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This video explains the process of being transferred back to your local neonatal unit to continue your care. It includes some stories from families who have experienced this neonatal journey.

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Transfer Closer to Home: The neonatal repatriation of your baby

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How to help keep your baby safe from infections from other people

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Why do we need to keep babies safe from infection?

It is very important to try and keep babies safe from infection, particularly in the first few weeks of life. Babies have immature immune systems , which means that they are particularly at risk from infections. Infections that may be mild in older children or adults can be

There are some key things that everyone can do to reduce the risk of serious infections in babies. It's important to follow THANKS - Think Hands And No Kisse S

It's also important not to visit a baby if you are ill or have recently been ill. This includes active cold sores as well as diarrhoea and vomiting illnesses. Staying away until you are fully recovered is a key part of keeping babies safe from infection.

Our THANKS buggy tags can be used on your pram to remind people to think twice about touching your baby while you're out and about, particularly if they haven't washed their hands.
Buy a buggy tag

Spotting infections in babies

It can be difficult to tell when your baby has an infection as infections can cause lots of different signs and symptoms, and babies can't say how they feel. But trust your instincts and, if you feel that something is 'not quite right' with your baby, seek help from your midwife, health visitor, GP, NHS 111 or visit an emergency department if you are very worried.
Your baby might have a serious infection if they:
You should also keep an eye on your baby's wet nappies and feeding and speak to a health professional if they have had fewer than 2-3 wet nappies in a 24-hour period.
It is important to get help if you are concerned that your baby might have an infection.

In collaboration with Annabel Karmel, who lost her baby, Natasha, to infection, we are currently running an awareness campaign around the importance of infection prevention. Watch Annabel's story here:
Infection Prevention Campaign

Key information to tell your health professional

Taking steps to prevent and keep babies safe from infection helps a lot, but it's also important to be aware of any exposures in pregnancy or after your baby was born that might have increased their risk of infection.

If you think your baby might have an infection, it is important that health professionals have all the information they need to help them treat your baby.

You will need to let them know if any of the following apply.

🔸 Baby's biological mother:

Had any illnesses during pregnancy such as flu-like symptoms

Missed any routine vaccinations in pregnancy , such as COVID-19, influenza or pertussis vaccines

Developed chicken pox 7 days before or after baby's birth

Has blisters or a rash on their breast/nipple (if breastfeeding)

Has ever had a genital herpes infection , even if they don't currently have symptoms

Had sexual contact with a new partner during pregnancy , particularly in the third trimester

Experienced symptoms of sexually transmitted disease during pregnancy

Travelled overseas during pregnancy

🔸 You or your baby:

🔸 Your baby has had contact with anyone who:

Make sure that you tell the health professionals caring for your baby if any of these apply to you, even if they don't ask. Having this information may give them clues as to why your baby is unwell.

Useful links for spotting and preventing infections

Download our infection prevention posters and red book insert from the bottom of this page. These resources are free to use and have been created in consultation with BPAIIG.

Here are some other links you may find useful:

🟡 Neonatal Herpes

Click here for information about Neonatal Herpes

Herpes simplex virus infection in a newborn baby is called neonatal herpes or neonatal HSV. In young babies who have immature immune systems, HSV infections can spread rapidly if left untreated, causing irreversible cell damage which can lead to permanent disability or death.

Early recognition and prompt treatment with antiviral medication is essential to save the baby's life.

Herpes simplex virus (HSV) is a very common and highly contagious virus which usually spreads from person to person by direct contact. HSV is carried by around 70% of adults in the UK and many carriers have no symptoms at all but in others it can lead to cold sores, blisters on the finger (called herpetic whitlow) or genital ulcers/sores. Infections on other areas of the body including the breast are also possible, but less common.

In older children and adults with normal immune systems, HSV infections are not normally serious and will get better without treatment but if left untreated in young babies, it is life-threatening.
More info here:
🟡 Group B Strep

Click here for information about Group B Strep

Group B Strep is one of the many bacteria that normally live in our bodies and usually cause no harm. It can be passed from person to person through direct physical contact, however it is not a sexually transmitted disease.

Testing for Group B Strep is not routinely offered to all pregnant women in the UK, often it is found by chance after a swab or urine test for another reason. Even if you carry Group B Strep, it is unlikely that your baby will develop this infection, however the risk of your baby becoming unwell with a Group B Strep infection is increased if your baby is born pre-term, if you have signs of infection in labour or if your labour hasn't started more than 24 hours after your waters break. Most early-onset Group B Strep infections can be prevented by antibiotics during labour. You should be offered these if you have tested positive for Group B Strep in pregnancy or if you have previously had a baby affected by a Group B Strep infection.
More info here:
🟡 Healthier Together

Click here for information about Healthier Together

The Healthier Together programme involves patients and healthcare professionals working together to improve how local healthcare is delivered. Each website, tailored for your specific region, provides advice for parents, young people and pregnant women, and clinical resources to support healthcare professionals - which means that your child is likely to receive consistently high-quality care, irrespective of which healthcare professional they see.
More info here:
🟡 Baby Check App

Click here for information about our free app

Baby Check is a free app from The Lullaby Trust. It features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when completed, a score is calculated that tells parents or carers how ill their baby is. The app then lets parents know whether their baby needs to see a doctor or health professional.
More info here: Download for FREE here:
The Lullaby Trust and Kit Tarka Foundation

Click here to read about The Lullaby Trust and Kit Tarka Foundation

You may have spotted an adorable little otter on our resources for preventing and spotting infections in babies. This very special otter symbolises the work of the Kit Tarka Foundation, whose guidance has been developed to create these important resources.

Kit Tarka Foundation was established in 2018 by Sarah and James de Malplaquet after their son Kit Tarka died at just 13 days old.

Kit's story

After discovering that Kit had died from neonatal herpes (the  cold sore virus in babies), Sarah set out to learn as much as she could about this devastating disease. She was astonished by the lack of awareness amongst the general public and, most disturbingly, by the huge gaps in knowledge of symptoms and best practice in the UK medical profession. It soon became clear that Kit's death had been preventable and that the lack of knowledge around the transmission, recognition and treatment of the virus had led to his tragic and untimely death .
You can tap here to read Kit's story
Deepening understanding around keeping babies safe from infection

After contacting several charities to see if they could facilitate long overdue research into neonatal herpes but being told it was not within the scope of any of them, Sarah and James decided they needed to establish their own charity to help prevent more tragedies like Kit's. To that end, Kit Tarka Foundation was launched with a mission to prevent newborn baby deaths through research and education, and deepen understanding around how to keep babies safe from infection.

With the sad news that Kit Tarka Foundation was winding down its activities in 2023, we at The Lullaby Trust felt that the work of this wonderful charity fit perfectly with our own mission of 'saving more babies lives'. Subsequently, the fantastic work of the Kit Tarka Foundation has been further developed with a team of infant infection specialists at The Lullaby Trust to widen the scope and cover a greater range of infant infections, with an ultimate goal to ensure this life saving information reaches as may families as possible.

Why an otter?

Kit was given the middle name Tarka for Sarah's love of swimming and James' love of otters. He was their little otter who never got to swim. They noticed from the clothes that Kit wore in his time with them that they also really liked the colour orange and it became his colour. Friends and family wore orange flowers in remembrance of Kit at his funeral. In memory of Kit and to recognise the outstanding work of the Kit Tarka Foundation, with kind permission we are happy to share that this little otter has joined us at The Lullaby Trust to continue to help keep babies safe from infections.
Please note, for simplicity of language, the information on this page may include the term 'woman' or 'mother' and this should be taken to include people who do not identify as women but who are pregnant or who have given birth.

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Keeping babies safe from infection - The Lullaby Trust

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It is important to try and keep babies safe from infection. Reduce the risk of by following THANKS guidance - Think Hands And No KisseS

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What if my baby is born early or poorly?

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What if my baby is born early or poorly?

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This information is available in verified by experts in our Editorial Board including representatives from Royal College of Midwives, Royal College of Paediatrics and Child Health and Royal College of Psychiatrists as well as other key health organisations in the UK. To download Baby Buddy, visit the relevant app store of your choice:

Introduction

The first video from the Small Wonders DVD explains the different levels of care your baby might need, and who might give it. We meet some of the families and hospital staff, and guide you as to how to use this DVD to get support, wherever you are on your journey.

In the second video from the Small Wonders DVD, we meet three families, two who had time to prepare for life in a neonatal unit and one who had very little warning. We see three births, one of which is the birth of triplets, and we follow the babies being prepared for transfer to the neonatal unit.

First hours

The third video from the Small Wonders DVD provides a look into the first hours and days in the neonatal unit and shows you how you, as a parent, can play a very important role in your baby's care.

Expressing breast milk

The fourth video from the Small Wonders DVD shows how mothers can express breast milk for their baby within a few hours of giving birth (if at all possible mothers should express milk within the first 6 hours after giving birth). Starting to express breast milk early and expressing milk often will help your body produce plenty of milk for the weeks and months to come.

Holding your baby

The fifth video from the Small Wonders DVD shows how skin-to-skin contact (also known as 'kangaroo care') can help both you and your baby. You will see families move from being nervous to being able to hold their babies with confidence.

Your time in hospital

The sixth video from the Small Wonders DVD follows families as they begin to feel more confident in caring for their babies on the neonatal unit. You will also see how some of our families cope with their baby's condition getting worse.

Feeding independently

The seventh video from the Small Wonders DVD follows four families as they learn to help their babies feed independently of tubes. Although some babies may go home being fed by tube, most will be feeding independently before they are discharged from hospital, whether they are breastfeeding or formula-feeding.

Preparing for home

The eighth video from the Small Wonders DVD covers what to expect when your baby is ready to leave hospital. We follow five families as they prepare to go home.

First months at home

The ninth video from the Small Wonders DVD follows nine families enjoying the early weeks and months at home with their pre-term baby. They all have different experiences and challenges.

Twins and triplets

The tenth video from the Small Wonders DVD follows four families who had twins or triplets and discovers some some of the joys and challenges that come with having more than one baby.

Bereavement

This video from the Small Wonders DVD is only for families who have to deal with bereavement. We have included it because parents asked us to. Only watch this video if you feel it will be helpful to you and please be aware that everyone's experience of bereavement is different and may not reflect your own. This film follows the journeys of families who lost babies during filming and chose to carry on sharing their experiences to help others.

The twelfth and final video from the Small Wonders DVD shows the families whose journeys we have been following in films 1 to 10 looking back on their experiences and sharing their thoughts and feelings.

Latest

The Impact Lead will focus on developing Best Beginnings' frameworks for monitoring and evaluating our national and international work ensuring that learning continues to be captured in ways that can be shared and used for effective advocacy and influencing. The successful candidate will also play a pivotal role influencing policy and its implementation within the maternity, early years, digital health and public health context.

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The Small Wonders videos have been designed to help you on your journey with your sick or premature baby.

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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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This short video explains what neonatal units are and a bit 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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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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Find out more about this screening for all newborn babies

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The padlet is a one-stop neonatal resource library coproduced with families for families.

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Set up to raise money to improve hospital experiences for patients, families and staff using our services. They have been a fantastic support to the Neonatal Unit year after year.

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Skip to content Cardiology Waiting Room Appeal In 2022 we launched a new appeal to raise the £23,000 needed for a complete renew of waiting area in the Cardiology Unit. Having a space where a patient feels comfortable waiting for treatments or updates on progress is extremely important, and makes a huge difference to patients and their loved ones during a very difficult time.

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Thames Valley and Wessex Neonatal Network 

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Thames Valley and Wessex Neonatal Network 

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Milton Keynes is one of 14 neonatal units in the Thames Valley and Wessex Network working together to provide the best neonatal care for our babies and families.

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You are the most important person in your baby's care

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You are the most important person in your baby's care

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Bliss is a national website with information and support for parents

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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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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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The chaplaincy team are here to support any one in the hospital in a way that is person-centred. This means that we start with the person and their needs rather than sharing our own faith or beliefs.

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A local family set up this charity and continue to support our families on the neonatal unit with beautiful gift boxes full of practical and special items when a baby is born here and needs neonatal care.

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The Heart of Touch — Essentials of Skin-to-Skin Care (Short)

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Angie Chisholm has produced a beautiful and effective video about kangaroo care. Share it with your staff and parents. Comment below and tell her what you think about it! VIsit her website and subscribe! https://www.heartoftouchfilm.com

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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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A leaflet to help you to recognise and respond to your baby's cues whilst on the neonatal unit and beyond

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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.

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

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I thought I'd taken a wrong turn and ended up in a zoo.

Man, I was confused. I thought this was a hospital for sick babies. Why were we talking about animals?

What the hell is kangaroo care?

Turns out it's a really important part of the neonatal journey - both for parents and baby. And while it's essential for mums to take part, it's also something that dads can participate in... and we even bring our own benefits to the party.

Here's how...

My first experience of kangaroo care with both sons.

What is kangaroo care?

Kangaroo care is a way of holding a baby which is popular in neonatal units. The baby is placed on the parent, crucially with skin exposed to allow skin-to-skin contact. Often, the baby will be placed down the top of the parent or underneath a blanket to keep them warm. The hold effectively mimics the way a mother kangaroo carries her joey in a pouch at the front - hence the name 'kangaroo care'.

Babies requiring neonatal care are often separated from their parents immediately or soon after birth. Kangaroo care is encouraged in NICU units as a way for parents - particularly mothers - to build a rapport with their newborns. This can help to regulate the mother's hormones and to stimulate her milk supply.

However, dads should also be included in kangaroo care, for several reasons.

Fathers can - and should - be included in kangaroo care

What are the benefits of kangaroo care for babies and dads?

I can't deny that the nine weeks in which my sons were in neonatal care were the most difficult of my life. However, looking back I relate the periods of kangaroo care and skin-to-skin contact to positive memories of the experience. These were the few times that I was able to cherish, in spite of the circumstances.

So, how does kangaroo care between dads and babies help both parties?

It helps dads to bond with their babies

Bonding with your baby in NICU is hard. It's not just a case of cuddling them and comforting them whenever you want - instead, you have to ask permission to hold them. You have to read through an incubator porthole instead of whilst cradling your child. You feed them through a tube instead of by a bottle.

But kangaroo care is a great way to build the father-child relationship. I relished every opportunity to hold my sons - either one at a time or together - as I felt it helped me to begin making that bond and effectively get to know them. A study backs this up, finding that skin-to-skin contact can help fathers feel more attached to their babies.

Kangaroo care is a great way to build the father-child relationship. I relished every opportunity to hold my sons.

It helps to grow dads' confidence

I'm sure I don't speak for all men here, but for me there was certainly a degree of nervousness about learning how to be a father. For example, how would I protect my sons, or soothe them and comfort them?

Kangaroo care, and having that early skin-to-skin contact, helped to ease my nerves and begin to learn the cues that my sons would give. This in turn meant I was better prepared and more confident in providing care.

Indeed, research has found that skin-to-skin can help to develop caring behaviours and increased sensitivity towards parenting in fathers.

It helps to settle baby's heart rate

Particularly in pre-term infants, heart rates can be erratic - I remember watching with abject concern as my sons' monitors beeped wildly at the endless swings between too many and too few beats per minute.

Kangaroo care allowed my boys to be close to one another, too.

Skin-to-skin contact has been shown to help stabilise neonatal infants' heart rates and reduce respiratory distress - both with mothers and fathers.

It helps regulate baby's temperature

Additionally, kangaroo care can with both parents can benefit the baby by helping them to regulate their body temperature. Babies born prematurely often need to be placed in incubators which are heated to body temperature, as their bodies are not sufficiently developed enough to maintain the correct temperature.

Skin-to-skin holding with parents can help the baby to develop this ability to regulate their temperature during the care. A study also found that kangaroo care with fathers was just as effective as with mothers in terms of baby's temperature regulation.

It helps to soothe and comfort your baby

Studies have also shown that father kangaroo care can contribute to soothing and comforting babies in neonatal care. I vividly remember holding my sons for the first time, and being apprehensive as they cried faintly as the nurses moved them from their incubators. But as soon as they were comfortable on my chest, they stopped crying and became content.

It's thought that the rhythm of the parent's heartbeat acts as a comfort and helps to reassure the baby.

It helps you both to relax

A further (and highly important) benefit of kangaroo care is that it can help both baby and father to feel relaxed and reduce stress levels. For babies, studies suggest that skin-to-skin contact contributes to decreased stress levels and reduced responses to pain.

A review of studies found that fathers experienced higher oxytocin (a hormone linked to love and care) levels and reduced levels of the stress hormone cortisol, both during and after skin-to-skin holding.

It helps the dad's relationship with the mother

I've spoken previously about just how much of a strain having a baby in NICU can put on a relationship. Though it was tense at times, my wife and I made it through together - and that may in part be thanks to kangaroo care.

The review of skin-to-skin care studies mentioned earlier also suggested that fathers who take part in kangaroo care go on to develop stronger relationships with the mother of the baby.

Building lifelong bonds

To recap, there's absolutely no doubt that having a baby in neonatal care is difficult. But amid all the angst and pain, kangaroo care really was a lifeline for me and, I suspect, many other fathers.

Though it was a heart-warming experience at the time, I firmly believe that I continue to reap the rewards of taking part today - my sons are now two years old and I have an unbreakable bond with them. That's something I might not have had if I wasn't able to hold them close during their dark early days.

Finally, if you or someone you know currently has a baby on a NICU or SCBU unit, check out my free checklist with helpful tips on how to bond:

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Kangaroo Care: Why It's Important For NICU Dads | PremDad

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I thought I'd taken a wrong turn and ended up in a zoo. Man, I was confused. I thought this was a hospital for sick babies. Why were we talking about animals? What the hell is kangaroo care? Turns out it's a really important part of the neonatal journey - both for parents and baby.

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

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

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

What causes jaundice?

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

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

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

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

Other types of jaundice

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

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

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

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

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

Which babies are most likely to get newborn jaundice?

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

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

Having a low birth weight.

Being male.

Being from an Asian or black family.

Getting jaundice in the first 24 hours after birth.

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

Being only fed with breastmilk.

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

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

Signs of jaundice in babies with darker skin tones

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

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

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

Jaundice on the neonatal unit

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

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

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

If you notice your baby has jaundice

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

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

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

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

Pale stools (poo) and dark urine

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

Useful guide to baby stool colour.

When your baby needs immediate medical help

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

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

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

Is becoming more and more yellow.

What tests might my baby have?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Being overly sleepy

Being irritable

Being floppy, or stiff with an arched back

Having pauses in breathing (apnoea)

Having unusual movements (seizures)

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

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

Where can I get more help and support?

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

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

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

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

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

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

Last reviewed: April 2022

Next review date: April 2025

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

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All babies have this examination, if your baby is on the neonatal unit this will be done by the medical team at the right time for your baby

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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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Getting going with expressing and breast feeding

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Getting going with expressing and breast feeding

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Lots of advice and videos about all aspects of feeding and expressing

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1st 2 Weeks - The Breastfeeding Companion

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

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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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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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How to be fully involved in your baby's care

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How to be fully involved in your baby's care

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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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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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Information to guide your choice of formula and advice on responsive bottle feeding

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To order our leaflets or publications in larger quantities please visit our online shop.

Leaflets

Mastitis and breastfeeding (Please note this updated version differs slightly to the one currently in print but the previous version is still available through the shop and can still be used.)

Expressing and Storing Breastmilk
(Please note this updated version is not yet available in print but the previous version is still available through the shop and can still be used.)

How Safe Is...? Alcohol, Smoking, Medicines and Breastfeeding PDF (1.14MB)

Supporterline Leaflet PDF (130kB)

Miscellaneous
Page last updated Feb 2021

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Publications & Leaflets - The Breastfeeding Network

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To order our leaflets or publications in larger quantities please visit our online shop. Leaflets Mastitis and breastfeeding (Please note this updated version differs slightly to the one currently in print but the previous version is still available through the shop and can still be used.)

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Support for you, your baby and your family.

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Rainbow Trust Children’s Charity provides emotional and practical support to families who have a child with life-threatening or terminal illness.

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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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This is a video to teach you how to safely administer resus to your little one. All families will be offered face to face basic life support training prior to discharge with our specially trained staff.

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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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A personal perspective of becoming a parent

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A personal perspective of becoming a parent

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NHS South East Clinical Delivery and Networks

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Being the parent of a premature baby; interview for the #ReadyforParenthood campaign

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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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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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Our team of neonatal community nurses may follow you up after discharge if you and your baby need additional support. This leaflet explains who they follow up and how they can support you.

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Taking your baby home, whether after a few days or months on the NNU, can be a relief yet also cause anxiety and uncertainty. When will my baby go home?
On the NNU you will have gradually learnt how to care for your baby and the staff will discuss with you when your baby is becoming well enough to be discharged home. There is a discharge criteria that the NNU staff use as a guideline, they will share this with you.
What do I need to know before I go home?
Getting ready to go home is part of helping you to feel more confident in taking this step.

The nursing staff will discuss and give advice on what your baby needs and how you can provide these needs, such as feeding, bathing, sleeping, medicines and when to seek advice.

Every baby is different, so we try to support you with what you and your baby needs.

For some babies this may include learning how to use medical equipment that is required at home, the staff will discuss this with you on an individual basis.
What support will I get once I am home?
On the NNU you will have received ongoing support and advice in the care of your baby, whereas at home you may feel more alone and apprehensive of making decisions concerning your baby.

The Health Visitor and GP are the main local support available to you, however some babies may benefit from the support of the Neonatal Community Team.

The Neonatal Community Team aim to provide appropriate support, to both you and your baby, by both visiting you at home and by providing advice and support via telephone.

The frequency of visits can range from daily to every two to three weeks. This is often done in conjunction with your Health Visitor.
What support do the Neonatal Community Team offer?
If our support is considered appropriate, we (neonatal community team or health visitor/midwife) will normally visit you at home within the first week of discharge.

We usually try to support you in the initial weeks you are home, longer if your baby has specific medical problems.

We discuss anything that concerns you and your baby, issues such as:
* Feeding
* Weight gain
* Sleeping- you and your baby!
* Medication
* Blood tests
* Hospital appointments
* How you are coping with the adjustment to having your baby home.

If specific advice or support is needed, we can liaise with specialists, such as the dietician, pharmacist or paediatrician.

We would only discuss your baby with your knowledge and consent.

Who are the Neonatal Community Nurses?
The Neonatal Community Team consists of three Neonatal Community Sisters. We are trained in the care of neonatal babies and work closely with NNU.

We work Monday to Friday 08.30-16.30 and are based in the Milton Mouse Unit. We visit families on NNU and in the community. To contact us, please call; 01908 996517 or ask a member of the nursing team to contact us on your behalf.

We will plan to meet you before you and your baby are discharged home.
How to contact the NNU Community Team once you have gone home
Our office number is;

01908 996517

We work Monday to Friday 08.30-16.30

If we are not there you can leave a message and we will get back to you.

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The Neonatal Community Team: Going Home - Milton Keynes University Hospital

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Taking your baby home, whether after a few days or months on the NNU, can be a relief yet also cause anxiety and uncertainty. When will my baby go home? On the NNU you will have gradually learnt how to care for your baby and the staff will discuss with you when your baby is becoming well enough to be discharged home.

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Clear step by step guide to looking after your expressing kit

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What to look out for with RSV and Bronchiolitis in your baby. When to worry and what to do.

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Bronchiolitis is an infection that causes the tiniest airways in your child's lungs to become swollen. This can make it more difficult for your child to breathe:

Bronchiolitis tends to affect young children (under 2 years of age) is caused by a number of different viral infections. One of the most common viruses that causes bronchiolitis is Respiratory Syncytial Virus (RSV).

Rates of RSV usually peak in winter (November and December). However, due to the social restrictions put in place last year, there were almost no cases of last year. This year, cases have been rising in Wessex since August and are likely to continue rising over the Autumn and winter.

Bronchiolitis usually only causes cold like symptoms and mild breathing difficulty - breathing may be faster than normal as well as noisy and they may not be able to take their usual amount of milk by breast or bottle. Your child may get a little worse each day until the 3rd or 4th day of their illness after which they are likely to start improving. However, most children get better on their own; there are no specific medical treatments that speed up recovery from bronchiolitis and many children will continue to cough for a few weeks afterwards.

Some children, especially those under 6 weeks of age or young children with heart or lung problems, can develop significant breathing difficulty and may need to go to hospital for help supporting their breathing and feeding.

If your child has any of the following:

Is pale, mottled and feels abnormally cold to touch

Has pauses in their breathing lasting more than 10 seconds, makes a grunting noise every time they breathe out or has blue lips

Is stiff or rigid or makes repeated, jerky movements of arms or legs that doesn't stop when you hold them (a fit or seizure)

Is extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)

Has a rash that does not disappear with pressure (the 'Glass Test')

Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features)

If your child has any of the following:

Difficulty breathing, including breathing fast all of the time; widening their nostrils or pulling in of the muscles below the ribs when breathing

Not interested in feeding and/or looks dehydrated (dry mouth, sunken eyes, no tears, drowsy, no wet nappies in the last 8 hours or sunken fontanelle (soft spot on the head)

Is drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) - especially if they remain drowsy or irritable despite their fever coming down

Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations) or continues to have a fever of 38.0°C or above for more than 5 days

Is getting worse or if you are worried

You need to contact a doctor or nurse today.

Please ring your GP surgery or call NHS 111 - dial 111

If symptoms persist for 4 hours or more and you have not been able to speak to either a member of staff from your GP practice or to NHS 111 staff, recheck that your child has not developed any red features.

None of the above features are present

It is normal for a baby to take slight pauses in their breathing for a few seconds, or to breath rapidly for a short period. By 6 weeks of age they should have a more regular breathing pattern.

Addition information is available about infant crying and how to cope - click here

What can you do to help your child?

If your child is not feeding as normal offer smaller feeds but more frequently.

Children with bronchiolitis may have some signs of distress and discomfort. You may wish to give either Paracetamol or liquid Ibuprofen to give some relief of symptoms (Paracetamol can be given from 2 months of age). Please read and follow the instructions on the medicine container.

If your child is already taking medicines or inhalers, you should carry on using these. If you find it difficult to get your child to take them, ask your Pharmacist, Health Visitor or GP. Bronchiolitis is caused by a virus so antibiotics will not help.

Although you should continue to place your baby on their back to sleep, you can tilt the head of their cot upwards to help their breathing. You can do this by raising the cot legs on blocks or putting a pillow under the mattress, although remember never put a pillow or cushion under your baby's head as this is unsafe.

Make sure your child is not exposed to tobacco smoke. Passive smoking can seriously damage your child's health. It makes breathing problems like bronchiolitis worse. Remember smoke remains on your clothes even if you smoke outside.

Avoid co-sleeping with your baby if they are unwell with bronchiolitis or a respiratory tract infection or if they were born prematurely (before 37 weeks ) or with a low birth weight (less than 2.5kg). For more information, click here

If you would like help to give up smoking you can get information / advice from your local GP surgery or by calling the National Stop Smoking Helpline Tel: 0800 169 0 169 from 7am to 11pm every day.

Watch a local GP and health visitor talking about what they would look out for in a child with a cough and cold:

Many thanks to ASKSNIFF for providing the clips of abnormal signs.

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don't need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

1. Visit a pharmacy if your child is ill, but does not need to see a GP.

2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.

3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children's Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

Breastfeeding, weaning and healthy eating

Exercise, hygiene and safety

Your child's growth and development

Emotional health and wellbeing, including postnatal depression

Safety in the home

Stopping smoking

Contraception and sexual health

Sleep and behaviour management (including temper tantrums!)

Toilet training

Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.
Contacting the School Nurse
Primary and secondary schools have an allocated school nurse - telephone your child's school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

encouraging healthier lifestyles

offering immunisations

giving information, advice and support to children, young people and their families

supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and carry out simple surgical procedures. Your GP will arrange a referral to a hospital specialist should you need it.

Sound advice

You have a choice of service:

1. Doctors/GPs can treat many illnesses that do not warrant a visit to A&E.

2. Help your child to understand - watch this video with them about visiting the GP or going to a walk in centre

For information on common childhood illnesses go to What is wrong with my child?

If you're not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you're not sure it's an emergency, call 111 for advice.

Sound advice

1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.

2. If your child's condition is not critical, choose another service to get them the best possible treatment.

3. Help your child to understand - watch this video with them about going to A&E or riding in an ambulance

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Bronchiolitis is an infection that causes the tiniest airways in your child's lungs to become swollen. This can make it more difficult for your child to breathe: Bronchiolitis tends to affect young children (under 2 years of age) is caused by a number of different viral infections.

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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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Breast feeding resources

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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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Explaining the different types of neonatal unit and why your baby may be moved between units

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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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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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Perinatal mental health issues can happen in pregnancy and in the first years of being a parent (antenatal and postnatal). Problems can affect new mums as well as dads, people with no history of mental health problems as well as those who have. The word perinatal simply means the time around (peri) childbirth (natal). 

Perinatal Positivity uses the real voices and experiences of women and men who have had mental wellbeing difficulties around the time of pregnancy, childbirth and beyond. We hope it will help you emotionally prepare and find support, if needed, at this time.

ForMed films would like to especially thank the women and men who agreed to be interviewed, to tell their stories and share their experiences to help others. These eight hours of interviews have formed the six minute film.

The film and a number of translations and versions are available to download or embed for free from www.perinatalpositivity.org

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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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Carl's story by Bliss Neonatal Conversations

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Becoming a parent and welcoming a baby into the world should be one of the happiest moments in life. But for parents whose babies start life in neonatal care, those positive feelings of optimism and joy can quickly be replaced by doubt, worry and fear.

Carl, a parent in North Lincolnshire, speaks to Bliss about how he felt when his twin sons were born premature in 2019 and why dads need more support.

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Bottle feeding resources

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Bottle feeding resources - Baby Friendly Initiative

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These resources cover a range of issues around bottle feeding, including making up feeds and responsive bottle feeding.

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The essential guide for new Dads.

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Neonatal

Introducing the DadPad Neonatal...

Being a new dad can be a difficult thing to come to terms with. However, being the parent of a child in neonatal care potentially brings even more complex emotions and problems, as well as a wealth of complex information to digest.

The idea for the DadPad Neonatal was conceived by consultant neonatologist Professor Minesh Khashu. He recognised that there was a need for better communication and support for fathers of babies on neonatal units. The product complements the existing DadPad for new dads and is thought to be the first resource of its kind.

Professor Khashu said:

"DadPad is such a good idea for new dads, bringing together a range of information in a handy and convenient pack.

"I was excited about the potential opportunities for neonatal units and keen to develop a specialised version for this purpose."

How will DadPad Neonatal help?

The pack of laminated cards contains practical information and advice on relevant matters. These include: how dads can best help themselves and their partners as they each deal with their feelings and emotions; where to go to seek further help, support and information; and practical guidance on holding, handling, bonding with and caring for their premature baby.

It is hoped that the DadPad Neonatal will significantly improve a dad's understanding of their baby's care and treatment. It will also help in conversations with healthcare professionals on a range of topics.

The resource should become a valuable tool for fathers during this sensitive time, as well as growing into a 'keepsake' book for the father, child and family, with spaces in which to record information and emotions.

The DadPad Neonatal was written by the DadPad team, in partnership with Professor Khashu. Funding from National Lottery's Awards4All allowed the concept to be developed, with the DadPad Neonatal initially launched in two units in 2018: Poole Hospital, in Dorset, and Royal Cornwall Hospital Treliske, in Cornwall.

Professor Khashu hopes that other neonatal units around the country will adopt the DadPad Neonatal and benefit from the support that it offers.

"Having a sick or preterm baby is a very stressful time for parents. It can get even more stressful for dads who may have to go back to work quite quickly and may not be able to spend as much time on the neonatal unit as they would wish to.

"I think the new pack will be a huge asset for all parents and staff, and especially for dads."

Find out more...

To find out more about the DadPad Neonatal, or if you are a healthcare professional looking for more support in your neonatal unit, please send a message to Julian or call him on 07403 274757.
...BREAKING NEWS... September 2019
We are delighted to report that the DadPad Neonatal was Highly Commended in the Innovation category in the 2019 BMA Patient Information Awards. Read all about the Award over on our News page...

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DadPad | DadPad Neonatal | Neonatal Guide for New Dads

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Being a new dad can be a difficult thing to come to terms with. However, being the parent of a child in neonatal care potentially brings even more complex emotions and problems, as well as a wealth of complex information to digest. The idea for the DadPad Neonatal was conceived by consultant neonatologist Professor Minesh Khashu.

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Expressing your milk and getting breast feeding off to a good start with a baby on the neonatal unit can be hard. Find lots of advice and support here.

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Explore Milton Keynes Hospital Neonatal Unit in 3D

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Take a virtual tour of the Neonatal unit at Milton Keynes Hospital.

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Supporting specialised parent-infant relationships

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Another padlet created by the Neonatal Psychology Team to support you and all your family during and after a stay on the neonatal unit

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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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Information about our neonatal unit, visiting and contact details

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

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

With the right support most people make a full recovery.

Depression during pregnancy

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

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

Symptoms of postnatal depression

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

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

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

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

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

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

a persistent feeling of sadness and low mood

lack of enjoyment and loss of interest in the wider world

lack of energy and feeling tired all the time

trouble sleeping at night and feeling sleepy during the day

finding it difficult to look after yourself and your baby

withdrawing from contact with other people

problems concentrating and making decisions

frightening thoughts - for example, about hurting your baby

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

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

you think you may be depressed

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

Remember that:

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

depression is an illness like any other

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

being depressed does not mean you're a bad parent

it does not mean you're going mad

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

Treatments for postnatal depression

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

These include:

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

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

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

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

Causes of postnatal depression

The cause of postnatal depression is not completely clear.

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

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

a history of mental health problems during pregnancy

having no close family or friends to support you

a difficult relationship with your partner

recent stressful life events, such as a bereavement

physical or psychological trauma, such as domestic violence

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

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

Preventing postnatal depression

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

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

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

you have a history of depression or mental health problems

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

This is so they can offer you appropriate treatment.

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

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

Myths about postnatal depression

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

These include:

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

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

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

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

These factors are equally true of antenatal depression.

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

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Postnatal depression (PND) is thought to affect as many as one in 10 men. Find out why, what the symptoms are and where to go for help.

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5 tips to help support Dads through the neonatal journey

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Premature baby

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Find out more about the baby unit and how your premature baby may be cared for in hospital. Your healthcare team can support you during this time.

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All the information you need to know about our hospital at Milton Keynes

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Home - Milton Keynes University Hospital

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Stories shared by men who have had babies on the neonatal unit for different reasons, different lengths of time and different years.

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News About us Get involved Run For Us Picnic Meet with your MP to ask for Neonatal Leave Now How to Fundraise You give | we do Subscribe to our newsletter Who We Are Our Mission After NICU: A post pandemic report 2021 Prem Aware Award Your premature child at

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An opportunity to talk through your birth experiences with a qualified health care professional

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The Birth reflections service provides the opportunity to explore your birth experiences with a qualified healthcare professional.
Every woman and birthing person's experience of labour and birth is different. For some, the way they feel about their birth experience can affect the way that they feel about themselves, their baby, their partner, their family or future pregnancies.

Many women and birthing people have unanswered questions about their experience of labour and birth. For some, labour and birth may not have been what they expected or planned. It can sometimes be difficult to understand what happened without information "to fill in the gaps." It is not always easy to take in all the information given at the time or just after birth and sometimes events can be difficult to understand.
Birth reflections offers:

A one-to-one discussion with an experienced midwife.

A private and open discussion where you can ask any questions which may help you understand your experience better.

The opportunity to review your maternity records.

The aims of the service:

To help women and birthing people explore and understand their experience of labour and birth.

To support women and birthing people to reflect and discuss any issues that their birth experience may have highlighted.

To explore the reasons why certain decisions were made during labour and birth.

We are committed to your wellbeing, and we value your suggestions and comments about your experience. To arrange a birth reflections appointment please:
Fill out the form at the bottom of this webpage and you will be sent an appointment in the post. If you cannot make the appointment or there are any barriers to you accessing this service, please contact the Professional Midwifery Advocate of the week Monday-Friday (9am-5pm) via the hospital switchboard (01908 660 033) or email the Birth Reflections team on [email protected]
Important Information

Birth Reflections is not a complaints or counselling service. Please ask your Midwife, GP, or Health Visitor if you need help to access more information about these services.

A birth reflections appointment can be arranged soon after the birth of your baby. We would advise that your appointment does not take place until at least six weeks after the birth.

You may not feel birth reflections is right for you at the moment. There is no time limit for accessing the service and you can contact us at any time.

Other Useful Numbers:

National Childbirth Trust 03003 300 700

Milton Keynes Pregnancy Crisis Centre 01908 230 508

Baby Basics MK - 07514 135 966

City Counselling 01908 231 131

The Samaritans 0845 7909 090 or 01908 667 777

Brook Counselling (under 24s only) 01908 669 215

Relate 01908 310 010

Your GP or Health Visitor may also be able to advise and support you.

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Birth Reflections - Milton Keynes University Hospital

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The Birth reflections service provides the opportunity to explore your birth experiences with a qualified healthcare professional. Every woman and birthing person's experience of labour and birth is different. For some, the way they feel about their birth experience can affect the way that they feel about themselves, their baby, their partner, their family or future pregnancies.

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Helpful information to support you to make an informed decision on feeding your baby

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Infant milks for parents & carers — First Steps Nutrition Trust

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First Steps Nutrition Trust is a charity which provides clear, evidence-based and independent information and support for good nutrition from pre-conception to five years of age.

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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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Sometimes the nursing and medical team may use specific wording, here you will find what those words may mean.

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

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

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

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

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

A

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

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

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

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

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

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

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

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

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

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

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

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

B

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

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

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

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

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

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

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

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

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

C

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

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

Cannulae (pronounced can-you-lee)

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

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

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

Cerebral Function Monitor (sometimes called CFM)

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

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

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

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

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

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

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

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

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

D

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

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

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

Changing how your baby is disturbed

Massaging your baby

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

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

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

E

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

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

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

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

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

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

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

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

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

F

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

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

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

G

Gases and Gas monitor See 'Blood gases'.

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

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

Grunting A noise made by a baby with breathing difficulty.

H

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

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

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

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

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

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

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

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

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

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

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

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

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

I

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

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

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

Inotrope A medicine used to support blood pressure

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

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

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

J

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

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

L

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

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

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

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

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

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

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

M

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

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

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

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

N

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

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

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

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

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

NICU This stands for the neonatal intensive care unit.

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

NNU This stands for the neonatal unit.

O

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

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

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

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

P

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

R

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

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

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

S

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

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

SCBU This stands for special care baby unit.

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

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

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

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

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

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

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

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

Syringe driver See infusion pump above.

T

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

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

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

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

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

Transient tachypnoea of the newborn (TTN).

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

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

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

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

U

Ultrasound scan See 'Scans' above.

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

V

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

Ventricle (cardiac) - pronounced ven-trick-al

The pumping chamber of the heart.

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

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

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

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

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

The information in this section is due for review November 2025

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Words you might hear on the neonatal unit | Bliss

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

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Sepsis is a life-threatening reaction to an infection. It happens when the body's normal immune system reacts to an infection and starts to damage the body's tissues and organs.

What causes sepsis in babies?

Babies born premature are more likely to get infections that can lead to sepsis. This is because they have a weaker immune system, and their skin and gut is more fragile than in babies born at term. Babies born premature are also more likely to develop infections that lead to late-onset sepsis (sepsis that happens over 72 hours after birth).

Infection can happen through equipment such as tubes into a vein (intravenous, or IV lines) or ventilation tubes, which help support your baby's breathing.

Babies born at term can also develop sepsis. In some cases, problems in pregnancy or labour can increase the risk of infection in the baby. An example of this can include pre-labour rupture of membranes (PROM), which is when the mother's waters break after 37+0 weeks of pregnancy and labour has not started.

The most common cause of early-onset sepsis (sepsis that happens in the first 72 hours after birth) is an infection caused by bacteria known as group B streptococcus (GBS). If this, or other bacteria is present in the mother's birth canal it can pass to the baby during birth. This can sometimes cause an infection which can lead to sepsis.

Signs of sepsis can be non-specific and difficult to spot in babies. This is because the signs of sepsis can also happen for other reasons. Some signs include, but are not limited to, the following:

A high or very low temperature.

Breathing difficulties.

Changes in skin colour. For example, this could include jaundice (yellowing of skin and whites of eyes) or going blue.

Changes in behaviour. For example, they could be more irritable or not feeding as usual.

If your baby is on the neonatal unit, the healthcare team looking after your baby will look for these signs.

Babies are also treated for sepsis if there are risk factors at birth that suggest that they are at risk of infection. These risk factors may include signs of sepsis in the mother or if the mother has pre-labour rupture of membranes (see above). This is usually done as a precaution.

If you are at home, the NHS website has guidance on what to do if you are concerned your baby or child may be showing some of the signs of sepsis.

How are infections and sepsis treated?

If doctors suspect that your baby has an infection and is developing sepsis, they will admit your baby to the neonatal unit (if they have not already been admitted). They may use several tests to confirm diagnosis, including the following:

Blood tests - to see if there has been an increase in white blood cells (if low white cell count is low), or if there is inflammation or infection present.

Blood cultures - which checks for any bacteria in the blood.

Urine tests.

X-rays.

Lumbar puncture - which tests the liquid around the brain and spinal cord. To do this, your baby's doctor or nurse will gently put your baby is a curled position on their side. They then put a small needle into one of the spaces low down in your baby's back. The liquid that is taken is sent for testing.

You may hear the staff on the neonatal unit use the term 'suspected sepsis' to describe your baby's condition. This is where there are concerns that a baby might have an infection but blood results have not confirmed this.

Doctors will treat any infections with antibiotics. Doctors will give these to your baby through a small plastic tube into a vein called a cannula or line. Sepsis can develop and get worse very quickly, so the earlier your baby is treated, the more likely they are to make a full recovery.

The length of your baby's treatment will depend on whether their blood test and lumbar puncture results show any signs of infection. Your baby's doctor will discuss their course of antibiotics with you.

If your baby is very sick, doctors may need to provide support for your baby in other ways. This might include more support with breathing using a ventilator, drugs to support the function of the heart or sugar water through a tube into a vein.

Sadly, in rare cases, sepsis can lead to septic shock, which can lead to organ failure. This can be fatal. We have more information about making critical care decisions, palliative care and bereavement, and links to some more sources of support further down this page.

Where can I find more information and support about sepsis?

Having a baby on a neonatal unit can be a stressful and scary experience. Your baby's healthcare team should talk to you about the tests or procedures your baby will need, what will happen and what they are for. If you are unsure about any part of your baby's diagnosis, treatment or care, speak to the healthcare professionals looking after your baby. It is okay to ask again if you need information repeated or made clearer. The healthcare professionals will understand and want to support you.

We have included some links to charities and organisations who can provide more support. Social media websites such as Facebook may also be able to provide information about local support groups where you can talk to other parents who have a baby with sepsis. If you need someone to talk to, you can also contact us on hello@bliss.org.uk. If your baby is on the neonatal unit or has recently been discharged, you can also arrange a video call with one of our volunteers.

Contact- Support families with disabled children. You can call their free helpline on 0808 808 3555

Group B Strep Support - Work to stop group B strep (GBS) infection in babies. Have a helpline that provides confidential support and information to families about GBS. You can call 0330 120 0796 or email info@gbss.org.uk

The UK Sepsis Trust - Have a helpline, support groups and information for anyone affected by sepsis. You can call 0808 800 0029 or send a request for email support through their website.

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

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Parent Information Leaflet on Neonatal IV antibiotics

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Intravenous Antibiotics (IVAB’s) - Milton Keynes University Hospital

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Why does my baby need intravenous antibiotics (IVAB’s)? The main reasons may be: ▪ If your membranes rupture over 18 hours before delivery of your baby and you were not

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

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If your baby was born before they were 31weeks or weighed less than 1.51kg they will have their eyes checked as explained in this leaflet.

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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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Your Experience Matters: open this link FFT - give us your feedback - Milton Keynes University Hospital (mkuh.nhs.uk) to the hospital website, click on 'Inpatient/Day Surgery' and select 'Neonatal Unit' to tell us about your stay. This is available in multiple languages

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What if my baby is born early or poorly?

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What if my baby is born early or poorly?

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

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

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

Birth

First hours

Expressing breast milk

Holding your baby

Your time in hospital

Feeding independently

Preparing for home

First months at home

Twins and triplets

Bereavement

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

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

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

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

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

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

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

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

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

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

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

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

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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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Learning to suck swallow and breath when bottle feeding

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Learning to suck swallow and breath when bottle feeding

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Be prepared: what do you need?

Whether you're bottle-feeding your baby using formula milk, expressed breastmilk, or a combination of the two, it helps to be prepared. Make sure you buy any kit you'll need like bottles and teats. There are many different types of bottles and teats for sale. It may take a while to try a couple of different ones to see what works best for you and your baby.

You can also buy additional equipment if you like. For example, some mums will express milk by hand, while others will use an electric breast pump. There is also a range of sterilisation equipment available to buy (NHS Choices 2018).

Making up infant formula

Bottles and teats need to be washed thoroughly and sterilised before each use (NHS 2016). Read about how to sterilise bottles and teats.

When making up infant formula, it is very important to ensure the water is at the correct temperature as formula powder is not sterile. Measure the correct amount of water at 70°C into the bottle, before adding the correct number of scoops of powder (directions for the volume of water and number of scoops will be found on the packaging) (NHS 2016). Different brands have different sized scoops. Care must be taken to avoid accidentally using too much or too little milk powder (UNICEF UK).

It's important to follow good hygiene practices like always washing your hands before preparing your baby's feed and following any instructions on the formula packaging. This is to help prevent your baby picking up an infection (NHS 2015).

How to spot 'early hunger cues'

Keep an eye out for any early signs your baby is getting hungry. They may start to stick their tongue out, suck on their fists or perhaps turn their head to the side. Crying is the last sign of wanting to feed, so it is better to feed your baby before they do (NHS, 2019).

If you learn how to spot these early feeding cues, you may find that your little one feeds more calmly and more easily. If your baby is already upset or crying, then try to soothe them first before offering them a milk feed. You could talk to them gently or try skin-to-skin contact which can also help to calm them (Breastmilk counts, 2019).

Bond with your baby

Feeding your baby, especially in the early days, can be a good time for closeness and bonding. So, whether it's you or your partner who would like some special time with your little one, make sure you're comfortable and create a calm environment. It's better to limit the feeding to you and your partner in the early days to build a close and loving relationship with your baby and help them feel safe and secure. Some babies respond well to background music, while others prefer it to be quiet. As they get older, most babies will enjoy looking up into your eyes (First Steps Nutrition Trust, 2018; UNICEF UK, 2016).

Responsive feeding

Responsive feeding is all about trying to respond quickly to your baby's needs, not getting distracted during feeding time and not encouraging your little one to over-eat or finish bottles of milk when they're no longer hungry (UNICEF UK, 2016).

Research into responsive feeding suggests that it can help parents from over-feeding their baby and therefore help to reduce the risk of obesity (UNICEF UK, 2016; DiSantis et al, 2011; NHS 2018).

How to hold your baby for bottle feeding

Hold your baby close to you. They should be fairly upright, with their head supported - so they can breathe and swallow comfortably. Support your baby so they're slightly raised and able to look at you. Babies shouldn't be flat on their backs or left alone with a propped-up bottle when they are being fed to avoid any risk of choking (UNICEF UK).

Try talking to your baby gently and look into their eyes to reassure them during feeds. This helps them to feel safe and loved (NHS 2015; UNICEF UK, 2019; NHS, 2012; NHS Choices, 2018).

How to feed your baby using a bottle

Rub the bottle teat against your baby's upper lip gently to encourage them to open their mouth and draw the teat in, rather than forcing it into the mouth. Tip the bottle horizontal with only a slight tilt just enough to ensure there is milk in the teat. This also prevents milk from flowing too fast. Be guided by your baby's reactions while feeding. They should be able to suck and swallow, slowly and naturally, without spluttering, and without pushing the teat out with their tongue (First Steps Nutrition Trust, 2018; NHS, 2018).

If the teat becomes flattened while feeding, pull gently on the corner of their mouth to release the vacuum (First Steps Nutrition Trust, 2018; NHS 2018, UNICEF 2018).

'Pacing' feed

Babies feed in bursts of sucking with short pauses to rest. When your baby slows their sucking and swallowing, you can help 'pace' the feed by partially moving the bottle teat out and then letting them draw it in again. This mimics the stop-start motion of breastfeeding. This can also help avoid over-feeding your baby. Interrupting the feed from time to time gives your baby a chance to register how full they are and how much more they need - helping them to control their intake (UNICEF, 2018).

If your baby gets upset at having the teat removed, tip the bottle downwards while it remains in their mouth, which will stop or slow down the flow. Holding the bottle horizontal to ground with only a slight tilt will also ensure that baby doesn't get milk while they're pausing for a rest (UNICEF 2018).

Winding your baby

Your little one may need short breaks during their feed and may need to be burped. Hold them upright and rock or rub and gently pat their back to help them bring up any wind. Continue feeding your baby when they are more comfortable.

Some babies will need more winding than others. If your baby cries excessively or you are concerned about their feeding, talk to your health visitor or GP (UNICEF UK).

When you have finished feeding your baby, remember to throw away any unused formula milk as it may become contaminated and give baby an upset tummy.

Hot or cold milk?

Some babies are happy with their milk cool (room temperature) while others like it warm. Always check the temperature of the milk from your baby's bottle on the inside of your wrist before you feed them to make sure it's not too hot. This is necessary in order to avoid scalding their mouth. It should be warm or cool, not too hot. You don't need to warm it up at all if you don't want to or your baby doesn't mind.

Precious moments

Sometimes in the early days, feeding your baby can seem overwhelming and time-consuming, especially if they feed little and often and you have to get up countless times in the night.

It can be helpful to remember that as your baby grows bigger, they will get more efficient at feeding and their milk feeds usually space out more as they grow. If you are concerned about your baby's feeding talk to your health visitor or GP (UNICEF UK).

Further information

NCT supports all parents, however they feed their baby. If you have questions, concerns or need support, you can speak to a breastfeeding counsellor by calling our support line on 0300 330 0700, whether you are exclusively breastfeeding or using formula milk. Breastfeeding counsellors have had extensive training, will listen without judging or criticising and will offer relevant information and suggestions. You can also find more useful articles here.

Our support line offers practical and emotional support in many areas of pregnancy, birth and early parenthood: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Tips for bottle-feeding your baby | Baby & toddler, Feeding articles & support | NCT

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Introducing bottle-feeding to a breastfed baby can take a bit of getting used to, so don't be discouraged if it doesn't go smoothly the first few times. Here we've put together some useful bottle-feeding tips to help you through.

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All adults, children and babies experience illnesses. We become protected from infections by either catching them or through vaccination.

Babies and young children get more colds than adults as their resistance to infections builds up over time. For babies born premature or sick, the risk of complications can be higher.

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All adults, children and babies experience illnesses. We become protected from infections by either catching them or through vaccination. Babies and young children get more colds than adults as their resistance to infections builds up over time. For babies born premature or sick, the risk of...

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A pregnancy/newborn app with a dedicated section for neonatal families to download and explore for information and support

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Ask the team about signing up to receive photos and videos when you are not able to be on the neonatal unit. : https://www.vcreate.tv/diaries

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This video shows the importance of babies sleeping in their own cot.

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Being a new dad is an amazing experience

But it's also exhausting. It's something no-one can prepare you for. And at the end of a long day, there's nothing more satisfying than to collapse on the sofa.

And that's where we need to stop you! More than 130 babies die in the UK every year as a result of unsafe sleeping.

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Being a new dad is an amazing experience But it's also exhausting. It's something no-one can prepare you for. And at the end of a long day, there's nothing more satisfying than to collapse on the sofa. And that's where we need to stop you!

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In this episode of Bluey her and her friends roleplay what it is like having a sibling on a neonatal unit.

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Bluey’s playgroup is at odds when Indy’s baby hospital collides with Rusty’s knights and dragons.

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Visit the webpage to hear from other families who have been on the unit, read more information about the team and facilities on the unit and links to further information.

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Neonatal Unit - Milton Keynes University Hospital

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The Neonatal Unit at MKUH cares for premature babies. Find out more about the unit, including virtually visiting the unit via a 3D tour

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A dad's blog about discharge day from a neonatal unit

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A dad's blog about discharge day from a neonatal unit

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"Aim for the due date and you won't be far off."

My sons were scarcely an hour old when a midwife uttered those words. That due date was almost 13 weeks in the future. Yet that's how long we'd apparently have to wait until we could take them home.

It dragged. There was so much that happened between that traumatic premature birth and the moment when I left the hospital with my family of four.

In this post, I rewind to that day in the summer of 2019 and relive the immediate aftermath of bringing my sons into the outside world.

Discharge: the long awaited day

Whether you've spent a day or what feels like a lifetime in NICU with your baby, you're affected for a long time. And all the while, the thing you focus on more than anything - even when you don't realise it - is going home... forever.

For me, that moment came, somewhat miraculously, earlier than that projected date. My sons had been patients in two different neonatal units for a total of nine weeks, gradually developing and progressing to the point where nurses, doctors and consultants all collectively agreed it was time.

The chaos of discharge day

Chaos? But hadn't everything been building to this moment?

Well, yes... and no.

Because while some people take their babies home hours after their birth with a happy smile and a grateful wave, parents of preemies have a lot to take in and think about.

"We'll do our best to send you home by early afternoon so you've got time to settle in", is what we were told.

But thanks to the unit seeing one of its busier days in terms of new arrivals and staff scurrying around the ward, it felt as though we were largely forgotten about for much of the day. After all, by this point, our babies were the ones needing the least amount of medical attention.

To get things moving, a consultant paediatrician needed to perform some final checks and sign the discharge papers to allow us to leave for good. In the midst of this, a photographer - one of those from Bounty that snaps newborns - was clicking away in the corner. This was in lieu of the boys not being photographed at their actual birth because of the medical interventions.

By the time those important (and unimportant) items were ticked off the list, I excitedly went to the car and unclipped the pristine new car seats we'd bought, and trudged back to the NICU ward with one in each hand.

But it still wasn't time. With dusk falling, there was another piece of admin: watching some videos about baby safety.

I get it: parents of sick or premature children are stressed. In fact, parents of any baby are stressed. But I really didn't see the benefit to me watching a DVD that warned me of the damage a parent can do if they shake their baby. Or how stress can cause a parent to inflict physical trauma on their child.

Was now really the time to be watching videos about parents harming their children?

I know it happens. I know there are sick individuals in the world who harm young people. But for the past nine weeks, I'd sat by the side of two incubators praying that my children would pull through - that they'd survive this ordeal.

Was this really the time I needed to watch it?

Another video followed; what to do if your baby stops breathing. Complete with a practice on a dummy.

Again, understandable - but why now? Why not any other time in these past nine weeks?

Freedom

Finally, at around 5:30pm, we bundled our boys into car seats for the first time and took them into the outside world for the first time. The two-minute walk to the car took at least 10 minutes, as I took in the experience; the first time their skin had been touched by fresh, outdoor air.

"Welcome to the world. These are trees. That's the sky"

In our shiny new car, having checked the seats had safely clicked into their bases a million times, I drove home at a snail's pace, hands clammy with nerves.

Never driven a car so carefully

And then, we were home. My wife and I each placed a seat on our living room floor and laughed at each other.

"Erm, what now?"

After weeks of coming home alone, here we were with our sons. Just us. No nurses, doctors or consultants. No prying eyes. No machinery and medical equipment. Just the only thing we'd prayed for - a healthy family of four.

Except... it wasn't.

Emotional baggage

The hospital had been our home from home for more than two months. Now we were home, parenting for real. At times in the hospital it had almost felt make-believe. Asking to hold your baby or changing their nappy while a nurse looks over you is not normal.

And while it felt great to finally have the boys with us, there was an overwhelming sense of trauma and raw emotion that we brought home too.

We'd had no chance to process everything that had happened and, to boot, we had the worry and angst of being solely responsible for our babies' health. Preemies are more at risk of illness and infection, and we were ultra-wary about exposing them to anything that might harm them.

With two babies to think about, it was hard enough keeping track of feeds, but we also had to administer medicines and supplements throughout the day.

I don't believe bringing any baby home is a cakewalk, but this - despite me not having any other experience - felt different.

The end of the beginning

Leaving the NICU for good is not the happy, fairytale end some people make it out to be. In fact, many babies find themselves back in the hospital due to complications or illness. Thankfully, we never found ourselves in that situation.

Once your baby is discharged from neonatal care, it may seem like the end, but really it's just a closing of a chapter. There are still emotions running high and there's lots to consider and overcome.

Of course, the experience will be different for every family, but there are many similarities that only parents of premature or sick babies will understand.

Time is the only healer.

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NICU Discharge Day: What To Expect | PremDad

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"Aim for the due date and you won't be far off." My sons were scarcely an hour old when a midwife uttered those words. That due date was almost 13 weeks in the future. Yet that's how long we'd apparently have to wait until we could take them home. It dragged.