About neonatal care - a quick guide

We know how overwhelming it can be when you arrive on a neonatal unit with your baby. Parents often tell us it can be difficult to process all the information you are given.

When you feel like you are ready, the pages in our ‘About neonatal care’ section are here to help. They will walk you through all the key things you might like to know about neonatal care and what this means for you and your baby.

For now, you might like some brief answers to some of the questions you may have about neonatal care, or for when you first arrive on a neonatal unit.

What is neonatal care and why does my baby need it?

Neonatal care is the type of care a baby receives in a neonatal unit. Units are a part of hospitals which provide care for babies who are born:

• prematurely (before 37 weeks’ gestation)

• with a medical condition which needs treatment, or at a low birthweight

• if they develop an illness after birth.

For more information about what neonatal care is and why your baby might need care, visit our page - What is neonatal care?

What are the different types of neonatal unit, and what do they mean?

There are three main types of neonatal unit:

• Special care baby unit (SCBU or SCU) – Level 1: This is for babies who do not need intensive care and often born after 32 weeks' gestation.

• Local neonatal unit (LNU) – Level 2: This is for babies who need a higher level of medical support and often born between 27-32 weeks' gestation.

• Neonatal intensive care unit (NICU) – Level 3: This is for babies with the highest need for support lasting more than 48 hours and often born before 28 weeks' gestation.

Your baby may need to be moved to a different unit and hospital. This is called a ‘transfer’. This can be for a number of reasons, but usually involves them needing some sort of specialist care. Transfers are quite common, and your baby will be cared for by a specialist team. At least one parent or carer will be able to travel with them.

For more information about how neonatal care works and the different levels of care, visit our page - What are the different levels of neonatal care?

What will happen when we get to the unit?

• When your baby arrives on the neonatal unit, one of the nurses or another member of your care team should show you around and explain how things work. Each unit works differently, but there are standard routines that apply in most hospitals.

• The staff will also keep you up to date on your baby’s care during the first few hours and at regular times after that.

• Staff on the unit work in shifts, coming on duty and going home at set times. Ward rounds happen once or twice a day. This is where you and the neonatal care team plan your baby’s care.

• Everyone coming into the neonatal unit must wash their hands and forearms thoroughly and, after drying, use the sanitising hand gel provided. The unit might also have what’s called a “bare arm policy”. This means no clothing or loose jewellery can be worn below the elbow.

• Because of COVID-19, some units might be using extra protection measures to control infection.

• Family members will need to stay away if they have COVID, a cold, the flu or a tummy bug, or if they have whooping cough, measles, chickenpox or other contagious infections.

How does access to the unit work?

• Parents are not considered visitors. You should be able to be with your baby 24 hours a day. It will be very important to the staff that you are not separated from your baby unnecessarily.

• Parents and visitors (for exampple, other family members) will usually be able to ring a doorbell to get into the unit.

• Each unit has its own visiting policy. The unit may have set visiting hours for other family members and might ask you to limit the number of people.

For more information about what how units are run and your access to the unit, visit our page - Routines on the unit

How can I look after my baby while they are in neonatal care?

• Arriving in the neonatal unit can be a shock for parents. You may feel like you aren’t able to do all the things you had hoped and imagined as a new parent. Some parents feel helpless and worried. This is completely natural.

• The type of care your baby is receiving might affect some of the things you would like to do with them.

• The staff will help you to look after your baby and encourage you to be involved in their care as much as possible. They might talk to you about skin-to-skin or ‘kangaroo care’, feeding, or washing and changing your baby.

• Even if you’re not able to hold your baby, you can talk to your care team about other ways you can strengthen your bond. This might include reading to your baby, watching them for signs of their care needs, or putting something with your smell into their cot or incubator.

For more information about how you can feel closer to your baby and be more involved in their care, visit our page - Getting involved in your baby's care

Who will be caring for my baby?

Different health professionals work as a team on the neonatal unit. You will see different faces looking after your baby, with staff coming and going on different shifts. They include:

• Nurse and nurse associates: They will support you in providing most of the day-to-day care for your baby.

• Doctors: They will organise your baby’s care and treatment in partnership with you.

• Other specialist staff: These staff will depend on what type of unit your baby is in, but can include speech and language therapists, occupational therapists and dieticians.
  

For more information about staff on neonatal units, visit our page - Neonatal staff and what they do

What practical support is available for me and my family?

• Having a baby in neonatal care can affect other areas of your life, such as difficulties with finances, travelling to and from hospital, or looking after other children.

• You can talk to your lead nurse about what support is available, e.g., free parking or food vouchers.

• You can find details of other organisations which might be able to support you, including by providing advice about money, on our page - Other helpful organisations

Who can I talk to when I feel like I need emotional support?

• Some units have access to professional counsellors, psychologists or psychotherapists. Ask your care team what is available on your unit.

• The Bliss Support Team are here to support you. If you would like to get in touch, you can email hello@bliss.org.uk, or visit this page - Emotional and practical support

• Bliss Champions are trained volunteers who can offer a listening ear over zoom or face to face chat on some units. You can ask your care team if there is a Bliss Champion who visits on your unit.

• You can also organise a video call with our Online Bliss Champions by visiting this page - Support via video call

• Our moderated peer-support group on Facebook is a private space for parents to talk to each other and seek support from other parents with neonatal experiences. You can join the group by following this link - Bliss Support Group for Parents of Babies Born Premature or Sick

For more information about what sort of support is available to you and your family, visit our page - Support for the first few days in the neonatal unit