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Welcome to Blackpool Neonatal Padlet. This page is ran by nursing staff on the neonatal unit who want to provide you with all the relevant information you may need if you and your baby require neonatal care at Blackpool Victoria Hospital. We hope you find the information published informative and useful.

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4Louis kindly donate all memory boxes to Blackpool Victoria Hospital for all angels of all gestations.

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SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS

SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS

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SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS SUPPORTING FAMILIES THROUGH MISCARRIAGE, STILLBIRTH AND CHILD LOSS

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Sands are a fantastic charity for help and support for grieving parents and family members.

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Sands - Saving babies' lives. Supporting bereaved families.

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Sands | Saving babies' lives. Supporting bereaved families.

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Sands works to support anyone affected by the death of a baby; improve the care bereaved parents receive; and create a world where fewer babies die.

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Blackpool Neonatal Unit 💜 (@blackpoolneonatalunit) on Instagram

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Lancashire & South Cumbria Neonatal Family Support - Believe In Miracles | Facebook

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Believe in Miracles is the Official Neonatal Parent Support Group across Lancashire and South Cumbria Hospitals. We provide parents with the opportunity to connect with a fellow parent who...

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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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WARNING: This page may contain potentially outdated information.

Retinopathy of prematurity is when the retinal blood vessels don’t develop normally in babies that are born earlier than their expected date of delivery.

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Quick links
– What is retinopathy of prematurity (ROP)?
– What causes ROP?
– How does ROP affect the eye?
– How common is ROP?
– How is ROP diagnosed?
– What is the treatment for ROP?
– How will ROP affect vision?
– Coping

What is retinopathy of prematurity (ROP)?

The retina is a delicate tissue made up of light-sensitive cells that lines the inside of the back of our eye. The retina converts light that we see into electrical signals that travel along the optic nerve to the brain. The brain interprets these signals so we can “see”. The retina is supplied with blood by a delicate network of blood vessels on its surface and by a layer of blood vessels underneath the retina.

Our retina needs a good blood supply to work properly. As a baby develops in the womb, the blood supply for the retina starts to develop around 16 weeks into pregnancy and only finishes around 40 weeks when a full-term baby is born. At full term, a baby's blood vessels are fully developed and can keep the baby's retina healthy.

If a baby is born too early then their retinal blood vessels don’t develop completely which can cause problems. Abnormal blood vessels may grow out of the retina and cause scar tissue to form, leading to detachment of the retina which can cause blindness. This damage is known as retinopathy of prematurity and if not monitored or treated at the correct time, can cause vision loss.

What causes ROP?

The reasons why babies develop ROP are complicated, but ROP is more likely to occur in babies that:

are born very prematurely – particularly those born before the 28th week of pregnancy

have a low birth weight of less than 1,500 grams

required oxygen treatment soon after they were born.

Often premature babies need additional oxygen which is necessary for the baby's survival but this can increase the risk of developing ROP.

Not all premature babies that need oxygen develop ROP. Paediatricians (hospital consultants that specialise in caring for children) monitor levels of oxygen a baby needs very carefully to ensure that enough oxygen is given for the baby’s survival while also taking into account the effects this may have on the baby's eye. Checks for ROP are a regular part of care for all premature babies born before 32 weeks or babies born weighing less than 1,500g (3lb).

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How does ROP affect the eye?

ROP mainly affects the retinal blood vessels. When the retinal blood vessels haven’t developed completely, the retina isn’t receiving enough oxygen so tries to grow new vessels. However, these new blood vessels grow abnormally and are fragile, can cause scarring and damage to the retina. The most severe forms of ROP are very rare but if left untreated, can lead to retinal detachment and blindness.

There are a few ways of describing the amount of ROP present in the eyes, which includes its location, extent and stage.

Location

The location on the retina is divided into three zones where zone 1 is the innermost and zone 3 is the outermost. The zones are centred around the optic nerve. This is because the blood vessels tend to grow from the area where the optic nerve leaves the eye called the optic disc.

Extent

The extent of ROP is described using clock hours. This refers to how much of the retina is affected by ROP. If you imagine the retina being divided up like a clock face: if there is ROP present from the bottom round to the left hand side, this would be equivalent to three clock hours.

Stage

Broadly speaking there are five stages of ROP. These stages describe what the ophthalmologist (hospital eye doctor) sees when they look into a baby's eyes.

Stage 1: This is where the junction of the central part of the retina that already has blood vessels and the peripheral part of the retina where blood vessels have not yet grown is marked by a demarcation line or a flat white line. Babies with stage 1 ROP usually recover without needing any treatment.

Stage 2: In stage 2, the demarcation line is raised and is more like a ridge. Babies with stage 2 ROP may recover without needing any treatment as well. These babies may require more regular check-ups to monitor progress.

Stage 3: Stage 3 is where new blood vessels start to grow out of the ridge. These blood vessels are very weak and they will cause vision problems if they start to scar. If there is also enlargement and tortuosity of the main normal blood vessels of the retina, this is known as “plus disease”. Stage 3 ROP with plus disease usually requires treatment.

Stage 4: In stage 4, the fragile new blood vessels that grow in stage 3 can contract (shrink) causing scarring which can pull the retina away from the back of the eye (partial retinal detachment).

Stage 5: Stage 5 is where the retina can become totally detached from the back of the eye (total retinal detachment). This would lead to permanent loss of vision.

Most babies with ROP only develop stage 1 and stage 2 with only a small number developing stage 3 and needing treatment.

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How common is ROP?

In the UK, about 65 per cent of babies who have a birth weight of less than 1,251 grams will have ROP. However, the majority of these babies will have mild ROP that doesn’t require treatment. There are only around six per cent of premature babies that will have advanced ROP requiring treatment (stages 3, 4 or 5).

The incidence of ROP is on the rise as more and more babies now survive when they are born prematurely. This means that there are more babies with ROP. Treatments are now offered at an earlier stage than in the past, so the sight threatening severe forms of ROP (stage 4 and 5) are rare.

How is ROP diagnosed?

All newborn babies that weigh less than 3lbs or 1,501g or babies born at or before 32 weeks of pregnancy will have at least one eye screening examination. An ophthalmologist will perform the screening and can diagnose retinopathy of prematurity. The first eye examination is done a number of weeks after birth. The timing of this is determined using a table based on the baby’s gestational age at birth.

Eye drops will be placed into the baby's eyes to enlarge the pupil which is necessary for the ophthalmologist to view the retina inside the eye clearly. Anaesthetic drops are also used so that the baby doesn’t feel any pain.

The ophthalmologist will use a special lens and light to view the retina which often only takes a few minutes. Often the doctor will use a speculum or a clip to help keep baby’s eyelids open while looking in the eye. They may also use an indentor, which is a tiny rod, to press gently on the eyeball so that the doctor can have a thorough look inside the eye. It’s not uncommon for your baby to cry during the procedure. Some centres may use a special camera to take pictures of the retina.

This screening will happen weekly or fortnightly until the risk of developing ROP requiring treatment has passed. If a baby has some signs of ROP then these examinations will continue until your baby’s due date.

Further details on timings and frequency of ROP screening for babies can be found in “Guidelines for Screening and Treatment of Retinopathy of Prematurity” produced by the Royal College of Ophthalmologists.

Following the eye examination, the ophthalmologist will then decide whether treatment is required.

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What is the treatment for ROP?

Many babies with ROP don't need treatment as it often resolves on its own.

If new blood vessels start to grow then treatment can be used to stop them causing more damage. Some babies will need more than one treatment.Usually treatment is done using a laser machine, but in certain circumstances treatment is done by injecting a drug into the eye. Treatment for ROP can be a distressing time for both parents and baby.

A baby will need to go on a ventilator which is a breathing machine and be intubated where a breathing tube is inserted in baby’s mouth for treatment; this means that your baby will be unconscious for the whole treatment. This is to ensure they are completely still and don’t experience any pain while the treatment is happening. Your baby’s heart and breathing are carefully monitored during the treatment. The treatment can take between one and two hours to complete. Most babies stay on the breathing machine for a day or two but sometimes can take longer to come off breathing support.

The treatment uses a laser to make small burns on the retina inside the eye. This can stop the new blood vessels from developing. Although the laser helps to safeguard vision, it can affect your baby’s peripheral or side vision.

Once the treatment is finished your baby’s eye may look red and swollen. Eye drops may also be required following treatment for a week or so, but the eye will no longer be painful. The baby's eye will need to be examined in about a week's time to check if the laser treatment has worked. Sometimes, further treatment will be required.

Another possible treatment option that is sometimes required for ROP is anti-vascular endothelial growth factor (anti-VEGF). The term “anti” means “against” and “vascular” refers to blood vessels. Anti-VEGFs are drugs that stop blood vessels from forming or growing and are given by injection into the eye. In the UK this treatment is for babies who do not respond to laser treatment or who are too sick to go back on the breathing machine. It is still not known what affect anti-VEGF injections into the eye might have on blood vessel development elsewhere in a baby, in particular on brain development.

In most babies early treatment is usually successful. This means that the abnormal blood vessels stop developing and a retinal detachment doesn't occur. In some babies the treatment may stop the retina from detaching, but their vision may still be affected; they may not recover all their sight after treatment.

In a baby with stage 4 ROP, surgical treatment such as a vitrectomy may be done. A vitrectomy procedure involves removing the vitreous gel in the eye and replacing it with a clear solution. The solution then holds the detached retina against the back of the eye. Some useful vision may be preserved by this type of surgery, especially if it is done very soon after stage 4 ROP has developed. Unfortunately, surgical treatment for stage 5 ROP rarely achieves useful vision.

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How will ROP affect vision?

Vision in children develops from when they are born up until they are around seven years old. It’s not possible for doctors to know what a baby's vision is like until at least six weeks after their original due date when vision “switches on”. Even then, as vision continues to develop during childhood, it may not be possible to know what a child’s vision is like until they are much older. However, doctors will be able to give an approximate estimate of how well each child is likely to be able to see, based on the health of the eyes, and of the brain.

Vision development depends on the health of the visual nerve pathways in the brain as well as of the eyes. Premature babies can have some areas of brain injury, usually caused by bleeding into the brain soon after birth. Unfortunately, some children who were born prematurely have poor vision due to brain injury, even if their eyes have not been damaged by retinopathy of prematurity.

Babies who have stage 1 and stage 2 ROP may not have any vision problems and therefore won’t usually require regular eye exams by an ophthalmologist. Often babies in Stage 1 and 2 would then only need to have the national vision screening which begins in school age at around the ages of 4-5 years. This is a vision check to make sure vision is developing normally in children. If you have any future concerns about your child’s eyes or vision, you should speak to your GP or optometrist (optician) who would be able to refer your child to an ophthalmologist.

Babies who have stage 3 ROP may be followed up in the hospital clinic according to the centre's protocol as they may be more likely to have eye problems. Babies who have had treatment will be regularly monitored for myopia or short sightedness and whether there are any long-term effects from the laser scars which can occasionally affect vision.

It’s likely that babies who have stages 4 and 5 ROP will have significant vision loss. Although vitrectomy surgery is successful in some of these babies, many have a poor visual outcome.

Although the incidence of ROP is rising due to more premature babies surviving, our knowledge and understanding of the condition has also increased. The number of babies with ROP requiring treatment still remains very small. There have been great improvements in the screening, diagnosis and treatment of ROP which has led to better visual outcomes for these children.

Babies who are born early are at higher risk for having vision problems, which aren't caused by ROP, when they grow older. Some of these problems may include:

myopia or short sightedness

squint

brain injury.

Myopia or short sightedness and squint can normally be corrected with glasses. Vision problems due to brain injury may be severe, and are then apparent at an early age. However, they may be mild and subtle and are then only recognised at an older age. Some of these milder problems consist of an inability to cope with a crowded visual environment (“crowding”), and reduced awareness of the lower visual field which can result in clumsiness while walking.

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Coping

It’s completely natural to be upset when your child has been diagnosed with an eye condition and it’s normal to find yourself worrying about the future. We’re here to support you every step of the way, and to answer any questions you may have – just get in touch with our Sight Loss Advice Service.

Your local authority (LA) should have at least one qualified teacher of visually impaired children (QTVI) to work with you and your child both at home and at school. QTVIs are qualified teachers who can provide support with development, play, learning and education. At an early stage, ask your local authority to put you in contact with a QTVI. They will support you and your child as soon as a vision impairment is suspected or diagnosed. If you have difficulty getting help, or need the details of the specialist teacher in your area, contact our Helpline.

Useful contacts

Bliss is the UK’s leading charity for babies born premature or sick.

LOOK, the national federation of families with visually impaired children, brings together families of children with visual impairment.

Guide Dogs offer a range of services and activities for children and young people, and also provide advice for parents and teachers.

VICTA supports children and young people who are blind or partially sighted and their families across the UK.

The Royal College of Ophthalmologists has guidance on ROP.

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You might also be interested in...

Our children, young people and education services

Eye clinic appointments: a guide for parents

Who does what in eye health

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About this guide

Last updated: March 2018
Next review: March 2021
Eye health information disclaimer

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Retinopathy of prematurity (ROP) is when the retinal blood vessels do not develop normally in babies that are born prematurely.

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Infant crying is normal and it will stop! Babies start to cry more frequently from around 2 weeks of age. Click on this LINK to read more about infant crying.

Comfort methods can sometimes soothe the baby and the crying will stop. Is the baby hungry, tired or in need of a nappy change? Click on this LINK to download some comfort techniques.

It's okay to walk away if you have checked the baby is safe and the crying is getting to you. After a few minutes when you are feeling calm, go back and check on the baby.

Never, ever shake or hurt a baby. It can cause lasting brain damage and death.

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This page contains information that you or parents you know may find useful. Please feel free to share, download and use the content on this page. Infant crying is normal and it will stop! Babies start to cry more frequently from around 2 weeks of age.

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