We are based in The womens' services (Purple Zone) on floor one, next to Barnsley Birthing Centre (Labour Suite).

The Neonatal Unit is a level 2 unit which provides care for babies who are born at 27 weeks gestation and above.

There are 14 cots in total: 2 Intensive Care, 3 High Dependency and 9 Special Care cots.

Other family and friends may visit any time between 10am and 7pm.

Contact number - 01226432269

If you feel like you need support, please reach out. Talking to your partner, a family member, a friend, a nurse, your health visitor, or your GP can make a real difference. You do not have to manage everything on your own, support is available, and you are not alone.

NHS Talking Therapies is a free and confidential NHS service that supports people experiencing common mental health difficulties. We provide evidence‑based treatments such as Cognitive Behavioural Therapy (CBT), counselling, and a range of other psychological interventions tailored to each person’s needs. Support is offered through workshops or one‑to‑one sessions delivered by trained professionals, helping individuals manage their symptoms effectively and improve their overall wellbeing.

In the first few weeks after having a baby, it’s common to find yourself thinking repeatedly about your labour and birth as you try to make sense of what happened. Sometimes these memories can feel upsetting, and you may experience unexpected emotions, flashbacks, or nightmares. This is a normal part of your body and mind adjusting after childbirth, and these feelings usually lessen or resolve within 4–6 weeks.

Talking about your birth experience with family, friends, your Community Midwife, or your Health Visitor can be helpful. These conversations often support the natural processing of events, and you may find that this alone helps you understand your experience more clearly.

If your feelings haven’t settled, or you feel you need a clearer understanding of what happened and why, you can speak with a Specialist Midwife. If further support is needed after this, we can refer you to our psychology service or other specialist services.

You may wish to contact us if you:

• Live in Barnsley or gave birth in the Barnsley area

• Want to talk through your birth experience, fill in any gaps, and make sense of events

• Feel distressed by your birth experience and are worried about how you’re feeling

You can refer yourself by getting in touch with our team.

Email address: bdg-tr.maternitymentalhealthmidwives@nhs.net

Phone number: 01226 436340. (voicemail service)

Mobile number:07779 445162(ring or text)

If you need help in a different language, just let us know and we’ll be happy to assist.

Facilities include access to a:

* Fridge

* Microwave

* Toaster

*Hot drinks

If you’d prefer to bring your own food, you can store it in the fridge if needed and use the microwave to heat your meal.

We also provide a selection of food for parents, which may include:

Sandwiches

Toast

Cereal

Fruit

Please help us keep the kitchen clean and tidy for everyone using it.

This provides a quieter, more private space where you can breastfeed or express breast milk.

You are also very welcome to breastfeed or express beside your baby if you prefer.

If you need any help with breastfeeding or expressing, please ask your baby’s nurse.

We can support you with:

* Breastfeeding

* Expressing breast milk

* Using the breast pumps

* Hand expressing

* Storing and labelling your milk

* Maintaining your milk supply

We follow strict hygiene procedures because premature and unwell babies can be particularly vulnerable to infection.

Depending on your baby’s feeding plan, the milk kitchen may be used for:

* Expressed breast milk

* Donor breast milk

* Formula milk

* Human milk fortifier

* Preparing and storing feeds

Please make sure any expressed breast milk you bring to the unit is labelled and stored as advised by the neonatal team.

Your baby’s nurse will explain how to bring expressed milk onto the unit and where it should be stored.

If you’re ever unsure, please ask before placing milk into a fridge or freezer.

During the ward round, you may see doctors and other members of the neonatal team gathering around your baby’s cot or incubator.

What happens during the ward round?

The team will review how your baby has been since their previous medical review.

Depending on your baby’s needs, they may discuss:

• Breathing and oxygen needs

• Feeding and nutrition

• Weight and growth

• Medicines

• Blood results and investigations

• Comfort and development

• Tests or treatments needed

• Ongoing care and discharge planning

The medical team may also examine your baby.

Your Voice Matters

Parents are encouraged and supported to be part of the ward round and involved in conversations and decisions about their baby’s care.

You know your baby best and you are your baby’s advocate. You are an important member of the care team, and your voice, observations, questions and concerns matter to us.

Ward rounds are a valuable opportunity to hear how your baby is progressing, ask questions, share what you have noticed and discuss the plan of care together.

We want you to feel informed, listened to, involved and confident to speak up for your baby.

You are not just visiting your baby. You are their parent, their voice and an essential part of their care team.

Every Wednesday, we hold our Neonatal Grand Round.

This is an opportunity for the different healthcare professionals involved in caring for our babies to come together and discuss each patient as a team.

The Grand Round may include:

• Neonatal doctors

• Advanced Neonatal Nurse Practitioners (ANNPs)

• Neonatal nurses

• Physiotherapy

• Occupational Therapy (OT)

• Speech and Language Therapy (SALT)

• Dietetics

• Pharmacy

• Neonatal Outreach Team

• Other specialist teams when required

During the Grand Round, the team reviews each baby’s progress, current treatment and ongoing plan of care.

We may discuss:

Breathing and oxygen support

• Feeding and nutrition

• Growth

• Medicines

• Blood results and investigations

• Development

• Specialist input

• Plans for the coming days

• Preparing for discharge

Grand Round brings everyone involved together, helping us provide coordinated and individualised care for your baby.

Why we weigh babies

We use weight to help guide feeding and nutrition, alongside other measures of growth and development.

What happens

Babies are weighed using specialist scales or incubator scales. Nurses ensure they are kept safe and warm throughout.

Weight changes

It is normal for babies to lose some weight after birth, and small changes are expected. We look at overall growth rather than single weights.

If growth is a concern

We may review milk intake, feeding, energy use, and whether any changes to nutrition are needed.

Parents Can Be Involved

We encourage you to be involved in weighing your baby whenever it is safe to do so.

Weighing is part of your baby’s routine care and can be another opportunity for you to take an active role.

Depending on your baby’s needs, you may be able to:

• Get everything ready with your baby’s nurse

• Undress your baby and remove their nappy

• Help carefully move your baby onto the scales

• Support any wires or tubing with guidance from the nurse

• Use containment holding to keep your baby calm and secure

• Talk or sing softly to reassure them

• Help move your baby safely back into their incubator or cot

• Put on a clean nappy and get them dressed again

• Settle them comfortably afterwards

• Record or celebrate their new weight

  
  

If your baby has breathing support, lines or other equipment, don’t worry. Your baby’s nurse will guide you and show you what you can safely do.

As your baby becomes more stable, you may find that you can gradually do more of their everyday cares yourself.

These little moments are a great way to build your confidence, get to know your baby and be an active part of their neonatal care.

Tuesday is our routine bloods day on the neonatal unit.

You may notice your baby having blood tests taken on this day as part of their ongoing care. Some babies may need blood tests on other days too, depending on their individual needs.

Why does my baby need blood tests?

Blood tests give us important information about how your baby is doing. They may be used to check things such as:

• Infection or inflammation

• Haemoglobin and other blood levels

• Salts and minerals

• Blood sugar

• Liver or kidney function

• Nutrition and growth

• Levels of certain medicines

Not every baby will need the same tests. We try to take only the blood that is necessary for your baby’s care.

How are blood samples taken?

There are different ways of taking blood from babies depending on which tests are needed and whether your baby already has intravenous access.

Blood may be taken from a small heel prick, from a vein, or from existing central or arterial access where appropriate.

We will choose the most suitable method for your baby.

Keeping your baby comfortable

We know it can be difficult for parents to watch their baby having a blood test. We will always try to make the experience as comfortable and gentle as possible.

How can I support my baby?

You can play an important role in comforting your baby during and after a blood test.

Depending on your baby’s condition, you may be able to:

• Offer skin-to-skin care

• Use containment holding, gently placing your hands around your baby to help them feel secure

• Let your baby hold your finger

• Talk, read or sing softly to them

• Offer a dummy if this is something your baby uses

• Breastfeed during or around the procedure when appropriate

• Help your baby settle afterwards

• Reduce unnecessary noise, light and stimulation

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For some babies, the team may use additional comfort measures such as sucrose, when clinically appropriate.

Your baby’s nurse can show you the best way to comfort and support your baby based on their gestation and individual needs.

Your touch, voice and presence can be very reassuring to your baby.

Results

Some blood results are available quickly, while others take longer.

The neonatal team will review your baby’s results and consider them alongside how your baby is doing overall.

If the results mean that something needs to change, such as your baby’s medicines, nutrition or treatment, we will discuss this with you and keep you involved in their plan of care.

Good nutrition is particularly important for babies who are born early or unwell.

Your baby’s nutritional needs will be individually assessed. Depending on their stage of development and medical needs, they may receive:

• Breast milk

• Donor human milk when appropriate

• Formula milk

• Milk through an NG or OG tube

• Additional nutrients such as human milk fortifier

• Nutrition through a vein (TPN)

As your baby grows, their feeds will be reviewed and gradually changed according to what they need.

It is usually thick and produced in small amounts. It contains important nutrients and substances that help protect your baby from infection.

If your baby isn’t ready to feed at the breast, you may be encouraged to express your colostrum.

Don’t worry if you only see tiny drops at first, this is normal.

Depending on your baby’s needs, your colostrum may be given as a feed or used for mouth care.

The neonatal team can show you how to collect, label and store your colostrum safely.

It can be particularly useful during the first few days after your baby is born.

A simple way to remember the technique is:

Wash – Massage – Position – Press – Release

Wash and dry your hands, get comfortable and gently massage your breast. Make a C shape with your thumb and finger a few centimetres behind your nipple, then gently press and release rhythmically.

Avoid pulling or sliding along your nipple.

It can take time and practice, so don’t worry if you find it difficult at first. Your neonatal/maternity team can show you how to hand express.

They can still receive milk through a small, soft feeding tube.

NG – Nasogastric tube: passes through the nose and into the stomach.

OG – Orogastric tube: passes through the mouth and into the stomach.

Tube feeding can allow your baby to receive the nutrition they need while they grow and develop their feeding skills.

Having a feeding tube doesn’t stop you being involved. Depending on your baby’s needs, you may be able to hold them, have skin-to-skin and become involved in giving their tube feeds.

Your neonatal nurse will show you what you can safely do.

Learning your baby’s feeding cues can help you recognise when they may be ready to feed – and when they need a break.

Early feeding cues can include:

Ready to feed: becoming more awake, bringing hands towards their mouth, licking or smacking their lips, opening their mouth, rooting/searching and showing interest in sucking.

Needs a pause: stopping sucking, turning away, changes in breathing, spilling milk, becoming sleepy or showing signs of stress.

Crying is generally a late hunger cue, so where possible we try to recognise earlier cues.

Premature babies may show very subtle cues. Your baby’s nurse can help you learn your baby’s individual signs.

For babies who have been born prematurely or have been unwell, this journey may happen gradually.

Your baby’s first experiences at the breast might simply involve skin-to-skin, smelling, licking or nuzzling at the breast.

Later they may begin to latch and take a few sucks. With time and maturity, they may become able to coordinate sucking, swallowing and breathing for longer periods.

There is no need to rush.

Celebrate the little steps along the way.

Your neonatal team can support you and your baby as you learn together.

Some simple things to remember are:

Close – Keep your baby close to your body.

Head free – Allow your baby to gently tip their head backwards.

Nose to nipple – Start with your baby’s nose opposite your nipple.

Wide mouth – Wait for your baby to open their mouth widely.

Chin first – Bring your baby towards the breast, allowing their chin to make contact first.

A good attachment should feel comfortable. Your baby’s cheeks should remain rounded and you may begin to see or hear swallowing.

Don’t worry if it takes practice. Ask your neonatal team to watch a feed and help with positioning.

Human Milk Fortifier, is a nutritional supplement that can be added to expressed human milk.

It provides additional nutrients such as protein, energy, vitamins and minerals, supporting growth and bone development.

Being offered fortifier doesn’t mean there is anything wrong with your milk. Premature babies can simply have higher nutritional requirements because they have missed some of the growth and nutrient transfer that would normally happen later in pregnancy.

The neonatal team will explain why your baby needs fortifier, how much they need and how long they are likely to receive it.

Your baby is held gently on their side, with their head slightly higher than their hips and their head, neck and body well supported.

This position can be particularly helpful for premature babies who are still developing their feeding skills.

Why do we use it?

Feeding requires babies to coordinate three important skills:

Sucking – Swallowing – Breathing

Elevated side-lying can help your baby:

• Control the flow of milk

• Coordinate sucking, swallowing and breathing

• Take natural pauses during their feed

• Stay comfortable and settled

• Show their feeding cues more clearly

The bottle is usually held fairly horizontal to help your baby control the flow of milk.

Watch your baby’s cues

Feeding isn’t about finishing the bottle. We want feeding to be a safe and positive experience.

Your baby may need a pause if they:

• Stop sucking

• Turn away from the teat

• Spill milk from their mouth

• Become sleepy

• Show changes in their breathing

• Show signs of stress

Give your baby time to rest and never force them to finish a feed.

Premature babies can tire easily, and their feeding skills will develop as they grow and become stronger.

Your baby’s bottle can contain expressed breast milk or formula milk, depending on your baby’s individual feeding plan and your feeding choices.

Some babies on the neonatal unit may need time to develop the skills needed to bottle feed safely, particularly if they were born prematurely or have been unwell.

Learning to bottle feed

Bottle feeding requires your baby to coordinate three important skills:

Sucking – Swallowing – Breathing

This can take lots of energy, so your baby may need regular pauses or may become tired before finishing their feed.

Responsive bottle feeding

We encourage responsive feeding, which means following your baby’s cues rather than focusing on finishing a set amount of milk.

Look for signs that your baby is ready to feed, such as becoming more alert, bringing their hands towards their mouth, rooting or showing an interest in sucking.

During the feed, allow your baby to set the pace and take breaks when they need them.

Your baby may need a pause if they:

• Stop sucking or turn away

• Spill milk from their mouth

• Become sleepy

• Show changes in their breathing

• Show signs of stress

Never force your baby to finish a bottle.

Positioning your baby

A special time together

Keep your baby close during their feed and take time to enjoy being together.

Talk softly to them, look at them and learn the little signs they use to communicate with you.

Some feeds will go better than others, and that’s okay. Feeding is a skill that develops with time, practice and maturity.

You and your baby are learning together, and we’re here to support you along the way.

When your baby is ready to wear clothes, you may wish to bring in:

• Vests

• Sleepsuits

• Cardigans

• Socks

Premature and tiny baby sizes are available from some shops, but don’t feel you need to buy lots – babies can grow surprisingly quickly!

Good to know - Parents and carers in the UK can claim free 3-packs of F&F premature baby sleepsuits (designed for 3lbs and 4lbs sizes) at over 350 participating Tesco Pharmacy

Please speak to a member of the neonatal team for more information about the vouchers and how to use them.

Premature babies have less muscle tone and can find it difficult to keep themselves in a comfortable, tucked-up position.

A nest provides gentle boundaries around your baby’s body.

It can help them:

* Feel contained and supported

* Keep their arms and legs comfortably tucked in

* Bring their hands towards their face and mouth

* Maintain a comfortable position

* Feel more secure

The aim is to recreate some of the boundaries and support your baby would have experienced inside the womb.

Inside the womb, your baby would have developed in a dark and protected environment.

An incubator cover can help reduce the amount of bright light reaching your baby and create a calmer environment.

This can help to:

* Protect your baby’s developing senses

* Support periods of restful sleep

* Reduce unnecessary stimulation

* Help create a more womb-like environment

The cover may be opened during cares, examinations and when your baby is ready for interaction.

This is an exciting step!

We may use a cot canopy to continue providing some protection from bright lights and activity around the neonatal unit.

The canopy can help create a calmer environment while your baby continues to develop.

As your baby approaches going home, we gradually encourage a more normal day and night routine, with daytime light and quieter, darker periods at night.

Moving into a cot is another step towards getting ready for home.

Sometimes gentle, still touch can be much more comforting.

Containment holding, sometimes called a hand hug, involves gently placing your hands around your baby to give them secure boundaries.

You may place one hand around their head or shoulders and another around their feet or body.

Keep your hands still, warm and gentle.

This can help your baby:

* Feel safe and supported

* Stay in a comfortable tucked position

* Settle during or after cares

* Experience positive touch

* Become familiar with your touch

Your baby’s nurse can show you how to do this and help you recognise whether your baby is enjoying the interaction.

Reading is a lovely way to spend some quiet time together.

You don’t need a special book – choose something that you enjoy reading.

You could:

• Read a favourite children’s story

• Read the same story regularly

• Ask siblings to choose a book

• Tell your baby a story about your family

• Simply talk about your day

Your baby doesn’t understand the words yet – it’s your familiar voice that matters.

If your baby is sleeping or needs some quiet time, their nurse can help you recognise when they are ready for interaction.

Story time can become a special part of your daily routine together.

With nurses, doctors and equipment caring for your baby, it can sometimes be difficult to know where you fit in.

But you have a very important role.

You are not a visitor, you are your baby’s dad and an important part of their care team.

There are lots of ways you can care for your baby, build your confidence and develop that special relationship together. Family Integrated Care encourages dads and other parents to be active partners in their baby’s care.

Sometimes families need a little extra support, and it’s okay to ask for it.

Barnsley’s Early Help services work with families to understand what is going well, what might be difficult and what support could make things easier.

Support may involve areas such as:

• Family life

• Housing

• Money worries

• Parenting

• Emotional wellbeing

• Other children in the family

• Accessing local services

Early Help is about getting the right support at the right time, before difficulties become bigger.

If you think your family could benefit from some additional support, please speak to a member of the neonatal team.

Our Amazon Wishlist contains items that can help support babies and families during their time with us.

The wishlist allows you to choose an item that the unit currently needs and have it delivered directly to us.

Items on the list may change depending on what our babies, families and unit need at the time.

There is absolutely no expectation to donate – but if you choose to, we are incredibly grateful for your kindness and support.

Please use the link or QR code below to view our current Amazon Wishlist.

It can be a very special way of spending time together and getting to know your baby.

Skin-to-skin may help support your baby’s:

heart rate
temperature
breathing
sleep
feeding and milk supply
bonding and comfort

Partners can enjoy skin-to-skin too.

We recommend around one hour to help with your babies development.

Even babies who need breathing support or other neonatal care may sometimes be able to have skin-to-skin. Our nurses will help you decide when your baby is ready and will support you to move and position them safely.

Don’t worry if you feel nervous the first time. With all the wires and equipment around your baby, this is completely understandable.

Ask our nurses about having some skin-to-skin time.

It is a breathing condition most commonly seen in premature babies whose lungs are still developing. Their lungs may not yet make enough surfactant, a substance that helps keep the tiny air spaces in the lungs open.

Babies with RDS may need support such as oxygen, CPAP, BiPAP or ventilation. Some babies may also be given surfactant directly into their lungs.

As the lungs mature, RDS usually improves.

It can happen when a baby’s brain has received less oxygen and/or blood flow around the time of birth.

HIE can vary from mild to severe, and every baby’s outcome is different.

Some babies with moderate or severe HIE may receive therapeutic cooling, where their body temperature is carefully lowered for around 72 hours to help protect the brain.

Your baby’s neonatal team will monitor them closely and explain any scans, brain monitoring or treatments that are needed.

It is a small, soft plastic tube that sits inside one of your baby’s veins.

It may be placed in your baby’s:

* Hand or arm

* Foot or leg

* Sometimes another suitable vein

Once the cannula is in place, the needle used to insert it is removed – the needle does not stay in your baby.

Why does my baby need one?

A PVL can be used to give:

* Fluids

* Antibiotics

* Medicines

* Other treatments directly into the bloodstream

PVLs are usually used for short-term treatment. Because babies have tiny, delicate veins, they sometimes stop working and need replacing.

After your baby is born, the blood vessels in their umbilical cord can sometimes be used to provide access to their bloodstream.

A UVC is a small, soft tube that is carefully passed through a vein in your baby’s umbilical cord.

Why might my baby need a UVC?

A UVC can provide reliable access when your baby needs treatments such as:

• Fluids

• Medicines

• Antibiotics

• Nutrition such as TPN

• Blood or blood products, when appropriate

This can be particularly helpful for premature or unwell babies who need frequent treatment.

Does it hurt my baby?

The line is inserted through the remaining umbilical cord rather than through your baby’s skin.

The team will make sure your baby is kept comfortable throughout the procedure.

Once inserted, the line is carefully secured and its position is checked before or during use according to your baby’s care plan.

Your baby’s team will regularly review whether the UVC is still needed and remove it when it is no longer required.

A UAC is a small, soft tube that is passed through one of the arteries in your baby’s umbilical cord.

Unlike a UVC, which goes into a vein, a UAC goes into an artery.

Why might my baby need a UAC?

A UAC can be particularly useful for babies who are very premature or unwell.

It can be used to:

* Continuously monitor your baby’s blood pressure

* Take blood samples

* Take blood gases to monitor things such as oxygen and carbon dioxide levels

This can sometimes reduce the number of separate blood tests or needle procedures your baby needs.

The line will be carefully secured and monitored by the neonatal team.

We will regularly review whether your baby still needs their UAC and remove it when it is no longer required.

PICC stands for Peripherally Inserted Central Catheter.

It is a very thin, soft, flexible tube that is inserted into a small vein and gently threaded along the vein so that the tip sits in a larger central vein.

Despite the name “long line”, most of the tubing is inside the vein rather than hanging outside your baby’s body.

Why does my baby need a long line?

A long line can be useful when your baby needs treatment for longer than a standard cannula is suitable for.

It may be used to give:

* TPN and nutrition

* Fluids

* Antibiotics

* Medicines

* Other intravenous treatments

One advantage of a long line is that it can stay in place for longer, which may reduce the need to repeatedly insert new cannulas.

Looking after the line

The line will have a dressing over it to keep it secure and help protect it from infection.

You may notice staff being particularly careful when handling your baby’s long line. We use strict infection-prevention techniques whenever we access it.

You can usually still cuddle, have skin-to-skin and be involved in your baby’s care while they have a long line. Your baby’s nurse will help you move your baby safely while protecting their line.

The neonatal team will regularly check the line and remove it when your baby no longer needs it.

We understand that hearing your baby needs to move to another hospital can feel worrying, especially when you have become familiar with our unit and the people caring for your baby.

There are different reasons why a transfer may be needed. Your baby may need specialist treatment, surgery, investigations or a higher level of intensive care that is provided at another hospital.

Sometimes babies are also transferred closer to home or back to Barnsley when they no longer need specialist care elsewhere.

We will explain why your baby needs to be transferred, where they are going and what you can expect.

A small sample of blood is collected from your baby’s heel and placed onto a special card.

The test is usually carried out when your baby is around 5 days old.

It screens for a number of rare but serious conditions. Finding these conditions early means that monitoring or treatment can begin as soon as possible.

Babies on the neonatal unit may occasionally need additional or repeat blood spot samples.

We will let you know when your baby’s blood spot is due and explain if another sample is needed.

Vitamin K helps the blood to clot normally.

Babies are born with relatively low levels of vitamin K. In a very small number of babies this can lead to a rare but serious condition called Vitamin K Deficiency Bleeding (VKDB).

To help prevent this, your baby will usually be offered vitamin K shortly after birth.

It is most commonly given as a small injection into your baby’s thigh.

Vitamin K can also be given by mouth, but several doses may be needed.

Premature babies need vaccinations too.

Routine childhood immunisations normally begin when your baby is 8 weeks old.

If your baby was born prematurely, vaccinations are usually given according to their actual age from birth – not their corrected age.

This means your baby may receive their first vaccinations while they are still staying with us on the neonatal unit.

The early childhood vaccination programme protects against serious illnesses including:

• Whooping cough

• Tetanus

• Diphtheria

• Polio

• Hib

• Hepatitis B

• Meningococcal B

• Rotavirus

• Pneumococcal infection

Your baby’s team will discuss their vaccinations with you and let you know when they are due.

Vaccinations given on the neonatal unit will be recorded so that your GP and health visitor know what your baby has received.

The screening test helps identify babies who may have hearing loss so that further assessment and support can be offered early.

Small sensors or an earpiece are used to check your baby’s response to sound.

The test does not hurt your baby and can often be carried out while they are settled or asleep.

Babies who have spent time on the neonatal unit may sometimes need a different or additional type of hearing screening.

Don’t worry if your baby doesn’t get a clear result the first time. This does not necessarily mean they have hearing loss and they may simply need the test repeated.

We will explain the result and let you know if any further appointments are needed.

It is very common in newborn babies and especially common in babies born prematurely, because their liver is still developing.

Some babies only need monitoring. Others need phototherapy, where special blue light helps the body break down bilirubin.

Newborn babies, particularly those born prematurely or who are already unwell, can sometimes become poorly very quickly with an infection.

Signs can include changes in breathing, feeding, temperature, colour, alertness or behaviour.

If the neonatal team suspects an infection, your baby may have blood tests and antibiotics may be started while results are awaited.

The team will monitor your baby closely and keep you updated.

It is a serious condition that causes inflammation in the bowel and is seen more commonly in premature or very low birthweight babies.

If NEC is suspected, feeds may be stopped temporarily to allow the bowel to rest. Your baby may receive antibiotics, fluids and nutrition such as TPN through a vein.

Most babies with NEC do not need surgery, but some babies with more severe NEC may require an operation.

It is common in babies and is particularly common in babies born prematurely or who have been unwell.

You may notice:

* Milk coming back up

* Hiccups or coughing

* Discomfort during or after feeds

* Back arching

* Fussiness

* Difficulty settling during feeds

Most babies improve as they grow and their digestive system matures.

Before birth, babies have a normal blood vessel called the ductus arteriosus which allows blood to bypass the lungs.

This usually closes after birth. In some babies, particularly premature babies, it stays open. This is called a PDA.

A PDA may cause a heart murmur and, if it is large, may affect breathing or circulation.

Some PDAs close by themselves. Others may need monitoring, medication or occasionally another treatment.

CLD can develop in babies who are born prematurely because their lungs are still immature and developing.

Babies who have needed oxygen or breathing support for a longer period may be more likely to develop CLD.

What does it mean for my baby?

Babies with CLD may need:

* Oxygen for longer

* Low Flow Oxygen

* Additional breathing support

* Medicines to support their breathing

* Extra nutritional support to help them grow

* Ongoing monitoring as their lungs develop

Some babies with CLD are otherwise ready to leave the neonatal unit but still need a small amount of oxygen. If appropriate, arrangements can be made for them to go home on Low Flow Oxygen.

The neonatal and community teams will provide training, equipment and support before this happens.

Will my baby’s lungs get better?

Your baby’s lungs will continue to grow and develop after birth.

Many babies gradually need less respiratory support and oxygen as they grow.

Some babies need additional follow-up after leaving the neonatal unit, particularly during their first few years.

Some babies are not ready to have all the nutrition they need as milk. TPN is a special liquid containing nutrients such as protein, carbohydrate, fat, vitamins and minerals.

Instead of going into the stomach, TPN is given directly into your baby’s bloodstream through a vein.

It may be given through an umbilical line or another intravenous line.

As your baby becomes able to tolerate more milk, their TPN can usually be reduced. Your baby’s neonatal team will regularly review their individual nutritional needs

It is particularly useful for babies who are born prematurely.

A small ultrasound probe is gently placed over the soft spot (fontanelle) on the top of your baby’s head.

The scan is painless and can usually be carried out beside your baby’s incubator or cot.

It can help us look at:

* The structure of your baby’s brain

* The fluid spaces within the brain

* Signs of bleeding, such as IVH

* How your baby’s brain is developing

Some premature babies have several cranial ultrasound scans at different stages of their neonatal stay.

Your baby’s doctor or nurse will explain when scans are planned and discuss the results with you.

An ECHO is an ultrasound scan of your baby’s heart.

It allows the medical team to see the structure of the heart, how it is working and how blood is flowing through it.

Your baby might have an ECHO if:

* We hear a heart murmur

* We suspect a PDA

* There are concerns about your baby’s circulation

* Your baby needs certain types of breathing support

* We need to look more closely at their heart

A small ultrasound probe with gel is gently moved over your baby’s chest.

The scan is painless and does not use radiation.

It is a routine examination offered to all babies.

The newborn examination is usually carried out within the first 72 hours after birth or when your baby gets to 34 weeks gestation.

As part of the examination, the healthcare professional specifically checks your baby’s:

Eyes – including checking for cataracts

Heart – listening and checking the circulation

Hips – checking how the hip joints move

Testes – for baby boys, checking whether they are in the correct position

Your baby will also be offered another physical examination at around 6–8 weeks old.

If your baby’s neonatal care means the examination needs to be arranged differently, the team will make sure the appropriate checks are completed.

ROP is a condition that can affect the blood vessels at the back of the eye (the retina) in babies who are born prematurely.

Babies who meet the screening criteria will have regular eye examinations while their eyes are developing.

Before the examination, eye drops are used to make your baby’s pupils larger so that the specialist can examine the back of their eyes.

Most babies who are screened do not need treatment.

If changes are found, your baby may need more frequent eye examinations. A small number of babies develop ROP that needs treatment.

Your baby’s team will tell you when screening is due and explain the results to you.

You are the most important people in your baby’s life and an important member of their care team.

At first, the neonatal environment and equipment can make it difficult to know what you can do for your baby. Our team will help you become involved at a pace that is right for you and your baby.

Depending on your baby’s needs, you may be able to help with:

Taking your baby’s temperature
Changing nappies
Providing mouth and skin care
Comforting and gently holding your baby
Skin-to-skin/Kangaroo Care
Feeding your baby
Expressing breast milk
Reading or talking to your baby
Helping with your baby’s first bath
Learning your baby’s cues and when they need rest

As your baby grows and becomes stronger, you will gradually do more as your confidence grows.

Please tell us what is important to you and ask your baby’s nurse how you can be involved.

We want you to feel like a parent, not a visitor.

CPAP stands for Continuous Positive Airway Pressure.

CPAP supports your baby’s breathing by providing a gentle, continuous pressure to help keep the tiny air spaces in their lungs open. Your baby is still breathing for themselves, with CPAP giving them some extra support.

There are several reasons why a baby may need CPAP.

It is commonly used for babies who are born prematurely because their lungs are still developing and they may need some extra help to keep their lungs open.

CPAP may also be used for babies who are having difficulty breathing for other reasons, or as support after a breathing tube has been removed following ventilation.

Every baby is different, and your neonatal team will explain why CPAP is the right breathing support for your baby.

What will my baby be wearing?

CPAP is usually given through Soft nasal prongs which sit gently inside the nostrils a small mask which sits over the nose.

You may see the neonatal team alternate between different masks or prongs. This can help reduce pressure on your baby’s delicate skin.

Your baby may also wear a special hat or bonnet. This helps keep the CPAP tubing and equipment securely in the correct position.

The tubing is connected to the CPAP system, which provides your baby’s breathing support.

What does CPAP actually do?

CPAP provides continuous gentle pressure while your baby breathes.

This pressure helps prevent the tiny air spaces in your baby’s lungs from closing completely between breaths.

Your baby continues to do their own breathing while CPAP helps make this easier.

If your baby also needs additional oxygen, this can be given through their CPAP.

Some babies on the neonatal unit need more help with their breathing. This may mean using a ventilator.

Seeing your baby connected to a ventilator for the first time can feel overwhelming. There may be lots of tubing, wires, numbers and alarms around them.

What is a ventilator?

A ventilator is a machine that provides breathing support for your baby.

Your baby will have a small breathing tube called an endotracheal tube (ET tube). This passes through your baby’s mouth or nose and into their windpipe (trachea).

The breathing tube is then connected to the ventilator. Depending on your baby’s needs, the ventilator can support some or all of their breathing and the amount of support can be changed as your baby’s condition changes.

Why might my baby need a ventilator?

There are many reasons why a baby may need ventilation.

For example, some babies who are born very prematurely have immature lungs and need additional breathing support.

Other babies may need ventilation because they are unwell, have difficulty breathing independently, they may have an infection, or need time for their lungs and body to recover.

Every baby’s situation is different.

Your baby’s doctor or nurse will explain why ventilation is needed for your baby and answer any questions you have.

Can I still touch my baby?

Yes. Your baby still needs you.

It is completely understandable to feel nervous about touching your baby when they have a breathing tube and lots of equipment around them.

Our nurses can show you how to touch and comfort them safely.

Will my baby be comfortable?

Keeping your baby comfortable is an important part of their neonatal care. The team will regularly assess your baby’s comfort.

Some babies may need medicines for comfort, pain relief or to help them tolerate certain treatments or procedures. This will depend on your baby’s individual circumstances. Even while your baby is ventilated, things such as your voice, gentle touch and comfort holding can also be important.

Removing the breathing tube is called extubation.

After extubation, some babies can breathe without additional support, while others may move onto another type of breathing support such as, BiPAP, CPAP, High Flow or Low Flow Oxygen.

BiPAP stands for Biphasic Positive Airway Pressure.

BiPAP provides breathing support using two different levels of positive airway pressure. The pressure alternates between a higher and a lower level to give your baby additional breathing support while helping to keep the tiny air spaces in their lungs open.

Your baby is still breathing for themselves, with the BiPAP providing additional support.

Why might my baby need BiPAP?

There are several reasons why a baby may need BiPAP.

It may be used when a baby needs more breathing support than CPAP alone can provide, or it may be used after a breathing tube has been removed following ventilation.

It is particularly useful for some premature babies whose lungs and breathing control are still developing.

On our unit, CPAP and BiPaP are delivered using the same machine, with the same nasal prongs and masks that you may see over your babies nose.

High Flow provides warmed and humidified air, with or without additional oxygen, through two small soft prongs which sit inside your baby’s nostrils.

The gas is delivered at a higher flow than standard low-flow oxygen and can help support your baby’s breathing.

What will I see?

Two small prongs sitting in your baby’s nose
Tubing connecting these to the High Flow machine
Equipment used to warm and humidify the gas

Your baby may move onto High Flow as they need less breathing support, or High Flow may be the most appropriate support for them at that particular time.

Some babies need a small amount of additional oxygen without needing other breathing support.

This may be given using Low Flow Oxygen.

Your baby will usually have two small, soft prongs which sit just inside their nostrils. These are sometimes called nasal cannulas.

The cannulas are connected to tubing which supplies oxygen to your baby.

Why does my baby need oxygen?

Some babies need additional oxygen while their lungs continue to grow, develop or recover.

The amount of oxygen your baby needs will be carefully prescribed and monitored by the neonatal team.

Some babies only need oxygen for a short period. Other babies may need it for longer.

Some babies are otherwise ready to leave the neonatal unit but still need a small amount of additional oxygen.

If this is the case for your baby, they may be able to go home with oxygen rather than remaining in hospital solely because they still need oxygen support.

The thought of taking your baby home with oxygen equipment can understandably feel daunting at first.

You won’t be expected to manage this without preparation and support.

If home oxygen is being considered for your baby, the neonatal team will discuss this with you and make an individual discharge plan.

Babies on the neonatal unit may need to be fed in different ways depending on how early they were born, how well they are and their stage of development.

Your baby may receive nutrition through a vein, through a feeding tube, at the breast or by bottle and this may change as they grow and become stronger.

Every baby’s feeding journey is different.

We will support you to be involved in feeding your baby whenever possible.

Having breathing equipment around your baby’s face can sometimes make cuddles and cares seem more difficult.

Please speak to your baby’s nurse about how you can still comfort, touch and, when appropriate, have skin-to-skin time with your baby.

Some babies need breathing support for a short time, while others need it for longer.

Every baby is different.

We know that spending long days on the neonatal unit can be tiring. Remember to look after yourself too, taking time to eat, drink and have a short break is important.

There are several places to buy food and drinks within Barnsley Hospital and nearby.

If you prefer to bring your own food, you can store it in the fridge if needed and use the microwave to heat your meal.

We also have a selection of food available for parents and families, including:

• Sandwiches

• Toast

• Cereal

• Fruit

Please help us keep the kitchen clean and tidy for everyone using it.

Having a baby on the neonatal unit may not be how you imagined spending your first days or weeks together.

The incubator, wires and medical equipment can sometimes make it difficult to know how to interact with your baby.

But there are lots of little ways you can build a special connection with your baby every day.

Your voice, touch, smell and presence are all familiar and comforting to them.

Bonding doesn’t have to happen all at once. Take your time, follow your baby’s cues and ask us how you can be involved.

You are an important part of your baby’s care.

You may be given two bonding squares.

One can be worn close to your skin so that it picks up your scent. This can then be placed near your baby, when appropriate.

The other may be placed with your baby so that you can take their familiar scent with you when you leave the unit.

The squares can then be swapped regularly.

Your smell is familiar and comforting to your baby and can be another lovely way of maintaining that connection when you can’t always be together.

You can still comfort them with your touch.

Comfort holding involves gently resting your hands around your baby while keeping them still.

For example, you may gently place one hand around your baby’s head and another around their feet or body.

Premature babies can sometimes find stroking or lots of movement overstimulating, so calm, still hands may feel more reassuring.

Watch your baby’s cues and let them tell you what they enjoy.

Your baby’s nurse can show you how to provide comfort holding safely.

One of the best ways to build confidence and get to know your baby is by becoming involved in their everyday care.

Depending on what your baby is ready for, you may be able to help with:

• Changing nappies

• Taking their temperature

• Mouth care

• Feeding

• Washing or bathing

• Changing their clothes

• Skin-to-skin

• Comfort holding

At first, all the wires and equipment can make this feel daunting.

We’ll help you learn at your own pace.

As you spend more time caring for your baby, you’ll start to recognise their little expressions, movements and cues.

These everyday moments are an important part of being their parent.

Your baby’s neonatal stay is part of their story.

You may want to capture some of the little moments and milestones along the way.

Ideas include:

• Taking photographs

• Keeping a neonatal diary

• Hand and footprints

• Milestone cards

• Keeping their first tiny nappy or hat

• Saving cot cards and name bands

• Taking photographs during skin-to-skin

• Celebrating their first outfit, bath or full feed

• Creating a memory or keepsake box

There is no right or wrong way to make memories.

Choose the moments that feel special to you and your family.

During their time on the neonatal unit, your baby may need one or more special lines.

These allow us to give things such as:

• Fluids

• Medicines and antibiotics

• Nutrition

• Blood or blood products

Some lines can also be used for monitoring or taking blood samples.

The type of line your baby needs will depend on their size, condition and treatment.

Please don’t worry if the equipment looks unfamiliar – always ask us if you’d like us to explain it again.

Every family is different, and everyone will need different types of support during their neonatal journey.

Whether you need someone to talk to, practical help, support for siblings, spiritual care or help finding local services, please speak to us.

You don’t have to manage everything on your own.

Barnsley Hospital has a multi-faith Chaplaincy Team, offering confidential support to patients and families of all faiths and beliefs, including those with no religious belief.

They can offer:

* Someone to talk to

* Prayer and spiritual support

* Blessings and naming ceremonies

* Baptism and other religious ceremonies

* Religious literature

* Contact with local faith leaders

The hospital Chapel is open 24 hours a day and can be used as a quiet space. Chaplains are normally available Monday–Friday, 8am–5pm; urgent support can be requested through hospital staff outside these hours.

Depending on your family’s needs, they can help with things such as parenting support, children’s development, childcare, wellbeing and connecting you with other local services.

There are Family Hubs across Barnsley, including Central, Dearne, North, North East, Penistone and South.

It’s an important period of rapid growth and development for your baby’s brain and body. Barnsley’s Start for Life offer brings together information and services to support families during this period.

Support can help families with:

* Bonding and relationships

* Infant feeding

* Your baby’s development

* Parenting

* Parent and baby wellbeing

* Finding local groups and activities

* Knowing where to go when you need extra help

Some conditions are common in premature or unwell babies, while others are less common.

Please remember that having one of these conditions does not mean your baby will experience everything listed here. Your baby’s team will explain their individual condition, treatment and progress.

Before birth, every baby has a small opening between the two upper chambers of the heart called the foramen ovale. It allows blood to circulate differently while the baby is still in the womb.

After birth, this opening usually closes. If it remains open, it is called a PFO.

PFOs are very common and often do not cause any problems or require treatment.

Your baby’s medical team will explain if a PFO has been seen on their heart scan.

Red blood cells carry oxygen around the body.

Anaemia is common in premature babies because they have fewer stored red blood cells, their bodies are still developing, and they may need regular blood tests while they are on the neonatal unit.

Some babies with anaemia may:

* Look pale

* Become tired during feeds

* Gain weight more slowly

* Need more breathing or oxygen support

* Have a faster heart rate

We monitor your baby’s blood levels with blood tests.

Many babies simply need monitoring while their body begins to make more red blood cells. Some babies may need iron supplements, and occasionally a blood transfusion may be recommended.

Your baby’s team will explain if treatment is needed.

It means there has been some bleeding into the fluid-filled spaces (ventricles) inside the brain.

IVH is more common in babies who are born very prematurely because the tiny blood vessels in their developing brain are particularly fragile.

How is IVH found?

Premature babies may have routine cranial ultrasound scans through the soft spot (fontanelle) on the top of their head.

These scans are painless and allow us to look at your baby’s brain.

IVH is graded from Grade 1 to Grade 4, depending on the extent of the bleeding.

Many smaller bleeds do not cause long-term problems. More significant bleeds may need closer monitoring and follow-up.

If an IVH is found, your baby’s neonatal team will explain:

* What the scan has shown

* What grade it is

* Whether further scans are needed

* What it may mean for your baby

Every baby’s situation is different, so please ask us any questions you have.

Glucose gives the body energy and is particularly important for the brain.

Some babies are more likely to develop low blood sugar, including babies who are:

* Born prematurely

* Smaller or larger than expected

* Unwell

* Having difficulty feeding

* Born to a mother with diabetes

How do we check it?

A small blood sample is usually taken from your baby’s heel to check their glucose level.

Some babies need their blood sugar checking several times until it remains stable.

How is it treated?

Treatment depends on your baby’s individual needs.

This may include:

* Encouraging regular feeding

* Breast milk or formula

* Feeding through an NG/OG tube

* Glucose gel when appropriate

* Glucose given through a vein if needed

Once your baby’s glucose levels are stable, they will usually need fewer checks.

If your baby was born prematurely, they will usually still receive their routine vaccinations according to their actual age from birth, rather than their corrected age.

This means that some babies may have their first routine vaccinations while they are still on the neonatal unit.

Your baby’s medical team will discuss which vaccinations or other protection your baby needs and answer any questions you have.

TB is a bacterial infection that mainly affects the lungs but can also affect other parts of the body.

The BCG vaccine helps protect babies and young children against serious forms of TB.

BCG is not routinely given to every baby in the UK.

It is offered to babies who have a higher risk of coming into contact with TB. This may include babies who:

* Have a parent or grandparent born in a country where TB is more common

* Will live or spend time in a country where TB is more common

* Have been in close contact with someone who has TB

* Meet other NHS eligibility criteria

If your baby needs BCG, the neonatal or maternity team will discuss this with you.

It is usually given as a small injection into the upper arm.

A small blister or sore can develop afterwards and may take several weeks to heal. This is a normal response to the vaccination.

RSV is a common respiratory virus. For most children it causes a mild illness, but premature babies and babies with certain medical conditions can become more seriously unwell.

Some babies at higher risk of severe RSV may be offered additional protection.

This may include babies who:

* Were born very prematurely

* Have certain chronic lung conditions

* Have certain heart conditions

* Have other medical conditions that put them at higher risk

Nirsevimab

Some eligible babies may be offered nirsevimab.

Nirsevimab is not a vaccine. It is a long-acting monoclonal antibody that gives your baby antibodies to help protect them against RSV.

It is usually given as an injection and can provide protection through the RSV season.

All babies receive protection against hepatitis B as part of their routine 6-in-1 childhood vaccinations.

Some babies need additional hepatitis B vaccinations from birth.

If a mother has hepatitis B during pregnancy, her baby will be offered additional protection to reduce the chance of the infection being passed to them.

The first hepatitis B vaccination should be given as soon as possible after birth, followed by further doses.

Some babies may also need an injection of antibodies called Hepatitis B Immunoglobulin (HBIG).

Embrace provides specialist transport for critically ill babies and children who need care at another hospital.

The team can include a transport nurse, doctor or Advanced Nurse Practitioner (ANP), and an ambulance driver.

Their ambulances carry specialist neonatal equipment so that your baby can continue to receive the monitoring, breathing support, medicines and other care they need during their journey.

These help us to:

* Monitor your baby’s growth and development

* Identify certain conditions early

* Check how different parts of the body are developing

* Decide whether any further monitoring or treatment is needed

Not every baby will need every test.

Some checks are offered to all newborn babies, while others are recommended because your baby was born prematurely or needs neonatal care.

We will explain each test to you and let you know when you can expect the results.

This may be recommended if something is noticed during your baby’s newborn physical examination or if your baby has certain risk factors for Developmental Dysplasia of the Hip (DDH).

The ultrasound allows us to look at how your baby’s hip joints are developing.

The scan is painless and does not use radiation.

Premature babies may have the timing of their hip scan adjusted according to their corrected age.

If your baby needs a hip ultrasound, we’ll explain why and arrange the appropriate follow-up.

The neonatal environment can feel very different, with lights, sounds, handling and medical procedures.

We use developmental care to help protect your baby’s developing brain and body and make their environment as comfortable as possible.

This can include:

* Supporting comfortable positioning

* Protecting periods of sleep

* Reducing unnecessary light and noise

* Gentle, positive touch

* Skin-to-skin

* Watching and responding to your baby’s cues

* Supporting their developing senses

Every baby is different. As your baby grows, we’ll help you learn what makes them feel comfortable and when they’re ready for more interaction.

Sleep is really important for your baby’s growth and development.

Premature babies can spend a large amount of their time asleep.

Periods of uninterrupted sleep help support their developing brain and body.

Where possible, we may:

* Group cares together

* Reduce unnecessary handling

* Keep noise levels low

* Reduce bright lighting

* Allow your baby time to settle after cares

Sometimes your baby will still need to be woken for important observations, treatments or feeds.

Don’t worry if your baby sleeps a lot, as they mature, you’ll gradually notice longer periods when they are awake and ready to interact.

These are used within the neonatal unit while your baby is closely monitored.

As your baby gets closer to going home, we will help them transition towards safe sleeping practices for home.

For sleep at home, babies should normally be:

Placed on their back

In their own clear, flat sleep space

With a firm, flat mattress

There should be no pillows, nests, cot bumpers, toys or loose bedding around your sleeping baby.

We’ll talk to you about safe sleep before discharge and answer any questions you have.

The unit can sometimes be a noisy place, with monitors, alarms, equipment and people talking.

We try to reduce unnecessary noise and create a calm environment whenever possible.

You can help by:

* Talking softly near your baby

* Closing incubator doors gently

* Avoiding placing objects on top of the incubator

* Keeping phone sounds low

* Allowing quiet periods for sleep

Not all sound is unwanted.

Your voice is special.

Talking, singing and reading quietly to your baby can provide positive and familiar sounds.

We have a light-up ear device on a neonatal unit which is a SoundEar noise-level monitor. It acts as a visual traffic light system to warn staff and visitors when the noise is too loud for fragile babies.

How It Works

•Green Light: Noise is at a safe, quiet level.

•Yellow/Amber Light: Noise is getting too loud and caution is needed.

•Red Light: Noise has exceeded the safe decibel limit.

We may use incubator covers, lower lighting and cot canopies to help protect your baby’s developing senses and support their sleep.

As your baby grows, we gradually introduce more normal patterns of daytime light and night-time darkness.

When your baby is awake and ready to interact, they may begin looking at your face and making brief eye contact.

Follow your baby’s cues, if they turn away or close their eyes, they may simply need a break.

They are learning about the world through:

Touch – your warm, gentle hands and skin-to-skin.

Sound – especially familiar voices.

Smell – your scent and the smell of breast milk.

Sight – gradually learning to focus on faces and their surroundings.

Taste – through milk, mouth care and feeding experiences when appropriate.

Premature babies can sometimes become overwhelmed by too much stimulation.

Watch your baby’s cues and introduce interaction gently and gradually.

Good positioning helps support this development.

We aim to help your baby maintain a comfortable, gently tucked position while allowing them opportunities to move.

You may see your baby positioned in different ways depending on their medical needs.

As your baby becomes stronger, we will encourage more natural movement and gradually prepare them for positioning at home.

Your baby’s nurse, physiotherapist or occupational therapist may give you individual advice if your baby needs additional support.

We also want them to experience positive, comforting touch.

Depending on your baby’s needs, you may be able to help with:

* Gentle mouth care

* Small amounts of colostrum for mouth care

* Offering comforting touch

* Allowing your baby to bring their hands towards their mouth

* Offering a dummy when clinically appropriate

* Skin-to-skin

These positive experiences can support comfort and help prepare your baby for future feeding.

When comfortable, your baby may:

* Relax their arms and legs

* Bring their hands towards their face

* Hold onto your finger

* Look towards you

* Settle with your voice or touch

* Show interest in sucking

When they need a break, they may:

* Turn away

* Spread their fingers

* Become stiff or floppy

* Change their breathing

* Yawn or hiccup

* Close their eyes

* Become unsettled

Learning these little signs helps us provide care at your baby’s pace.

Don’t worry if you don’t recognise them straight away.

As you spend time together, you’ll become an expert in your own baby’s cues.

One of the simplest and most important things we can all do to protect them is clean our hands properly and regularly.

Everyone entering the neonatal unit – including parents, visitors and staff – has a part to play in keeping our babies safe.

Clean hands help protect little lives.

This is especially important:

* When entering the unit

* Before touching your baby

* Before skin-to-skin or cuddles

* Before feeding or expressing milk

* Before preparing or handling milk

* Before and after changing a nappy

* After using the toilet

* After coughing, sneezing or blowing your nose

* After using your phone

* After leaving and returning to the unit

You may need to clean your hands many times throughout the day.

It might feel repetitive, but every time you clean your hands you are helping us protect your baby.

Please tell us if you are feeling unwell before visiting the unit.

This includes symptoms such as:

* Cough or sore throat

* High temperature

* Vomiting or diarrhoea

* Cold or flu symptoms

* A new rash

* Cold sores

* Any infectious illness

Please also let us know if you have recently been in close contact with someone who has an infectious illness.

We understand how important it is to be with your baby. We’ll talk to you about the safest way to protect them while keeping you involved wherever possible.

If you’re unsure whether you should visit, please contact the neonatal unit before coming in.

After spending time surrounded by monitors and neonatal staff, it is completely understandable to feel both excited and a little nervous about taking your baby home.

Before discharge, we’ll help you prepare and make sure you feel confident caring for your baby.

We’ll talk to you about:

* Feeding

* Medicines and vitamins

* Safe sleep

* Keeping your baby warm

* Basic Life Support

* Travelling safely

* Follow-up appointments

* Who to contact if you’re worried

Some babies may also go home with additional equipment or support.

There will be plenty of opportunities to ask questions before you leave.

A simple room thermometer can help you keep an eye on the temperature.

Babies don’t need a very warm room, and getting too hot can increase the risk of Sudden Infant Death Syndrome (SIDS).

To check whether your baby feels too warm, feel their chest or the back of their neck rather than their hands and feet.

Their hands and feet may naturally feel cooler.

If your baby feels hot or sweaty, remove a layer.

We’ll help you understand how to dress your baby appropriately before going home.

Each baby should be placed:

* On their back

* On a firm, flat mattress

* With their face and head uncovered

* In a clear sleep space

The safest place is in the same room as you for the first 6 months.

Twins may sometimes share a cot when they are very young if it can be done safely, but there are important considerations around positioning, bedding and when they should move into separate sleep spaces.

Because babies born prematurely or at a low birth weight have additional safer-sleep considerations, please discuss your babies’ sleeping arrangements with us before discharge.

Learning what to do in an emergency can help you feel more confident when taking your baby home.

BLS may cover:

* What to do if your baby is unresponsive

* How to check breathing

* Baby CPR

* What to do if your baby is choking

* When to call 999

We understand that learning BLS can feel scary.

Being taught these skills doesn’t mean we expect something to happen to your baby.

They are useful emergency skills for every parent and carer to know.

ICON is a simple message to help parents and carers cope safely with crying:

I – Infant crying is normal

C – Comforting methods can help

O – It’s OK to walk away

If you have checked that your baby is safe and the crying is becoming too much, place them somewhere safe and take a few minutes to calm yourself.

N – Never, ever shake a baby

Speak to someone if you need support.

Crying doesn’t mean you’re doing anything wrong.

If you’re concerned that your baby is unwell or their crying is unusual, seek medical advice.

Before discharge we’ll explain:

* What each medicine is for

* How much to give

* When to give it

* How to give it safely

* How to obtain more

Depending on your baby’s needs, supplements may include things such as vitamin D, iron or other vitamins and minerals.

Your baby’s individual plan may be different from another baby’s.

We’ll make sure you have the medicines and information you need before you leave.

If your baby needs home oxygen, this won’t be arranged suddenly.

Before discharge you’ll receive information and training about:

* Your baby’s oxygen equipment

* How to use it safely

* What to do if there is a problem

* Travelling with oxygen

* Keeping oxygen away from flames and smoking

* Who to contact for help

The equipment you need will be arranged before your baby comes home.

Your baby will continue to be monitored after discharge and their oxygen requirement will be reviewed.

As their lungs grow and become stronger, many babies gradually need less oxygen.

Depending on their needs, your baby may have follow-up appointments with different healthcare professionals.

These could include:

* Neonatal follow-up

* Paediatric appointments

* Hearing appointments

* Eye/ROP appointments

* Physiotherapy

* Dietitian support

* Community nursing

* Health visitor

* GP

* Other specialist teams

We’ll explain which appointments your baby needs before you leave.

Please keep your contact details up to date and let us know if you’re unable to attend an appointment.

Get medical advice if you’re concerned about changes in your baby’s:

* Breathing

* Colour

* Feeding

* Temperature

* Alertness or behaviour

* Wet nappies

* Vomiting

* General appearance

You know your baby.

If something doesn’t seem right, ask for help.

For an emergency or if your baby is seriously unwell, call 999.

For urgent advice when it isn’t an emergency, use NHS 111.

You can also contact your GP or the healthcare team involved in your baby’s follow-up care.

Make sure your baby is registered with a GP so that prescriptions, vaccinations and ongoing healthcare can be arranged.

Keep your baby’s Red Book safe and take it to appointments.

Check that the healthcare team has your correct:

* Home address

* Telephone number

* GP details

You may also need to arrange or update things such as Child Benefit and other financial support.

For eligible babies born on or after 6 April 2025, parents may be able to receive up to 12 weeks of Neonatal Care Leave, in addition to other parental leave.

Eligibility for Statutory Neonatal Care Pay has additional requirements.

This extra time may help families spend more time together after their baby leaves neonatal care.

Check the current Government guidance or speak to your employer to find out what you’re entitled to.

They can provide:

* Emotional support

* Practical information and guidance

* Ongoing support after leaving hospital

* Help understanding what happens next

* Support with appointments and follow-up

* Signposting to other organisations and services

Support is available for parents, partners and families.

Barnsley Hospital’s Chaplaincy Team supports people of all faiths and beliefs, including people with no religious belief.

They can offer:

* A confidential listening ear

* Prayer or spiritual support

* Blessings

* Baptism or naming ceremonies

* Religious ceremonies

* Contact with local faith leaders

* Quiet time in the hospital chapel

Please tell us about any religious, cultural or spiritual wishes that are important to your family.

We want to know what we are doing well and where we could make things better for babies and their families.

Whether you would like to share a compliment, suggestion, concern or idea, we would love to hear from you.

Your feedback helps us learn, improve and continue developing the care and support we provide to families.

Where possible, we would like the opportunity to listen and help resolve concerns while your baby is still with us.

You can speak to:

* Your baby’s nurse

* The nurse in charge

* A member of the medical team

* Another member of staff you feel comfortable talking to

Please don’t worry that raising a concern will affect your baby’s care.

PALS is separate from the neonatal team and can:

* Listen to your concerns

* Provide information and advice

* Help you find the right person to speak to

* Help resolve problems

* Explain how to make a formal complaint if needed

You can tell us in person, leave feedback or send a message to the hospital.

We’ll make sure your kind words are shared with the staff involved.

Thank you messages mean a great deal to our neonatal team.

We encourage you to use the lockers rather than keeping unnecessary belongings around your baby’s cot or incubator.

This helps us:

* Keep your baby’s area tidy

* Maintain good infection prevention

* Keep walkways and clinical areas clear

* Protect your personal belongings

Please avoid bringing valuable items onto the unit where possible.

Please ask a member of staff if you’re unsure where they are.

Remember to wash your hands thoroughly with soap and water before returning to your baby’s cot or incubator.

Good hand hygiene is one of the most important ways we can all help protect babies on the neonatal unit.

A blood gas is a small blood sample that gives us useful information about how your baby is breathing and how their body is responding to treatment.

It can tell us about:

* Oxygen levels

* Carbon dioxide (CO₂) levels

* pH – how acidic or alkaline the blood is

* Bicarbonate and base excess

* Lactate

* Sometimes other results such as glucose and electrolytes

Why does my baby need one?

Blood gases can help us decide whether your baby’s respiratory support needs adjusting.

Blood gases may be taken from a small heel-prick sample, a vein, or from an arterial line such as a UAC if your baby already has one.

The results are available quickly and will be interpreted alongside how your baby looks, their oxygen requirement, breathing and other observations.

Not every result needs to be “perfect”. What’s considered appropriate will depend on your baby’s gestation, condition and individual needs.

Sometimes your baby may need to be transferred to another neonatal unit for specialist or intensive care.

Some neonatal units you may hear us talk about include:

Barnsley Hospital

Level 2 – Local Neonatal Unit

Jessop Wing, Sheffield

Level 3 – Neonatal Intensive Care Unit

Leeds General Infirmary

Level 3 – Neonatal Intensive Care Unit

Bradford Royal Infirmary

Level 3 – Neonatal Intensive Care Unit

Other Local Neonatal Units within the wider Yorkshire & Humber network include hospitals such as:

Doncaster Royal Infirmary

Local Neonatal Unit

Rotherham Hospital

Local Neonatal Unit

Pinderfields Hospital, Wakefield

Local Neonatal Unit

Calderdale Royal Hospital

Local Neonatal Unit

York Hospital

Local Neonatal Unit

There are also other neonatal units across Yorkshire & Humber.

Your baby’s destination will be chosen according to their individual medical needs and where an appropriate neonatal cot or specialist service is available.

Once your baby is well enough and no longer needs specialist intensive care, we will aim to bring them back closer to home when appropriate.

Your baby may return to Barnsley Neonatal Unit to continue:

* Growing

* Feeding

* Reducing their breathing or oxygen support

* Learning to maintain their temperature

* Preparing for discharge home

This is sometimes called repatriation.

Coming back to Barnsley can be another positive milestone in your baby’s neonatal journey.

The timing will depend on your baby’s medical needs and the availability of an appropriate neonatal cot.

We are extremely grateful for your support.

However, because our babies are particularly vulnerable to infection and have specific needs, we aren’t always able to accept every item offered.

Our requirements can also change throughout the year.

If you would like to donate items such as:

* Baby clothes

* Blankets

* Toiletries for parents

* Books

* Muslin Cloths

* Parent care packages

* Memory-making items

Please contact the neonatal unit before purchasing or bringing anything in.

We can let you know what we currently need and whether we’re able to accept your donation.

These include:

• Intensive Care Room

• Special Care Room

• Cubicles

  
  

Your baby may move between these areas as their needs change.

Wherever possible, your baby will not be moved to a different room without you being there or being told beforehand. We will aim to keep you informed about any planned moves and explain why the move is needed.

Where your baby is cared for will always be based on what is most appropriate for them at that time.

Babies cared for here may need:

* Ventilation, CPAP, BiPAP or other breathing support

* Additional oxygen

* Continuous monitoring

* Intravenous fluids or TPN

* Specialist lines such as UVCs, UACs or long lines

* Medicines given through a vein

* More frequent blood tests and observations

There can be lots of equipment, monitors and alarms around your baby. This can feel overwhelming at first.

Please remember that alarms don’t always mean something is wrong. Staff will assess your baby and respond when needed.

Even when your baby needs intensive care, you are still an important part of their care.

We’ll help you become involved with touch, containment holding, mouth care, nappy changes, expressing, skin-to-skin and other cares whenever your baby is ready.

Babies in special care may be:

* Learning to feed

* Growing and gaining weight

* Maintaining their own temperature

* Receiving some oxygen

* Having observations and monitoring

* Receiving medicines

* Preparing for discharge home

Moving into special care can be an exciting milestone in your baby’s neonatal journey.

As your baby becomes more stable, we’ll encourage you to take an increasingly active role in their everyday care.

This might include feeding, changing, bathing, giving medicines and learning your baby’s routines.

The aim is to help you feel confident caring for your baby before you go home together.

A cubicle provides a more separate space from the main nursery.

There are different reasons why your baby may be cared for in a cubicle.

This may include:

* Infection prevention and isolation

* Protecting particularly vulnerable babies

* Providing a quieter environment

* Specific clinical or nursing needs

* Providing additional privacy when appropriate

If your baby needs to be cared for in a cubicle, we’ll explain the reason to you.

You may notice additional infection-control measures such as gloves, aprons or other protective equipment depending on your baby’s individual circumstances.

Please follow the hand hygiene and infection-prevention guidance displayed outside the room.

Being in a cubicle doesn’t mean you can’t be involved in your baby’s care. We’ll continue to support you to cuddle, feed, comfort and care for your baby whenever possible.

Premature and small babies can find it difficult to maintain their own body temperature because they have less body fat and their temperature-control systems are still developing.

An incubator can help:

* Keep your baby warm

* Control the temperature around them

* Provide humidity when needed

* Reduce heat and fluid loss

* Create a protected environment

* Allow staff to closely observe and care for your baby

You can still be involved in your baby’s care while they are in an incubator.

Depending on how well your baby is, you may be able to touch them, provide containment holding, change their nappy, take their temperature and enjoy skin-to-skin cuddles.

Unlike an incubator, it doesn’t have an enclosed top.

Heat is provided to help your baby maintain a comfortable body temperature.

A Babytherm may be used when your baby:

* Needs help maintaining their temperature

* Needs close observation

* Requires frequent cares or procedures

* Needs easy access for medical treatment

* Is transitioning between different types of neonatal care

Your baby will continue to have their temperature monitored closely.

You can still touch, comfort and be involved in caring for your baby whenever their condition allows.

This can feel like a big milestone.

Your baby no longer has the controlled warmth of an incubator, so we’ll continue checking their temperature to make sure they remain comfortable.

Being in a cot can also make it easier for you to become even more involved with:

* Nappy changes

* Dressing

* Feeding

* Cuddles

* Comforting

* Everyday cares

Some babies may use a cot canopy to help protect them from bright light and provide a calmer environment while they continue to develop.

Before making the move, we’ll consider things such as your baby’s:

Temperature

Weight and growth

Gestation

Medical condition

Overall stability

After moving into a cot, we’ll continue to monitor your baby’s temperature closely.

If your baby becomes too cool, they may occasionally need some extra warmth or need to return to an incubator for a while or use something called a cot warmer that lays on top of your babies mattress to help keep them warm.

This doesn’t mean your baby has gone backwards.

Every baby develops at their own pace, and we’ll choose the safest and most comfortable environment for them.

Look back occasionally.

The ventilator that isn’t needed anymore.

The incubator that’s been replaced by a cot.

The tiny feeds that have become full feeds.

The clothes that used to look enormous.

The weight your baby has gained.

Progress can be measured in grams, millilitres and oxygen percentages – but it can also be measured in moments.

Be proud of every step.

Babies on the neonatal unit are routinely screened for MRSA (Meticillin-resistant Staphylococcus aureus).

MRSA is a type of bacteria that can live harmlessly on the skin or in the nose. This is known as colonisation and does not necessarily mean that your baby has an infection.

What happens?

A member of the neonatal team will gently take a small swab from your baby. This is quick and should not be painful.

At Barnsley Neonatal Unit, routine MRSA screening is carried out:

Every Thursday and Sunday

The swab helps us identify whether MRSA is present so that we can take appropriate infection-prevention precautions and help protect all of the babies on our unit.

If your baby’s result is positive, this does not automatically mean they are unwell. We will explain the result and any additional precautions or treatment that may be needed.

CPE are bacteria that live in the gut and have developed resistance to some antibiotics.

A baby can carry CPE without being unwell. This is called colonisation.

What happens?

Screening usually involves taking a small swab. The sample is then sent to the laboratory for testing.

At Barnsley Neonatal Unit, routine CPE screening is carried out:

Every Sunday

Screening helps us identify babies who may be carrying these bacteria so that appropriate infection-prevention measures can be used and the risk of spreading them to other vulnerable babies can be reduced.

If a result is positive, we’ll talk to you about what this means for your baby and answer any questions you have.

Good hand hygiene remains one of the most important ways we can all help prevent infections from spreading on the neonatal unit.

Premature and unwell babies are still developing important movement and sensory skills.

An OT may help with:

Positioning and comfortable movement

Supporting your baby’s developing senses

Developmental care

Understanding your baby’s cues

Helping your baby cope with touch and handling

Supporting sleep and periods of calm

Skin-to-skin and positive touch

Helping parents feel confident handling and caring for their baby

Advice about development as your baby grows

They may also provide advice about activities and positioning to support your baby’s development after discharge.

Parents are an important part of developmental care. Your OT can show you simple ways to support your baby’s development through everyday cuddles, cares and interaction.

In neonatal care, SALT has an important role in supporting feeding, swallowing and early communication.

A SALT assessment may be helpful if your baby is finding oral feeding difficult.

They may look at:

Sucking and swallowing

Coordinating sucking, swallowing and breathing

Breast and bottle feeding skills

Your baby’s feeding cues

Signs that your baby needs a break during feeding

Positioning during feeds

The flow of milk

Whether feeding is safe and comfortable

Supporting positive experiences around your baby’s mouth and feeding

They may work closely with you, your baby’s nurses, doctors, dietitians and other therapists to develop an individual feeding plan.

For premature babies, learning to feed is a developmental skill and it can take time.

The aim isn’t simply to get your baby to finish a bottle. We want feeding to be safe, comfortable and positive, while following your baby’s cues.

Development • Movement • Sensory experiences • Feeding • Communication • Comfort

Not every baby will need to see these teams.

If we think your baby would benefit from specialist support, we’ll explain why and involve you in their assessment and care plan.

Please ask questions and get involved. We’ll show you how you can continue supporting your baby’s development and feeding too.

Neonatal Outreach Team

The Neonatal Outreach Team can provide an important link between the neonatal unit and home.

As your baby gets closer to discharge, the team may be involved in discussions about what support your baby and family might need after leaving hospital.

Depending on your baby’s individual needs, this may include ongoing monitoring, feeding support, oxygen or other specialist care at home.

Having the Outreach Team involved in care, helps us plan ahead for a safe and supported transition from hospital to home.

* Bonding squares (for baby to smell you for comfort)

*Hot drink flasks (to use when at the bedside for safety)

*Expressed breast milk cool bag (to transport any EBM between the ward & home)

*Water bottle (to stay hydrated)

*V-Create form (sign up to get photos sent of your precious baby)

*Mothers & others guide (lots of useful tips & ticks)

*Small mirror (to see baby while having skin to skin)

Neonatal physiotherapists have specialist knowledge of premature and unwell babies. They work alongside parents and the neonatal team to support your baby’s movement, positioning, development and comfort.

Why might my baby see a Physio?

Babies develop lots of their movement skills during the final weeks of pregnancy. When a baby is born early or is unwell, they are developing these skills in a very different environment.

A physiotherapist may assess and support your baby’s:

* Movements and muscle tone

* Posture and positioning

* Head shape

* Flexibility and range of movement

* Comfort when being handled

* Development as they grow

* Ability to bring their hands towards their face and body

* Individual developmental needs

They may also work closely with Occupational Therapy (OT), SALT, doctors, nurses and the Neonatal Outreach Team.

Positioning & Developmental Care

Your physiotherapist may recommend different ways of positioning your baby to help them feel comfortable, contained and supported.

While your baby is on the neonatal unit, this may include using nests or positioning aids under close monitoring.

As your baby approaches discharge, the team will help you transition to safe sleep practices for home.

Parents Are an Important Part of Physiotherapy

Physiotherapy isn’t just something that happens to your baby. You can be involved too.

Your physiotherapist can show you simple ways to support your baby through everyday care, including:

* Comfortable positioning

* Containment holding

* Positive touch

* Skin-to-skin

* Supporting your baby during nappy changes and cares

* Recognising when your baby needs a rest

* Encouraging comfortable, natural movement

* Tummy time when your baby is developmentally ready

* Activities to support development as your baby grows

These don’t need to feel like exercises. Often, the best developmental support happens naturally through cuddles, play, touch and everyday care with you.

The shower room offers:

* Shower facilities

* Toilet and washing facilities

* Disabled access

* Space for parents who may need additional accessibility support

* Privacy while using the facilities

Please bring toiletries, towels and any personal items you may need.