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Call the Helpline 0808 8088 100

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We are here to make sure that the 99,000 seriously ill children and their families across the UK can make the most of every moment they have together, whether that's for years, months or only hours.

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Hypoxic-ischaemic encephalopathy (HIE) may be diagnosed if your baby’s brain does not receive enough oxygen and/or blood flow around the time of birth

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What are the long-term effects of HIE?

While some babies with HIE recover fully and have no long-term problems, others may develop difficulties that need help and support from healthcare professionals, such as physiotherapists or speech and language therapists.

If your baby has had cooling treatment, you will meet with your baby's doctor to talk about your baby's MRI scan results. They will also talk to you about your baby's behaviour and progress. This will be used to make a plan for further assessment and follow-up. The amount of appointments your baby will have will depend on their needs.

All babies who have been affected by HIE will need their development monitored closely, particularly during the first 2 years of their life.

When your baby is between 18 months and 2 years old, a healthcare professional will look at your baby's progress in the following areas of their development:

Motor (your baby's ability to move around and hold and grasp objects).

Sensory (your baby's sight, touch, taste, smell and hearing).

Language (your baby's ability to communicate and understand language).

Cognition (how your baby learns to think and reason).

This assessment can help to provide a better understanding of how your child is developing and can help to answer any concerns that you may have.

Some babies will develop cerebral palsy, which is a physical condition that affects movement, posture and co-ordination . Some babies may develop problems with their eyesight and hearing, or have learning or behavioural difficulties. Some babies will go on to develop epilepsy, which is a condition that affects the brain and causes seizures.

Knowing that your baby could have long-term problems as a result of their HIE can be frightening and overwhelming at first, but there is support available. At the bottom of this page we have listed some organisations and sources of support that can help.

Sadly, some babies will die of HIE. We have more information about making critical care decisions, palliative care and bereavement, and link to some more sources of support further down this page.

Where can I get more help and support?

Having a baby in intensive or special care can be a stressful experience. Having a baby who is unwell can make you feel out of control of your situation. Some parents feel grief or loss as they lose or let go of hopes and plans they had. Having a baby with HIE is always unexpected.

How you feel and process what has happened to you might be different to others who face these challenges. Feeling this way is very common.

If you are unsure about any part of your baby's diagnosis, treatment or care, the staff on the unit will help you in any way they can. It is okay to ask again if you need information repeated or made clearer. The team will understand and want to support you.

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

Peeps HIE charity - Provides support to parents affected by HIE, and raises awareness.

Hope for HIE - Works to improve the quality of life for children and families affected by HIE through useful resources and support.

The Birth Trauma Association - Provides support to women who have had a traumatic birth experience.

The Rainbow Trust - Provides emotional and practical support to families who have a child with a life-threatening or terminal illness.

Sands - A charity that supports anyone affected by the death of a baby.

Scope - A charity that supports disabled people and their families through practical information and support, particularly at the time of diagnosis.

Together for Short Lives - A charity for children with life-threatening and life-limiting conditions.

Epilepsy Action - Provides advice and support to anyone affected by epilepsy.

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Hypoxic-ischaemic encephalopathy (HIE) | Bliss

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Find out more about hypoxic-ischaemic encephalopathy (HIE) is, the signs to look out for in your baby, and the treatment available.

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Repatriation (when your baby is ready to move on)

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Repatriation (when your baby is ready to move on)

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A short 5 minute animation

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Transfer Closer to Home: The neonatal repatriation of your baby

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Premature Babies - clothes made for them

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Premature Babies - clothes made for them

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SuperDinky was born from a shared passion for supporting NICU and SCBU families. We’re Lorna and Beth—two mums whose journeys brought us together in the world of neonatal care

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We are on a mission to bring JOY to the NICU/SCBU. Shop our beautiful bright joyful vests and blankets for your baby or as a gift to your NICU.

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Rainbow Trust (practical and emotional support for parents with a child who has a life threatening or terminal illness)

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Rainbow Trust (practical and emotional support for parents with a child who has a life threatening or terminal illness)

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Any family can receive support from the moment of their child or young person’s diagnosis, (including antenatal and neonatal periods when diagnosis has been made)

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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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South West Neonatal Network - A Stay in Neonatal Care - An Animated Guide to your... (RUNNER UP)

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MNVP Neonatal Care padlet poster with QR code

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MNVP Neonatal Care padlet poster with QR code

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Please print, laminate and display where you can so that more parents are aware of the support that is available.

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Padlet_Posters_Neonatal QR code July 2025

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Promoting family connection, involvement and skin-to-skin contact from birth, throughout your Neonatal journey and at home

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The SW Cuddle Bundle is a collaboration of quality improvement projects from around the region. Originating with the Cuddle Bundle project from Plymouth NICU, where the team observed a need to further support families with the frequency and duration of skin-to-skin contact 'Kangaroo Care' cuddles with their babies. They implemented staff education and strategies to improve their practice.

Plymouth's work has been combined with other quality improvement projects from around the South West region to develop a bundle of care aimed at increasing closeness and connection for every baby and family from birth, throughout their neonatal journey and at home. The bundle focuses on the following 5 main elements:

Early and frequent skin to skin contact cuddles

Implementation of Kangaroo Care Cuddle Wraps©

Cuddles and parental involvement during painful procedures

The bundle also includes the consideration for kangaroo care during transport, drawing on the KaKoon project within the SONAR transport service and cuddles during therapeutic hypothermia treatment with support from the CoolCuddle study.

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Skin-to-skin - South West Neonatal Network

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The SW Cuddle Bundle is a collaboration of quality improvement projects from around the region. Originating with the Cuddle Bundle project from Plymouth NICU, where the team observed a need to further support families with the frequency and duration of skin-to-skin contact 'Kangaroo Care' cuddles with their babies.

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3D Virtual Tours of Neonatal Units in South West

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3D Virtual Tours of Neonatal Units in South West

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Barnstaple

Bath

Bristol (Southmead)

Bristol (St Michael's)

Exeter

Gloucester

Plymouth

Swindon

Taunton

Torbay

Truro

Yeovil

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Services 1 - South West Neonatal Network

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The network consists of 12 neonatal units and one neonatal transport service. Find information about each of these services, including a virtual tour, below.

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Parent and Family area of South West Neonatal Network

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Parent and Family area of South West Neonatal Network

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Here you will find information to support you on your neonatal journey and beyond. Information about groups you can join online/in person.

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Parents & Families — South West Neonatal Network

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The SuPPORT Project: Supporting Parents and Professionals through NeOnatal Resuscitation in Theatre

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The SuPPORT Project: Supporting Parents and Professionals through NeOnatal Resuscitation in Theatre

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Supporting healthcare practitioners to provide high quality communication during neonatal resuscitation.​

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Investigating communication during Neonatal Resuscitation | The SuPPORT Project

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The SuPPORT Project: Investigating current practice of communication between the anaesthetic team, mothers and birth partners during neonatal resuscitation in obstetric theatres. Raising awareness. Developing high quality guidance and resources.

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The Smallest Things - Premature Baby Charity (UK)

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The Smallest Things - Premature Baby Charity (UK)

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Because prematurity doesn’t end when you leave NICU.

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We've been there too

It's impossible to know what it's like behind NICU doors unless you've walked those corridors, scrubbed your hands, heard the alarms and felt the fear of losing the most precious thing in the world to you. We get it because we've been there too. The Smallest Things is run entirely by volunteers who've had premature babies. And that's exactly what inspires us to support families, raise awareness and instigate change. We believe in a better world for families of premature babies. A world in which parents have the time they need before returning to work, without money worries; the support they need after they leave the hospital; and the reassurance that they are not alone on their journey. Because prematurity doesn't end when you leave NICU.

Founder and chair
Catriona is a paediatric occupational therapist, with nearly twenty years experience working with children, young people and families. She was chair of the Royal College of Occupational Therapists Specialist Section for Children and Young People (2009 - 2011) and founded the Smallest Things premature baby charity in September 2014 following the premature birth of both her sons. Having worked in NHS hospitals, including in neonatal intensive care units, for many years, Catriona now works with children and young people in the community, specialising in Special Educational Needs.

Communications director
Sarah cut her teeth as a journalist at the BBC in 2002 and now works in content marketing for global brands with a focus on health and family. As Editor of Tesco Magazine she oversaw Cancer Research UK's Race for Life magazine and ran communications workshops for CLIC Sargent. A former parent adviser for Bliss, she currently volunteers for TAMBA (Twins and Multiple Birth Association) Bereavement Support Group. Sarah gave birth to premature twins at 28 weeks and spent over six months in NICU before her youngest died from surgical complications.

Strategy director
Matt works in the public sector and has held jobs in homelessness and children's services at Birmingham City Council during his 12 years with the local authority. He is currently Head of Business Change at Core Assets, one of the UK's largest independent providers of children's services. Matt and his wife, Sally, had their daughter Isabelle at 34 weeks' gestation back in 2011 and then twin boys Harry and Sam at 25 weeks' gestation in 2015. Sadly, Sam was too fragile and passed away at 16 days old. After various fundraising events and activities raising money as #prematurerockstar for different premature baby charities, including The Smallest Things, Matt became one of our Trustees in 2018.

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Who We Are - About - The Smallest Things

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We get it because we've been there too. The Smallest Things is run entirely by volunteers who've had premature babies. And that's exactly what inspires us to support families, raise awareness and instigate change. We believe in a better world for families of premature babies.

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Financial help with travel costs to be with your baby in NICU

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Financial help with travel costs to be with your baby in NICU

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Call Patient Advice Liaison Service (PALS) or Patient Support and Complaints (PCST) for more information about claiming

RUH Bath: 01225 825656

GWH Swindon: 01793 604031

SFT Salisbury: 01722 429044

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

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The Neonatal Care (Leave and Pay) Act 2023 – a new leave and pay entitlement for parents with a baby in neonatal care

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The Neonatal Care (Leave and Pay) Act 2023 – a new leave and pay entitlement for parents with a baby in neonatal care

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Neonatal Care Leave and Pay: Guidance and FAQs | Bliss

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The Neonatal Care (Leave and Pay) Act 2023 – a new leave and pay entitlement for parents with a baby in neonatal care – comes into effect in England, Scotland and Wales on 6 April 2025.

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You and your partner may be able to get paid time off work if your newborn baby is premature or sick and needs neonatal care.

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

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If your baby or babies are at The Dyson Centre Neonatal Unit in Bath, you may have the opportunity to stay close by in one of the 4 NICU 'Flats'. Each room comes with an en-suite bathroom and access to a private shared courtyard with other neonatal parents.

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Our colleagues at Salisbury Foundation Trust Neonatal unit have put together this wonderful resource padlet for parents.

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This information leaflet is for parents whose babies are on the Neonatal Unit or being cared for under the Transitional Care Pathway on the post-natal ward Mary ward

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Transitional Care Pathway for parents

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Mondays, 10am - 11.30am, Bear Flat (Bath)

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Mondays, 10am - 11.30am, Bear Flat (Bath)

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A weekly group for children from birth up to 2 years who are not reaching their developmental milestones for whatever reason.

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Babies born premature or sick often have different nutritional needs.

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Babies born premature or sick often have different nutritional needs.

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Some premature and sick babies will need more nutrients in addition to breast milk. They may be given supplements, such as a breast milk fortifier, to increase the amount of nutrition in their milk.

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

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

How to know if your baby is getting enough nutrition

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

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

Are growing and gaining weight

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

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

Parenteral nutrition (PN)

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

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

Colostrum and first milk

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

Breast milk

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

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

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

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

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

It improves brain development.

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

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

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

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

Supplements and fortifiers

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

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

We have more detailed information about expressing milk and breastfeeding.

Donor milk

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

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

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

Formula

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

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

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

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

We have more information about bottle feeding your baby.

Combination feeding

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

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

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Infant crying (Babies born prematurely) ICON

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Infant crying (Babies born prematurely) ICON

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Special Considerations for premature babies being discharged from Neonatal Units

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Reality of having a baby born fifteen weeks too early (book)

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Reality of having a baby born fifteen weeks too early (book)

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Premature birth and neonatal care, and the impact they've both had on non-fiction author, Amy Brett, and her family's mental health, wellbeing and stability.

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Find about more about premature birth and neonatal care, and the impact they've both had on non-fiction author, Amy Brett, and her family's mental health, wellbeing and stability.

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Thames Valley & Wessex cover Salisbury Maternity & Neonatal Unit

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Thames Valley & Wessex cover Salisbury Maternity & Neonatal Unit

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Click on the hospitals below to find out more about the units within our network and to view each unit's individual website. To find out more about where each unit is situated across our region, you can also visit our interactive map.

Accessibility Toolbar

close Toggle the visibility of the Accessibility Toolbar

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Unit Information - Neonatal Network South East

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Click on the hospitals below to find out more about the units within our network and to view each unit's individual website. To find out more about where each unit is situated across our region, you can also visit our interactive map.

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RUH Dyson Centre Bath - Emotional Support whilst on the neonatal unit

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RUH Dyson Centre Bath - Emotional Support whilst on the neonatal unit

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Information about the psychology service

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RUH Dyson Centre in Bath welcome feedback. Please scan the code or ask the staff for a paper copy.

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RUH Dyson Centre in Bath welcome feedback. Please scan the code or ask the staff for a paper copy.

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If your baby is in RUH Dyson Centre in Bath or being cared for by the neonatal care team then you can access their Psychologist 

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If your baby is in RUH Dyson Centre in Bath or being cared for by the neonatal care team then you can access their Psychologist 

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Understanding your preterm or sick baby in hospital

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Understanding your preterm or sick baby in hospital

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FREE course to UK parents. Code given to gain access when you sign up.

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A helpful resource for those who are likely to receive care for their babies here (eg. multiple babies, underlying health conditions)

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Information Services Department, Royal United Hospital

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Royal United Hospitals Bath NHS Foundation Trust

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https://www.ruh.nhs.uk - Royal United Hospitals Bath NHS Foundation Trust

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Bath & North East Somerset, Swindon and Wiltshire (BSW) Maternity Voices Partnership Plus

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​While we make every effort to keep these padlets up to date, we make no warranties or representations that the information will be:

As an MVP, we are not liable for any loss or damage that may come from using these padlets. We are unable to endorse the information held on third party websites, it is for information only.

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Resources - Bath North East Somerset, Swindon and Wiltshire Maternity Voices Partnership Plus

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​While we make every effort to keep these padlets up to date, we make no warranties or representations that the information will be: As an MVP, we are not liable for any loss or damage that may come from using these padlets.

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Feedback anonymously about care at Bath (Dyson Centre), GWH Swindon and Salisbury Foundation Trust.

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Leave Feedback - Bath North East Somerset, Swindon and Wiltshire Maternity Voices Partnership Plus

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We as your Maternity voices parternership want to hear the voices of all parents. You can find us at groups across the region and we're always keen to come somewhere new so please reach out if you would like us to come to your group / event / meet up to talk about the experiences of maternity services.

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Debbie is your Bliss Champion. She

provides a listening ear, emotional support and information to families like yours with babies on the unit. Available Tuesdays 11am til 1pm

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I am here to provide a listening ear, emotional support and information to families like yours with babies on the unit.

When I am available

If you want to talk to someone in confidence, we will be available on the unit every Tuesday from 11:00am-1:00pm.

For further support, please email hello@bliss.org.uk.

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I am here to provide a listening ear, emotional support and information to families like yours with babies on the unit. When I am available If you want to talk to someone in confidence, we will be available on the unit every Tuesday from 11:00am-1:00pm. For further support, please email hello@bliss.org.uk.

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Swindon (GWH) Neonatal Social Share and Support (Facebook) 

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Swindon (GWH) Neonatal Social Share and Support (Facebook) 

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For staff to share information related to work, social events organised for work colleagues and to support each other. Open to all staff working on Swindon Neonatal Unit either permanent or regular bank.

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Swindon Neonatal Social Share and Support | Facebook

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For staff to share information related to work, social events organised for work colleagues and to support each other. Open to all staff working on Swindon Neonatal Unit either permanent or regular bank.

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Bath (RUH) NICU Bliss Babies (Facbeook) 

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Bath (RUH) NICU Bliss Babies (Facbeook) 

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This group is for the parents of babies, or the babies themselves if they are now all grown up, who have spent time at RUH Bath NICU.

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This group is for the parents of babies, or the babies themselves if they are now all grown up, who have spent time at RUH Bath NICU. This group is to share our experiences of our time at NICU and...

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This page is not monitored all the time. Please do not seek medical advice via this facebook page.

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Welcome to the Bath Neonatal unit facebook page. This page is not monitored all the time. Please do... combe park, ba1 3ng Bath, UK

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Ask your midwife about this system and if it's available to you if your baby or babies are in NICU.

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Ask your midwife about this system and if it's available to you if your baby or babies are in NICU.

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vCreate is an NHS Trusted secure video messaging service that helps patients, families and clinical teams stay connected throughout their care journey

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Trusted by healthcare partners around the world

vCreate Neuro
Secure video service to support clinical teams with remote diagnosis, management and decision-making.

How it works:

Invited patients/carers upload videos, photos and clinical data

Clinicians review uploads and respond to patients/carers within the app

All uploads and data can be shared with colleagues and integrated with the Electronic Medical Record

Find out more

vCreate Diaries
Secure video diary service to provide reassurance and help minimise separation anxiety for families in Neonatal Units.

How it works:

Unit staff take videos and photos to securely upload

Families are notified and log in to access on any device

Videos and photos can be downloaded to keep forever

Find out more

As featured on

What clinicians are saying

vCreate Forms

vCreate Forms helps clinical teams streamline clinical processes and improve the patient experience.​

Teams can create, import and digitise existing forms and schedule reminders for patients, families and staff. Published forms can be accessed and responses monitored remotely, uploaded to the Electronic Medical Record and shared with other services to standardise care.

Read more about vCreate Forms

​

What patients and families are saying

I have wanted this access to share videos with the neuro team for several years now. I'm so pleased we can now do this. It helps the parents, the medical team and also getting what's right for the patient.

I recommend this service to every parent in my position. I am beyond grateful to the staff for sending me my little videos. You can always have another peek at them, and they just keep you sane in the knowledge that they are getting the best care possible. All hail EVERY neonatal staff member, as they all go out of their way to make your journey as stress free as possible. Unbelievably grateful.

Very easy to use, and thanks to the online service it saves a lot it time but also gives us reassurance that the behaviour will be assessed and if needed further action taken.

Enhanced Security and Clinical Safety

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Secure video technology for healthcare transformation

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A Secure Video service for healthcare connecting patients, families and clinical teams for improved diagnostic management and enhanced family-focused care

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PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth)

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PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth)

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Launched in April 2020, this is a perinatal care bundle to improve the outcomes for premature babies across the West and South West regions. The bundle consists of eleven interventions that demonstrate a significant impact on brain injury and mortality rates amongst babies born prematurely.

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Launched in April 2020, PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) is a perinatal care bundle to improve the outcomes for premature babies across the West and South West regions. The bundle consists of eleven interventions that demonstrate a significant impact on brain injury and mortality rates amongst babies born prematurely.

Links to each of the bundle elements and resources for implementation can be found at the bottom of this page.

View the PERIPrem baby and clinical passports.

At the 2021 HSJ Patient Safety Awards, PERIPrem was highly commended as the Patient Safety Pilot of the Year. PERIPrem was also shortlisted for Provider Collaboration of the Year at the 2021 HSJ Awards.

PERIPrem has achieved life changing, sustainable improvements to the way the most vulnerable babies are cared for and accelerated perinatal working culture and innovation. As of December 2021, 1,094 babies have been cared for using the bundle. As measured by the National Neonatal Audit Programme’s (NNAP) latest report, units across the South West achieved, on average, the:

highest rate of delayed cord clamping (by over 21%),

third lowest rates of mortality to discharge,

the second lowest rates of necrotising enterocolitis,

alongside the fourth highest administration levels of magnesium sulphate (MgSO4) across England.

Read more about PERIPrem’s impact in our case study. In April 2022, NHS Confederation also published a PERIPrem case study.

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We are working with The South West Neonatal Network, Health Innovation Network (HIN), British Association of Perinatal Medicine (BAPM) and other organisations to ensure the PERIPrem bundle is at the forefront of innovation and research.

PERIPrem is not just about implementing a care bundle. It is about forging a new way of working, where clinicians from obstetrics, midwifery and neonatal join together to drive forward and revolutionise care for pre term babies. Read more about the project.

As of April 2021, PERIPrem became part of the West of England’s local activity to deliver the ambitions of the NHS  Maternal and Neonatal Safety Improvement Programme.

Watch our short video where parents of premature babies give their accounts of how their births were affected by the implementation of the PERIPrem care bundle:

Perinatal equity

Want to be part of a network to explore improvements and improve equity outcomes for parents across the West of England and beyond? Find out more about our Regional Perinatal Equity Network.

Resources to implement PERIPrem

Official PERIPrem resources have received Neonatal Nurses Association (NNA) endorsement. They were also recommended in the latest GIRFT Neonatology Report.

Our resources page contains all of the current clinical tools and documents that will support teams on a PERIPrem journey. This includes a number of documents in both English and other languages that are designed to help inform and fully involve parents in the care of their preterm baby.

Our useful materials page  contains general resources and playlists of key videos.

The PERIPrem bundle elements

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The PERIPrem care bundle | West of England AHSN

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Launched in April 2020, PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) is a perinatal care bundle to improve the outcomes for premature babies across the West and South West regions. The bundle consists of eleven interventions that demonstrate a significant impact on brain injury and mortality rates amongst babies born prematurely.

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Black Maternity Matters: maternity care improvement project

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Black Maternity Matters: maternity care improvement project

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Last week two important reports demonstrating racism across UK Maternity services were released. In this week’s article Ann Remmers, Maternal and Neonatal Clinical lead, West of England Academic Health Science Network, shares a co-produced project to improve the care of Black women in the South West Region.

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In May Birthrights UK published the findings of their year-long inquiry into racial injustice and human rights in UK maternity care, ‘Systemic racism, not broken bodies’.

“The report uncovers the stories behind the statistics and demonstrates that it is racism, not broken bodies, that is at the root of many inequities in maternity outcomes and experiences.”

Listening to testimony from Black and Brown women and birthing people, as well as lawyers and health care professionals, they conclude that systemic racism in maternity care exists and set out a call to action to all parts of the maternity system.

The findings will come as no surprise to many maternity care providers where the evidence has been clear for some time that Black and Brown women and birthing people experience disproportionately poorer outcomes than their white counterparts (MBRRACE, 2018).

Two weeks ago our perinatal team at the West of England Academic Health Science Network held a very special event as we launched our Black Maternity Matters project .   Inspired by the vision that one day Black mothers will no longer be disproportionately in danger during pregnancy and the first year after birth, Black Maternity Matters is a partnership between our organisation and some amazing people who are leading the way in making a significant difference to the lives of Black people and their experiences of maternity care. As a team who are working on the national Maternity and Neonatal Safety Improvement Programme, we are supporting organisations to improve safety for Black and Brown women and families to reverse the stark statistics on outcomes.  Black women are four times more likely to die during pregnancy or in the postnatal period than White women, while stillbirth rates of Black and Black British babies are over twice those for White babies (MBRRACE, 2021).

We wanted to find a way to make a tangible difference to improving outcomes for Black women and birthing people and had an idea to form a collaborative of maternity organisations and health care professionals to develop bespoke cultural competency training for midwives and maternity support workers in co-production with partner organisations.

Sonah Paton and Aisha Davies

It was important to us to involve people with lived experience of the issues we wanted to address. Fortuitously my colleague, Noshin Menzies and I met Sonah Paton and Aisha Davies from Black Mothers Matter in 2021.  Together with their friend Yomi Oluwatudimu they decided to form Black Mothers Matter following their own experiences during pregnancy and childbirth with the “vision that one day Black mothers are no longer disproportionately in danger during pregnancy and the first year after birth.”

Listening to Sonah and Aisha’s stories was very moving for us and highlighted the racial discrimination that sadly exists and impacts on childbirth experience as well as outcomes. These three friends are incredible women who set about supporting other Black women through childbirth.

Sadly, when they approached local maternity units for support their emails were never answered. As a midwife I found this so upsetting but it highlighted to me how difficult it can be for those who are not given a voice to make themselves heard.

We asked Sonah and Aisha what they would like to happen if we could “wave a magic wand”. They told us that we needed to go further than providing training, by supporting professionals to make real change and giving them the confidence to be allies and support other staff in their learning about the impact of racism.

This led us to develop our project idea further to include quality improvement support for the participating midwives to enable them to translate their learning into action. By being part of a learning collaborative participants would be able to support each other through a frank and honest journey to implement lasting and meaningful change.

Through the luck of good timing, we were very fortunate to have the opportunity to apply to the Health Foundation for funding to support local learning initiatives as part of the Q community. We felt we had hit the jackpot when we were awarded £20,000 towards funding for our Black Maternity Matters project. This enabled us to fund the training package, engage some fantastic experts and provide some protected time for our midwife champions.

We approached Bristol, North Somerset and South Gloucestershire (BNSSG) Local Maternity and Neonatal Systems (LMNS), , and not only were they keen to take part in supporting the pilot but they also successfully bid to their Integrated Care System (ICS) for additional funding. This has enabled 17 midwives and maternity support workers to be released to attend the six-month programme, and more time for our midwife champions.

The training programme has been developed and is led by two people with a proven track record of providing excellent cultural competency training, Katie Donovan-Adekanmbi from BCohCo https://www.bcohco.com/ and Aisha Thomas from https://www.repmatters.co.uk/

We cannot believe how incredibly lucky we were to meet these two inspiring women with all their experience, and for them to want to work with us on this project was just what we needed.

As soon as we set up the project, we wanted to involve two of our local trusts to take part in our pilot programme. We really hoped that they would want to be involved and agree to support their maternity staff to take part in the programme. We talked to the leads from the Local Maternity and Neonatal System and the two Heads of Midwifery from the two trusts, University Hospitals Bristol and Weston NHS Foundation Trust and North Bristol NHS Trust.  We listened to any questions or concerns they had about the project. It was key that it worked for both maternity services and engaged their staff to want to take part in the programme. If we could not convince them, then the project may fail.

While they fully supported what we were trying to do, there was an understandable concern about releasing staff to take part. This was at a very difficult time for maternity units who were experiencing major staff shortages due to the Covid pandemic. The timing was right though as there was a real desire to address health inequities, particularly in maternity care, and we were able to make changes to the delivery of the project without compromising on the content or length.

The national Maternity Equity strategy  and the NHS Core20Plus5 approach had also just been launched and trusts and LMNSs were developing their own equity plans and submitting them to the Regional Maternity and Perinatal Network. The Black Maternity Matters collaboration was able to support this momentum by bringing together people who really want to make a positive difference to the maternity experience and outcomes for Black families.

Our training kicked off in early May and takes the participants through exploring their own feelings and background, examining their unconscious biases and how those impact on others. Our midwife champions both work for the trusts involved and have put themselves forward to take an active and leading role in the programme and bring with them an enthusiasm and passion for the programme. They will be working with the trainers to ensure that the programme reflects the issues facing maternity staff daily.

We are also recruiting Black parents to join our programme to ensure that real life experiences are used to further shape the training and that the participants are fully supported in their development and learning. A book club and action learning set provide support and interaction in between each of the three training days. The programme is flexible to allow learning amongst the participants to influence the programme as it develops.

The Black Lives Matter movement brought into sharp focus the shocking inequalities experienced by people based on the colour of their skin. It not only raised awareness but led some of us to examine our own prejudices, which we may previously have been unaware of. These words by George Floyd’s brother really resonated with me: “educate yourself”. Our outlook on the world is based on our personal experiences, race, ethnicity, socio-economic background. As a starting point we can look at ourselves, our identity, and our influences and how this may impact on others.

Opening our eyes to racism and the part we all play in this is the first place to start. “But I’m not racist” is often said when faced with the stark reality. But I have learnt that first you must look at yourself, your experiences, your background to find out what is influencing the way you view racism. It is not an easy journey but if you are prepared to start it you will be rewarded with knowing that you will make an impact on reducing the disadvantages of racism.

My own learning began when I attended a weekend workshop last year accredited by the Royal College of Midwives (RCM) and run by the Sheffield Maternity Cooperative. This was the start of my journey of learning about racism and how I could make a difference and I will be forever grateful to them for this.

I have had the privilege of meeting some incredible Black and Brown women who have taught me so much. I feel saddened by hearing of their experiences and how they have been made to feel less important and less special at such a unique and significant time in their lives when they are becoming a mother.  Now is the time for all of us, particularly from within maternity services to ensure that the voices of Black and Brown women and families are heard, and that we take up the mantle as professionals to advocate for and ease the burden and trauma on those brave enough to speak out.

It is time to dismantle the systemic racism within our NHS.

This is why I’m so proud of our new project, which brings together midwives and maternity staff from across two Bristol maternity services with a shared ambition to improve outcomes for Black women and birthing people and their babies.

As a local collaborative, the project provides psychological safety and peer support where the midwives and maternity support workers can explore the issues and what changes can be made in how we provide more equitable maternity services and care. Our vision is that as the programme develops, we will undoubtedly learn more and will be able to share our learning to enable wider participation. Translating learning into improving quality of care to benefit everyone involved, carers and families, values the significance of addressing racism.

Ultimately our goal is to support maternity organisations to be anti-racist and for outcomes and experience for all Black and Brown women and birthing people to be better.

Ann Remmers,

Maternal and Neonatal Clinical lead, West of England Academic Health Science Network,

May 2022

Find out more about the Black Maternity Matters project at www.weahsn.net/black-maternity-matters.

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Black Maternity Matters: maternity care improvement project - Maternity & Midwifery Forum %

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Last week two important reports demonstrating racism across UK Maternity services were released. In this week’s article Ann Remmers, Maternal and Neonatal Clinical lead, West of England Academic Health Science Network, shares a co-produced project to improve the care of Black women in the South West…

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Salisbury Parents: PAG - Parent Advisory Group 

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Salisbury Parents: PAG - Parent Advisory Group 

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The Thames Valley & Wessex PAG always welcome new members. Contact: england.tv-w-neonatalnetwork@nhs.net for further information.

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Supporting you when your baby is sick or premature

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Supporting you when your baby is sick or premature

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Small Wonders are 12 bite-size films following families and their journey in neonatal units.

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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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You may be reading this because you have a preterm baby, or because you are expecting to deliver your baby before full term and you want to be prepared. Perhaps you're supporting someone who has recently had a preterm baby. Whatever your situation then we hope this information will help to get breastfeeding off to a successful start.

Before your baby arrives
Your premature newborn
Establishing breastfeeding
Looking after your own health and wellbeing
Taking your breastfed baby home

Before your baby arrives

If you know your baby will be arriving soon, you may wish to try antenatal expression of colostrum. This is where you hand express some of the thick, creamy first milk into a sterile container such as a syringe. This can be given to your baby immediately after birth reducing the possibility of them needing to have early formula feeds. Hypoglycaemia (low blood sugar) can cause serious long term health problems if left untreated, and preterm babies are at higher risk of low blood sugar than babies born at term. Having some colostrum ready means that this is available instead of formula (or donor milk if available).

If you are at risk of early labour and taking precautions to avoid it, then consult with your healthcare professionals about your individual case before starting antenatal expression as it may be considered to increase your risk of going into labour.
You can read more about antenatal expression here.

If there is time before your baby arrives, someone from the paediatric team on the neonatal unit where your baby will be cared for should come and talk to you about how you plan to feed your baby. You can supply them with any expressed colostrum you have in a labelled container, and discuss how you wish your baby to be fed while you are establishing your milk supply.

Some neonatal units will have access to donor breastmilk, and will be able to tell you if your baby will be eligible to receive this - as supply is limited, this is likely to be restricted to the babies who need it the most. They will discuss and get your consent if formula may need to be given while you are building your milk supply. This may also be the time to talk about how you want supplementary feeds to be given to your baby.

Smaller or weaker babies will be given a nasogastric tube, to allow milk (your own, donor or formula) to be fed down the tube. Bigger and stronger babies may be given bottles. You may wish to discuss paced bottle feeding (the art of giving bottle feeds in a way that supports breastfeeding) or cup feeding.

If you wish to express breastmilk for your baby, then your hospital should be able to provide you with a breastpump - asking for this before your baby is born means that you have it ready as early as possible. In the early days you need to be stimulating milk production in your breasts between eight and twelve times in twenty four hours, including at least once at night - this might be by your baby feeding effectively at the breast, or pumping sessions.

To read more about successfully expressing breastmilk, click here.

Your premature newborn

When you baby arrives there is likely to be a sudden rush of activity as your baby is checked and stabilised. They may be rushed off to the neonatal unit leaving you feeling stranded in the delivery unit. Be kind to yourself. You may feel that starting to express milk is a practical way that you can be involved in their care even when you are apart from each other. There is evidence to show that if you start expressing within the first hour after birth it can have a long term positive effect on your milk supply.

Establishing breastfeeding

You may be expressing on your ward (if you are still an inpatient) or on the neonatal unit. Many mothers find that being close to their babies while they are expressing can help to increase the amount that they are able to express. If you are separated, looking at photos of your baby can help or smelling something that has been close them.

If you are expressing on the unit, you may wish to be close to your baby as you do so. Some mothers use screens for privacy. You can ask for these to be provided. You don't have to use screens if you prefer not to - using scarves or nothing at all is a completely acceptable choice. Do what you feel comfortable with and helps your milk to flow easily. Listening to music may help you to relax and increase your milk production.

You are the person most known and familiar to your baby. Being with you is the safest and most secure they can possibly feel. If your baby is very fragile they may not be able to come out of their incubator at first. Ask the staff how you can be involved in their care and to show you how to hold and comfort them through the vents in the incubator. Once your baby is able to come out of the incubator, then kangaroo care can become an important part of your time together. This is where your baby is placed skin to skin on your chest for as long as possible and a blanket put over both of you. Your baby is able to enjoy the sensations of your closeness and the deep relaxation and comfort they feel helps them to regulate their breathing, temperature and other health indicators. It also helps your breast to become a familiar environment and allows them to practise feeding directly from the breast easily.

It used to be thought that babies under a certain gestation didn't have the ability to suck and swallow, or that directly breastfeeding was tiring to them. Happily, more recent studies have disproved these concerns. Once babies are well enough to breathe unaided (off ventilation and continuous positive airway pressure - CPAP), they can be brought to the breast. Smaller and younger babies will still need to have some of their milk given to them via tube feeds, but this allows you and your baby to learn to breastfeed together without a feeling of pressure.

Smaller babies have smaller mouths and lower muscle tone. This may mean you need extra support to get breastfeeding established. Seek skilled help early and often. Keep asking until you find someone who is able to support you effectively.

Premature babies often find it easier to feed in laid back breastfeeding positions. This is where you are supported in a reclined position with your baby tummy down on top of you. This helps gravity to 'stick' your baby to you and stops them slipping off. If you need to sit in a more upright position, then supporting the whole length of your baby's body close to yours with a hand behind their shoulders means they don't have to support their weight and stops them from curling in on themselves. Read more about laid back breastfeeding here.

You may find that your baby quickly falls asleep when breastfeeding. This isn't a sign that you are exhausting them, but that they are small and being soothed. You can help them to stay awake for longer by washing their face with cool water, gently blowing on them or tickling their feet. You may find that breast compressions - gently smoothing down your breast towards the nipple - helps your baby to stay alert and interested in feeding as this makes the milk flow more quickly and easily for them.

All new babies need to feed frequently - and premature babies are no different. The volume of milk that their stomachs can take at each feed is very small, and breastmilk is easily digested. It is normal for babies to feed between 8-12 times in a 24 hour period, including at least once at night.

Neonatal unit staff need to be able to ensure that all the babies in their care are receiving the right amount of milk for them to grow. Premature or sick babies may be less able to communicate their need for milk. These two things combined mean that units often use feeding schedules, with feeds timetabled every two, three, or even four hours.

When you agree how often your baby is to be offered supplemental feeds (any milk not directly from the breast) it may be helpful to remember that four hourly is less frequently than you would expect a healthy, full term newborn to feed. You may also choose to consider these as 'backup' feeds - any time spent feeding directly from the breast doesn't reset the clock, but is bonus extra calories. Keep writing down how often you are breastfeeding in your baby's notes, as this may help you and the staff to feel confident about the transition from scheduled, measured feeds, to baby led, responsive feeding.

One of the things the unit staff will look for in a baby coming close to going home is that your baby is able to rouse themselves to feed. If your baby is waking for feeds more often than their feeding 'schedule' (and you are spotting signs of effective feeding), this may be a sign that they are becoming better able to manage their own need for milk. You will probably need to keep offering more frequently than they ask for milk - this is true for many babies. Remember, you can't feed too often, and your baby can always say no if they don't want milk right now!

Breastmilk is an incredibly responsive food, made specially for each baby. The milk that you are making for your premature baby will be even more densely nutritious than the milk of a full term mother. Every drop of milk that you can supply for your baby is like medicine - strengthening and building their immune system and providing the calories they need to grow. Some mothers feel that providing milk for their babies is a unique way that they can care for their babies. It can be an important part of bonding with a new and fragile baby. While your baby will continue to benefit from your milk for as long as you provide it, you aren't tied to expressing for longer than you want to do so. If you decide it's time to stop, then gradually reducing your pumping sessions will slow and stop your milk production without causing problems for you.

Looking after your own heath and wellbeing

You will be recovering from pregnancy and birth, and may be experiencing additional health problems. It is important to remember to look after yourself - the more smoothly your recovery goes, the more strength and energy you will have to become more and more involved in your baby's care. If you have older children at home, you may be struggling to balance meeting their needs with being present with your newborn. Many mothers have to leave hospital long before their baby is ready to come home and have to travel back and forwards to be with their baby. This is a time to say yes to as many offers of help as you possibly can. If someone can provide a lift, deliver a meal, entertain an older child or do a load of washing - or just sit with you to talk things over in the hospital cafe - these may make life a little easier for you and help you to keep going at a difficult time.

You may be taking medications yourself and be concerned about them passing through your milk. Discuss your concerns with your and your baby's medical teams. They may be able to reassure you or find suitable alternatives. For specialist information about whether a drug is compatible with breastfeeding, you can contact your local LLL Leader who has access to resources and professional support.

It may feel impossibly painful to keep leaving your baby. Remember that by looking after yourself - eating, sleeping and taking the medication you need to get well - you are making sure that you carry on being able to be there to look after your baby.

Taking your breastfed baby home

Separately to any health issues your baby may be facing, your neonatal unit will want to know that you are able to make sure your baby is getting enough milk to continue growing. Being aware of your baby's early hunger cues is important so that you can feed responsively and before baby gets too upset. You may have a very sleepy baby who still needs your help to wake themselves up to feed beyond their due date. Setting an alarm for the middle of the night can help you to make sure they don't go for longer than a four hour stretch without feeding at night.

Read more about recognising early hunger cues and about waking a sleepy baby here.

Read more about how to tell if your baby is getting enough milk here.

Many breastfeeding mothers and babies enjoy safe cosleeping. Premature babies are at greater risk of Sudden Infant Death Syndrome or Sudden Unexplained Death in Infancy (SIDS/SUDI). While they will benefit from sleeping close to their mother, premature babies should sleep on a separate, firm surface such as a sidecar cot.

It can be scary to make the transition from caring for your baby in hospital with a team of staff around you, to being at home. Your healthcare professionals are likely to make extra visits to support you and to keep an eye on your baby's weight gain. You may find that being home together, able to stay together all the time, and in a comfortable environment, you rapidly get to know and understand your baby more easily and become more confident in your mothering skills.
Photo credits: Olivia Brown and other mothers
Other resources

You can read a mother's story about mothering her premature baby through special care

This video looks at breastfeeding in the first hour after birth

The drugs in breastmilk service, while not an LLL resource, gives quick access to information from a qualified pharmacist

The Small Wonders films follow families through their experiences of having a baby on a neonatal unit

Global Health Media have a series of videos about various aspects of life with a small baby

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Successfully breastfeeding your premature baby - La Leche League GB

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You may be reading this because you have a preterm baby, or because you are expecting to deliver your baby before full term and you want to be prepared. Perhaps you're supporting someone who has recently had a preterm baby. Whatever your situation then we hope this information will help to get breastfeeding off to [...]

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See our other MVP Padlet for information about Infant Feeding

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See our other MNVP Padlet for information about perinatal mental health

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This document is to be given to the parent of every preterm baby born in the South West region, and is designed to help inform and fully involve parents in the care of their preterm baby by outlining the relevant PERIPrem Bundle elements their baby should receive.

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West of England Academic Health Science Network

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The West of England Academic Health Science Network (AHSN) and the South West AHSN are working in collaboration with Southwest Operational Delivery Network to improve the outcomes for premature babies across the region through a neonatal care bundle: PERIPRem.

Official PERIPrem resources have received Neonatal Nurses Association (NNA) endorsement.

This section contains all of the current tools and documents that will support you as a clinical team on your PERIPrem journeys. All documents are also available on Life Qi (see final section on this page for more information). Bundle specific tools can be found under each Bundle Element (these are displayed on the PERIPrem home page).

Our aim is to support you to further develop your confidence and skills in applying quality improvement techniques to ensure that PERIPrem is embedded into your units and that the innovation you develop continues to shape the care that you deliver.

1. Getting Started

The following papers are designed to give you the background and context into PERIPrem and Perinatal QI. This section will give you all of the information that you will need to know about PERIPrem including guidance on establishing a PERIPrem Team.

2. Preparing and Planning

These next tools are to be used to set up PERIPrem within your team and units. They will aid baselining, building your team and identifying what bundle elements you are performing well in as well as those you want to put further work into.

The following tools are designed to support the implementation of PERIPrem within your unit and more widely.

3. Implementation and Measurements

PERIPrem Clinical Passport
This document is to be used by each perinatal team for every preterm born in the South West region, and is designed to serve both as a prompt on the PERIPRem Bundle as well as data capture tool. We encourage you to start using this within your teams immediately.

PERIPrem Baby Passport
This document is to be given to the parent of every preterm born in the South West region, and is designed to help inform and fully involve parents in the care of their preterm baby by outlining the relevant PERIPrem Bundle elements their baby should receive. We encourage you to start using this within your teams immediately.
PERIPrem Maternal Early Breast Milk Patient Leaflet
This document is to be given to the parent of every preterm born in the South West region, and is designed to help inform and fully involve parents in the care of their preterm baby by outlining, in detail, the benefits of Maternal Early Breast Milk as part of the PERIPrem Bundle. It is also available in multiple languages. We encourage you to start using this within your teams immediately.

PERIPrem Optimisation Tool
Recognising that you will need access to unit level data immediately, this is a very simple tool that will enable you to collate and share anonymised data from the PERIPRem Passports, in order to show how you are performing as a perinatal team in real time. The Optimisation tool will need to be returned at the end of each month.

The Optimisation tool will also generate a printable infographic for each element that you can use to demonstrate the progress on each bundle element as well as your overall optimisation target.
PERIPrem Debrief Tool
Reviewing progress as you go and identifying further opportunities for improvement ( making small scale changes through PDSA cycles) is central to designing a version of the PERIPrem Bundle that is right for the culture and processes of your unit. The following tool will support the reviewing of patient cases to inform further improvements.

4. Embedding and Sustaining Improvements
Life QI
We selected Life Qi to support the design and implementation of PERIPrem. We encourage all units to use Life Qi as a comprehensive platform to guide you through QI. It includes driver diagram templates for each of the bundle elements, including measures as well as the function to input PDSA information.

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PERIPrem Resources - West of England Academic Health Science Network

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The West of England Academic Health Science Network (AHSN) and the South West AHSN are working in collaboration with Southwest Operational Delivery Network to improve the outcomes for premature babies across the region through a neonatal care bundle: PERIPRem. Official PERIPrem resources have received Neonatal Nurses Association (NNA) endorsement.

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Dads sometimes get overlooked in the pregnancy journey, but it's important to remember that preterm birth is difficult for them too.

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Gayle is the Bliss Champion on the neonatal unit at Great Western Hospital.

She is here to provide a listening ear, emotional support and information to families like yours with babies on the unit. Email: hello@bliss.org.uk

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My name is Gayle and I am the Bliss Champion on the neonatal unit at Great Western Hospital.

I am here to provide a listening ear, emotional support and information to families like yours with babies on the unit.

When I am available

If you want to talk to someone in confidence, I will be available on the unit every week, please check with the staff when I will next be in.

For further support, please email hello@bliss.org.uk.

Related content

Support via email

Being a parent on the neonatal unit

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My name is Gayle and I am the Bliss Champion on the neonatal unit at Great Western Hospital.

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Salisbury NICU Warriors Parent support (Facebook)

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Salisbury NICU Warriors Parent support (Facebook)

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This private group is for NICU mums to share thoughts, feelings, rants, events, articles or anything you feel will help the group

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Salisbury NICU warrior parents has 234 members. It's very hard having a baby in NICU and harder still as your family, friends and other mums can't understand what you have been through or are going...

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Salisbury (SFT) Neonatal Unit (LNU- Local Neonatal Unit)

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Salisbury (SFT) Neonatal Unit (LNU- Local Neonatal Unit)

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The neonatal unit in Salisbury is classed as a Local Neonatal Unit (LNU) within the Thames Valley and Wessex Neonatal Network (TVWNN). The unit in Salisbury cares for babies born after 27 completed weeks gestation, and those requiring less than 48 hours ventilation.

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The Neonatal Unit

The neonatal unit in Salisbury is classed as a Local Neonatal Unit (LNU) within the Thames Valley and Wessex Neonatal Network (TVWNN). The unit in Salisbury cares for babies born after 27 completed weeks gestation, and those requiring less than 48 hours ventilation. Those babies born at less than 27 weeks gestation, babies of any gestation who require the support of a ventilator for more than 48 hours or require surgery or specialist treatments including cooling, are transferred by a specialist neonatal transport service to one of the Neonatal Intensive Care Units (NICU) in the network. Our two local units are in Southampton and Portsmouth. On the rare occasions that the two NICUs are full we may transfer babies to Bristol or Oxford.

When a woman presents in preterm labour at a gestation less than 27 completed weeks of her pregnancy, or if the baby is suspected to have a condition that may need specialist treatment such as surgery, plans are usually made to transfer Mother and Baby to one of the specialist units prior to birth. However if labour is progressing quickly or the Mother is too unwell to travel, the baby may be born in Salisbury and transferred out once the condition has been stabilised. This means that we care for all babies at all gestations that are born in Salisbury Hospital and offer treatment and stabilisation for the smallest and sickest babies prior to their transfer to one of the Neonatal Intensive Care Units within the TVW Neonatal Network.

At Salisbury Hospital Neonatal unit we are proud of our extensive facilities available for family use. We have parent accommodation which has direct access to the unit. There are four double bedrooms all with ensuite bathrooms and there is a large sitting room for parents and their visitors with two sofas and television.

There is a communal kitchen for food preparation with fridge, microwave and dishwasher. Tea, coffee and milk are all supplied for parents and their visitors. We also have a private enclosed patio area/outdoor dining area, playground and a play room specific for supervised sibling use.

In addition there is a large separate toilet with disabled and toddler changing facilities, a cloakroom with lockers for parents and visitors to leave outdoor wear and bags which should not be bought into the unit for both safety and infection control reasons.

There is a small quiet room for use at any time for parents to spend some quiet time alone or together as a couple. This room is also used for private conversations with doctors or nurses or to express breast milk. However we do encourage parents to express milk whilst holding the baby or sitting closely to the cot or incubator as this has a positive effect on milk flow.

Parent craft sessions are offered to help parents learn skills to aid in caring for their baby, these include resuscitation skills which are taught to all parents whose baby or babies have been cared for in the neonatal unit for more than 48 hours.

Within the unit itself there are four single rooms known as 'Kangaroo Care Rooms' where one parent is able to stay in a room together with the baby/babies. Generally these rooms are used by the mother, however some fathers stay at times. These rooms are used for giving you the opportunity to ‘room in' with your new baby prior to discharge home.
The rooms are also often used for those babies who have been in the unit for a number of weeks and still require nursing care they allow you to ease yourself into parenthood by spending time close to your baby, and having opportunity to give prolonged skin to skin contact to the baby. Bathroom facilities exist with shower on a shared basis. Whilst in the Kangaroo care rooms parents are asked to leave the blinds open at all times except whilst dressing and undressing, this is to ensure that the nursing staff can continue to closely observe the baby.

There is a small but comprehensive kitchen on the unit for use by those parents using the kangaroo care rooms.

The unit is divided into three areas; intensive care, special care and kangaroo care.

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Swindon (GWH) Neonatal Unit (3D Virtual Tour)

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Swindon (GWH) Neonatal Unit (3D Virtual Tour)

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The unit looks after babies who need more than the usual level of care. This includes babies:

Born prematurely

Who are unwell after birth

With antenatal concerns

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This was formally called the Special Care Baby Unit (SCBU).

The unit looks after babies who need more than the usual level of care.

This includes babies:

Born prematurely

Who are unwell after birth

With antenatal concerns

The unit has special care, high dependency and intensive care cots.

It is divided into two areas:

A room for the babies who need additional support and monitoring

A room for babies who are learning to feed and are growing, where parents can provide most of the care to their baby (although we encourage and support parents to be active partners in their baby's care throughout their stay in the unit, even when receiving intensive care support)

Facilities include:

Playroom for siblings

Breast feeding and expressing area, with individual cubicles and storage for freezing your breast milk

Parents' sitting area

Parent accommodation (two double rooms and a single room)

The unit is a Local Neonatal Unit (LNU) within the South West Neonatal Network.

Location

Great Western Hospital - second floor (please see Floor plan).

Your baby's stay

The length of a baby's stay in the unit varies greatly depending on his or her needs.

We will support the family throughout, and encourage parents to become involved in their baby's care.

Once your baby is settled in the unit, they will be fully assessed and the treatment and care will be tailored to their specific needs.

The nurse caring for your baby will be able to update you on their progress when you visit, or by phone.

Staff are always available to offer advice and answer any questions.

Please see also What happens if your baby is sick or premature.

Going home

We have an outreach service to help parents through the transition from the Neonatal Unit to home.

Visits are scheduled before discharge; families receive three visits from the nursery nurse, who will weigh the baby, discuss feeding and answer any concerns.

Contact

Neonatal Unit Tel: 01793 605174
Unit Manager Tel: 01793 605175

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This was formally called the Special Care Baby Unit (SCBU). The unit looks after babies who need more than the usual level of care. This includes babies: Born prematurely Who are unwell after birth With antenatal concerns The unit has special care, high dependency and intensive care cots.

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The neonatal unit provides care for premature and sick term newborn babies.

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Introduction

The neonatal unit provides care for premature and sick term newborn babies. Approximately 10% of all babies will need admission to a neonatal unit, commonly because of prematurity, infection, breathing difficulties or feeding problems.

The unit works as part of a wider network, with the main intensive care being delivered in Bristol if your baby is extremely preterm or needing surgery, along with some sick term babies requiring further intervention. Once these babies are stable they will complete their care in this local neonatal unit.

The unit has 21 cots, and we have facilities for parents including 4 double en suite bedrooms, a breast milk expressing room, a parents coffee room, quiet room, a play area for siblings and a garden.

Click here to read a summary about our Neonatal Unit and its services.

Parent and Carer Information
Car Seat Challenge Correctly labelling breast milk for safe storage Community Neonatal Outreach Service Decontamination of baby feeding equipment and utensils
Going home with your baby

Infection in newborn babies
Jaundice in newborn babies
Maternal Thyroid Disease

Nasogastric Tube Feeding
Neonatal Hypoglycaemia - protecting your baby from low blood glucose Patent Ductus Arteriosus (PDA) in premature babies Probiotics and Your Baby
Retinopathy of Prematurity - Screening

Retinopathy of Prematurity - Treatment

Staying with your baby

Transitional Care Pathway

Treatment of Apnoea and Bradycarida of prematurity with caffiene
Vitamin K and your baby Your baby's Inguinal Hernia
Neonatal Unit Parent Questionnaire

Please tell us about your recent experience of the Neonatal Unit. Your feedback is important to us and will help us to continue to improve family experience. You can complete the NICU parent questionnaire here:
NICU Parent Experience Questionnaire

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Information Services Department, Royal United Hospital

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Royal United Hospitals Bath NHS Foundation Trust

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The neonatal unit provides care for premature and sick term newborn babies. Approximately 10% of all babies will need admission to a neonatal unit, commonly because of prematurity, infection, breathing difficulties or feeding problems. The unit works as part of a wider network, with the main intensive care being delivered in Bristol if your baby is extremely preterm or needing surgery, along with some sick term babies requiring further intervention.

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About this MNVP Neonatal Care and Special Care Baby Unit padlet

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About this MNVP Neonatal Care and Special Care Baby Unit padlet

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This resource padlet has been put together by a team of MNVP volunteers. Simply click on the 'tile' and it will take you to the resource (PDF, website, form, video) It is aimed at Parents/to-be but may be useful for midwives, MCAs, Neonatologists and other Healthcare professionals. Contact: chaya.tagore@nhs.net

While we make every effort to make sure these padlets are up to date, we make no warranties or representations that the information will be
* current
* accurate
* secure
* complete
* free from bugs or viruses

As an MNVP, we are no liable for any loss or damage that may come from using these padlets. We are unable to endorse the information held on third party websites, it is for information only.

www.bswmaternityvoices.org.uk