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Introduction and information about the Special Care Baby Unit IOW.

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Welcome info Special Care Baby Unit - update 1103

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The Neonatal Care (Leave and Pay) Act (from April 2025)

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The Neonatal Care (Leave and Pay) Act (from April 2025)

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Neonatal Leave and Pay - Working Families

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The Neonatal Care (Leave and Pay) Act is intended to support parents of babies who are admitted into neonatal care within 28 days of birth. Eligible employees will be able to take up to 12 weeks of paid leave in addition to their other family leave entitlements such as maternity and paternity leave. Neonatal Care Leave is a day-one right. The Act will come into force on 6th April 2025.

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Explore St. Mary’s Hospital Neonatal Unit in 3D

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Take a virtual tour of the Neonatal unit at St. Mary’s Hospital.

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

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

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A personal perspective of becoming a parent

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A personal perspective of becoming a parent

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NHS South East Clinical Delivery and Networks

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

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Having a baby in the neonatal unit can be an emotional time for the whole family, including older siblings and other children close to the family.

Nell and the Neonatal Unit is an engaging and interactive free app designed for pre-school and primary school-aged children (approx. 3–8 years) to help them understand the neonatal environment.

Through interactive stories, familiar sounds, and friendly explanations, the app introduces them to the equipment, staff, and different journeys babies and families may experience.

With fun and engaging games, tools to support big emotions, and thoughtful conversation starters, Nell and the Neonatal Unit helps parents and siblings connect, making the experience feel less overwhelming and more familiar.

Developed for neonatal families by clinical psychologists, neonatologists, and paediatricians, with support and collaboration from neonatal families.

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‎Nell has recently become a big sister. Her baby brother was born a little early and must stay in the Neonatal Unit. Join her on a journey to make friends and discover all about the processes, equipment and healthcare professionals helping to care for her brother. This app has been created by a team…

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Barnardo's offer a range of courses and workshops, based at the Isle of Wight Family Centres to support the needs of families.

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Infant milks for parents & carers — First Steps Nutrition Trust

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

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Expressing milk by hand

For the first few days after your baby is born, it can be easier to express colostrum (your first milk) by hand. Expressing milk by hand stimulates the hormone oxytocin, which helps to trigger the let-down reflex. This means that hand expressing can be useful if you:

Have just given birth and can only express a small amount of colostrum

Need to increase your milk supply

Have blocked milk ducts

Have engorged breasts (when your breasts become overly full and feel hard and painful)

Have been separated from your baby

Will be only expressing, or expressing for a long period of time.

A midwife or neonatal nurse should show you how to express by hand. We have more information about how often to express and the let-down reflex on this page. We have also included some tips below. UNICEF has a useful video which explains how to express by hand.

You may also want to try expressing with a breast pump.

You can feed expressed milk to your baby using a bottle, which is a great way for partners to be more involved in caring for their baby.

We have some more information about how to store your breast milk at the bottom of this page.

Getting ready to hand express

To reduce the risk of infection to your baby, wash your hands thoroughly before getting ready to express. Have a clean towel ready to catch any spills. A syringe can be used at first to make sure you catch every drop of milk. When you have more milk, using a wide-mouthed container is useful.

Make sure that you are as relaxed and comfortable as possible before hand expressing, as this can help improve milk flow. Taking some deep breaths and concentrating on your breathing can help with this. Expressing after  skin-to-skin  or spending time with your baby can help stimulate the hormone oxytocin. A sturdy chair with arms can make expressing more comfortable. Try to sit with your back straight or leaning slightly forward.

Partners can help by helping you to feel relaxed, and ensuring that you have something to eat or drink nearby. Some parents find that having a photo or something that smells of of their baby close by or listening to relaxing music can help with milk flow, so partners can help to organise this before expressing.

How to hand express

1. Start with a very gentle breast massage for a few minutes before expressing to encourage the let-down reflex.

2. Cup your breast in a 'C' shape and feel back from the base of the nipple to around 2 to 3 cm, or to where the texture of your breast feels different. Gently squeeze your thumb and index finger together in this area and then release. This should not hurt.

3. Release the gentle press and release motion again and again, building up a rhythm. Avoid sliding your fingers over the skin. Milk may start to flow. If this does not happen, try moving your fingers slightly forward or back and try again. When the flow slows down, change the position of your index finger and thumb clockwise to express another area of your breast.

4. When you have expressed one breast, repeat on the other. Keep changing the breasts until the milk stops or drips very slowly. Changing from one breast to another can help to stimulate the milk ejection reflex.

5. Continue until the milk flow stops.

You may find that one breast produces more milk, or that milk from one breast flows faster. This is normal.

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For the first few days after your baby is born, it can be easier to express colostrum (your first milk) by hand. Expressing milk by hand stimulates the hormone oxytocin, which helps to trigger the let-down reflex.

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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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A snack box has been set up in the SCBU Parents Dayroom, provided through the Sophie's Legacy charity .

To our parents - please help yourselves to the food to keep you going through your baby's stay.

Sophie's Legacy was started in 2020 after 10-year-old Sophie sadly died following a brave battle with rhabdomyosarcoma, which is a rare type of cancer.

Sophie wanted to change a number of things nationally so a charity was set up in Sophie's name to help provide play specialists for youngsters in hospital, improve food for patients and their parents, and to increase funding for childhood cancer research. This will be her legacy in memory of a remarkable young girl who touched so many lives.

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​

Daisy Chains IW was founded in 2012 and is an Isle of Wight based children's charity. The charity was founded by a group of Island parents who have children that have been affected by long term/life limiting  illness or disability.

​

Over the years the main focus of the charity has become the travel needs of these families especially those needing to get to mainland hospitals for urgent and sometimes life changing treatment, it is little known that there is no funding for these families to make these journeys to the mainland for care and treatment, unless on some very specific benefits.

Over the past few years our support for families that have had a premature baby has grown hugely after the SCBU unit was downgraded meaning that all babies born before 32 weeks usually need to have some sort of stay in a mainland unit. For some this can be a week and for others it can be months. We pay for the parents to travel over to spend precious time with their baby before coming back to the Island SCBU or home.

​
Emergency Ferry travel is available for families with a Newborn/Premature baby who has been transferred to a mainland hospital and parents need to travel to be with their baby.

Referrals must be made by a medical professional caring for the child and they must make the referral on the information that is available to them ensuring that the above criteria is met. Referrals can be made by a Neonatal Nurse.

Over the years we have built a great working relationship with Red Funnel who support us with discounted travel and also Wightlink , Hovertravel and South Western Rail enabling us to book and pay for all of the families travel needs so they don't have to worry about organising anything.

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Parent information leaflet about the Special Care Baby Unit, Isle of Wight.

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Our small team consists of Paediatric Consultants, Paediatric Registrars, Advanced Neonatal Nurse Practitioners (ANNP), Specialist Neonatal Nurses and Nursery Nurses.

Uniforms:

Matron: Navy blue with red trim

Ward Sister: Navy blue

ANNP: Paediatric scrubs

Senior Staff Nurses: Royal Blue

Staff Nurses: Blue

Nursery Nurses: Sky blue

Specialist roles - Navy blue with white spots

Risk Governance Lead

Family Integrated Care Lead

Education Lead

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The screening tests that are offered to you and your baby

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The screening tests that are offered to you and your baby

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

Details

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

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

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

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

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

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

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

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

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

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Screening tests for you and your baby (STFYAYB)

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

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

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

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

Birth

First hours

Expressing breast milk

Holding your baby

Your time in hospital

Feeding independently

Preparing for home

First months at home

Twins and triplets

Bereavement

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Sleeping resources

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Sleep and night time resources - Baby Friendly Initiative

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

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

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When to change a nappy

Babies need frequent nappy changes.

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

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

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

What you need for nappy changing

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

a changing mat or towel

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

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

barrier cream to protect your baby's skin

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

clean clothes

Where to change a nappy

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

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

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

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

How to change a nappy

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

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

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

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

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

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

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

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

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

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

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

Nappy hygiene

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

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

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

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

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

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

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

What baby poo looks like

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

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

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

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

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

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

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

Read the NCT guide to newborn baby poo.

How often should my baby do a poo?

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

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

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

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

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

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

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

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

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

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

Disposable and washable cloth (reusable) nappies

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

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

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

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

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

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

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

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Building relationships

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Relationship building resources - Baby Friendly Initiative

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

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Find out what to expect from breastfeeding in the first few days after birth, including what colostrum is, what happens when your milk ‘comes in’ and what the let-down reflex feels like.

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Peer-to-Peer Advice

Every year, we give over 600 families with a baby, in the Neonatal Intensive Care Unit, many who have been born prematurely, one less thing to worry about by giving them a place to stay, free of charge just minutes from their baby's bedside. Parents might stay with us for a few nights or sometimes months.

Parents tell us that when their baby is born prematurely, they often feel scared, overwhelmed, lost and helpless. As World Prematurity Day approaches on Tuesday 17 November, we asked parents of premature children to share their advice to help others going through something similar.
We asked: What one piece of advice would you give? What are the ways parents can cope? If you had known, what would you have taken with you to the hospital? How can you remain close and connected with your baby while they're in hospital? How did you look after yourself while your baby was in hospital? How do you adjust after hospital? Any other advice Back to the top Back to the top Back to the top Back to the top Back to the top Back to the top Back to the top

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World Prematurity Day - The Sick Children's Trust

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17 November is World Prematurity Day, a global movement to raise awareness of premature birth. Join the conversation using #WorldPrematurityDay.

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

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What if my baby is born early or poorly?

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What if my baby is born early or poorly?

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

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

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

Birth

First hours

Expressing breast milk

Holding your baby

Your time in hospital

Feeding independently

Preparing for home

First months at home

Twins and triplets

Bereavement

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

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

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

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

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

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

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

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

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

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

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

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

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

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A Stay in Neonatal Care - Preparing to Take Your Baby Home

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Thames Valley and Wessex Neonatal Network 

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Thames Valley and Wessex Neonatal Network 

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

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Parental Access

As partners in care, parents/carers have open access to their baby whilst admitted to the Special Care Baby Unit IOW.

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

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

1. Purpose of screening

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

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

2. About these conditions

2.1 Sickle cell disease

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

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

2.2 Cystic fibrosis

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

2.3 Congenital hypothyroidism

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

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

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

These are:

phenylketonuria (PKU)

medium-chain acyl-CoA dehydrogenase deficiency (MCADD)

maple syrup urine disease (MSUD)

isovaleric acidaemia (IVA)

glutaric aciduria type 1 (GA1)

homocystinuria (pyridoxine unresponsive) (HCU)

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

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

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

3. The screening test

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

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

4. Safety of the test

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

5. Screening is your choice

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

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

6. Possible results

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

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

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

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

7. Getting my results

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

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

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

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

to improve the screening programme

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

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

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

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

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

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

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Safe sleeping

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The safest cot is a clear cot

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

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

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

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

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

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Safer sleep overview - The Lullaby Trust

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

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

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Tips for changing your baby’s nappy | Bliss

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

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Transfer Closer to Home: The neonatal repatriation of your baby

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

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Whilst your baby is in the SCBU, we can arrange free car parking for parents. All we need is your car registration number to inform Security.

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This incredible charity supports multiple neonatal units across the country ... read more of what they do for our team. To donate, please scan the QR code and select Isle of Wight.

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Bliss is a national website with information and support for parents

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For babies born premature or sick | Bliss

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

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Improving the health of children and young people in Dorset, Hampshire and Isle of Wight.

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healthier together, wessex, what0-18, nhs, home, worried about my child, parent support tool, pregnancy, child, children, young people, professional, parent, carer

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Preparing for your baby to come home from the neonatal unit can feel exciting but may also feel daunting. You may feel worried about looking after your baby at home without the constant support of the unit. These feelings are normal, and lots of parents feel this way.

The staff on the unit will help you to get ready to leave the unit from early on in your stay. This might mean you are involved in changing nappies, giving feeds and having skin-to-skin time with your baby. The staff on the unit will want to help you feel confident in all areas of your baby's care. Your baby is coming home because they are well enough to leave the unit, and the staff are confident that you are able to look after them. We have more information about when your baby may be able to come home.

Research shows that getting involved in your baby's care can help you to feel more prepared for the transition to being at home with your baby. We have more information about how you can be involved in your baby's care on the unit that you may find helpful.

Getting organised to go home

Getting organised early will help you be able to be more prepared to look after your baby when they come home. The staff on the unit will help you to plan, and you can ask them if you have any concerns.

If you will be expressing and/or bottle feeding your baby when you go home, you may want to talk to the unit staff about bringing in the bottles or teats so that your baby can start to get used to them. You can ask the unit staff when the best time to do this might be. We have more information about feeding when you go home that you may find helpful.

If you are planning to express milk at home and are not hand expressing, you will also need your own breast pump. If the pump that you used in hospital is working well for you, you may want to buy or rent the same type of machine. Your local breastfeeding support service or health visitor may also be able to give you details of where to hire a breast pump or get a pump for a shorter term.

Staff on the unit may help you to learn how to express milk by hand. Your local breastfeeding support service or health visitor will be able to help you with this when you get home.

If you plan to breastfeed your baby at home, you may want to research the support that is available in your local area before you go home. This could come from a community breastfeeding support group or a lactation consultant. We have more information about breastfeeding here. You could ask the staff on the unit for more information.

You may also want to bring in a brightly coloured toy for your baby's cot. Bringing something which smells of home, such as a special blanket may help your baby to be comforted by familiar objects and smells when they arrive home. Check with the staff first if it is appropriate before you bring any objects onto the unit.

Many parents ask about getting special equipment for their baby, such as cots, pushchairs and car seats. The members of staff on the unit who are supporting you with your discharge or your community neonatal nurse will talk to you about any specific equipment that your baby might need, and will answer any questions you might have.

Rooming-in

Before going home, hospitals might offer you the chance to 'room-in'. This means you stay with your baby in a room on or near the unit and care for them overnight for 1 to 2 days. The aim of rooming-in is to give you more confidence in caring for your baby, while having the support of unit staff to help you if you need it.

Rooming-in can be a reassuring experience and can help you to continue to build a close relationship with your baby. It can also help you to look out for cues (your baby's way of telling you what they need) and changes in behaviour. Talk to the unit staff about whether rooming-in is available at your unit.

Registering your baby's birth

You should register your baby's birth as soon as possible. In England, Wales and Northern Ireland a baby must be registered within 42 days of being born. In Scotland, a baby must be registered within 21 days.

You need to register your baby's birth close to the hospital where your baby was born rather than close to their home address. The hospital will tell you if you can register the birth there. If parents are married, one parent can register the birth, but it is different for parents who are not married. Gov.uk has more information.

Registering your baby with a GP

You will need to register your baby with a general practitioner (GP) as soon as possible. This is important for you to get any medical prescriptions after going home. It is also important so that your baby can get their vaccinations on time.

If your baby is going home on oxygen

If your baby requires oxygen support, they may go home on oxygen. Unit staff will talk to you about this in good time so you can plan your baby's discharge together, receive training to care for your baby's oxygen needs and ask any questions. We have more information about what to prepare for when looking after your baby if they are on oxygen.

If your baby is on medication

It is possible that your baby will still need medication when you are told they can go home. Even though some babies may still have ongoing medical issues, these issues will be ones that staff are sure you are able to cope with at home. Unit staff will show you how to give your baby their medication. You should also talk to your local pharmacist to explain what medication your baby needs and to explain that you will be coming in regularly for repeat prescriptions. This will help the pharmacist to have a supply of the medication your baby needs ready for you.

If your baby has a nasogastric (NG) tube

If your baby is going home with a nasogastric tube (also called an NG tube), a member of unit staff might show you how to feed, care for and replace the tube yourself. It may be you, your health visitor or your community neonatal nurse who will replace the tube when you go home. This will depend on your baby's needs and the support the unit provides.

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

Travelling by car

It is important to have an appropriate car seat for your baby, even if the only car journey you are going to make is from the hospital to home. If you do not own a car, you may be able to borrow or hire a baby seat to take your baby home from hospital by car or taxi. You can ask the staff on the unit if there is a local loan scheme.

Some babies may have a test to check if they fit properly in their car seat before leaving the unit. This is sometimes called a 'car seat challenge'.

We have more information about travelling by car, including information about the use of car seats with premature or sick babies.

If you have twins or multiples

If you have twins or multiples, it is common that one baby may be ready to go home before the other/s. Visiting and caring for two or more babies in different places can be emotionally and practically difficult. Your babies will only be separated if there is likely to be a long period between them being ready to go home. Units will try to ensure that babies come home at the same time if there is only likely to be a few days between them being ready.

You may want to contact Twins Trust, who provide support to parents with twins or multiples.

Preparing for discharge

Some units will have a discharge checklist for you to fill in before you leave the unit. Here are some examples of things that might be on a discharge checklist:

Do you know how to reassure your baby and make them comfortable?

Do you know how to give your baby a bath?

Have you been shown how to give your baby medication?

Have you been shown how to use and order any specialist equipment, such as a nasogastric (NG) tube and home oxygen?

If you are breastfeeding, do you have enough information and support to breastfeed and know where to go for help?

If you are expressing and bottle-feeding, or formula feeding, do you know how to sterilise bottles and make up your baby's feeds?

Have you had resuscitation training?

Do you know how to check, monitor and control your baby's body temperature?

Do you know safer sleep guidelines to reduce the risk of sudden infant death syndrome (SIDS)?

Do you know how to recognise if your baby is ill and what to do if they become ill?

Always remember to talk to the staff on the unit, and ask questions if you are unsure about anything. They will be happy to help you.

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Take a look at our tips to help you prepare to leave the neonatal unit with your premature or sick baby.

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The essential guide for new Dads.

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I was a bit scared when we found out we were having a baby, obviously happy, but a bit scared and in the beginning I was a bit clueless. The child development part is my favourite bit, but there's things in there, like things about mental health, that I didn't know about and that I didn't know you needed to know about.

Ross, 22

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DadPad | The Essential Guide for New Dads | Support Guide for New Dads

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Developed with the NHS, DadPad gives new dads and dads-to-be the knowledge and skills needed to gain confidence and give their baby the best start in life.

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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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Canopie App - a psychological support for parents and caregivers

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Canopie App - a psychological support for parents and caregivers

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Canopie provides comprehensive and scalable mentalhealth support for parents and caregivers.

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Neonatal Canopie Patient - Referral Cards

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

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

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

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

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

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

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

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

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

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

1. Purpose of screening

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

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

2. About the conditions

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

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

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

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

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

3. The screening test

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

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

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

listen to their heart using a stethoscope to detect heart sounds

examine their hips to ensure the joints are working properly

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

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

4. Safety of the test

There are no risks associated with having this test.

5. Screening is your choice

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

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

6. Not having the test

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

7. Possible results

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

8. Getting my results

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

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

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Eyes, heart, hips and testes (physical examination)

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

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Supporting specialised parent-infant relationships

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

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

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

Destiny, mum to Leo

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

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

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

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

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

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

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

Ventilators and breathing machines

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

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

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

There are two types of basic ventilator:

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

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

Other breathing machines can include:

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

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

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

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

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

Vital signs monitor

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

Oxygen saturation monitor

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

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

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

Feeding tube

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

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

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

Annie, mum to Alfie

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

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

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

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

Long lines

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

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

Phototherapy lamp or light blanket

If your baby has jaundice, they may be treated with blue light lamps (called 'phototherapy lamps') or a special light blanket (called a 'bili-blanket'). Jaundice (pronounced 'jawn-diss') is the name for yellowing of the skin and the whites of the eyes.

It is very common for newborn babies to get jaundice. In most cases it is harmless and goes away without needing treatment by the time your baby is about two weeks old.

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

The information in this section is due for review November 2025

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

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

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Support for you, your baby and your family.

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

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

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

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

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Premature baby

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

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Learning to suck swallow and breath when bottle feeding

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Learning to suck swallow and breath when bottle feeding

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Be prepared: what do you need?

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

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

Making up infant formula

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

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

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

How to spot 'early hunger cues'

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

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

Bond with your baby

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

Responsive feeding

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

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

How to hold your baby for bottle feeding

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

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

How to feed your baby using a bottle

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

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

'Pacing' feed

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

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

Winding your baby

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

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

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

Hot or cold milk?

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

Precious moments

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

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

Further information

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

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

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

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

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

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

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Bottle feeding resources

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Bottle feeding resources - Baby Friendly Initiative

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

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

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

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

The most common reasons for crying are:

hunger

a dirty or wet nappy

tiredness

wanting a cuddle

wind

being too hot or too cold

boredom

overstimulation

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

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

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

How to calm a crying baby

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

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

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

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

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

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

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

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

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

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

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

Ask your health visitor for advice.

Crying during feeds

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

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

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

You can also ask your health visitor for advice.

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

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

If your baby cries constantly

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

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

Colic

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

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

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

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

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

Call 999 and ask for an ambulance if your baby:

has a fit (seizure or convulsion)

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

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

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

is being violently sick a lot (projectile vomiting)

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

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

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

Getting help with a crying baby

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

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

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

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

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

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

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

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

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

Never shake your baby

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

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

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Safe administration of medications at home

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Medicines are not always needed for minor illnesses like coughs and colds in children.
If your child does need a medicine, it's important they have one that's right for their age and you know how to give it to them safely.

Paracetamol and ibuprofen for babies and children

Paracetamol and ibuprofen are safe for treating pain and a high temperature in babies and children. Both are available as liquid medicines for young children.

It's best to choose a sugar-free version. Medicines that contain sugar can harm your child's teeth.

Make sure you get the right strength for your child's age and check the label for the correct dose. Or you can ask a pharmacist for advice.

It's a good idea to keep one or both medicines stored in a safe place at home.

At what age can I give my baby paracetamol or ibuprofen?

You can give paracetamol to children aged 2 months or older for pain or fever.

You can give ibuprofen to children who are aged 3 months or older and who weigh more than 5kg (11lb).

If your child has asthma, get advice from a GP or pharmacist before giving them ibuprofen.

Do not give aspirin to children under 16 unless it's prescribed by a doctor. It's been linked with a rare but dangerous illness called Reye's syndrome.

If you're breastfeeding, ask your health visitor, midwife or GP for advice before taking aspirin.
Read more about breastfeeding and medicines

Antibiotics for children

Children do not often need antibiotics. Most childhood infections are caused by viruses. Antibiotics only treat illnesses caused by bacteria, not viruses.

If your child is prescribed antibiotics for a bacterial infection, they may seem better after 2 or 3 days. But it's important to always finish the whole course to make sure all the bacteria are killed off.

If you do not finish the whole course, the infection is more likely to come back. It also increases the risk of the bacteria becoming resistant to antibiotics.

Antibiotics work best if they are given at regular intervals. Giving them to your child at the same times each day may help you to remember.

Giving medicine to your child

Make sure you know how much and how often to give a medicine. Recording it in your child's Personal Child Health Record (PCHR, or red book) may help you remember.

Always read the label on the bottle, and stick to the recommended dose. If in doubt, check with a pharmacist, health visitor or GP.

Most medicines for young children come with a special measure called an oral syringe.

This helps you measure small doses of medicine more accurately. It also makes it easier to give the medicine to your child.

If you're not sure, your health visitor or pharmacist can explain how to use the syringe.

You can also watch a video from Great Ormond Street Hospital showing how to use an oral syringe.

Never use a kitchen teaspoon to give your baby or child medicine, because they come in different sizes.

Children and side effects from medicine

The leaflet that comes with a medicine will list any possible side effects.

If you think your child is reacting to a medicine - for example, with a rash or diarrhoea - speak to a GP, health visitor or pharmacist. In the evenings or at weekends you can call NHS 111.

Keep a note of the medicine's name in your child's red book for future reference.

Can you get over-the-counter children's medicines for free?

Some pharmacies run what's known as a minor ailment scheme for specific ailments, such as coughs and colds and diarrhoea and vomiting.

When pharmacies provide medicines as part of a minor ailment scheme, you get the medicines on the NHS. You will not pay a prescription charge for children under 16.

Not all pharmacies offer a minor ailment scheme, and the ailments covered by the scheme vary from area to area.

Children's medicine safety tips

Always check the expiry date - if you have any medicines at home that are out of date or your child no longer needs them, take them to a pharmacist to dispose of safely.

Never give your child medicines that have been bought or prescribed for someone else.

Always keep medicines out of your child's reach and out of sight.

Ask a pharmacist about storing the medicine - some need to be kept in the fridge or out of direct sunlight.

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Medicines are not always needed for minor illnesses like coughs and colds in children. If your child does need a medicine, it's important they have one that's right for their age and you know how to give it to them safely. Paracetamol and ibuprofen are safe for treating pain and a high temperature in babies and children.

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

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

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

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How to wash and bath your baby.

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

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Breast feeding resources

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

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Peeps HIE Charity | HIE Awareness & Support

Welcome to Peeps HIE

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

Some of the things we do include:

Provide information about HIE

Buddy/peer support

Counselling and therapy

Funding for equipment

Find out more about what we do...

Our Family stories

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

Read our Family Stories

Peeps on Twitter

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

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

#HeardOfHIE

2

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

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

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

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

From informational resources to emotional...

Twitter icon
View more

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Peeps HIE Charity | HIE Awareness & Support

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

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

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

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NHS information about ill or premature babies

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NHS information about ill or premature babies

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Neonatal care in hospital

Special care for babies is sometimes provided on the ordinary postnatal ward and sometimes in a specialist newborn (neonatal) area.

Having a baby in neonatal care can be worrying, but the staff looking after your baby should make sure you receive all the information, communication and support you need.

Not all hospitals provide specialist neonatal services, so your baby may be transferred to another hospital if they need special care.

Why babies need special care

Your baby could be admitted to neonatal care for a number of reasons, including when they:

are born early (premature)

are very small and have a low birthweight

have an infection

have jaundice

had a very difficult birth

are waiting for, or recovering from, complex surgery

Touching and holding your baby

The special care baby unit may seem strange and confusing at first, especially if your baby is in an incubator or on a breathing machine. There may also be tubes and wires attached to their face and body.

Ask the nurse to explain what everything is for and show you how you can be involved in your baby's care. You may be able to change your baby's nappy, wash them and change their clothing.

Once your baby's stable, you'll be able to hold them. The nurses will be able to help you take your baby out of the incubator and show you how to have skin-to-skin contact.

Your baby will benefit greatly from physical contact with you. You can talk to your baby as well - this can help both of you.

You should wash your hands carefully and dry them thoroughly before touching your baby.

Feeding

To begin with, your baby may be too small or too sick to feed themselves. You can express some of your breast milk, which can be given to your baby through a tube.

A fine tube is passed through their nose or mouth into the stomach. This will not hurt them.

Talk to a midwife at the hospital about how you can express breast milk for your baby. The hospital may have breast pumps you can use.

Your milk has particular benefits, especially if your baby is sick or premature, as it's enriched with proteins (such as antibodies), fats and minerals.

If your baby is not able to have your milk to begin with, the milk can be frozen and given to them when they're ready.

When you go home, you can express milk for the nurses to give while you're away. There's no need to worry about how much milk you produce - every bit helps your baby.

Incubators

Babies who are very small are nursed in incubators rather than cots to keep them warm. You can still have a lot of contact with your baby.

Some incubators have open tops, but if your baby's incubator does not, you can put your hands through the holes in the side of the incubator to stroke and touch them.

Newborn babies with jaundice

Jaundice in newborn babies is common because their livers are not fully developed. Jaundice will make their skin and the whites of their eyes look a bit yellow.

Babies with severe jaundice may be treated with light therapy (phototherapy). The baby is undressed and put under a very bright light, usually with soft eye pads or a special box over their head to protect their eyes.

The special light helps break down the chemical that causes jaundice. It may be possible for your baby to have phototherapy by your bed in the postnatal ward so you do not have to be separated.

Light treatment may continue for several days, with breaks for feeds, before the jaundice clears up. Sometimes, if the jaundice gets worse, your baby may need a blood transfusion. This is not common.

Some babies have jaundice because of liver disease and need different treatment. A blood test that checks for liver disease is done before phototherapy is started.

Find out more about how newborn jaundice is treated.

Babies with jaundice after 2 weeks

Many babies are jaundiced for up to 2 weeks after they're born, or 3 weeks in premature babies.

It's more common in breastfed babies and does no harm. It is not a reason to stop breastfeeding.

It's important to see your doctor within a day or 2 if your baby is still jaundiced after 2 weeks, especially if their poo is chalky white. This can indicate a liver problem.

A blood test will distinguish between jaundice that'll go away by itself, or jaundice that may need urgent treatment.

Babies with disabilities

If your baby is disabled, talk to people about how you feel, as well as about your baby's health and future.

Your GP, a doctor for newborn babies (neonatologist), a children's doctor (paediatrician) or your health visitor can all help you.

You can also contact the hospital Patient Advice and Liaison Service (PALS) or your social services department (through your local authority on GOV.UK) for information about local organisations that may be able to help.

The organisations listed here can offer help and advice:

Talking to other parents with similar experiences can often help.

Worries and explanations

Hospital staff should explain what kind of treatment your baby is being given and why. If they do not tell you, ask them.

It's important that you understand what's happening so you can work together to make sure your baby gets the best possible care.

Some treatments need your consent to go ahead, and the doctors will discuss this with you.

It's natural to feel anxious if your baby needs special care. Talk over any fears or worries with the hospital staff. Hospitals often have their own counselling or support services, and a number of charities run support and advice services.

The consultant neonatologist or paediatrician should arrange to see you, but you can also ask for an appointment at any time if you wish.

The hospital social worker may be able to help with practical issues, such as travel costs or help with looking after children.

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Find out about the special care given to babies born early (prematurely) or those who are sick, jaundiced or born with a disability.

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ICON offers advice and support for you and your new born

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

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

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

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

What is the blood spot test?

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

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

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

What does the blood spot test involve?

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

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

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

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

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

Which conditions is the blood spot test for?

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

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

Sickle cell disease

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Severe combined immunodeficiency (SCID)

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

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

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

Does my baby have to have the blood spot test?

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

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

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

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

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

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

When will we get the results?

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

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

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

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

You'll be contacted:

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

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

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

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

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

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

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

What do the results mean?

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

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

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

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

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

More information

Take our survey

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

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

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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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Congenital Diaphragmatic Hernia charity 

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Congenital Diaphragmatic Hernia charity 

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

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

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Information for parents about eye screening for premature babies

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Screening for retinopathy of prematurity - information for parents and carers

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

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Necrotising Enterocolitis | Nec Uk | England

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

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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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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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you think you or your child have missed any vaccinations

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

Your GP surgery can book or rearrange an appointment.

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

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

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We're consistently proud of the results that the young men who complete our 'Quest for Community' programme achieve; with 80% of participants either going on to not re-offend or reporting a much lower severity in their offending behaviour.

We achieve this success by bringing young men and adult role models together for an intensive rite-of-passage programme coupled with an accredited mentoring curriculum. This immersive journey both challenges and encourages the young men's growth, whilst providing them with the foundation of a lasting community and a wider network of support.

Our pioneering approach has been tailored to address the key contributors to offending behaviour identified both within the Social Exclusion Unit's report "Reducing Re-offending by Ex-prisoners" (2002) and equally the findings of the MOJ report "Transforming Rehabilitation: a summary of evidence on reoffending" (2013).

Our impact on the five primary areas highlighted in these reports can be seen in the outcomes below, that were taken from our most recent longditudinal evaluation in 2018.

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Support for you and your premature baby at home

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

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Unexpected beginnings- the neonatal unit 

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Unexpected beginnings- the neonatal unit 

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A podcast hosted by parents for parents, discussing some of the issues faced during the neonatal unit journey.

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Hosted by veteran neonatal parents, Caroline Verdon and Kerry Bickerdike, this podcast will hold your hand through every step of the neonatal journey whether your baby is premature or full term, well or needing surgery.

Having a baby on a neonatal ward is a traumatic experience no matter how well your baby is doing. The wires, the bleeps, the medical terminology can all add up to create an environment that can feel really isolating and worlds away from what you had expected when you first saw your baby on an ultrasound.

Through listening to other parents experiences and speaking to doctors, surgeons, mental health workers and everyone in-between, this podcast aims to make you feel less alone and more supported, signposting you to help and information along the way.

This podcast has been recorded with the help and support of Leeds Children's Hospital, Leeds Teaching Hospital NHS Trust and funded by Leeds Hospital Charity.

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Children's Neonatal Services, What We Do

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We look after babies with 3 sorts of problems: Those born very early or too small. Those who have problems in the way that they are made (congenital anomalies). Those who become ill around the time of birth with problems like infection.

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

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Link to the online SCBU family feedback form.

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Microsoft Forms is a web-based application that allows you to:

Create and share online surveys, quizzes, polls, and forms.

Collect feedback, measure satisfaction, test knowledge, and more.

Easily design your forms with various question types, themes, and branching logic.

Analyze your results with built-in charts and reports, or export them to Excel for further analysis.

Integrate Microsoft Forms with other Microsoft 365 apps, such as Teams, SharePoint, and OneDrive, so you can collaborate with others and access your forms from anywhere.

Explore templates

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Microsoft Forms - Free tool to create online surveys, forms, polls, and quizzes

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Use Microsoft Forms to easily create online surveys, forms, quizzes and questionnaires. AI powered, free survey tool from Microsoft.

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Registering your baby on the Isle of Wight 

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Registering your baby on the Isle of Wight 

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

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

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

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

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

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

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

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

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

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

Vitamin K for newborn babies

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

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

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

Stitches for tears or cuts

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

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

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

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

Preventing bleeding after the birth

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

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

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

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

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

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

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

Now read about you and your body after the birth.

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

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Skip to main content

There may be times when you need to express your breast milk. Have a look through our guide to expressing breast milk and bottle feeding.

Expressing your breast milk

Expressing milk means extracting milk out of your breasts so you can store it and feed it to your baby later. You can express breast milk by hand or with an electric or manual pump, whichever is more comfortable for you.

After you've expressed your milk, you can either give it your baby straight away, or store it in the fridge or freezer.

Why express breast milk?

There are various reasons why you may want to express milk, for example:

if your baby is premature or has problems after birth - you may not be able to breastfeed, but they can still have your expressed breast milk

you're returning to work or study

your breasts feel uncomfortably full

your baby isn't able to latch on or suck well

you want to boost your milk supply

when you start introducing solids, you may want to include some breast milk

If you do not need to express your milk straight away, it's best to wait until you and your baby feel happy and confident with breastfeeding before you start expressing milk regularly.

For confidential breastfeeding information and support, call the National Breastfeeding Helpline on 0300 100 0212. Lines are open 9:30am to 9:30pm every day.

Sign up now for our pregnancy, baby and toddler guide

Get personalised emails for trusted NHS advice, videos and tips on your pregnancy week by week, birth and parenthood.
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Read about how to express your breast milk using a manual or electric pump, or by hand, on Start for Life.

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Skip to main content There may be times when you need to express your breast milk. Have a look through our guide to expressing breast milk and bottle feeding. Expressing milk means extracting milk out of your breasts so you can store it and feed it to your baby later.

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Video content with practical advice and support

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Best Beginnings - creators of Baby Buddy

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Best Beginnings - creators of Baby Buddy

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

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Established by a neonatal parent and psychologist, Miracle moon is a popular source of support for NICU parents.

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There is power in community and in connection, it helps you to know that you are not alone, it is never just you feeling how you do.

We run an Instagram page where we provide free, accessible information to NICU parents, this community has grown over the past few years and is incredibly compassionate and engaged. Frankie is responsible for the educational & supportive content on our social media and works alongside Georgie as a graphic designer to bring the content to our audience.

Frankie creates posts which help to understand, name, and validate some common feelings you may have around your NICU experience. We also provide psychoeducation about how you can support yourself.

Some people have shared their story and written social media posts for us and blogs, if you would like to write for us or share your story, get in touch.

We have a closed Facebook group where people are able to talk to other like minded parents, who have similar experiences.

We also run a podcast, where we have spoken about common thoughts, feelings and some parents and professionals have shared their experiences.

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There is power in community and in connection, it helps you to know that you are not alone, it is never just you feeling how you do. We run an Instagram page where we provide free, accessible information to NICU parents, this community has grown over the past few years and is incredibly compassionate and engaged.

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How to use the Padlet

Use the heading column to find the information you need

Scroll down the column to see information

Click on the links to view information

Scroll right to find other heading

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Reducing the risk of infection for your baby

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Reducing the risk of infection for your baby

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

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Why do we need to keep babies safe from infection?

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

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

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

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

Spotting infections in babies

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

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

Key information to tell your health professional

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

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

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

🔸 Baby's biological mother:

Had any illnesses during pregnancy such as flu-like symptoms

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

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

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

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

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

Experienced symptoms of sexually transmitted disease during pregnancy

Travelled overseas during pregnancy

🔸 You or your baby:

🔸 Your baby has had contact with anyone who:

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

Useful links for spotting and preventing infections

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

Here are some other links you may find useful:

🟡 Neonatal Herpes

Click here for information about Neonatal Herpes

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

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

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

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

Click here for information about Group B Strep

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

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

Click here for information about Healthier Together

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

Click here for information about our free app

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

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

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

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

Kit's story

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

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

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

Why an otter?

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

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Keeping babies safe from infection - The Lullaby Trust

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

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

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Being a new dad is an amazing experience

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

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

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

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

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

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

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

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

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

A

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

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

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

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

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

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

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

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

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

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

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

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

B

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

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

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

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

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

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

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

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

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

C

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

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

Cannulae (pronounced can-you-lee)

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

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

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

Cerebral Function Monitor (sometimes called CFM)

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

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

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

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

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

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

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

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

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

D

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

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

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

Changing how your baby is disturbed

Massaging your baby

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

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

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

E

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

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

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

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

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

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

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

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

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

F

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

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

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

G

Gases and Gas monitor See 'Blood gases'.

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

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

Grunting A noise made by a baby with breathing difficulty.

H

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

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

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

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

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

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

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

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

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

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

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

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

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

I

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

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

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

Inotrope A medicine used to support blood pressure

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

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

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

J

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

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

L

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

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

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

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

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

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

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

M

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

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

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

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

N

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

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

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

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

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

NICU This stands for the neonatal intensive care unit.

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

NNU This stands for the neonatal unit.

O

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

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

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

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

P

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

R

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

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

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

S

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

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

SCBU This stands for special care baby unit.

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

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

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

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

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

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

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

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

Syringe driver See infusion pump above.

T

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

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

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

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

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

Transient tachypnoea of the newborn (TTN).

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

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

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

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

U

Ultrasound scan See 'Scans' above.

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

V

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

Ventricle (cardiac) - pronounced ven-trick-al

The pumping chamber of the heart.

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

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

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

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

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

The information in this section is due for review November 2025

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Words you might hear on the neonatal unit | Bliss

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

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

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

Before sterilising, you need to:

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

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

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

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

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

How to sterilise baby feeding equipment

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

cold water sterilising solution

steam sterilising

boiling

Cold water sterilising solution

Follow the manufacturer's instructions.

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

Change the sterilising solution every 24 hours.

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

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

Steam sterilising (electric steriliser or microwave)

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

Sterilising by boiling

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

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

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

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

After you've finished sterilising

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

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

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

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

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

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