At St Peter's Neonatal Intensive Care Unit we believe in family centred care.
We recognise that the family is the constant in the baby's life, while the personnel within our unit fluctuate. We welcome you the parents to be present during ward rounds which occur twice a day morning and evening) for intensive care babies and once a day for high dependency and special care babies.
We usually commence the morning ward round in intensive care at 09.30am. We encourage you to be present so that the consultant can update you at the cot-side.
By sharing with you, on a continuing basis and in a supportive manner, you will receive the best and up to date information regarding your baby's health
Our aim is to work together with you to provide the best possible care for your baby. However, sometimes we have to act urgently. It is therefore possible that some investigations, treatments or changes may be carried out before we have had an opportunity to discuss them with you. These will of course be discussed with you at the earliest convenient moment.
During your baby's stay we will involve you as much as you want in their day to day care. We will show you how do change a nappy, help with cleaning him/her and help with feeding and soothing you this will help you and your baby to get to know each other and it will help build your confidence. You will be supported by the named nurse you will find it awkward to begin with but with our support and practice you will be great.
Mouth care is an important task to undertake for your baby.
If you have expressed some breast milk, dip a cotton swab into the milk and clean your baby's mouth slowly, with a gentle press and scoop action to the lips. You can use sterile water for your baby's mouth care too.
At the start of your baby's journey you might be scared as he/she is so very small or very sick. Observe the nurse changing your baby's nappy. Then when you are ready to be involved, with the support of the nurse, ask if you can help with the nappy change. Maybe start with just fixing the clean nappy in place and then settling your baby afterwards. Then as you feel more confident, take the process further each time. You will be amazed at how quickly you become proficient at nappy changing.
Comfort holding is one of many ways for your baby to get to know each other. Comfort holding is a way to experience loving touch when your baby is not ready to be held. Your baby may be more comfortable lying in the incubator. The staff may suggest that you try and comfort hold if they think your baby is well enough. Cradling your baby with still, resting hands can be more comforting than stroking or massage. You will learn to watch for signs from your baby that will guide you on how and when to do it.
Skin to skin is a way of re-establishing the intimacy that was cut short by premature birth. Having the skin to skin with your baby will help you build up self-confidence you need to form the close bond that is so important for you and your baby.
You baby will have the chance to get to know your voice, your smell, your heart beat.
With skin to skin your baby will sleep more restfully and for longer. These periods of sleep are essential for the growth of your baby and are times of rest and recovery after medical procedures.
There are many benefits for you and your baby having skin to skin. In a majority of cases a baby's heart beat and breathing are more regular and more rhythmic during skin to skin. Skin to skin has special benefits for the mother as it helps to stimulate the milk supply.
Your baby knows your voice, so this is something that only you can do. Hearing your voice gives your child the reassurance that only you can give.
In each nursery we have a small selection of books for you to read to your baby. You might notice whilst you are reading that your baby's heart rate will often settle and he will be observably calmer because he knows you are there. This is where reading aloud can help.
All babies are individuals and each one will develop at a slightly different rate. Your baby's development will be affected by gestation at birth, how much they weigh and by how well they are. Each baby's genetic makeup will also play a part in how they develop and mature. In the womb the baby will experience a variety of sensations. The baby will move around in the amniotic fluid and be able to get hands to mouth. They will hear the mother's voice and other sounds from outside. The baby will sleep and be active according to the mother's daily pattern of activity.
The new-born preterm baby has to quickly accommodate to their new surroundings. These surrounding affect behaviour and development and it is important that we recognise how your baby reacts and how we can help their development to progress by observing the baby's behavioural cues.
Behavioural cues are defined as non-verbal and special forms of communication that new-borns use widely to express their needs and wants, these behavioural cues can be classified and divided into two categories;
- Defensive / avoidance behaviours or
- Coping / approaching behaviours
Appropriate interpretation of these behavioural cues by caregivers, is a vital piece of developmentally appropriate care, promoting infant organisation and enhancing optimal neuro-developmental outcomes. It has been found to provide positive improvements for the infant such as, a more stable heart rate, respiratory rate and oxygen consumption, fewer days of ventilation, reduction in complications, earlier feeding, shorter stay in hospital and enhanced bonding for the family.
When a baby is displaying coping /approaching behaviour consider the following strategies
- Speak softly to an infant
- Make eye contact with them if appropriate
- Provide positive touch
- Offer a sucking feed/ or finger to hold
- Carry out necessary activities, i.e. nappy change, top and tail, blood- taking, examination, bathing
- Encourage parents/carers to experience the delight of having their new child respond to their voices and study their faces, promoting the development of a positive parent - child relationship
- Record what situations facilitate these coping/ approaching behavioural cues in the baby’s nursing care plan/medical notes
- If a baby is asleep; strongly consider not disturbing the baby until it wakes naturally
When a baby is displaying defensive/ avoidance behaviour consider the following strategies
- Provide tactile support such as;
- Help baby achieve hands to mouth position
- containment holding
- kangaroo care
- provide boundaries – nesting
- reposition baby with flexion of the extremities to midline
- Reduce noise / light levels
- Observe baby’s ability to "block-out" the stimulation causing avoidance behaviour
- Provide pacifiers for comfort, small toys or blanket to grasp
- Speak gently and calmly to the baby
- Pace activity according to the infant’s cues and communication
- Stop or pause activity until infant is able to recover and "cope", before continuing
- Complete activity as quickly and efficiently as possible to minimise stress to the infant
- Record all events that induce avoidance behaviour in the infant’s nursing care plan / medical notes
Please ask for the leaflet - "Look at me I'm talking to you"