Neonatal units provide medical care for babies who are premature or have health problems that require specialist help. Find out more about the support that’s available for newborns, and their families.
Being told that your baby needs to spend extra time in hospital after birth can be frightening, but understanding how special care units help newborn babies and knowing what support is available, for them and for you, can help to make it all a little less confusing.
- Why do some babies need special care after birth?
- What happens if my baby needs extra care?
- Where will my baby be looked after?
- What is a special care unit like?
- How long will my baby have to stay in hospital?
- Support when your baby’s in special care
Why do some babies need special care after birth?
There are various reasons why newborn babies need to be admitted to a special care unit. In some cases, a potential health problem may have been picked up during pregnancy, for example at one of your NHS scans, and doctors will want to carry out additional checks after the birth. However, in many cases, you won’t know that your baby needs extra care until after they’re born.
More babies have to go to neonatal units than you may think: more than one in eight newborns are admitted to neonatal units every year in the UK. Of those, around 40% are premature (born before 37 weeks gestation) and the others are full-term but in need of additional care.
Here are some common reasons why babies need special care after birth:
- Being born prematurely: babies who are born early often need extra help with breathing, feeding and keeping warm.
- Low birth weight: for example, if there’s been growth restriction in the womb, your baby’s feeds and weight gain might need to be monitored.
- Breathing difficulties: sometimes newborn babies need additional support to get their respiratory system working as it should.
- If the mother has diabetes: the baby’s blood sugar can drop dangerously low after birth so they need to be monitored.
- Having an infection: some babies contract infections during birth which will need treatment, and they might also need extra help fighting the germs in their early days.
- Jaundice: babies with jaundice sometimes need continuous light treatment over a few days.
- If it was a difficult birth: babies who might have suffered from low oxygen during birth, for example, may need some extra care.
- If they need surgery: some babies may need surgery shortly after birth and they will be looked after in a high-needs unit beforehand, as well as when they’re recovering.
- Being a twin or triplet: multiples are more likely to need some level of extra care after birth. Sometimes just one baby will need to spend time in a neonatal unit.
What happens if my baby needs extra care?
If you’ve been told during your pregnancy that your baby might need to receive extra care after birth, your doctor will probably advise you that it’s safest for you to give birth in a labour ward where there are paediatricians and equipment on hand to help your baby straight away.
If you’re giving birth at home or in a birth centre and your midwife is concerned that your baby’s not doing as well as expected at any point during labour, you’ll be transferred to hospital by ambulance immediately for specialist help.
As soon as your baby’s born, the midwife will carry out their first health checks and, if they think that extra care or monitoring is required, you will then be taken to a local hospital where the specialist team can help your baby.
Depending on the level of care your baby needs after birth, they may be transferred to a different hospital which can provide the necessary care, equipment and specialist staff.
Where will my baby be looked after?
Some checks, tests and monitoring of your baby may be able to be done by health care providers while you’re both on the postnatal ward. However, if your baby requires more specialist care, they’ll be taken to a dedicated neonatal unit.
There are three different levels of care units and your baby may be moved between them as their needs change. You can look up the maternity units in your local area to find out what level of care is offered in different locations.
Special care baby unit (SCBU)
SBCUs are for babies who need short-term specialist support from paediatric doctors and nurses – for example, continuous monitoring for their breathing and heart rate, or treatment for jaundice – but who don’t require high dependency care.
Premature babies who are born after 33 weeks are often looked after in an SCBU. If your baby receives care in a local neonatal unit (LNU) or neonatal intensive care unit (NICU) after birth, they may be moved to an SCBU after a while as a step on their path to coming home.
Local neonatal unit (LNU)
LNUs offer short-term care for babies who need more help than an SCBU can offer. Most babies born between 27 and 32 weeks of gestation receive their full care, including short periods of intensive care, in an LNU.
Neonatal intensive care units (NICU)
NICUs provide intensive treatment for newborn babies who need the highest level of nursing and medical care. Critically ill babies and premature babies born before 27 weeks usually have to stay in NICU.
What is a special care unit like?
A neonatal unit is very different from any other environment you’ve probably been in, and it’s completely normal to feel out of your depth when you go to see your baby.
The first thing you might notice is that the unit is very warm, especially if it’s an NICU. The room temperature is set at around 25 degrees celcius to help the babies keep up their body temperature.
You’ll then see that each baby has their own cot or incubator, and that there are a lot of wires and machines around. Seeing lights, screens and tubes around your baby for the first time is bound to be overwhelming.
Alicia’s baby was taken to the neonatal unit after a difficult birth:
‘When I went to see my son in NICU for the first time he was hooked up to many different wires and had a feeding tube. I wasn’t at all prepared to see him like that and it was really difficult emotionally.’ Read Alicia’s story
Specialist equipment in the neonatal unit
Understanding how all the different equipment helps your baby can be reassuring. Here are some of the things you might come across:
- Incubators – help to regulate the baby’s body temperature.
- Light machines – lamps or blankets used to treat babies with jaundice.
- Ventilators – work to help the lungs with breathing.
- Oxygen masks or nose prongs – can feed the baby extra oxygen.
- Tubes – transfer fluids, food and medicine straight to baby’s veins or tummy, normally from a drip.
- Monitors – to keep check of various things like the baby’s heart rate, blood pressure and oxygen levels.
- Alarms – these can be set off by monitors registering even a tiny change in your baby’s environment.
Medical staff can help to explain what’s happening or why different machines are being used and should keep you informed on your baby’s care – but feel free to ask questions too if you’re ever unsure.
Both doctors and nurses work on the neonatal unit. The doctors look after your baby’s treatment and progress, while the nurses look after your baby’s day-to-day care needs.
How can I be involved in my baby’s care?
Your baby needs you just as much when they’re in a neonatal unit as they would if they were at home with you. While nurses can look after your baby’s medical needs, nothing can replace the comfort that they get from hearing, feeling and smelling their parents.
It can be tricky to know where to start when it comes to helping out with your baby’s care, especially if they’re hooked up to different machines or are very small, but the staff at the unit will be more than happy to show you how best to look after your baby.
Here are a few ways you can get involved:
- Skin-to-skin contact/kangaroo care: All newborn babies benefit from skin-to-skin contact, but for premature babies it’s even more beneficial and can help to regulate their body temperature and heart rate, as well as reducing their stress or pain levels. Your baby will be placed on your bare chest, wearing just a nappy, with a blanket over the two of you. Your baby can still have wires and feeding tubes attached while you have them skin-to-skin.
- Touching and talking: Even if you can’t have your baby skin-to-skin straight away because they have to be in an incubator, they’ll still benefit from feeling your touch and hearing your voice. Some incubators have open tops while others have holes on the side which allow you to put your hands through to stroke your baby while talking to them.
- Feeding: You can breastfeed your baby when they’re in special care. If your baby can’t feed straight from the breast, staff should help you to express milk instead. NICUs can get awarded a ‘baby-friendly status’ if they’re especially good at helping parents breastfeed. If your baby’s formula fed, you can likewise help feed them with either a bottle or a feeding tube which goes straight to their stomach.
- Other care needs: As well as feeding and comforting your baby, you can ask to help out with things like changing nappies, washing your baby and getting them dressed. Particularly if they start out poorly and have to stay in special care for a longer time, getting involved in their day-to-day care needs will help you bond as a family and make you feel more prepared when it’s time to take them home.
How long will my baby have to stay in hospital?
The average time for babies to stay in neonatal units in England, Scotland and Wales is seven days, but how long your baby will spend in special care can vary from a few hours up to several months, depending on their care needs.
Babies born nearer their due date, after 37 weeks of gestation, tend to spend the shortest time in the neonatal unit, with the average stay being just four days. Premature babies usually stay in special care until they’re close to full-term, so if your baby’s born at 28 weeks they will probably stay in hospital for around two months.
Can I stay with my baby?
It’s not usually possible for you to stay overnight in the special care baby unit. After you’ve given birth, you may be admitted to the postnatal ward in the same hospital for one or more nights, which could make it easier to go to see your baby in the unit.
However, once you’re discharged you’ll usually have to spend the nights at home, or in accommodation near the hospital. If you live far away from the hospital, it could mean a lot of time, and money, spent travelling back and forth between your home and the unit.
‘Because my little one was premature, we had to make trips back and forwards to the hospital for three weeks, and it’s just a lot easier when the hospital is closer to where you live.’ Reena, whose baby was born seven weeks early.
For many parents, having to be apart from their newborn baby is one of the most difficult aspects of special care. While you won’t be able to stay with your baby overnight, you should be able to be with them as often and for as long as you want during the days.
Can family and friends visit?
You can usually have visitors for your baby on the unit, as long as you the parent are there as well. All units have different policies on how many people they allow in at a time, so it’s best to check directly with the nurses or doctors before your family or friends come to the hospital.
If you are having visitors, it can be good to remind them that the babies in special care are very sensitive to infections, so it’s important that they wash their hands carefully before coming in and hold off visiting if they have a cold, cough or sickness bug.
Support when your baby’s in special care
Having a baby in a neonatal unit can be very stressful and frightening. It can help to speak with other parents who have had similar experiences, and there are organisations that specialise in supporting parents during this time. For more information, you can turn to:
- Bliss – a charity dedicated to helping parents of premature or sick babies.
- Tommy’s – provide information and support to families following miscarriage, stillbirth or premature birth.
- Tamba – for parents of twins or multiples.
These are the sources of information used in this article:
Birth Characteristics in England and Wales: 2016, Office for National Statistics, 2017
NDAU Annual Report 2016, Imperial College, 2017