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Wirral University Hospital NHS Foundation Trust

Neonatal Care

We are a designated Level 3 Neonatal Intensive Care Unit – one of only 2 in Cheshire and Merseyside. This means we are able to care for some of the most poorly babies.

Our Neonatal Unit has 24 cots which enable us to provide specialised care for babies from around 24 weeks of pregnancy. Many of the babies we care for are born early (premature). However some babies born around the time they are due (term) can have problems too, some requiring a brief stay with us and others a more intensive, longer stay.

Our approach is caring, holistic, individualised and with an emphasis on family. We provide research based care and strive to keep abreast with the latest research and medical technology. We consider the psychological, physiological, social and spiritual needs of baby and family.

Parents, grandparents, family and friends are often shocked and upset when a baby needs to be cared for by us. We try to keep parents as informed as possible, allaying fears and worries when we can and enabling them to relay baby's progress to their family and friends.

Photographs are taken as soon as possible after birth so mum and dad can show family and friends their baby.

Our priority is to stabilise and investigate baby's condition as quickly as possible. Our aim is to provide expert care proficiently and to keep parents as included as we can during the admission of baby and ongoing care. We strive to be supportive to parents enabling them to gain confidence in caring for their baby.

We often explain to parents that their baby's progress may be something of a 'rollercoaster journey' - two steps forward, one step back, and that there will be good days and bad days but we shall be travelling with them.

Our Wirral Women and Children’s hospital has a Ronald McDonald House on site. This provides free ‘home away from home’ accommodation for parents with premature babies being treated at our hospital.  

We have recently launched a secure website to help parents keep in touch with their baby whilst in our Neonatal Intensive Care Unit. We know how difficult this time can be for mum, dad, family and friends. Called “I See You”, parents will be given a secure reference login in which daily updates and pictures will be posted online. Ask our team for more details about this unique service.

Consultants/Doctors

Consultants

The consultants are the most senior members of the Neonatal medical team, who are highly specialised in Neonatal medicine, with broad past experience in general paediatrics and individual areas of expertise. They each rotate for a week at a time. In addition there are other consultants for community and paediatric wards.

The consultant has overall responsibility in the care and management of each baby admitted to Neonatal Unit and they provide support to parents as required through full discussion of more complicated issues relating to the health needs of the child.

The consultants review the health and development of babies following discharge from Neonatal Unit according to their individual needs ensuring there is appropriate support and advice for the families of babies admitted to Neonatal Unit, both during admission and following discharge.

Dr David Lacey and Dr Lil Breen follow up babies who are on oxygen and lead ward rounds on the Neonatal Unit. Dr Russell Austen and Dr Todd care for babies on the post natal wards, in paediatric wards, on the community.

Each consultant has a team of registrars and senior house officers working for them.

Registrars

The Registrars who have at least two years experience of paediatric and Neonatal medicine give 24 hour on-call presence to supervise ongoing care of all babies on Neonatal Unit. They offer ongoing support, training and education to Senior House Officers. The registrars communicate with parents about individual issues concerning the health of their baby as it develops. They perform and supervise complicated procedures and investigations.

Senior House Officers (SHOs)

SHOs are qualified junior doctors from a range of specialities including paediatrics, obstetrics and surgery. They hold a daily review of all babies admitted to the Neonatal Unit including physical examinations, review of results and tests in discussion with nursing staff. They will attend complicated deliveries on the Labour Ward where risks to the health of the newborn may occur.

24 hour support for review of all babies on the Neonatal Unit where new problems or concerns have been identified by parents and Nursing Staff. The SHOs with the nursing staff ensure that GPs and Community Teams are informed of all problems and health issues relating to babies by letter or fax, and that all referrals to specialist consultants such as Cardiology and Orthopaedics are made as required.

Nurses/Midwives

Some or all of the following staff will be involved in the care of your baby - and their families - in the neonatal unit. A brief description of their roles is included.

Advanced Neonatal Nurse Practitioner/Educator 

Responsible for overseeing the day to day care of all babies on the unit. 

Advanced Neonatal Midwives and Nurses

Responsible for assisting medical staff with emergency and anticipated neonatal problems on the delivery suite and for liaising with postnatal ward staff. 

Senior Neonatal Midwives and Nurses

Senior Neonatal Midwives and Nurses often co-ordinate the unit and may have a special interest within neonatal care e.g.: running the eye clinic, breast feeding, infection control, transfer of babies.

Midwives

Your midwife will continue to care for you during your stay in the hospital and at home. Your Midwife can do post natal checks on the neonatal unit or you can arrange to meet her on the post natal wards. Your midwife will liaise with our community neonatal midwives about follow up care for you when baby goes home.

Neonatal Nurses

Responsible for providing direct nursing care to babies on the neonatal unit and looking after the babies from admission to going home. They support the parents with feeding, explanations of baby's condition, assisting and teaching parents in the care of their baby - aiming to assist to a smooth transition to home.

Co-ordinator on the Neonatal Unit (NNU)

The coordinator's role is to ensure the best care for babies and their parents -offering clinical neonatal care, developmental care and emotional support, so the babies on the unit reach their maximum potential. Click here to view a full description.

The Nursery Nurse/Assistant Practitioner

Responsible for the care of babies within the low and high dependency areas of the neonatal unit. Supports parents in all aspects of care.

Health Care Assistants

Support the nursing and medical staff. To ensure all the supplies are stocked and ordered and to help coordinate many of the clinics within the department and take on specific tasks within their job role e.g. Milk bank work.

Medical and nursing students

Training is essential for all health professionals so there are opportunities for students to learn about the speciality of neonatal care; if you do not wish your baby to be involved you may do so without adversely affecting his/her care please inform the manager/ nurse caring for your baby.

Infection control nurses

There are identified nurses on the neonatal unit who act as a link with the infection control team at the hospital. 
 

Common Terminology

Common Terminology

Pregnancy can be a confusing time, but we're here to help you. See below for the most commonly used terms and an explanation of their meaning.

Anaemia

Having too few red blood cells which carry oxygen in the blood.

Antibiotics

Medication used to treat bacterial infection without harming good bacteria within the body.

Apnoea of prematurity (Apnoea means no breathing)

Pathways within the brain are not fully formed causing lack of control over his/her breathing.

Blood gas

This may be taken from the heel prick or direct from an artery (blood vessel which carries oxygen). The blood gas tells us baby's respiratory condition. Commonly in small early babies a line is put into the arterial blood vessel in baby's umbilical cord (tummy button) called an umbilical arterial catheter. Baby's blood pressure can be monitored via this and blood samples taken without disturbing baby.

Blood oxygen level

The amount of oxygen present in the baby's blood.

Blood pressure (BP)

This is measured with a small cuff (baby sized version of the one you had during your pregnancy) or directly via the umbilical arterial line and tells us how much pressure is being used to pump the blood around baby.

Blood transfusion

Blood transfusions are sometimes required. Transfusions are performed to replace blood that babies have not been able to produce.

Brady, bradycardia, dips

The baby's heart beat has slowed down. A cardiorator will be used to record the heart beat via three sensors two on the chest and the other on a leg.

Medication is given to help support the breathing and heart rate when born below 32 weeks. The medication of choice is caffeine (a bit like us having a strong black coffee in the morning.) This is given daily.

Bronchopulmonary dysplasia (BPD) - Chronic lung disease

A complex disorder of the lungs which resulted from the premature baby needing support from a ventilator in the first few weeks of life.

Continuous positive airway pressure (CPAP)

Air and oxygen are given under pressure into the nose via small tubes attached to a hat. This allows baby to breathe with assistance because the air sacs within the lungs do not fully collapse making the exchange of carbon dioxide and oxygen easier.

Desats, desaturation

The blood oxygen levels have dropped below a normal amount. The nurses or doctors will set an alarm depending on baby's gestational age. This helps them to decide if baby needs extra oxygen.

Donor EBM

Breast milk that has been collected, tested and pasteurised from another mother and made available for other babies to use.

EBM

Expressed breast milk.

Electrolytes

Minerals that are present in the blood eg. calcium, sodium and potassium which are essential for life and need to be balanced.

Endotracheal tube (ET tube)

A soft tube that is introduced into the mouth and leads into the lungs, connected to a ventilator.

Haemoglobin

The oxygen carrying part of the red blood cell.

Heart beat/rate

The number of times the heart is contracting to push blood carrying oxygen to the brain, lungs and rest of body. Your baby's heart rate can vary from 120-160 beats per minute.

Hypoglycaemia

Lack of glucose in the blood which is needed for energy.

Incubator

A clear plastic box bed with drawers below allowing baby to be kept warm. It supports the lines and leads attached to baby. Parents and medical staff care for baby through small doorways called portholes.

Intravenous lines, IV and Drips

These are very thin tubes inserted into the blood vessel in an arm or leg, allowing nutritious fluid to be given.

Jaundice

The breakdown of excess red blood cells after birth which lay down bile salts in the skin.  A Phototherapy light is usually used to treat the yellow colouring.

Kangaroo care (KC)

Skin to skin holding which all parents are encouraged to do once baby is stable. The baby will rest onto mum or dads bare chest and both are covered by a blanket.

Meconium

The first poo/stool, produced during the pregnancy usually a green black colour and very sticky.

Nasal cannula/nasal prongs

A measured amount of oxygen will be given into the nose via small tubes in the nasal nares.

Oedema

Extra fluid collected beneath the skin which leads to swelling.

PDA, patent ductus arteriosus

The ductus arteriosus is open during the pregnancy and the placenta supplies the foetus(baby) with oxygen. Normally within 24hours of birth when baby is breathing for himself the ductus arteriosus closes. When this flap does not close it is called a patent ductus arteriosus. It can correct itself over the next few months but may require medication or surgery to close it.

Platelets

Particles that float around in the blood and help blood to clot.

Pyrexial

When the baby’s temperature is measuring higher than normal. The nurse will use a hand held thermometer or a sensor on the body. Monitoring the temperature is very important, a low temperature also indicate a problem. The aim is to keep babies temperature between 36.6°C and 37.2°C

Respiratory distress syndrome

A lung disorder that affects premature babies due to their lungs being immature and not producing sufficient surfactant.

SB, bili, bilirubin level

These refer to the blood test levels of bilirubin in the blood which makes baby look yellow ie. jaundiced.

Surfactant

A chemical in the lungs of term babies and adults which helps keep their airway open.

Tube feeding

A tube can be inserted into the stomach via the nose or mouth in order to give milk.

Umbilical arterial catheter

This measures your baby's blood pressure and blood samples can be taken without disturbing baby.

Umbilical venous catheter

A line/tube into the vein in the umbilical cord which allows nutritious fluid to be given.

Urea

A waste product removed from the body in urine.

Vent/ventilator

A breathing machine which can be controlled by the doctors and nurses giving measured amounts of oxygen allowing baby to breathe with the machine inflating and deflating the lungs. The breathing may be quite fast initially and as baby improves the machine will do less and baby will do more of the breathing. This is weaning baby off the vent.

Vital Signs

Heart beat, temperature, blood oxygen level, blood pressure.