can be hard to know what they need, especially in the early days. Use these tips to help soothe them.

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This link covers medical conditions found on the neonatal unit, some babies may never have any of these conditions so we advise only reading about them if your baby has had a diagnosis, these conditions include:
Respiratory conditions
Meningitis
Jaundice
Necrotising enterocolitis (NEC)
Sepsis
Patent ductus arteriosus (PDA)
Hypoxic-ischaemic encephalopathy (HIE)
Reflux
Brain haemorrhage
Brain haemorrhage in full term babies
Intraventricular haemorrhage (IVH)

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Find out more about different medical conditions and types of infection.

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Travelling with your baby in the ambulance or making your own way to the neonatal unit.

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We will always try to offer one parent the opportunity to travel in the ambulance with your baby, if space allows. The team transferring your baby will offer you this opportunity when they meet you. Unfortunately it is not possible for mothers receiving maternity care to travel with their baby.

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A how to sterilise your babies bottles

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It's important to sterilise all your baby's feeding equipment, including bottles and teats, until they're at least 12 months old.
This will protect your baby against infections, in particular diarrhoea and vomiting.

Before sterilising, you need to:

Clean bottles, teats and other feeding equipment in hot, soapy water as soon as possible after feeds.

Use a clean bottle brush to clean bottles (only use this brush for cleaning bottles), and a small teat brush to clean the inside of teats. You can also turn teats inside out then wash them in hot soapy water. Do not use salt to clean teats, as this can be dangerous for your baby.

Rinse all your equipment in clean, cold running water before sterilising.

You can put your baby's feeding equipment in the dishwasher to clean it if you prefer. Putting feeding equipment through the dishwasher will clean it but it does not sterilise it. Make sure bottles, lids and teats are facing downwards. You may prefer to wash teats separately by hand to make sure they are completely clean.

The advice about how to clean your baby's feeding equipment applies to all of the equipment, and whether you are using expressed breast milk or formula milk.

How to sterilise baby feeding equipment

There are several ways you can sterilise your baby's feeding equipment. These include:

cold water sterilising solution

steam sterilising

boiling

Cold water sterilising solution

Follow the manufacturer's instructions.

Leave feeding equipment in the sterilising solution for at least 30 minutes.

Change the sterilising solution every 24 hours.

Make sure there are no air bubbles trapped in the bottles or teats when putting them in the sterilising solution.

Your steriliser should have a floating cover or a plunger to keep all the equipment under the solution.

Steam sterilising (electric steriliser or microwave)

It's important to follow the manufacturer's instructions, as there are several different types of sterilisers.

Sterilising by boiling

Make sure the items you want to sterilise in this way are safe to boil.

Boil the feeding equipment in a large pan of water for at least 10 minutes, making sure it all stays under the surface.

Set a timer so you do not forget to turn the heat off.

Remember that teats tend to get damaged faster with this method. Regularly check that teats and bottles are not torn, cracked or damaged.

After you've finished sterilising

It's best to leave bottles and teats in the steriliser or pan until you need them.

If you do take them out, put the teats and lids on the bottles straight away.

Wash and dry your hands before handling sterilised equipment. Better still, use some sterile tongs.

Assemble the bottles on a clean, disinfected surface or the upturned lid of the steriliser.

Find out more about expressing breast milk and how to make up formula feeds.

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How to sterilise your baby's bottles and other feeding equipment safely and effectively, whether you're using boiling, steam or cold water sterilising equipment.

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ICON offers advice and support for you and your new born

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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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Family Integrated Care In the NICU, infants are physically separated from their parents and this often has an impact on the physical, psychological, emotional health of both the parents and the infants. Family Centered Care is an approach to planning and delivery of health care that encourages greater parent involvement in their infants care.

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A video to teach you how to safely administer resus to your little one

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Before you leave the neonatal unit, a trained doctor or nurse will show you how to resuscitate your baby if they stop breathing.

The thought of having to resuscitate your baby can be very scary, and is something that no parent or carer ever wants to have to do or think about. But the training is designed to help you be as prepared as possible.

Research suggests that learning how to resuscitate your baby could help increase your confidence and reduce any anxiety you may have.

If your baby stops breathing, it is important to stay calm and call 999; the emergency call handler will help. If you need to perform CPR on your baby, the call handler will talk you through the process until the ambulance arrives.

We have more information on what to do if you think your baby is becoming unwell.

We are currently reviewing our resuscitation video and will upload the new version later this year. Until then, our friends at the St John's Ambulance have an instructional video about what to do if your baby stops breathing.

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Having resuscitation training can help you be more prepared to care for your premature or sick baby after leaving the neonatal unit.

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you think you or your child have missed any vaccinations

you or your child have a vaccination appointment - but you've missed it or cannot attend

Your GP surgery can book or rearrange an appointment.

It's best to have vaccines on time, but you can still catch up on most vaccines if you miss them.

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A full list of the routine vaccinations offered on the NHS and when they should be given.

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Support for you and your premature baby at home

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Taking your premature baby home can be exciting but may also a little daunting. The community healthcare team will help you all settle in.

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If you’re worried your baby is unwell, our free Baby Check app helps you decide whether they need to see a health professional or not…

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Welcome to the Newborn Care Unit (also known as the Neonatal Unit) at the John Radcliffe Hospital, Oxford. We provide specialist medical and surgical care for babies across the Thames Valley Neonatal Network.

All expectant parents hope their babies will be healthy, but sometimes problems arise, such as antenatal concerns requiring monitoring or treatment, premature birth or a difficult delivery.

It can be very stressful when your baby is admitted to Newborn Care, but the healthcare professionals in the Newborn Care Unit will do their best to support you. It can be very helpful to be involved in your baby's care, and we will encourage this.

We also have many newborn care leaflets available to give you the information you need.

Once your baby has settled in, they will receive care tailored to their specific needs. The doctors will update you regularly on the condition of your baby and the nurse caring for your baby on any shift will be available at any time to update you on any changes.

We have a 24-hour phone number for parents, to ensure you can always speak to the nurse caring for your baby.

Find us and contact us
How to find the John Radcliffe Hospital
Oxford Newborn Care Unit is in the John Radcliffe Hospital Women's Centre, at the top of the John Radcliffe Hospital site.

John Radcliffe Hospital site map (pdf)

Enter via the Maternity entrance on Level 2 of the Women's Centre, and ask at reception or follow directions for Newborn Care.

Oxford Newborn Care Unit Secretaries: 01865 221355

Neonatal Intensive Care Unit

The Neonatal Intensive Care Unit (NICU) looks after babies from extremely premature neonates, term neonates who have had difficult deliveries and babies with antenatally diagnosed conditions.

A baby in NICU is cared for by a nurse who may also have one other patient, depending on the level of nursing care needed. A baby in NICU may require invasive respiratory support from a ventilator and complex medications. The nurses on NICU have all had specific Neonatal Intensive Care training so your baby is in safe hands.

There is a Nurse in Charge on each shift who is easily identifiable by their yellow Nurse in Charge badge.

Once your baby is stable and old enough, we will transfer them back to your local unit, to make space for other babies who require Level 3 care - we will give you as much notice as possible before this happens.

If you live in Oxford, your baby will move to our HDU or LDU when they are old enough and well enough.

High Dependency Unit

The Neonatal High Dependency Unit (HDU) looks after premature and term babies who do not need intensive care.

Extremely premature babies who are cared for in NICU will eventually move to HDU when they are well enough. Some babies born prematurely can be admitted straight to HDU along with term babies who need additional support.

Babies can be cared for in HDU on non-invasive respiratory support, feeding and fluid support and as well as for other neonatal therapies such as phototherapy for jaundice.

A baby on HDU is cared for by a nurse who cares for up to two other patients, depending on the level of nursing care needed. This means the nurse will not be at the bedside continuously, but monitors displaying each babies' observations are visible at all times and will alert the nurses to any problems.

Low Dependency Unit

The Neonatal Low Dependency Unit (LDU) looks after babies who no longer need ITU or HDU levels of care.

Nursery nurses can care for up to four babies so will not be constantly at the bedside - your baby will have a saturation monitor or a special mattress which will alert the nursery nurses to any problems.

Babies cared for in LDU may require feeding and growing support, as well as long-term respiratory support that can continue at home, such as Low Flow Therapy.

Our nursery nurses are trained to help and support parents to care for their baby independently. LDU also offers parents basic life support sessions before they take their baby home.

Accommodation

Please visit Parent accommodation

SONeT

The Southampton Oxford Neonatal Transport (SONeT) team is a collaboration between Oxford and Southampton neonatal intensive care units, providing a 24-hour, seven days a week, 52 weeks a year intensive care and transfer service to hospitals in the Thames Valley and Wessex region.

Depending on clinical need, SONeT provides advice or patient transfers. They will locate the closest appropriate level neonatal cot to your local hospital and transfer your baby. If there is no suitable NICU cot within the network (Oxford, Portsmouth and Southampton) they will find a cot in the nearest NICU.

The SONeT team comprises a doctor or Advanced Neonatal Nurse Practitioner (ANNP) and a specialist transport nurse. A NICU transport consultant is available at all times for advice, if not physically part of the team.

SONeT is also responsible for moving your baby back to your local unit, when they are old and well enough.

Southampton Oxford Neonatal Transport (SONeT)

Links

Support groups
Support for Sick Newborn and their Parents (SSNAP)
Oxford Newborn Care Unit is supported by the registered charity, Support for Sick Newborn and their Parents (SSNAP).

Support for Sick Newborn and their Parents (SSNAP)

Tel: 01865 221359
Bereavement support Bereavement services following late miscarriage, stillbirth or neonatal death
Infant feeding
Prematurity information Having a premature baby - Tommys Screening tests Transport service
Southampton Oxford Neonatal Transport (SONeT)

Work for us
We are currently recruiting staff for our Newborn Care Unit.
Please contact us for details.

Oxford International Neonatal and Paediatric Fellowship Scheme

This scheme is for non-UK / EEA paediatricians, with MRCPCH or other such postgraduate qualifications, to undertake high quality postgraduate training in paediatrics for a maximum of 24 months, before returning to work in their home countries.

Oxford International Neonatal and Paediatric Fellowship Scheme

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Copyright (c) 2024 Oxford University Hospitals NHS Trust

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Oxford Newborn Care Unit at the Oxford University Hospitals.

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Vcreate is a way of having videos or pictures of your baby emailed to you at home! Such a lovely way of seeing what your little one has been up to!

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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.

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The Breastfeeding Network | Independent Breastfeeding Support

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The Breastfeeding Network (BfN) is an independent source of support and information for breastfeeding women and others.

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Community Support for Breastfeeding: LLL Oxford

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Community Support for Breastfeeding: LLL Oxford

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La Leche League's mission is to help mothers worldwide to breastfeed through mother-to-mother support, encouragement, information and education, and to promote a better understanding of breastfeeding as an important element in the healthy development of the baby and mother. La Leche League is an international, nonprofit, nonsectarian organisation dedicated to helping people who want to breastfeed.

We're still here and happy to support you and your family with breastfeeding/mothering/parenting. We especially love using our well-established, friendly women-only Facebook group to keep our community closely connected. Please see our regular meetings page and our antenatal sessions page.

You can find support any time on our Facebook group and you are also welcome to attend virtual meetings run by other groups. Please see the LLLGB website for a listing of meetings.

Here are some other ways you can get breastfeeding support if you need it.

As always, if you are worried about your baby or yourself, please contact your midwifery or health visiting team, or NHS 111 (or 999 if it's an emergency).

Look on the LLLGB website. It's been greatly expanded in recent years and has up to date, accurate information on many common breastfeeding issues, all written by LLL Leaders. It's much appreciated if you can check to see if you can find what you need online before contacting a Leader.

Another excellent place to look online is Kellymom, which is non-LLL resource but consistent with our philosophy. It's comprehensive and easily searchable.

Post your question on our private, women-only Facebook group. This is the most efficient way to ask a specific question, as we can support many mothers with similar issues at the same time, and mothers can support each other. The group is usually checked by Leaders several times a day. If you prefer your question to be posted anonymously, you can This email address is being protected from spambots. You need JavaScript enabled to view it.or message us via our Facebook page and we will post it in the group on your behalf.

Contact a local LLL Leader. This is usually the quickest way to talk to someone 1:1. You might need to call a few people and/or leave a couple of messages before you find someone - most of us also have jobs and some will be much busier than usual during this time. Please keep trying.

Call the LLL National Helpline on 0345 120 2918. Leaders all over the country will be trying hard to increase capacity on the helpline (though it still may be quicker to call a local Leader directly).

Use LLLGB's webchat or Helpform services. Log onto the LLLGB website to see if the Chat box pops up.

With much LLLove to you and your families and solidarity with LLL families all round the world.

Jayne, Gisella, Hannah, Liz, Nicola, Ruth, Vicki, Meg & Catriana

You can take out membership in La Leche League Great Britain at any time during the year by joining online here. Details are on our membership page. Or if you would rather make a donation to say thank you for help you've received you can donate online here.

To receive news of local meetings please join our mailing list.

LLL Great Britain has been helping and supporting families for over 49 years. LLLGB's website provides a wealth of evidence-based information as well as the experiences of many breastfeeding mothers. Our national helpline number is 0345 120 2918 and you can submit an online help request here.

Lasst updated December 2022

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breastfeeding maternity support infant baby toddler nursing breast feeding oxford banbury oxfordshire kings sutton bloxham witney la leche league lll

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La Leche League Oxfordshire provides local breastfeeding support and information for mothers in Oxfordshire, UK, featuring free mother-to-mother support meetings in Oxford, North Oxfordshire and West Oxfordshire.

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Tommy's - Organisations for support around premature birth

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Tommy's - Organisations for support around premature birth

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Organisations for support around premature birth

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Having a premature birth can impact on your physical and emotional health. But you are not alone. There are lots of organisations that can provide more support.

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A This charity supports families whose little one has suffered from HIE (hypoxic ischaemic event).

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Peeps HIE Charity | HIE Awareness & Support

Welcome to Peeps HIE

We provide support to parents, families & friends of those affected by HIE (Hypoxic-Ischaemic Encephalopathy), raising awareness of HIE.

Some of the things we do include:

Provide information about HIE

Buddy/peer support

Counselling and therapy

Funding for equipment

Find out more about what we do...

Our Family stories

We pride ourselves on the support we can give to families experiencing the challenges of day-to-day life with children affected by HIE.

Read our Family Stories

Peeps on Twitter

Our information leaflets are written by families, with families, for families.
They can be downloaded from our website, or printed copies sent out - please get in touch if we can help support.

https://www.peeps-hie.org/resources-downloads/

#HeardOfHIE

2

If you'd like to find out more about our new book club, starting in 2024, and register an interest, please check out our website:

It will be online, peer-led, from the comfort of your own home, and just for H.I.E. parents/grandparents/carers.
Suggestions...

We recognise that each H.I.E. journey can be unique; we aim to provide support and guidance tailored to the diverse needs of our community.

Inclusion matters and is an agenda item on every meeting we have with Trustees and employees.

From informational resources to emotional...

Twitter icon
View more

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Peeps HIE Charity | HIE Awareness & Support

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Peeps is a UK charity, dedicated to supporting those affected by HIE (hypoxic-ischaemic encephalopathy). We provide emotional, practical and financial support.

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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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The neonatal networks within the South East region consist of the Thames Valley and Wessex Operational Delivery Network and the Kent, Surrey and Sussex Operational Delivery Network. The two combined networks cover 27 provider units.

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Professor Caroline Hartley, Principal Investigator, and Dr Marianne van der Vaart, Postdoctoral Researcher, in the Paediatric Neuroimaging Group at the Department of Paediatrics, have launched a series of animations aimed at improving parental understanding of brain development in premature infants, and the effect it has on breathing and apnoeas (the cessation of breathing).

The series, called My Baby’s Brain, has been developed to support parents of premature babies, enabling them to understand why premature babies have apnoeas, the treatment they receive, and the equipment that is used.

My Baby’s Brain is a free, online resource that was created in collaboration with parents of premature babies alongside SSNAP.

You can read more and watch the animations here:

My Baby's Brain - Research Project | SSNAP

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View the animations here.
Professor Caroline Hartley, Principal Investigator, and Dr Marianne van der Vaart, Postdoctoral Researcher, in the Paediatric Neuroimaging Group at the Department of Paediatrics, have today launched a series of animations aimed at improving parental understanding of brain development in premature infants, and the effect it has on breathing and apnoeas (the cessation of breathing).

The series, called My Baby's Brain, has been developed to support parents of premature babies, enabling them to understand why premature babies have apnoeas, the treatment they receive, and the equipment that is used.

My Baby's Brain is a free, online resource that was created in collaboration with parents of premature babies alongside SSNAP (Supporting sick newborn and their parents), a charity based in the Newborn Care Unit at the John Radcliffe Hospital in Oxford.

Lauren Young, mother to Georgie, (age 7 and born at 40 weeks) and to Rosie (age 3 and born at 24 weeks), and also part of the Family Care Team at SSNAP, was part of the parent group that led to the creation of the series. She had a "traumatic, exhausting and long hospital stay of nearly 6 months" following the birth of her youngest daughter, and proactively wanted to help neonatal research and development.

She said: "In my role with the Family Care Team for SSNAP I see so many parents trying to navigate all the information they receive from the medical teams. I feel strongly that anything helping parents to process the information, feel more comfortable with their surroundings and the care that their child is receiving, can go a really long way to helping them on the journey."

"These animations will be so helpful to parents and families with premature babies. They will help them to understand the reasons their baby is needing the care they receive and give a very clear picture of equipment used, as well as a soft introduction to language and terminology they may hear along their journey. My Baby's Brain will help parents feel more in touch with their babies' care and help them to build confidence in the neonatal setting."

Professor Hartley said: "In the UK, 1 in 13 babies is born prematurely. Apnoea of prematurity is a common problem in neonatal care, affecting around 50 percent of premature infants. Apnoeas are well-managed by the clinical team but can be worrying for parents. These animations have been put together with parents in mind, to give parents of premature babies a better understanding of how their baby's brain is developing, how apnoea is linked to the immaturity of a premature infant's brain, and the techniques researchers use to investigate brain development. Working together so closely with SSNAP and parents on this project has been extremely rewarding and enjoyable and has greatly enriched the animations which we hope will be a valuable resource for parents."

Martin Realey, Charity Lead for SSNAP, said: "We are delighted to be able to support the creation of My Baby's Brain which will be an indispensable tool to all parents to premature infants on neonatal units here in the John Radcliffe Hospital, and across the country. They have been made with parents in mind to ensure the information is accessible and easy-to-understand. The videos can be accessed using QR codes making them available on mobile devices, allowing parents to choose a time that best suits them to watch and process the information: This could be cotside with their baby, in the quiet of their home, or even sharing them with other family members. Viewers are also able to choose from bite-sized clips or longer videos which helps manage what can be an exhausting time of processing so much new information."

My Baby's Brain was funded by the Wellcome Trust Enriching Engagement programme, an initiative created to support researchers' public engagement outreach. This series is the public engagement activity of Professor Hartley's core research project into the relationship between apnoeas and brain development in premature infants.

Professor Hartley is a Sir Henry Dale Fellow at the Department of Paediatrics.

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My Baby's Brain is a free, online resource that was created in collaboration with parents of premature babies alongside SSNAP.

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neoEPOCH is working with parent, patients and health professionals to improve neonatal research and care.

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The National Perinatal Epidemiology Unit (NPEU) is a multidisciplinary research unit based at the University of Oxford. Our work involves running randomised con

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15. RePHyNe parent opt out information QR Code v1.0 06.06.2025

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PADLET RHC Participant Information Sheet Version 0.6, 30.08.2023_Localised

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Sensory Beginning- Sensory Recommendation for the Neonatal Unit

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A wonderful resource that explains sensory development in the womb and how best to support this development in your preterm baby.

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Sensory Beginnings- Sleep on the Neonatal Unit

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A resource that gives some practical tips on supporting your baby to sleep on the neonatal unit and also an explanation of the different behavioural states our little ones demonstrate.

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A resource that looks further at the benefits of positive touch for your baby.

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A useful guide with some tips on how best to talk/ interact with your preterm baby.

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EiSMART- Early Play Development 0-3 months

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This is a useful guide on how best to support your babies early play development once they get discharged from the neonatal unit. If you would like advice while you are on the unit- please do speak to Aoife Garvey, OT.

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With the world of technology quickly changing, this is a useful guide on screen time for babies.

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Congenital Diaphragmatic Hernia charity 

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Congenital Diaphragmatic Hernia charity 

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This charity supports families whose little one was born with a CDH (congenital diaphragmatic hernia).

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Research Click The Image To Download Our CDH Information Booklet About CDH UK https://youtu.be/9mYdPE3md48 We like to think of CDH UK as a modern charity made up of experts providing complimentary care to patients and their families in the form of information, emotional and practical support and by conducting, encouraging and funding research.

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Feeding will take up a lot of your time in the first few months of your babies' lives.
Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies.

Some mothers can feed 2 babies at the same time, while some prefer to feed 1 after the other.

Others feed whenever their babies seem hungry (on demand).

If 1 baby is smaller and needs to feed more often, you will not be able to feed them at the same time at first.

If you want, you can work towards bringing their feeding routines together as your babies grow.

If you have any concerns about your babies' growth, you can take them to your local baby clinic to have them weighed and measured.

Your health visitor can tell you where to find your nearest baby clinic.

Some health visitors will visit you regularly at home to keep an eye on your babies' progress.

Breastfeeding twins or more

It's important not to be put off breastfeeding because you're having more than 1 baby.

Breastfeeding is a great way to soothe your babies and helps you build a strong bond with them.

It's perfectly possible to breastfeed twins, triplets or more. Lots of twins are breastfed until they start eating solid foods.

You may like to try a few breastfeeding positions to see which suits you best.

You'll get support with breastfeeding at the hospital and also when you take your babies home.

The benefits of breast milk for your babies are the same as for single babies.

But as multiple babies are more likely to be born prematurely, there are extra benefits.

Breastfeeding premature twins

Breast milk is better for premature babies as their gut is immature and it's easier for them to tolerate and digest.

Breast milk also contains proteins and antibodies to protect your babies against infections.

If your babies are very tiny or sick when they're born, you may need to express your breast milk to begin with.

Your expressed milk may be fed to your babies through a thin tube that passes through the nose and into the stomach.

Visit the Twins Trust website for more information on breastfeeding twins or more.
Watch videos of mums talking about breastfeeding more than 1 baby

Formula feeding multiples

You may need to combine formula feeding with breastfeeding if, for example, you have triplets or more, or you may choose to only formula feed your babies.

Formula feeding is more expensive than breastfeeding when you have twins or more.

But it does mean that other people can help with feeding your babies.

As with breastfeeding, you'll need to decide whether you're going to feed your babies together or separately.

Bottles need to be freshly prepared for each feed. This can be quite time consuming with twins or more, so you may want to ask your partner or someone else to help with this.

As with breastfeeding, formula feeding your babies can help you build a close and loving bond.

Hold your babies close during feeds, look into their eyes and talk to them.

Learn to notice their cues when they want to be fed and when they have had enough.

Visit the Twins Trust website for more information on formula feeding twins or more.

Weaning twins on to solids

When your babies are around 6 months old, you can give them their first solid foods.

It's not unusual for 1 baby to be ready to begin solids before the other.
Find out more about your baby's first solid foods
If your babies were born prematurely, your health visitor can give you advice on the best time to start solids.

Unless 1 of your babies has a serious infection, it's safe for them to share spoons and bowls.

Visit the Multiple Births Foundation website for more advice on all aspects of feeding twins, triplets or more (PDF, 5.96kb).

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Feeding will take up a lot of your time in the first few months of your babies' lives. Whether you breastfeed or formula feed, you'll need to create a routine that suits you and your babies. Some mothers can feed 2 babies at the same time, while some prefer to feed 1 after the other.

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Good hygiene is very important when making up a formula feed.
Your baby's immune system is not as strong as an adult's. That's why bottles, teats and any other feeding equipment need to be washed and sterilised before each feed.

This will reduce the chance of your baby getting an infection, in particular diarrhoea and vomiting.
Find out more about sterilising baby bottles

Product recall: Elecare Similac and Alimentum Similac powdered formula

Some batches of Elecare Similac and Alimentum Similac powdered formula, made by Abbott, have been recalled as a precaution because they may contain bacteria. If you have bought or been prescribed either of these types of formula, return them to where you got them from and do not give them to a baby.
Find out more from the Food Standards Agency

Step-by-step guide to preparing a formula feed

Step 1: Fill the kettle with at least 1 litre of fresh tap water (do not use water that has been boiled before).

Step 2: Boil the water. Then leave the water to cool for no more than 30 minutes, so that it remains at a temperature of at least 70C.

Step 3: Clean and disinfect the surface you are going to use.

Step 4: It's important that you wash your hands.

Step 5: If you are using a cold-water steriliser, shake off any excess solution from the bottle and the teat, or rinse them with cooled boiled water from the kettle (not tap water).

Step 6: Stand the bottle on the cleaned, disinfected surface.

Step 7: Follow the manufacturer's instructions and pour the amount of water you need into the bottle. Double check that the water level is correct. Always put the water in the bottle first, while it is still hot, before adding the powdered formula.

Step 8: Loosely fill the scoop with formula powder, according to the manufacturer's instructions, then level it using either the flat edge of a clean, dry knife or the leveller provided. Different formulas come with different scoops. Make sure you only use the scoop that comes with the formula.

Step 9: Holding the edge of the teat, put it into the retaining ring, check it is secure, then screw the ring tightly onto the bottle. Make sure the ring is attached firmly.

Step 10: Cover the teat with the cap and shake the bottle until the powder is dissolved.

Step 11: It's important to cool the formula so it's not too hot to drink. Do this by holding the bottle (with the lid on) under cold running water.

Step 12: Test the temperature of the formula on the inside of your wrist before giving it to your baby. It should be body temperature, which means it should feel warm or cool, but not hot.

Step 13: If there is any made-up formula left in the bottle after a feed, throw it away.

Dos and don'ts of making up formula feeds

Do follow the manufacturer's instructions very carefully, as they vary as to how much water and powder to use.

Do not add extra formula powder when making up a feed. This can make your baby constipated or dehydrated.

Do not add extra water when making up a feed. Too little powder may not give your baby enough nourishment.

Do not add sugar or cereals to your baby's formula.

Never warm up formula in a microwave, as it may heat the feed unevenly and burn your baby's mouth.

Reducing the risk of infection

Even when tins and packets of powdered infant formula are sealed, they can sometimes contain bacteria.

Bacteria multiply very fast at room temperature. Even when a feed is kept in a fridge, bacteria can still survive and multiply, although more slowly.

To reduce the risk of infection, it's best to make up feeds 1 at a time, as your baby needs them.

Use freshly boiled drinking water from the tap to make up a feed. Do not use artificially softened water or water that has been boiled before.

Leave the water to cool in the kettle for no more than 30 minutes. Then it will stay at a temperature of at least 70C. Water at this temperature will kill any harmful bacteria.

Remember to let the feed cool before you give it to your baby. Or you can hold the bottle (with the lid on) under cold water from the tap.

Do not use bottled water to make up formula feeds

Bottled water is not recommended for making up feeds, as it's not sterile and may contain too much salt (sodium) or sulphate.

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How to make up formula milk feeds for your baby correctly and safely.

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Meet the neonatal psychology team and find out how we can support you.

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Please use this link to access the neonatal psychology padlet, which we have specifically put together for parents and families with a baby on the neonatal unit. It has a range of resources to help support yourselves and your baby.

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An illustrated, step-by-step process on how to complete a standing transfer for skin-to-skin.

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A lovely booklet made by our colleagues in the Yorkshire and Humber Neonatal ODN!

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Many people ask 'what is an OT?' and 'what can an OT do to support my baby?'. Find here some information that explains how we can help both you and your baby. The OT on your neonatal unit is: Aoife Garvey (ee-fa).

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Physiotherapists aim to support babies (and their parents) who have any condition which may effect their movement.

This may include:

*Babies who have had a brain bleed or other changes which may effect brain development. This may be term born or premature babies. We can offer specific assessments to look at development. We can offer specialist advice to help you to support your baby with their movements.

*Babies who are born with musculoskeletal abnormalities affecting their joints or muscles.

*Babies that are born very prematurely.

*Babies who have developed altered head shape - plagiocephaly (uneven flattening towards back of head) , scaphocephaly (long thin head shape).

If you would like your baby to see a physiotherapist or have questions you would like to ask please ask your nurse or doctor to refer to physiotherapy.

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Physiotherapy

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Babies born prematurely develop differently to babies born at term. Premature infants are at a greater risk of having delay in their motor development. Common reasons which cause this delay are:

Their muscles are imbalanced compared to a baby born at term

Their head shape may not be round, so they tend to favour facing one direction

They are easily distracted / over stimulated and have problems self calming

This information has been created to show parents and carers how to provide additional support to help your baby to learn new skills in the first few months after their due date. These early skills are gaining good head control; raising their head and chest up when on their tummies with their arms forward; grasping toys and bringing them to their mouth.

Play Time Ideas

Short periods of supervised play will provide your baby with the opportunity to discover how their body works. Choose a time when they are settled and calm. Minimise the noise in the room so they can focus on the activity.

Different muscles work in different positions so vary the positions that you lie your baby in.

Click on the links below to get some practical tips for different play positions:

Sleeping Positions

Official Sudden Infant Death guidelines recommend that your baby sleeps on their backs at home, with their feet at the bottom of the bed until they are 6 months old. Make sure that there are no pillows or soft toys near their face which could obstruct their breathing.

Alternate which way your baby's head faces when you put them down to sleep. Try and approach the cot from different sides so that your baby gets used to looking in both directions. This may help prevent the head from becoming flatter on one side.

CLICK HERE for further guidance from the Lullaby Trust

Equipment to Avoid

Below is a list of equipment that is particularly unsuitable for preterm infants. Research has shown that this equipment can delay babies development when they are learning to sit and walk.

Baby bouncers and bouncy chairs move when your baby pushes backwards into the chair. It over-strengthens the muscles that arch your baby's back. These arching muscles work against the muscles that keep the babies in an optimal 'curled up' position. Constant bouncing can also make it difficult for babies to learn how to reach accurately for things.

Doorway jumping seats/ jumperoos encourage babies to bounce on their toes and arch their backs. Your baby may then find it difficult to learn to sit and be still.

Baby walkers allow babies to walk abnormally, and do not strengthen the muscles needed for sitting, crawling or independent walking. Babies are better off being placed on the floor to learn these skills.

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Babies born prematurely develop differently to babies born at term. Premature infants are at a greater risk of having delay in their motor development.