Baby's Name... Home Address Birth Date... Birth Time... Birth Weight... Consultant... Named Nurses

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2 Baby's Name... Home Address Birth Date... Birth Time... Birth Weight... Consultant... Named Nurses......

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4 Some other members of the Neonatal Care Team are: Neanatal Care Team Medical care of your baby is supervised by Consultant Neonatologists: Dr Michael Hall, Dr Robert Ironton, Dr Alyson O'Donnell, Dr Victoria Puddy and Professor Howard Clark. They have a team of doctors called Specialist Registrars and Senior House Officers (SHO) who provide the daily medical care. In addition to these doctors there is a team of highly trained neonatal nurses called Neonatal Nurse Practitioners (NNP). The Senior Clinical Nurse on the Neonatal Unit is Carol Woolridge There is a large team of specially trained nurses, midwives, and nursery nurses caring for you and your baby throughout the 24 hours. This is a teaching hospital so medical students and student nurses may be visiting and working with our trained staff members. Neonatal Physiotherapist Family Care Sister Liaison Health Visitor Social Worker Ultra Sound Specialist Ward Pharmacist Radiographers Chaplin Technician Infant Feeding Advisor Denise Hart Lisa Leppard Margaret Hanson Pauline Hilton Dr M. Hanna Amanda Bevan Paediatric Team Karen MacKinnon Ian Chapman Sandy Jackson

5 Newborn surgical service Some babies require specialist surgical input or an operation at sometime after they are born. Surgical care is provided by a dedicated experienced surgical team that includes the following: - Consultant Paediatric Surgeon: - Mr Burge Clinical Lead in Neonatal Surgery Clinical Surgical Nurse Specialist: - Melanie Drewett. Neonatal Surgical Specialist Registrar Surgical Support Sister: - Sandra Edwards All babies will have a named consultant surgeon who will also be closely involved in your babies care. Your baby will be seen every day by the surgical team to plan their ongoing care. Melanie will be very closely involved in the specialist surgical management of your baby s care supported by the Neonatal Surgical Specialist Registrar. We will endeavour to discuss all issues with you as soon as mutually convenient but would encourage you to approach us with any concerns that you may have. If your baby s condition has been diagnosed before birth it is likely that you will have met Sandra already. Sandra will provide information and support plus specialist surgical teaching and expertise. The neonatal surgical office is based on the neonatal unit and our contact details are as following: - Office Telephone: Melanie s Mobile: Other paediatric surgical consultants include: - Mr Griffiths, Miss Kitteringham, Mr Wheeler, Mr Malone and Mr Steinbrecher Urology

6 Newborn babies who need surgery If your baby is on a ventilator the operation will usually be performed on the unit without the baby needing to be moved to an operating theatre. Occasionally it may be necessary for your baby to be transferred to Southampton General Hospital for surgery or other investigations. Your baby will receive all the support and monitoring necessary and will be accompanied by members of the neonatal team during the journey. If transferred it is likely that your baby will go to the Paediatric Intensive Care Unit (PICU). Once on PICU your baby would then be moved to the operating theatre for surgery and would then return to PICU until ready for transfer back to the Neonatal Unit. You will be able to visit and spend time with your baby on PICU. If your baby needs a neurological (brain) or a cardiac (heart) operation your baby may be transferred to the specialist neurological or cardiac unit in Southampton General Hospital for the operation and after-care. Discharge- We will try to get you and your baby either home or back to your local hospital if appropriate when it is safe for your baby. The surgical team will co-ordinate arrangements as necessary and we will also be available to support you once your baby has been discharged. We try to see all babies within a week of discharge and most early follow up is led by Melanie.

7 Regular care and events on the Neonatal Unit Having a baby admitted to the Neonatal Unit may be a new and extraordinary experience for you. In these circumstances nothing will be routine for you. However, the medical care needs of your baby will be familiar to the doctors and nurses who specialise in the care of sick newborn babies. Even though all babies are individual, many essential aspects of your baby s care will follow a standard course, for example it is very important that all premature, low birth weight and sick babies are given Vitamin K soon after delivery as part of their medical care. Babies who have breathing difficulties will regularly have blood tests, chest x-rays, ultra-sound scans and other investigations to monitor their needs and progress and these are essential parts of their care. Many babies who require admission to the Neonatal Unit will need drips put into veins or arteries. These drips allow fluids and medicines to be given to the baby and blood samples to be removed for testing. Some babies, especially the earliest, smallest and sickest babies who need a lot of blood tests also need small, frequent blood transfusions, which can be given through one of the drips. Aspects of your baby s care will usually be discussed with you. However, in order to give your baby the best possible nursing and medical care it is important that we respond to your baby s monitoring, investigation and treatment needs as soon as they arise. It is possible therefore that some investigations, treatments or changes may be carried out before there has been an opportunity to discuss them with you. These will of course be discussed with you when you next visit your baby. Occasionally a baby may need a special test or procedure. The need for a special test will be discussed with the baby s parents and their permission sought to carry out that particular test. As part of your baby s care on the Neonatal Unit your baby may receive eye checks. Hearing checks will also be performed if your baby is on the Neonatal Unit for more than 48 hours. You will be informed of the results of these checks. In order to provide the very best medical and nursing care for early, small and sick babies it is essential that research studies be carried out to discover the most effective treatments available. At times some of this important research takes place in this Neonatal Unit. A nurse or doctor may talk with you about studies currently in progress. Your permission will always be sought before your baby participates in any study.

8 Routines on the Neonatal Unit The Specialist Registrars, SHOs and NNPs and nurses do a ward round every morning to assess each baby and plan together the medical and nursing care of your baby for that day. You are welcome to join the doctors and nurses for the discussion about your baby. However, we would ask that you appreciate the need for confidentiality and privacy of other parents and their babies during these ward rounds. You are, of course welcome to discuss your baby s care and treatment with the doctors and nurses at any time. Nurses do a ward round at the hand-over time between shifts (7.30am and 8pm). These hand-over sessions take approximately minutes at each time. To minimise overcrowding and to observe the confidentiality and privacy of other parents and babies we will ask all parents to leave the room during these hand-over sessions. We would like to thank you in anticipation of your co-operation. There is a larger ward round led by the Consultant Neonatologists every Wednesday morning starting at 9.30am. Every baby is discussed in detail with input by all those involved with your baby s care. Previous care is reviewed and a plan of future care is made. Because of the thoroughness of this ward round it may take a few hours to complete. To minimise overcrowding and to observe the confidentiality and privacy of other parents and babies we will ask all parents to leave the room during this ward round. We would like to thank you in anticipation of your co-operation. There will, of course be opportunities for you to discuss the proposed plan of care with the doctors and nurses later in the day. Quiet Time We have a quiet time for the babies each day between 1pm - 2pm. During this time the babies are left to rest and nursing and medical handling is kept to minimum. This however can be a good opportunity for you to have some relaxing time with your baby such as Kangaroo Cuddles. No nappy changes should take place during this time.

9 Visiting your baby Parents are welcome and encouraged to spend as much time with their baby as they wish. You are the most important people to your baby and we hope you will feel able to visit as frequently as possible. We understand that having your baby in the NNU is very stressful and you may only feel comfortable to visit for short periods at a time or your visiting pattern may be influenced by other important commitments. Rest is very important for sick babies and at first your baby may not be well enough to cope with being held or cuddled. However, your baby has become familiar with the sound of your voice whilst in the womb. It may be very reassuring and comforting to your baby if you gently touch and talk to your baby for a time during your visits. Your baby s brothers and sisters are very welcome to visit and gently touch your baby. However, we ask you not bring your other children into the NNU if they have a cough, cold, tummy upset or other infections due to the risk of passing an infection on to your baby. May we remind you that you remain responsible for your children whilst visiting the Neonatal Unit. For their own safety we ask that older brothers and sisters do not run freely around, however, we do not expect them to be still and silent! You are welcome to bring grandparents and other adult family and friends to see your baby. For the security of all, we would prefer that a parent accompany all other visitors to the NNU. If at any time you are unable to visit your baby yourself and would like someone else to visit on your behalf please inform the nursing staff of the visiting details. If you are experiencing any difficulties with visiting, please discuss these with a senior member of staff. To avoid overcrowding could you please ensure that no more than three adults are around your baby at any time. Coat hooks are provided in the corridor for outdoor coats and jackets but please do not leave anything valuable here. To minimise the risk of infection to your baby we ask everyone to use the alcohol hand gel on entering the rooms. Most importantly if you are touching your baby wash your hands before and after. General visiting times for relatives and friends; Daily

10 Visiting your baby - Hospital Security You are welcome to visit your baby whenever you wish day or night. For the safety of all, the Princess Anne Hospital has installed CCTV cameras in the main entrance and corridors. At the entrance to the Neonatal Unit the door is locked 24 hours a day. To gain entry please ring the bell. Again, please be patient if there is a short delay if the nurses are busy. You will be seen by a camera, please say your name and the name of your baby. The staff will open the door lock automatically. The fire alarms are tested weekly on a Friday at 1pm. A series of short rings will sound. If this alarm does not stop within a few rings or you hear the fire alarm at any other time please stay or go to the nearest ward and await further instruction from hospital staff. For safety reasons do not use the lift. Mothers Toilet: This can be found in the corridor, leading the main door of the unit. The toilet door is locked and the key is kept in Nursery 1. Please ask a member of staff for the key. Visitors Toilets: These are found opposite the waiting area at the D Level entrance. Car parking Subsidised parking is available for parents with a baby on the Neonatal unit. The cost of the parking will be 50P per visit, but there will be no time limit for each visit. This concession only applies to parents with a baby on the Neonatal unit, Princess Anne Hospital. Please take a ticket from the machine when you arrive at the car park. When you are ready to leave, hand your ticket to a member of staff who will validate it for you. The ticket then needs to be paid for at the pay point on level D or B, prior to leaving the car park. Pay Phone There is a pay phone located on Level D, near to the entrance of the hospital Overnight Facilities Unfortunately facilities for parents to be resident on the Neonatal Unit are limited but it is sometimes possible for your partner and other children to stay with you. If you would like to stay overnight with your baby please discuss the options available to you with the nursing staff.

11 Feeding your baby Almost every baby can be fed with their mother s own milk. If your baby is not well or old enough to take a breast feed you can express your milk by hand or by using a special pump. You will be shown how to hand express. Breast pumps are available on the postnatal ward and you will be shown how to use one. If you are ready to go home before your baby is ready to be discharged from the Neonatal Unit we can loan you a pump to take home free of charge. Please return the pump when your baby is discharged home. If you would like to express your milk whilst visiting your baby we provide an expressing room and pump (on Broadlands Ward - E level) and individual expressing kits (kept on the Neonatal Unit). You will be given a booklet called A guide to expressing milk which contains more information about expressing and caring for yourself and your milk. 24 hours of expressed milk can be put into one bottle. This milk can be stored in the fridge for 48 hours, after that time it must be frozen. If you wish to bottle feed your baby, commercial brands of milk stocked by the Hospital are available and your baby will be fed with the one you choose. Some very premature and small babies need extra milk supplements to help them grow quickly. For breastfed babies this is given in powder form (fortifier), which is added to the breast milk, and bottle fed babies are given special formula milk for a time whilst they are in the Neonatal Unit. These extra supplements will stop before your baby is ready for discharge home. Before your baby is ready to take all breast or bottle feed, he/she may be fed via a special cup or by a fine tube, which is passed through the nose, down the food pipe and directly into the stomach. If you would like to learn how to feed your baby using a cup or tube we will be happy to teach you. Although all members of nursing and midwifery staff are available to assist you with feeding your baby, sometimes extra help is required. Sandy Jackson and her team, from Breastfeeding Babes are available for help, advice and information on Monday Friday from 10am to 1pm. Please ask a nurse to contact Sandy for you.

12 Donor Breast Milk Human milk is the best food for human babies. It is particularly valuable for babies who are born prematurely and /or sick. Breast milk helps to protect them from infections and helps their brain grow and develop. It also helps to protect them from the digestive problems to which sick newborns are particularly vulnerable. The best milk of all is mother s own milk for her baby. Sometimes mothers milk is either not available or there is not enough of it. In these circumstances we would like your permission to give donor milk from our Milk Bank. Women who are breastfeeding their own healthy babies at home have donated this milk. Donors are visited at home by our Infant Feeding Specialist who checks on their general health. A blood test is carried out to check for Hepatitis B and C and for HIV. Every bottle of milk is then pasteurised. It is then checked again to ensure that no bacteria are present. Any milk that does not meet our very high standard of infection control is discarded. Newborn Bloodspot screening Within the first week following the birth of your baby they should have a screening test carried out. The screening test identifies rare but serious conditions that the baby may have and early treatment can improve their health and prevent serious disability or even death. Babies within this unit are screened for: Phenylketonuria, Congenital Hypothyroidism, Sickle Cell disorders and Cystic Fibrosis. Screening your baby for all these conditions is strongly recommended but not compulsory. If you do not want your baby screened for any or all of these conditions please discuss it with the nurse looking after your baby. More information regarding this and other screening can be found in the screening tests for you and your baby. Copies of this booklet are avaliable in the individual nurseries. Donor breast milk is a safe, healthy food and we hope that you will agree to its use if we consider it medically necessary for your baby.

13 Family Support Lisa Leppard is the family care sister on the neonatal unit. She is an experienced neonatal nurse who has worked here for many years. She currently specalises in supporting families of babies admitted to the neonatal unit. Please ask a member of staff if you would like to speak to her or bleep her on Parent Groups As the parent of a baby on the Neonatal Unit you are invited to some special meetings: The Parents Coffee Morning takes place every Wednesday morning between 9.30am 12md. We meet in the neonatal Seminar Room on Broadlands ward, level E. This is a relaxed and friendly way for you to meet with other parents in a similar situation as you with a baby on the Neonatal Unit. So come along for a cup of coffee/tea and a chat. Members of the health care team are always available to help you in any way they can with information or advice. Children are very welcome and toys are available. Pop in for 5 minutes or stay all morning, whatever suits you best. There are Parents Evenings each month. Again this is an informal opportunity for you to meet with other parents who have a baby on the Neonatal Unit. On the second Tuesday of some months, we have an informal chat or presentation with a speaker on a variety of subjects relating to small, early or poorly babies. On the third Tuesday of each month the Parents Evening focuses on what to do if a baby chokes or stops breathing at home. Please look out for posters around the Neonatal Unit for details about the next meeting. These meetings are open to all parents who have a baby in the Neonatal Unit. In addition, those parents whose baby has been discharged home but who wish to maintain a link with the Neonatal Unit and to those who anticipate that their baby may need special care around the time of birth are also very welcome. You are welcome to bring a friend or family member with you. All meetings take place in the Neonatal Unit Seminar Room on Broadlands Ward,Level E.

14 Family Information The Neonatal Unit has lots of BLISS information leaflets and leaflets on benefits, baby care and health matters for you and your family. Theses can be found in the Parents Coffee Room and Mothers Expressing Room. Please feel free to browse, read and take away any booklets or leaflets. In addition there are a number of childrens books available for those who wish to read quietly with their children whilst visiting the Neonatal Unit. If you would like more information on any topic or you can t find the information you want please ask the nurse looking after your baby to contact Lisa Leppard, Family Care Sister for help. Parents Library A selection of books, on a range of topics related to having a baby on a neonatal unit, is available for free loan. These books are on display during the Coffee Morning and the Parents Evening sessions. Please ask the nursing staff to contact Lisa Leppard, Family Care sister to browse or borrow books at other times. Please return the books when you have read them so that they are available for other parents. Spiritual Care on the Neonatal Unit Having a baby whom needs neonatal care can be extremely distressing and there may be times when you would like someone to talk things over with as you deal with what is happening for you, your baby and your family. Chaplins are here for any relative or carer on the unit, irrespective of whether you have a religious faith or not, and are avaliable to provide a caring, confidential, listening ear. There is a named link Chaplin attached to the unit. If you do have a religious faith, the Chaplin is avaliable for short blessing and baptism services, as well as pastoral support. The Chaplin can also put you in touch with a local faith leader for your particular faith tradition. You can contact a Chaplin by asking a member of the nursing team to refer you to the Chaplaincy team or directly yourselves by calling (if outside the hospital) or extension 8517 (if calling within the hospital). There is a 24 hour on call Chaplaincy servive for urgent requests (these must be made by a member of staff).

15 Baby Clothes The Neonatal Unit provides a large selection of baby clothes in a range of sizes to fit your baby whilst in hospital. Each day please choose the colour and style of clothes you would like your baby to wear. Please ask the nurse helping you look after your baby for any advice you might need. You are of course welcome to bring in your own baby clothes for your baby. To reduce the risk of losing or spoiling them in the Neonatal Unit washing machine please write your baby s name on the label. It is helpful if you also inform the nurses that your baby is wearing his or her own clothes. It is best if your clothes are washed at home so we will place dirty clothes inside the incubator drawer or cot cupboard for you to take home for washing. If you would like to buy special sized premature baby clothes for your baby leaflets from a range of suppliers (local and mail order) are available in the Family Information Room. Samples of premature baby sized knitting patterns are also available. Please see Lisa Leppard, Family Care Nurse or any other member of nursing staff if you would like a pattern. Nappies We do ask you to provide cotton wool and once your baby s weight has reached 1.5kg we ask you to provide nappies. Toys Babies love brightly coloured toys. You are very welcome to place small toys in your baby s incubator or cot. To reduce the risk of loss, please ask a nurse to attach a name label to each toy. You might like to bring in a hairbrush or some baby bath emollient when your baby is well enough to go into the bath. The unit will provide bath towels.

16 Refreshments - In the Princess Anne Hospital Photographs When your baby is admitted to the Neonatal Unit we will take two digital photographs of your baby (one for each parent) free of charge. At any time you may buy other digital photographs for 1.50 each. We would like to encourage you to take photographs of your baby using your own camera or video. Please respect the privacy of other parents, babies and staff and take care not to include other babies, parents or staff in your photographs without their expressed permission. There is also a Baby s First Portrait service within the hospital, for more details see the leaflets in the Parents Coffee Room. Disposable cameras can be bought from the shopping Mall in the entrance to the General Hospital. All visitors to the Princess Anne are welcome to use the Dining Area on Level E for meals, drinks and snacks. The Dining Area is open from? 8am 8pm. Parents and siblings of babies in the Neonatal Unit are exempt from the supplement charged on all purchases made by all other visitors. Please ask a member of staff on the Neonatal Unit for a Dining Room voucher at each mealtime. The voucher must be handed over when you get to the cash till for payment. Vending machines for hot and cold drinks and snacks are available in the entrance hall on Level D. There is also a change machine in the entrance hall area of Level D. Refreshments - On the Neonatal Unit To help make your visits more comfortable we have provided a small but cosy Coffee Room for you on the Neonatal Unit. Please make your own drinks and ask a member of staff if the tea, coffee, milk or sugar needs topping-up. Iced water is also available on the Neonatal Unit - please help yourself. Refreshments - At Southampton General Hospital There are also a variety of food outlets, shops and a Nat West cash point in the entrance Mall of the General Hospital.

17 Members of the Neonatal Unit care team who can help you Child Health Social Work Department The Child Health Social Work Team is based on G Level at the General Hospital. This team can provide help and support for families who have a baby on the Neonatal Unit. Such support can include: - - Short term counselling / emotional support Liaison Health Visitor The Liaison Health Visitor visits the Neonatal Unit at least once each week. She will keep your own Health Visitor informed about your baby s progress. The Liaison Health Visitor for the Neonatal Unit is Margaret Hanson. Your child will be given a red parent held child health record book on admission. You will take this home with you to record your baby s progress. - Advice on accommodation for relatives with a baby on the Neonatal Unit - Advice on local community support services - Liaison with other agencies e.g. Housing Department, DSS - Child care and parenting skills advice - DSS benefits advice Please ask your baby s Named Nurse or another member of staff to contact the Child Health Social Work Department on telephone extension 4415.

18 Discharge from the Neonatal Unit Before your baby is ready to be transferred to the postnatal ward or discharged home your baby must be healthy with good temperature control, have established the feeding pattern to be followed at home and be gaining weight. Your baby does not have to reach any specific target weight but must be healthy, feeding and gaining weight well. Monitoring of heart rate and breathing are reduced and discontinued prior to going home. The length of time spent on the Neonatal Unit by your baby will be dependent on the reason for admission and the progress made. These factors are individual to every baby. However, for those of you with a premature baby it may be helpful to keep in mind the date your baby was due to be born as an approximate date when your baby might be ready for discharge home. To help you and your baby prepare for going home you may like to become resident with your baby on the Neonatal Unit for a few days and nights. Staying during the day and overnight in a Family Room gives you the opportunity to become really familiar with your baby s habits and care needs whilst you still have easy access to nurses and doctors to answer your queries or concerns. You can stay for a few days and nights to help encourage a feeding pattern to become established and /or as preparation before going home with your baby. Your health visitor will be contacted before your baby s discharge and will visit you at home.

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