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Colostrum is a name given to the breast milk produced in the first few days and has many amazing benefits for premature and newborn babies.

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Your breastmilk in the first week - The Breastfeeding Network

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Before your baby is born, and for the first few days afterwards, your breasts will produce colostrum. Colostrum is a highly valuable fluid. It is rich in protein, immunoglobulins, vitamins, anti-infective agents, living cells and minerals. It can be described as being low volume and high yield; there is plenty for your baby in the […]

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Remember, it can take a while to feel confident about breastfeeding, but you're not alone. Your midwife and health visitor are there to help, guide and support you.

There's also lots of advice available online or via support groups, helplines and websites.

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Breastfeeding help and support - Start for Life

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It can take a while to feel confident with breastfeeding, but there is lots of help and support available. Find out more.

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Find below a range of useful resources for parents on infant feeding and relationship building, as well as information on overcoming common breastfeeding challenges.

There are various mother support groups which offer infant feeding support:

Find more useful organisations.

Breastfeeding is the healthiest way to feed your baby. If you decide not to breastfeed or to stop breastfeeding, it is possible to restart. Giving infant formula to a breastfed baby will reduce your milk supply. You do not need to eat any special foods while breastfeeding, but it is a good idea for you, just like everyone else, to eat a healthy diet.

Resources to support you

Below is a selection of resources to support you with feeding, caring, and building a close and loving relationship with your baby.

Overcoming breastfeeding problems

You may find whilst trying to establish breastfeeding that you run into problems. Whilst these can be debilitating and painful, thankfully the most common ones can be solved relatively quickly and easily - given the right support.

Unfortunately, support is often not available or, what is worse, mothers are told that problems such as engorgement and sore nipples are a normal part of breastfeeding. This is not true.

Below you can read about how different problems develop, how to spot them at a early stage, and how to solve them by yourself or with the support of a health professional.

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Support for parents - Baby Friendly Initiative

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Resources and information for parents to support with feeding and developing close and loving relationships with their baby.

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

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

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

Video not working? Contact us

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Positioning and attachment video - Baby Friendly Initiativ

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

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Unicef UK Baby Friendly Initiative | Hand expression

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Expressing milk means squeezing milk out of your breast so you can store it and feed it to your baby later.

You might want to express milk if:

How to express breast milk

You can express milk by hand or with a breast pump. How often you express your milk, and how much you express, will depend on why you're doing it.

Sometimes it takes a little while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow.

You may find it easier to express if you cover your breasts with a warm towel first, or after you have a shower or bath.

Expressing breast milk by hand

Some find it easier to express milk by hand, especially in the first few days or weeks. It also means you can express without needing a pump, or an electricity supply.

Hand expressing allows you to encourage milk to flow from a particular part of the breast. This may be useful, for example, if one of the milk ducts in your breast becomes blocked.

Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

These tips may help:

Before you start, wash your hands with soap and warm water.

Have something clean ready to collect the milk in.

Some find gently massaging their breasts before expressing helps their milk to let down.

Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.

Squeeze gently, keeping your finger and thumb a few centimetres away from your nipple, just outside the darker area around it (areola). Do not squeeze the nipple itself as you could make it sore. This should not hurt.

Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.

Drops should start to appear, and then your milk usually starts to flow.

If no drops appear, try moving your finger and thumb slightly, but still avoid squeezing the darker area near your nipple.

When the flow slows down, move your fingers round to a different section of your breast, and repeat.

When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether.

Watch a video about expressing milk by hand on the UNICEF website

Expressing milk with a breast pump

There are 2 different types of breast pump: manual (hand-operated) and electric.

Manual pumps are cheaper but may not be as quick as an electric pump.

You may be able to hire an electric pump. Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you.

The suction strength can be altered on some electric pumps. Build up slowly. Setting the strength to high straight away may be painful or damage your nipple.

You may also be able to get different funnel (the part that goes over your nipple) sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it's sucked into the funnel.

Always make sure that the pump and container are clean and sterilised before you use them.

Find out how to sterilise baby bottles

Storing breast milk

You can store breast milk in a sterilised container or in special breast milk storage bags:

in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) - if you're not sure of the temperature of your fridge, or it is higher than 4C, use it within 3 days

for 2 weeks in the ice compartment of a fridge

for up to 6 months in a freezer, if it's -18C or lower

Breast milk that's been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.

Storing breast milk in small quantities will help avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk

It's best to defrost frozen breast milk slowly in the fridge before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water or holding it under running warm water.

Once it's defrosted, give it a gentle shake if it has separated. Use it straight away. Do not re-freeze milk that's been defrosted.

Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.

Warming breast milk

You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water or holding it under running warm water.

Do not use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby's mouth.

Storing breast milk if your baby is in hospital

If you're expressing breast milk because your baby is premature or sick, ask the hospital staff caring for your baby for advice on how to store it.

Read more about breastfeeding a premature or sick baby

If you're having difficulty expressing breast milk

If you're finding it difficult or uncomfortable to express your breast milk:

Ask your midwife, health visitor or breastfeeding supporter for help. They can also tell you about other breastfeeding support available near you.

Search online for breastfeeding support in your area.

Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).

The Bliss website also has advice about expressing milk for a premature or sick baby

Community content from HealthUnlocked

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Everything you need to know about expressing and storing your breast milk, including tips on hand expressing and electric breast pumps, and how to freeze, defrost and warm breast milk.

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Breastfeeding support services near Slough

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Breastfeeding support services search results for Slough

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A great source for evidence based feeding and milk advice.

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First Steps Nutrition Trust is an independent public health nutrition charity. We endeavour to fill practical and policy-relevant information gaps and provide resources for health workers supporting eating well from pre-conception to five years.

Our Mission

To influence policies which enable the safe, appropriate and optimal feeding of infants and young children in the UK, and to protect them from commercial interest.

To ensure that the importance of good nutrition from pre-conception to age five remains on everyone's agenda.

To provide conflict of interest-free information on infant milks marketed in the UK, and to promote better regulation and marketing of breastmilk substitutes.

To provide resources for health workers to support them in their work with pregnant women and young families.

Our Resources:

Are put together by nutrition experts and are regularly updated.

Can be used in Unicef UK Baby Friendly Initiative accredited settings.

Are available as free pdf downloads for use by anyone promoting better public health on a not-for profit basis.

Everyone who works at First Steps Nutrition Trust feels passionately about the need for better information and support for good nutrition - and good food - from pre-conception to five years.

First Steps Nutrition Trust is supported by generous individual donations and conflict of interest free grants. First Steps Nutrition Trust does not work with organisations or individuals that work with, or take funding from, the breastmilk substitute industry and we reserve the right not to sell them our subsidised resources.

First Steps works with and supports a number of organisations including Unicef UK Baby Friendly Initiative, the Baby Feeding Law Group, the Obesity Health Alliance, the Children's Food Campaign and the APPG on Infant Feeding and Inequalities.

First Steps Nutrition Trust host and regularly update their partner site infantmilkinfo.org which contains comprehensive information about infant milks (for 0-12 month olds) available on the UK market.

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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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Going home from the neonatal unit | Bliss

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

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Wexham Park Hospital Neonatal Outreach Service

Is provided by our friendly and experienced specialised Neonatal Nurses and Nursery nurse, giving you and your baby continued care in the community.

We facilitate discharge from the Neonatal unit and establish a rapport with you before your baby gradates to living with you at home.

Who do we see?

We will follow up all babies born at 34 weeks and below, less than 2kg or below 2nd centile. We will also see babies with an ongoing nursing need due to a medical/surgical condition, we offer support with feeding, monitor growth and development and offer parental support.

Our Network

We work closely with our Consultants, Health visitors, physiotherapist, speech and language therapist, occupational therapist and any other agencies.

Teaching.

Basic life support - before discharge. Weaning sessions, oral health sessions and much more in partnership with the local children's Centre where we run our twice weekly outreach clinics.

Our Availability

Is Monday to Friday 9am - 6pm.

Please contact us;

Donna Reid - Team Lead - 07747 008526. Sinead Barlett - 07767002016

Fathima Shibly - 07442865461

We look forward to working with you.

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If you have had a baby on the neonatal unit within the past 2 years we welcome you to join with other families to share your experiences over refreshments.

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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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We are here to support you with your baby's feeding journey whether that be breast feeding, bottle feeding, expressing breastmilk or via a NGT (Nasal Gastric Tube)

The staff can support with expressing breastmilk for your baby. We have a breast pump available for every cot space and can borrow a pump free of charge for your use at home while your baby is admitted.

Breastfeeding support is available on the unit and we have a Lactation consultant on our maternity ward who will visit any family needing extra guidance.

We can help with safe, responsive bottle feeding and how to prepare infant formula milk.

If your baby is feeding via an NGT (Nasal gastric Tube) we can support you to feed your baby via the NGT when you feel ready.

We have SALT (Speech and Language Therapy) staff on the unit regularly who can also support with any feeding concerns.

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Information on how to express breast milk

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Expressing your milk by hand is a useful skill to have. It may take a bit of time and practice, but once you've mastered it, you'll find it's very helpful.

And the great thing is you only need your hands and a container - rather than a shop-bought breast pump.

Hand expression can be useful in various situations, for example if your baby isn't feeding or latching on well, if you want to stimulate your milk production, or if your breasts become engorged (this is a good way to relieve them).

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Expressing breast milk by hand - Start for Life

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Watch our video and read our step-by-step guide to expressing breast milk by hand.

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All parents on the neonatal unit have access to the Counselling service at Wexham Park hospital. We can make referrals on your behalf.

Self referrals can also be made.

Contact; 03006154461

03006154620

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During your time on the unit you will come across many different health professionals. Below are some of staff you may meet on our unit.

Nurses

Nursing associates

Nursery nurses

Outreach nurses (Community team)

Doctors

Pharmacists

Dieticians

Speech and language therapists (SALT)

Occupational therapist (OT)

Ophthalmologists

Hearing screening team

Clerical staff

Support workers and cleaning staff

Nursing and Midwifery students

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Unicef UK Baby Friendly Initiative | Hand expression

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Different health professionals work as a team on the neonatal unit. You will see different people looking after your baby, with staff coming and going on different shifts. You will probably get to know some of the staff, but it can feel confusing at first to know who’s who, and what their job is.

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This page talks about the different members of the neonatal care team, and provides some suggestions for questions you can ask them about your baby's care.

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The chapel at Wexham Park is always open for staff, patients, relatives and friends to use (except during the Christian Service and Muslim Prayer). People of different faiths use the chapel as a place of prayer and devotion (with appropriate resources available); it is also used by people who do not profess any religious faith as a place of quiet and reflection. There are separate weekly service for Christians and Muslims.

At Wexham Park, the chapel is on the main corridor just behind the hospital’s main entrance reception

Tuesday: Christian service in Wexham Park chapel, 1-1:30pm
Thursday: Catholic communion in Wexham Park chapel, 1-1:30pm
Friday: Muslim Jum'uah prayer in Wexham Park chapel, 1-1:30pm

fhft.chaplaincy@nhs.net

Wexham Park Hospital - 0300 615 3660

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The Lullaby Trust

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Your time on the unit and family support

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Your time on the unit and family support

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Parents are welcome on the unit 24/7

Siblings of the baby are welcome on the unit with parents present.

Grandparents can come to the unit 24/7 when accompanied by a parent or alone once a consent form has been completed.

Other visitors (Over 18 yrs) are welcomed between 11am - 8pm when accompanied by a parent.

Only 3 people to a cot side at one time, one must be a parent.

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Please call anytime, we are always happy to speak to you.

03006153148

03006154533

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What are ward rounds?

On our ward rounds the neonatal doctors and nurses review and discuss your baby’s progress, and make plans for the rest of the day and week.  Many of the additional staff on the unit (dieticians, neonatal occupational therapists and pharmacists) may also join the ward round to provide further information.

The doctors carry out daily ward rounds starting at 09.30am. We fully encourage you to attend the ward rounds to participate in discussing your baby’s progress and plan for treatment with the team.

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

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

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

How to know if your baby is getting enough nutrition

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

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

Are growing and gaining weight

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

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

Parenteral nutrition (PN)

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

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

Colostrum and first milk

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

Breast milk

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

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

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

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

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

It improves brain development.

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

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

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

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

Supplements and fortifiers

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

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

We have more detailed information about expressing milk and breastfeeding.

Donor milk

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

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

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

Formula

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

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

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

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

We have more information about bottle feeding your baby.

Combination feeding

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

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

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Every Friday at 09:30 am, our neonatal unit hosts a parent‑led ward round—a supportive and collaborative session where parents are warmly welcomed to join the wider multidisciplinary team (MDT) in reviewing their baby’s progress. This inclusive approach allows parents to share their invaluable insights, participate confidently in the discussion, and work as true partners with doctors, nurses, and other specialists in shaping decisions about their baby’s care. By centering parents in the conversation, the ward round fosters shared understanding, reinforces trust, and empowers families to be an active voice in their babies journey.

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Parking is available for the neonatal unit at Gate 4 in front of the maternity unit.

Parking is free of charge for parents with a baby on the neonatal unit. The staff will arrange this for you on admission.

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A weekly session for in patient neonatal families to connect, share, and unwind

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The hospital provides free Wi-Fi to the public. Please find this under your Wi-Fi settings on your phone to connect.

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Parents are very welcome to use our family room at anytime. Please feel free to eat food, use your mobile phone or just take some time out form the nursery.

There are children's toys and books for siblings to use but please do not leave them unattended in this room.

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

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Parents and siblings are welcome to help yourselves to tea, coffee and juices whilst on the unit. Hot drinks can be enjoyed by your baby in the nursery as long as you use a lidded cup.

Breakfast foods can be found in the family room and lunch can be provided too. Please speak to a member of staff.

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What is tube feeding?

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

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

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

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

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

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

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

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

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

Check the tube is in the correct position before feeding

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

Position your baby correctly for tube feeds

Give the milk slowly to support comfortable digestion

Know what to look for during a feed.

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

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

When can my baby stop tube feeding?

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

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

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

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

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

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

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

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On the Neonatal Unit, we aspire to provide high quality and evidence based; clinical, developmental and family integrated care to ensure the best outcomes for babies in our care and their families. We work to support and empower parents to be partners in their baby's care and are committed to caring for all families with compassion, dignity and respect throughout their neonatal journey.

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

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Caring for your baby on the neonatal unit

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Caring for your baby on the neonatal unit

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

Being involved in your baby's care

Some research shows that being more involved can mean that:

Babies spend less time in hospital

Parents feel less stressed

Babies are more likely to gain weight

Parents feel happier with the care their baby is getting

Parents have more success with breastfeeding

Parents are more comfortable and confident when their baby goes home

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

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

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

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

Skin-to-skin

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

Skin-to-skin care can also help:

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

Your baby to sleep better

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

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

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

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

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

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

Speaking to your baby

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

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

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

Being physically and emotionally close

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

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

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

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

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

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

Getting used to holding your baby

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

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

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

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

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

The most empowering part of getting involved

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

Skin-to-skin

Holding them

Feeding them

Bathing them

Touching them

Clothing them

Talking to them

Reading to them

Singing to them

Watching them

Changing their nappy

Expressing milk

Being involved in ward rounds

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

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How getting involved on the neonatal unit helps | Bliss

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

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

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

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

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

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

More neonatal resources to support you

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You and your baby leaflet - Baby Friendly Initiative

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

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If you have had a baby on the neonatal unit within the past 2 years we welcome you to join with other families to share your experiences over refreshments.

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

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

Comfort holding

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

Comfort holding can:

soothe your baby during uncomfortable procedures.

settle a restless baby.

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

encourage your baby to be quietly awake and responsive.

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

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

Be careful to:

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

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

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

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

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

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

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

Kangaroo Care

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

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

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

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

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

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

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

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Skin-to-skin contact - Baby Friendly Initiative

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

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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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On the unit we have will provide you with steam sterilising bags to use for your feeding equipment or breast pump.

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How to sterilise equipment - Start for Life

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Read about the different ways to sterilise baby bottles and any feeding equipment.

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An animated guide to neonatal care

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A stay in neonatal care - An animated guide

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

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

Product recall: Elecare Similac and Alimentum Similac powdered formula

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

Step-by-step guide to preparing a formula feed

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

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

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

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

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

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

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

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

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

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

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

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

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

Dos and don'ts of making up formula feeds

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

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

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

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

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

Reducing the risk of infection

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

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

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

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

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

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

Do not use bottled water to make up formula feeds

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

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

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It can take several weeks for you and your baby to feel happy and confident with breastfeeding.
Once you've both got the hang of it, it's usually possible to offer your baby bottles of expressed milk or formula alongside breastfeeding.

This is sometimes called mixed or combination feeding.

Why combine breast and bottle?

You may want to combine breastfeeding with bottle feeding if you:

are breastfeeding and want to use a bottle to offer your baby some expressed breast milk

want to breastfeed for some of your baby's feeds, but give bottles of formula for 1 or more feeds

are bottle feeding your baby and want to start breastfeeding

need to leave your baby and want to make sure they have some milk while you're away

Introducing formula feeds can affect the amount of breast milk you produce. There is also a small amount of evidence to show babies may not breastfeed as well because they learn to use a different kind of sucking action at the bottle than at the breast.

Introducing formula feeds

If you're combining breastfeeding with formula feeds both you and your baby can carry on enjoying the benefits of breastfeeding.

If you choose to introduce infant formula:

it's best to do it gradually to give your body time to reduce the amount of milk it makes - this helps lower your chance of getting uncomfortable, swollen breasts, or mastitis

if you're going back to work, start a few weeks beforehand to give both of you time to readjust

if your baby is 6 months old or more and can drink milk from a cup, you may not need to introduce a bottle at all

For more information, see drinks and cups for babies.

Giving your baby their first bottle

It may take a while for a breastfed baby to get the hang of bottle feeding.

it usually helps to give the first few bottles when your baby is happy and relaxed - not when they're very hungry

it may help if someone else gives the first bottle feeds, so that your baby is not near you and smelling your breast milk

you might want to try using a different position for bottle and breastfeeding

See more advice on how to bottle feed.

Breastfeeding more and giving fewer bottles

If you want to start breastfeeding more and give your baby fewer bottles, it's a good idea to ask your midwife, health visitor or breastfeeding supporter for support.

These tips may help too:

Hold and cuddle your baby as much as possible, ideally skin to skin. This will encourage your body to make milk and your baby to feed.

Express your breast milk regularly. Expressing releases the hormone prolactin, which stimulates your breasts to make milk. About 8 times a day, including once at night is ideal. It may be easier to express by hand to begin with - your midwife, health visitor or breastfeeding supporter can show you how.

Try bottlefeeding while holding your baby skin to skin and close to your breasts.

If your baby is latching on, feed often. Do not worry if your baby does not feed for long to begin with. See tips on how to get your baby properly positioned and attached.

Choose times when your baby is relaxed, alert and not too hungry, and do not force your baby to stay at the breast.

Decrease the number of bottles gradually, as your milk supply increases.

Consider using a lactation aid (supplementer). A tiny tube is taped next to your nipple and passes into your baby's mouth so your baby can get milk via the tube as well as from your breast. This helps to support your baby as they get used to attaching to the breast. Your midwife, health visitor or breastfeeding supporter can give you more information.

See more tips on boosting your milk supply.

Help and support with mixed feeding

If you have any questions or concerns about combining breast and bottle feeding:

talk to your midwife, health visitor or breastfeeding supporter

call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm, every day)

find breastfeeding support near you

Video: why combine breast and bottle feeding?

In this video, 3 mothers discuss ways to combine breast and bottle feeding.

Community content from HealthUnlocked

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How to combine breast and bottle feeding

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Find tips on combining breastfeeding and bottle feeding (mixed feeding), including how to introduce a bottle to a breastfed baby.

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

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

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

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

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

Offer the bottle when your baby shows feeding cues.

Gently invite your baby to take the teat.

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

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

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

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

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

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

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Learning to suck, swallow and breathe when bottle feeding

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Learning to suck, swallow and breathe when bottle feeding

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Bottle feeding resources

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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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Expressing milk means squeezing milk out of your breast so you can store it and feed it to your baby later.

You might want to express milk if:

How to express breast milk

You can express milk by hand or with a breast pump. How often you express your milk, and how much you express, will depend on why you're doing it.

Sometimes it takes a little while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow.

You may find it easier to express if you cover your breasts with a warm towel first, or after you have a shower or bath.

Expressing breast milk by hand

Some find it easier to express milk by hand, especially in the first few days or weeks. It also means you can express without needing a pump, or an electricity supply.

Hand expressing allows you to encourage milk to flow from a particular part of the breast. This may be useful, for example, if one of the milk ducts in your breast becomes blocked.

Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

These tips may help:

Before you start, wash your hands with soap and warm water.

Have something clean ready to collect the milk in.

Some find gently massaging their breasts before expressing helps their milk to let down.

Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.

Squeeze gently, keeping your finger and thumb a few centimetres away from your nipple, just outside the darker area around it (areola). Do not squeeze the nipple itself as you could make it sore. This should not hurt.

Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.

Drops should start to appear, and then your milk usually starts to flow.

If no drops appear, try moving your finger and thumb slightly, but still avoid squeezing the darker area near your nipple.

When the flow slows down, move your fingers round to a different section of your breast, and repeat.

When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether.

Watch a video about expressing milk by hand on the UNICEF website

Expressing milk with a breast pump

There are 2 different types of breast pump: manual (hand-operated) and electric.

Manual pumps are cheaper but may not be as quick as an electric pump.

You may be able to hire an electric pump. Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you.

The suction strength can be altered on some electric pumps. Build up slowly. Setting the strength to high straight away may be painful or damage your nipple.

You may also be able to get different funnel (the part that goes over your nipple) sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it's sucked into the funnel.

Always make sure that the pump and container are clean and sterilised before you use them.

Find out how to sterilise baby bottles

Storing breast milk

You can store breast milk in a sterilised container or in special breast milk storage bags:

in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) - if you're not sure of the temperature of your fridge, or it is higher than 4C, use it within 3 days

for 2 weeks in the ice compartment of a fridge

for up to 6 months in a freezer, if it's -18C or lower

Breast milk that's been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.

Storing breast milk in small quantities will help avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk

It's best to defrost frozen breast milk slowly in the fridge before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water or holding it under running warm water.

Once it's defrosted, give it a gentle shake if it has separated. Use it straight away. Do not re-freeze milk that's been defrosted.

Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.

Warming breast milk

You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water or holding it under running warm water.

Do not use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby's mouth.

Storing breast milk if your baby is in hospital

If you're expressing breast milk because your baby is premature or sick, ask the hospital staff caring for your baby for advice on how to store it.

Read more about breastfeeding a premature or sick baby

If you're having difficulty expressing breast milk

If you're finding it difficult or uncomfortable to express your breast milk:

Ask your midwife, health visitor or breastfeeding supporter for help. They can also tell you about other breastfeeding support available near you.

Search online for breastfeeding support in your area.

Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).

The Bliss website also has advice about expressing milk for a premature or sick baby

Community content from HealthUnlocked

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Everything you need to know about expressing and storing your breast milk, including tips on hand expressing and electric breast pumps, and how to freeze, defrost and warm breast milk.

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

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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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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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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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Download the DadPad App. Also available on social media.

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New dads will feel excited, but may also feel left out, unsure and overwhelmed. The Dadpad® gives dads-to-be the knowledge and practical skills necessary to support themselves and their partner, so that babies get the best possible start in life.

To complement the original DadPad® set of Cards, the DadPad® has now been developed further as an App to act as an on-the-go supportive guide.

Being rolled out as part of the UK's Maternity Transformation Programme's Better Birth's Strategy, the information and signposting you get will be local to your NHS Trust or relevant Health Authority.

Just select the area that applies to you to open up your DadPad® and get to know what you can do as a new dad. If your area isn't included, let us know and we'll make contact with those who can make it happen!
Build confidence around subjects such as:
- Holding and handling your baby
- Washing and bathing your baby
- Getting to know your baby
- Getting through the first few months
- Supporting your baby's mum
- Looking after yourself
- Supporting each other
.....and much more

As new UK NHS Trusts or relevant Health Authorities adopt the DadPad® App, more locations will appear, as will new up-to-date information and features such as explanatory animations and videos.
From the start, the DadPad® has been working with mums, dads, Health Visitors, Midwives and Public Health Teams to provide the most relevant and accurate information available, and continues to do so.

Having chosen to invest in including and engaging with dads-to-be, and wanting to encourage new dads to get involved and come forward with questions and issues they have throughout their partner's pregnancy and beyond, the DadPad App is free to you.

A very basic parenting app

Very basic advice. I'm soon to be a first time father and found this app to be quite patronising. I appreciate you've got to cater to a wide audience but a lot of this is common sense. Aesthetically, I also think the app is is very quality with poor stock images and an even worse colour scheme. Obviously, the aesthetic feedback isn't crucial but I would suggest the developer(s) seek professional advice on this.

Great app

Our health visitor recommended this app and as a new dad to be I've found this has given me a lot of confidence in advance of our baby being born. Really easy to refer to all topics and being in bitesize chunks manageable to read which is great for anyone like me who hates reading lots. Best app I've downloaded for a new dad to be.

Very helpful

Great clear info. Helps answer the questions you forget or don't know to ask about

The developer, Inspire Cornwall CIC, indicated that the app's privacy practices may include handling of data as described below. For more information, see the developer's privacy policy.

Data Not Collected

The developer does not collect any data from this app.

Privacy practices may vary based on, for example, the features you use or your age. Learn More

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‎New dads will feel excited, but may also feel left out, unsure and overwhelmed. The Dadpad® gives dads-to-be the knowledge and practical skills necessary to support themselves and their partner, so that babies get the best possible start in life. To complement the original DadPad® set of Cards, the...

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More support for dads on the neonatal unit.

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According to the charity Sane "1 in 2 people is affected by a mental disorder in their lifetime."

There has too long been stigma and taboo around men talking about their mental wellbeing. Mental wellbeing covers everything from sleeplessness, loneliness, stress to depression, bipolar and dissociative conditions. We all can learn to talk about and work on managing our mental health.
Articles from our Health and Wellbeing Group on Stress Management
Dr Chis Manning Article
Paul Egerton Article
We're very much in support of #timetotalkday and encouraging men to have a chat with someone they trust about how they are coping mentally especially in light of the pandemic.
https://www.optimale.co.uk/trt/trt-manual/male-menopause-mental-health-guide/
'Man Up' and talk about your feelings.

For #timetotalkday, we speak to Chris and Conor , two very different but courageous men. Listen as they share with us their journey in managing their mental health.

"Understanding the Male Menopause and Mental Health"
"We still don't have answers to what happened to my dad but i know he wasn't registered at a doctors and sadly he would never admit if he was in physical pain.
Kayleigh's Story

We were blown away to read Kayleigh's Story on instagram. Read her account growing up with a dad who battled with his mental health.

Toxic masculinity is one of the reasons men don't reach out as they don't want to appear weak. They feel like it's not ok to talk about their feelings or that if they do they'll just be told to "man up" or if they get sick they're told "is it the man flu?"

8 in 10 men would choose to endure an illness rather than seek help - and 39% have let symptoms get to the point where the pain is "unbearable", at which point they had no choice but to visit their GP, according to a survey of 2,000 men by bupa.

They feel like it's not ok to talk about their feelings or that if they do they'll just be told to "man up"

depression is often found to be more difficult to diagnose in men because they don't tend to complain about the typical symptoms and this is why when looking at statistics online it will state that on average more women and non binary people are diagnosed with mental health problems than men yet the rate of male suicide is significantly higher.

please nag your loved ones about going to the doctors for annual check-ups. please know the signs of different mental health disorders and recognise them if someone you know is struggling. please encourage men to talk about their feelings and offer to go with them to any appointments related to it. please never brush them off or take any part in toxic masculinity. please share if you know this might help someone."

Thanks to Kayleigh for sharing her experience with what she describes as toxic masculinity - her post can be found here https://www.instagram.com/p/CKrwIGDg6jL/

Call your doctor or simply someone you trust if you are struggling with Anxiety, Depression, Loneliness, Panic Attacks, Phobias, Seasonal affective disorder, Sleep problems, Stress, Sleeplessness and related concerns.

If you feel you need professional counsel, we have included details of a selection of professional helplines you can call below.

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Mental Wellbeing - UKMSA Men's Sheds Association

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Tackling the taboo surrounding men talking openly about their mental health. Time to talk day is an important reminder of what's at stake.

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Hear the experiences of parents talking openly about their mental health on the unit, how they face challenges, and how you can get more support from health professionals.

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Listen to Your stories on Spotify. We're Bliss, the UK's leading charity for babies born premature or sick. Our podcast presents the voices of parents who have been through a neonatal experience. It's their their thoughts, feelings and advice for other parents, in their own words.

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Berkshire - Children and young people online resource

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Berkshire - Children and young people online resource

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Children Young People and Families Online Resource

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If you're pregnant or have a child under the age of 4, you could be eligible for the NHS Healthy Start scheme. This means you could be entitled to a discount on vegetables, fruit, milk, infant formula milk, pulses and Healthy Start vitamins.

To find out more, visit the Healthy Start website

Contact the Health Visiting service

If you have a child aged 0-5 and could do with some advice, you can text a member of the health visiting team in confidence using our ChatHealth service.

Perhaps you have some worries about breastfeeding or bottle feeding, child development, toileting, sleep, behaviour, parenting, food and nutrition, or their health.

Send a text to07312 263283and we'll text you back to chat.
ChatHealth is available if you live in Bracknell, Wokingham, Reading or West Berkshire. Please see our Health Visiting page for who to contact if you live in these areas. Please note, ChatHealth is not used for professionals. Please see our Health Visiting page for details of how to contact us.
ChatHealth is a text service only and has successfully supported to date over 2,500 families. We appreciate it is a new and different way of contacting our Health Visiting team and ask that you bear with us while we adapt to using this service. Texting can be an easier way for us to be able to provide you with links and websites that will further support and reassure you with whatever your concerns are.

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Your Baby and you | Children Young People and Families Online Resource

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If you're pregnant or have a child under the age of 4, you could be eligible for the NHS Healthy Start scheme. This means you could be entitled to a discount on vegetables, fruit, milk, infant formula milk, pulses and Healthy Start vitamins.

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Reducing the risk of SIDS for premature babies

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Reducing the risk of SIDS for premature babies

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Babies who are born prematurely (before 37 weeks) or of low birth weight (under 2.5kgs) are particularly vulnerable and it is important that all the safe sleep advice is followed. Premature babies are sometimes slept on their front in hospital for special medical reasons. When they are getting ready to go home these babies should always sleep on their back to reduce the risk of sudden infant death.

Download our Safer Sleep Advice for Premature Babies guide below for further information on reducing the risk of SIDS.

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Babies who are born prematurely (before 37 weeks) or of low birth weight (under 2.5kgs) are particularly vulnerable and it is important that all the safe sleep advice is followed. Premature babies are sometimes slept on their front in hospital for special medical reasons. When they are getting ready to go home these babies should [...]

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How to Give Baby CPR - First Aid Training - St John Ambulance

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What do if your baby is choking - St John's Ambulance

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What do if your baby is choking - St John's Ambulance

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What to do if Your Baby is Choking - First Aid Training - St John Ambulance

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Bliss offers a wide range of free services for the families of premature and sick babies including a video call support service.

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Alongside giving grants, we offer families raising a disabled or seriously ill child, on a low income, wider support, including information and resources on where to go for help with money and benefits, budget planning, their children's education, mental health and wellbeing, digital training and creative workshops.

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Use our wider support section to find information and resources to help with finances, caring and education as well as digital technology.

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Government support with travel.

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If you’re referred to hospital or other NHS premises for specialist NHS treatment or diagnostic tests by a doctor, dentist or another primary care health professional, you may be able to claim a refund of reasonable travel costs under the Healthcare Travel Costs Scheme (HTCS).

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Sure Start Maternity Grant is a £500 payment to help with the costs of a new baby: what you’ll get, eligibility and how to apply (claim form SF100).

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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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Transfer Closer to Home: The neonatal repatriation of your baby

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Safer sleep, co-sleeping, travel and baby product advice from The Lullaby Trust.

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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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What is NNAP and what do we do with the information?

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What is NNAP and what do we do with the information?

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National Neonatal Audit Programme (NNAP)

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Some babies in the UK need specialist care when they are born. They may be born too early, with a low birth weight or have a medical condition. Since 2008, our clinical audit aims to improve care to these infants.

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

What is the blood spot test?

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

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

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

What does the blood spot test involve?

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

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

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

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

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

Which conditions is the blood spot test for?

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

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

Sickle cell disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Severe combined immunodeficiency (SCID)

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

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

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

Does my baby have to have the blood spot test?

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

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

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

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

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

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

When will we get the results?

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

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

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

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

You'll be contacted:

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

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

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

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

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

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

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

What do the results mean?

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

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

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

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

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

More information

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

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Car seat guidance from The Lullaby Trust.

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

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As your baby gets closer to going home we will ask you to bring in your baby's car seat We will then check that your baby is safe and supported to travel in their car seat. We will place a sensor on your baby's hand or foot to monitor whilst they sit in their car seat for 30 minutes. The sensor will let us know your baby's oxygen levels whilst positioned in their car seat.

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Screening for retinopathy of prematurity - information for parents and carers

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

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All babies are routinely swabbed for MRSA on admission to the unit. These swabs are then repeated weekly.

If your baby has arrived at Wexham from another unit they will also have a stool sample sent for CPE (Carbapenemase - producing Enterobacterales)

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Guidance on car seat for your baby.

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Children must normally use a child car seat until they're 12 years old or 135 centimetres tall, whichever comes first.

Children over 12 or more than 135cm tall must wear a seat belt.

You can choose a child car seat based on your child's height or weight.

Height-based seats

Height-based seats are known as 'i-Size' seats. They must be rear-facing until your child is over 15 months old. Your child can use a forward-facing child car seat when they're over 15 months old.

You must check the seat to make sure it's suitable for the height of your child.

Only EU-approved height-based child car seats can be used in the UK. These have a label showing a capital 'E' in a circle and 'R129'.

Weight-based seats

The seat your child can use (and the way they must be restrained in it) depends on their weight.

Only EU-approved weight-based child car seats can be used in the UK. These have a label showing a capital 'E' in a circle and 'ECE R44'.

You may be able to choose from more than one type of seat in the group for your child's weight.

0kg to 10kg

0

Lie-flat or 'lateral' baby carrier, rear-facing baby carrier, or rear-facing baby seat using a harness

0kg to 13kg

0+

Rear-facing baby carrier or rear-facing baby seat using a harness

9kg to 18kg

1

Rear- or forward-facing baby seat using a harness or safety shield

15kg to 25kg

2

Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield

22kg to 36kg

3

Rear- or forward-facing child car seat (high-backed booster seat or booster cushion) using a seat belt, harness or safety shield

Manufacturers can now only make booster cushions approved as group 3. This won't affect any existing booster cushions in group 2 and you'll still be able to use them.

Fitting a child car seat

You must only use a child car seat if your car's seat belt has a diagonal strap, unless the seat is either:

specifically designed for use with a lap seat belt

fitted using ISOFIX anchor points

You must also:

deactivate any front airbags before fitting a rear-facing baby seat in a front seat

not fit a child car seat in side-facing seats

Children with disabilities or medical conditions

The same rules apply for children with disabilities or medical conditions, but they can use a disabled person's seat belt or a child restraint designed for their needs.

A doctor can issue an exemption certificate if a child is unable to use a restraint or seat belt because of their condition.

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The rules for child car seats and booster seats - height, weight, age, type of vehicle, car, minibus, licensed taxi

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Buying baby products: the ultimate guide for expectant parents

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Sometimes the nursing and medical team may use specific wording, here you find out 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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Improving the quality of care for children and young people across Frimley and Wexham Park.

It can be extremely stressful when your child is unwell. We know that there is a huge amount of information available at your fingertips, but finding something that provides clear and accurate information is not always easy!

The resources on the Healthier Together website have been developed in partnership between parents and healthcare professionals from across Frimley and Wexham Park using the lead and original initiative Healthier Together 0-18 pioneered by Dr Sanjay Patel https://what0-18.nhs.uk/about-us/introducing-team. As the initiative rolls out nationally, we are collaborating across the country with other regions including South Yorkshire, Wales and Hertfordshire. This provides a platform to share and discuss information nationally and provide consistency in the messages we provide.

You'll find clear information on common childhood illnesses, including advice on what 'red-flag' signs to look out for, where to seek help if required, what you should do to keep your child comfortable and how long your child's symptoms are likely to last.

Most importantly, the resources are used not only by parents but also by healthcare professionals. This means that your child is likely to receive consistently high quality care, irrespective of which healthcare provider you take them to see. And their advice is likely to mirror that on the Healthier Together website. Reducing unnecessary variation improves the overall quality of care and reduces the parental anxiety that inconsistent advice generates

For more information about the vision of Healthier Together, you can listen to a podcast by clicking here.

Core Principles

1. Parents feel empowered about whether and when they need to seek the advice of a healthcare professional.

2. Parents are clearly signposted to appropriate healthcare services when required.

3. At every point of contact, the healthcare practitioner (doctor, nurse, paramedic, pharmacist) should have a clear understanding of the limits of their own competence and when and where to seek guidance.

4. Parents should receive consistent and appropriate advice across the whole urgent care system.

5. Standardisation of local referral pathways and clinical guidelines across the whole acute care system, which are understood by all healthcare practitioners.

6. Effective communication and information sharing between healthcare practitioners and services across the whole acute care system should be in place.

We have actively listened to the views of parents/carers accessing the service as well as the healthcare professionals delivering urgent care paediatric services. By working together we aim to improve how care is delivered to children and young people in the areas covered by Frimley and Wexham Park.

Feedback from parents
"We have been through a month or more of our child (now almost 15 months) being ill with several virus infections and a number of visits to the doctors. It has been a very stressful and worrying time. I have just come across this website (picked up the leaflet from our doctors surgery) and it is BRILLIANT. Simple, reassuring and helpful. THANK YO"It's like a mini doctor for you at home, that's how it is, that's how I see it. It gives all information, what should I do, in what cases I need to go to hospital or how I can treat my baby at home." "It's so clear isn't it? It's simple, it's in your face, you start at the bottom, you tick them off and you go up and start ticking them off and say, okay, this is the point I've got to, we need to go to the doctor or, oh, we've got pain or diarrhoea but no vomiting and nothing else so we're all right. No, I think that's really well laid out and really clear." "He had been struggling to eat for two or three days, and it was clearly stated on the website that don't worry about babies not eating, little and often might be a better way than standard meals. That kind of put my mind at rest actually yesterday, because I was getting a little bit stressed that he wasn't eating the meals in the times that he usually did. Yesterday I changed my strategy and I was feeding him bits here and there, and he ended up eating the same amount, but it was a lot less stressful for me and probably for (name of baby) as well." "We felt reassured that, 'oh actually, my baby's okay, to keep it at home for two, three days, I don't need to panic, or....' It's very good" U."

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Improving the quality of care for children and young people across Frimley and Wexham Park. It can be extremely stressful when your child is unwell. We know that there is a huge amount of information available at your fingertips, but finding something that provides clear and accurate information is not always easy!

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Bliss offers a wide range of free services for the families of premature and sick babies including a video call support service.

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5 tips to help support Dads through the neonatal journey

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Finding out you are pregnant with twins, triplets or more can be an exciting but sometimes overwhelming time. We have all the support you need.