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Neonatal Care

For most parents, pregnancy is a time of excitement, of planning for the birth and dreaming of a perfect, healthy baby.

 

However, sometimes babies arrive unexpectedly early, or they can be unwell at birth and require admission to the neonatal unit for investigation and treatment.

Baby in neonatal incubator cot

Caring for families in NICU

When your baby is admitted to NICU, it can be a worrying time. Parents say they feel at least some reassurance after they speak with a senior doctor or nurse in the neonatal team, and so the team will aim to talk with you as soon as possible. 

 

One important thing for you to know from the outset is that parents are not visitors – they are an integral part of the neonatal team and are welcome at all times.

Being admitted to NICU

Why has my baby been admitted to the neonatal unit?

Sometimes babies arrive unexpectedly early, or are unwell at birth and require admission to the neonatal unit for investigation and treatment.

 

Around 10% of all births receive some support from neonatal teams (across all maternity units in the UK).

  • Scans and x-rays
    May be needed on babies when they are too ill to be taken to the x-ray department. For this reason the ultrasound scanner and x-ray machine stay permanently on the unit; they can be used for routine investigations or quickly in the event of an emergency. Staff can view the image at baby's cot side before a report is made by the Radiologist.
  • X-rays
    X-rays use radiation to give a picture of part of the baby's body and are carried out to check out placement of tubes or to check for problems within the heart, chest, abdomen or with bones. The amount of radiation is very small and no more than we are exposed to through normally daily life. Every attempt to minimise the radiation exposure your baby gets by only doing x-rays when absolutely needed.
  • Ultrasound scans (USS)
    USS use sound waves to give a picture of part of the baby's body and may be carried out to check your baby's brain, heart or other organs. The process is the same as when you received scans during your pregnancy.
  • Incubator
    Is a type of cot made from clear plastic and that has a lid. It is specially adapted to allow baby to be nursed naked (except for a nappy) in a warm and sometimes humidified environment; this permits staff to closely monitor your baby. Depending on baby's needs, oxygen can be given directly into the incubator. The incubator is used most often for babies born prematurely or those who require phototherapy.
  • An open bed with radiant warmer
    Is a flat mattress with an overhead heater. It is used for babies who are usually nursed in cots but have become unwell and need investigations or treatments that cannot be given in the cot. Babies who require eye treatment will also be nursed on this type of bed.
  • A warming cot
    This might either be a babytherm or Kanmed/Cosytherm cot. With both of these devices, baby receives additional warmth from beneath the mattress. These types of bed/cot are used with babies who need less observation and are able to be dressed and wrapped.
  • Regular cot
    This is used for babies who do not need any additional warmth to enable them keep their temperature within the normal range.
  • There are several different types of monitor used in the support of a baby
    Took a look over the following types.
  • Cardio-respiratory monitor
    Measures a baby's heart rate, respiratory rate, oxygen level, temperature and blood pressure Heart rate and respiratory rate are measured using 3 electrocardiograph (ECG) leads are attached to his chest/abdomen. Oxygen levels are measured using a saturation probe (this looks like a little plaster with a red light) that is attached to baby’s hand or foot. Temperature is measured using skin temperature probes placed on baby's chest/abdomen and on a foot. Blood pressure is measured in 2 ways: by wrapping a cuff around baby’s arm or through an arterial cannula/catheter placed into baby’s umbilical or peripheral artery
  • Saturation monitor
    Measures a baby's heart rate and oxygen level (see above).
  • Temperature monitoring
    Temperature is measured in 3 ways: In the axilla (armpit) with a digital thermometer With skin temperature probes placed on baby's chest/abdomen and on a foot. The probes are attached to a monitor and the temperature measurements are continuously displayed. Comparing these two measurements can help in determining if baby is becoming unwell. In the rectum (in baby’s bottom) to give a recording of the internal body temperature. This is us for babies receiving therapeutic hypothermia (cooling).
  • Apnoea monitor
    Measures baby's breathing. A small disk is attached to baby’s tummy and when baby breathes, this triggers a signal to a machine. If baby stops breathing for longer than 20 seconds or the disk falls off of baby, the machine gives off an alarm.
  • CFAM monitor
    This is a monitor measuring baby's brain electrical activity. Four tiny electrodes are inserted into baby’s scalp.
  • NIRS monitor
    NIRS stands for Near-infrared spectroscopy and is a means of measuring the oxygen levels in the region beneath the skin probe, which typically is attached to the forehead.
  • Breathing Support
    Many babies are able to breathe spontaneously without the need for help. For others, this may be impossible and they may need one or more of the following: Oxygen pressure via prongs or a nasal mask, or a breathing tube and machine (ventilator)
  • Oxygen
    Oxygen can be given directly into an incubator or through small plastic tubes that are placed just within the nostrils; these are called nasal prongs or nasal cannulae. Oxygen may also be given with machines that give extra pressure or additional breaths.
  • Pressure
    Sometimes a baby requires a little extra background pressure to help him breathe more easily. To receive pressure, baby needs to wear nasal prongs or a small face mask covering his nose which is then attached to a machine that pushes a continuous flow of air or oxygen (creating pressure) to the airways to help keep open the tiny air passages in the lungs. The machines in the NNU that deliver a continuous flow of air or oxygen are called CPAP (continuous positive airway pressure) machines and high flow nasal cannula (HFNC or Vapotherm) machines.
  • Breaths
    Some very immature and/or sick babies are unable to breath often enough or deeply enough and so need additional help. Help is given by placing a small plastic tube (endotracheal tube [ET Tube]) through baby’s mouth into the top portion of their airway; this tube is then attached to a breathing machine or ventilator. The ventilator can give oxygen, pressure and additional breaths depending on baby’s needs.
  • Humidification
    When a baby breathes naturally, the nose and upper airways warms and humidifies the air baby breathes. This stops the airway from drying out and the mucus becoming thick and sticky. Therefore air or oxygen given to baby by equipment that delivers pressure and breaths is also warmed and humidified to help the airways to work effectively.
  • When a baby is born, they usually have many more red blood cells than they need.
    This a treatment for jaundice. The body deals with this by breaking them down; this process releases a substance called bilirubin which is removed from the body in urine and stool. Immature or sick babies sometimes find it hard to get rid of all the bilirubin so builds up in baby’s skin, eyes, and other tissues turning them yellow or jaundiced. Jaundice can also develop because of other problems. Treatment for jaundice depends on how severe it is but usually babies will be started on Phototherapy. Phototherapy is blue spectrum light. It can be given a by special lamps or blankets; babies will wear patches to protect their eyes from the bright lights and usually be nursed naked other than wearing a nappy.
  • Gastric tube
    Some babies admitted to the NNU are too immature or unwell to breast or bottle feed but they may be well enough to receive mother's breast milk or formula milk. To be able to give a baby milk, a small tube is passed through the nose or mouth into their stomach. This tube is called a gastric tube. Every time the tube is used it is checked to be in the correct position.
  • Cannulae
    There are a few types of cannulae but when staff in the unit talk about cannulae, they are usually referring to a small tube (no more than a few centimetres long) that is inserted into a vein in baby's hand, forearm or foot. This might also be called a peripheral intravascular (IV) cannulae or line. Peripheral IV cannulae enables fluid/nutrients and medicines to be delivered directly to your baby's blood stream. Sometimes these solutions are very irritant to the vein and need to be changed frequently; if this is the case the medical team may decide that your baby will need a central line.
  • Central line
    A central line is a long, thin plastic tube (catheter) that is positioned in a large vein close to your baby's heart. There are a number of types of central line: The most common is a fine catheter that is passed into a vein (usually in the arm or leg) and then threaded up the vein until it's tip lies in a large vein close to the heart. The position is checked with an X-ray. This type of line is often called a PICC line. These lines and can be inserted into baby without him/her leaving the neonatal unit. An umbilical venous catheter is a very fine tube that is passed into the vein in the umbilical cord which previously brought blood from the placenta to the baby. This line is called a UVC and can be inserted within the neonatal unit. Central lines can also be placed into the larger veins in the chest, neck or groin. These are surgical lines and your baby will be transferred to the Royal Hospital for Children and Young People, Edinburgh, for the insertion of these lines. The benefit of a central line is that it can be left in place for 2-3 weeks or longer, whereas peripheral intravenous lines are likely to need replacing every 2-3 days. There are risks associated with lines but on balance the benefits to baby outweigh these risks and we feel that their use is a definite advantage. The main risk is the introduction of infection. This risk is reduced by care in the way we handle the lines. There are other problems that have been reported but with correct positioning of the lines these are extremely rare.
  • Arterial line
    An arterial line is a fine tube (catheter) that is passed into an artery; it may be placed peripherally, in the arm or centrally via the artery in the umbilical cord which previously took blood from the baby to the placenta. This line is called a UAC. These catheters allow your baby's blood pressure to be monitored continuously and can also be used for taking blood samples that are needed to monitor baby's condition. Arterial catheters have risks associated with them which are not always avoidable. However these risks are small compared with the benefit baby will get from their use. Very occasionally these catheters can disturb the blood supply to the hands and legs and we will monitor that closely. Infection is always a risk with any line in a small baby. Again we will monitor for infection closely. The arterial catheter will be removed as soon as it is no longer essential
  • Pumps are usually used to give fluid and or drugs to a baby.
    The pump may be called a syringe driver or an intravascular (IV) infusion device. The syringe driver pushes fluids or drugs from a syringe into the IV line; with the IV infusion device, an intravenous line is threaded through the pump and the pump allows a measured amount of fluid to infuse into baby each hour. Sometimes pumps are used to give milk continuously to a baby.

Who will be looking after my baby if I am not there?

There is a large team of professionals in the Simpson Neonatal Unit, some of whom you can meet virtually in the tour. 

  • Scans and x-rays
    May be needed on babies when they are too ill to be taken to the x-ray department. For this reason the ultrasound scanner and x-ray machine stay permanently on the unit; they can be used for routine investigations or quickly in the event of an emergency. Staff can view the image at baby's cot side before a report is made by the Radiologist.
  • X-rays
    X-rays use radiation to give a picture of part of the baby's body and are carried out to check out placement of tubes or to check for problems within the heart, chest, abdomen or with bones. The amount of radiation is very small and no more than we are exposed to through normally daily life. Every attempt to minimise the radiation exposure your baby gets by only doing x-rays when absolutely needed.
  • Ultrasound scans (USS)
    USS use sound waves to give a picture of part of the baby's body and may be carried out to check your baby's brain, heart or other organs. The process is the same as when you received scans during your pregnancy.
  • Incubator
    Is a type of cot made from clear plastic and that has a lid. It is specially adapted to allow baby to be nursed naked (except for a nappy) in a warm and sometimes humidified environment; this permits staff to closely monitor your baby. Depending on baby's needs, oxygen can be given directly into the incubator. The incubator is used most often for babies born prematurely or those who require phototherapy.
  • An open bed with radiant warmer
    Is a flat mattress with an overhead heater. It is used for babies who are usually nursed in cots but have become unwell and need investigations or treatments that cannot be given in the cot. Babies who require eye treatment will also be nursed on this type of bed.
  • A warming cot
    This might either be a babytherm or Kanmed/Cosytherm cot. With both of these devices, baby receives additional warmth from beneath the mattress. These types of bed/cot are used with babies who need less observation and are able to be dressed and wrapped.
  • Regular cot
    This is used for babies who do not need any additional warmth to enable them keep their temperature within the normal range.
  • There are several different types of monitor used in the support of a baby
    Took a look over the following types.
  • Cardio-respiratory monitor
    Measures a baby's heart rate, respiratory rate, oxygen level, temperature and blood pressure Heart rate and respiratory rate are measured using 3 electrocardiograph (ECG) leads are attached to his chest/abdomen. Oxygen levels are measured using a saturation probe (this looks like a little plaster with a red light) that is attached to baby’s hand or foot. Temperature is measured using skin temperature probes placed on baby's chest/abdomen and on a foot. Blood pressure is measured in 2 ways: by wrapping a cuff around baby’s arm or through an arterial cannula/catheter placed into baby’s umbilical or peripheral artery
  • Saturation monitor
    Measures a baby's heart rate and oxygen level (see above).
  • Temperature monitoring
    Temperature is measured in 3 ways: In the axilla (armpit) with a digital thermometer With skin temperature probes placed on baby's chest/abdomen and on a foot. The probes are attached to a monitor and the temperature measurements are continuously displayed. Comparing these two measurements can help in determining if baby is becoming unwell. In the rectum (in baby’s bottom) to give a recording of the internal body temperature. This is us for babies receiving therapeutic hypothermia (cooling).
  • Apnoea monitor
    Measures baby's breathing. A small disk is attached to baby’s tummy and when baby breathes, this triggers a signal to a machine. If baby stops breathing for longer than 20 seconds or the disk falls off of baby, the machine gives off an alarm.
  • CFAM monitor
    This is a monitor measuring baby's brain electrical activity. Four tiny electrodes are inserted into baby’s scalp.
  • NIRS monitor
    NIRS stands for Near-infrared spectroscopy and is a means of measuring the oxygen levels in the region beneath the skin probe, which typically is attached to the forehead.
  • Breathing Support
    Many babies are able to breathe spontaneously without the need for help. For others, this may be impossible and they may need one or more of the following: Oxygen pressure via prongs or a nasal mask, or a breathing tube and machine (ventilator)
  • Oxygen
    Oxygen can be given directly into an incubator or through small plastic tubes that are placed just within the nostrils; these are called nasal prongs or nasal cannulae. Oxygen may also be given with machines that give extra pressure or additional breaths.
  • Pressure
    Sometimes a baby requires a little extra background pressure to help him breathe more easily. To receive pressure, baby needs to wear nasal prongs or a small face mask covering his nose which is then attached to a machine that pushes a continuous flow of air or oxygen (creating pressure) to the airways to help keep open the tiny air passages in the lungs. The machines in the NNU that deliver a continuous flow of air or oxygen are called CPAP (continuous positive airway pressure) machines and high flow nasal cannula (HFNC or Vapotherm) machines.
  • Breaths
    Some very immature and/or sick babies are unable to breath often enough or deeply enough and so need additional help. Help is given by placing a small plastic tube (endotracheal tube [ET Tube]) through baby’s mouth into the top portion of their airway; this tube is then attached to a breathing machine or ventilator. The ventilator can give oxygen, pressure and additional breaths depending on baby’s needs.
  • Humidification
    When a baby breathes naturally, the nose and upper airways warms and humidifies the air baby breathes. This stops the airway from drying out and the mucus becoming thick and sticky. Therefore air or oxygen given to baby by equipment that delivers pressure and breaths is also warmed and humidified to help the airways to work effectively.
  • When a baby is born, they usually have many more red blood cells than they need.
    This a treatment for jaundice. The body deals with this by breaking them down; this process releases a substance called bilirubin which is removed from the body in urine and stool. Immature or sick babies sometimes find it hard to get rid of all the bilirubin so builds up in baby’s skin, eyes, and other tissues turning them yellow or jaundiced. Jaundice can also develop because of other problems. Treatment for jaundice depends on how severe it is but usually babies will be started on Phototherapy. Phototherapy is blue spectrum light. It can be given a by special lamps or blankets; babies will wear patches to protect their eyes from the bright lights and usually be nursed naked other than wearing a nappy.
  • Gastric tube
    Some babies admitted to the NNU are too immature or unwell to breast or bottle feed but they may be well enough to receive mother's breast milk or formula milk. To be able to give a baby milk, a small tube is passed through the nose or mouth into their stomach. This tube is called a gastric tube. Every time the tube is used it is checked to be in the correct position.
  • Cannulae
    There are a few types of cannulae but when staff in the unit talk about cannulae, they are usually referring to a small tube (no more than a few centimetres long) that is inserted into a vein in baby's hand, forearm or foot. This might also be called a peripheral intravascular (IV) cannulae or line. Peripheral IV cannulae enables fluid/nutrients and medicines to be delivered directly to your baby's blood stream. Sometimes these solutions are very irritant to the vein and need to be changed frequently; if this is the case the medical team may decide that your baby will need a central line.
  • Central line
    A central line is a long, thin plastic tube (catheter) that is positioned in a large vein close to your baby's heart. There are a number of types of central line: The most common is a fine catheter that is passed into a vein (usually in the arm or leg) and then threaded up the vein until it's tip lies in a large vein close to the heart. The position is checked with an X-ray. This type of line is often called a PICC line. These lines and can be inserted into baby without him/her leaving the neonatal unit. An umbilical venous catheter is a very fine tube that is passed into the vein in the umbilical cord which previously brought blood from the placenta to the baby. This line is called a UVC and can be inserted within the neonatal unit. Central lines can also be placed into the larger veins in the chest, neck or groin. These are surgical lines and your baby will be transferred to the Royal Hospital for Children and Young People, Edinburgh, for the insertion of these lines. The benefit of a central line is that it can be left in place for 2-3 weeks or longer, whereas peripheral intravenous lines are likely to need replacing every 2-3 days. There are risks associated with lines but on balance the benefits to baby outweigh these risks and we feel that their use is a definite advantage. The main risk is the introduction of infection. This risk is reduced by care in the way we handle the lines. There are other problems that have been reported but with correct positioning of the lines these are extremely rare.
  • Arterial line
    An arterial line is a fine tube (catheter) that is passed into an artery; it may be placed peripherally, in the arm or centrally via the artery in the umbilical cord which previously took blood from the baby to the placenta. This line is called a UAC. These catheters allow your baby's blood pressure to be monitored continuously and can also be used for taking blood samples that are needed to monitor baby's condition. Arterial catheters have risks associated with them which are not always avoidable. However these risks are small compared with the benefit baby will get from their use. Very occasionally these catheters can disturb the blood supply to the hands and legs and we will monitor that closely. Infection is always a risk with any line in a small baby. Again we will monitor for infection closely. The arterial catheter will be removed as soon as it is no longer essential
  • Pumps are usually used to give fluid and or drugs to a baby.
    The pump may be called a syringe driver or an intravascular (IV) infusion device. The syringe driver pushes fluids or drugs from a syringe into the IV line; with the IV infusion device, an intravenous line is threaded through the pump and the pump allows a measured amount of fluid to infuse into baby each hour. Sometimes pumps are used to give milk continuously to a baby.

What happens in the neonatal unit?

  • Scans and x-rays
    May be needed on babies when they are too ill to be taken to the x-ray department. For this reason the ultrasound scanner and x-ray machine stay permanently on the unit; they can be used for routine investigations or quickly in the event of an emergency. Staff can view the image at baby's cot side before a report is made by the Radiologist.
  • X-rays
    X-rays use radiation to give a picture of part of the baby's body and are carried out to check out placement of tubes or to check for problems within the heart, chest, abdomen or with bones. The amount of radiation is very small and no more than we are exposed to through normally daily life. Every attempt to minimise the radiation exposure your baby gets by only doing x-rays when absolutely needed.
  • Ultrasound scans (USS)
    USS use sound waves to give a picture of part of the baby's body and may be carried out to check your baby's brain, heart or other organs. The process is the same as when you received scans during your pregnancy.
  • Incubator
    Is a type of cot made from clear plastic and that has a lid. It is specially adapted to allow baby to be nursed naked (except for a nappy) in a warm and sometimes humidified environment; this permits staff to closely monitor your baby. Depending on baby's needs, oxygen can be given directly into the incubator. The incubator is used most often for babies born prematurely or those who require phototherapy.
  • An open bed with radiant warmer
    Is a flat mattress with an overhead heater. It is used for babies who are usually nursed in cots but have become unwell and need investigations or treatments that cannot be given in the cot. Babies who require eye treatment will also be nursed on this type of bed.
  • A warming cot
    This might either be a babytherm or Kanmed/Cosytherm cot. With both of these devices, baby receives additional warmth from beneath the mattress. These types of bed/cot are used with babies who need less observation and are able to be dressed and wrapped.
  • Regular cot
    This is used for babies who do not need any additional warmth to enable them keep their temperature within the normal range.
  • There are several different types of monitor used in the support of a baby
    Took a look over the following types.
  • Cardio-respiratory monitor
    Measures a baby's heart rate, respiratory rate, oxygen level, temperature and blood pressure Heart rate and respiratory rate are measured using 3 electrocardiograph (ECG) leads are attached to his chest/abdomen. Oxygen levels are measured using a saturation probe (this looks like a little plaster with a red light) that is attached to baby’s hand or foot. Temperature is measured using skin temperature probes placed on baby's chest/abdomen and on a foot. Blood pressure is measured in 2 ways: by wrapping a cuff around baby’s arm or through an arterial cannula/catheter placed into baby’s umbilical or peripheral artery
  • Saturation monitor
    Measures a baby's heart rate and oxygen level (see above).
  • Temperature monitoring
    Temperature is measured in 3 ways: In the axilla (armpit) with a digital thermometer With skin temperature probes placed on baby's chest/abdomen and on a foot. The probes are attached to a monitor and the temperature measurements are continuously displayed. Comparing these two measurements can help in determining if baby is becoming unwell. In the rectum (in baby’s bottom) to give a recording of the internal body temperature. This is us for babies receiving therapeutic hypothermia (cooling).
  • Apnoea monitor
    Measures baby's breathing. A small disk is attached to baby’s tummy and when baby breathes, this triggers a signal to a machine. If baby stops breathing for longer than 20 seconds or the disk falls off of baby, the machine gives off an alarm.
  • CFAM monitor
    This is a monitor measuring baby's brain electrical activity. Four tiny electrodes are inserted into baby’s scalp.
  • NIRS monitor
    NIRS stands for Near-infrared spectroscopy and is a means of measuring the oxygen levels in the region beneath the skin probe, which typically is attached to the forehead.
  • Breathing Support
    Many babies are able to breathe spontaneously without the need for help. For others, this may be impossible and they may need one or more of the following: Oxygen pressure via prongs or a nasal mask, or a breathing tube and machine (ventilator)
  • Oxygen
    Oxygen can be given directly into an incubator or through small plastic tubes that are placed just within the nostrils; these are called nasal prongs or nasal cannulae. Oxygen may also be given with machines that give extra pressure or additional breaths.
  • Pressure
    Sometimes a baby requires a little extra background pressure to help him breathe more easily. To receive pressure, baby needs to wear nasal prongs or a small face mask covering his nose which is then attached to a machine that pushes a continuous flow of air or oxygen (creating pressure) to the airways to help keep open the tiny air passages in the lungs. The machines in the NNU that deliver a continuous flow of air or oxygen are called CPAP (continuous positive airway pressure) machines and high flow nasal cannula (HFNC or Vapotherm) machines.
  • Breaths
    Some very immature and/or sick babies are unable to breath often enough or deeply enough and so need additional help. Help is given by placing a small plastic tube (endotracheal tube [ET Tube]) through baby’s mouth into the top portion of their airway; this tube is then attached to a breathing machine or ventilator. The ventilator can give oxygen, pressure and additional breaths depending on baby’s needs.
  • Humidification
    When a baby breathes naturally, the nose and upper airways warms and humidifies the air baby breathes. This stops the airway from drying out and the mucus becoming thick and sticky. Therefore air or oxygen given to baby by equipment that delivers pressure and breaths is also warmed and humidified to help the airways to work effectively.
  • When a baby is born, they usually have many more red blood cells than they need.
    This a treatment for jaundice. The body deals with this by breaking them down; this process releases a substance called bilirubin which is removed from the body in urine and stool. Immature or sick babies sometimes find it hard to get rid of all the bilirubin so builds up in baby’s skin, eyes, and other tissues turning them yellow or jaundiced. Jaundice can also develop because of other problems. Treatment for jaundice depends on how severe it is but usually babies will be started on Phototherapy. Phototherapy is blue spectrum light. It can be given a by special lamps or blankets; babies will wear patches to protect their eyes from the bright lights and usually be nursed naked other than wearing a nappy.
  • Gastric tube
    Some babies admitted to the NNU are too immature or unwell to breast or bottle feed but they may be well enough to receive mother's breast milk or formula milk. To be able to give a baby milk, a small tube is passed through the nose or mouth into their stomach. This tube is called a gastric tube. Every time the tube is used it is checked to be in the correct position.
  • Cannulae
    There are a few types of cannulae but when staff in the unit talk about cannulae, they are usually referring to a small tube (no more than a few centimetres long) that is inserted into a vein in baby's hand, forearm or foot. This might also be called a peripheral intravascular (IV) cannulae or line. Peripheral IV cannulae enables fluid/nutrients and medicines to be delivered directly to your baby's blood stream. Sometimes these solutions are very irritant to the vein and need to be changed frequently; if this is the case the medical team may decide that your baby will need a central line.
  • Central line
    A central line is a long, thin plastic tube (catheter) that is positioned in a large vein close to your baby's heart. There are a number of types of central line: The most common is a fine catheter that is passed into a vein (usually in the arm or leg) and then threaded up the vein until it's tip lies in a large vein close to the heart. The position is checked with an X-ray. This type of line is often called a PICC line. These lines and can be inserted into baby without him/her leaving the neonatal unit. An umbilical venous catheter is a very fine tube that is passed into the vein in the umbilical cord which previously brought blood from the placenta to the baby. This line is called a UVC and can be inserted within the neonatal unit. Central lines can also be placed into the larger veins in the chest, neck or groin. These are surgical lines and your baby will be transferred to the Royal Hospital for Children and Young People, Edinburgh, for the insertion of these lines. The benefit of a central line is that it can be left in place for 2-3 weeks or longer, whereas peripheral intravenous lines are likely to need replacing every 2-3 days. There are risks associated with lines but on balance the benefits to baby outweigh these risks and we feel that their use is a definite advantage. The main risk is the introduction of infection. This risk is reduced by care in the way we handle the lines. There are other problems that have been reported but with correct positioning of the lines these are extremely rare.
  • Arterial line
    An arterial line is a fine tube (catheter) that is passed into an artery; it may be placed peripherally, in the arm or centrally via the artery in the umbilical cord which previously took blood from the baby to the placenta. This line is called a UAC. These catheters allow your baby's blood pressure to be monitored continuously and can also be used for taking blood samples that are needed to monitor baby's condition. Arterial catheters have risks associated with them which are not always avoidable. However these risks are small compared with the benefit baby will get from their use. Very occasionally these catheters can disturb the blood supply to the hands and legs and we will monitor that closely. Infection is always a risk with any line in a small baby. Again we will monitor for infection closely. The arterial catheter will be removed as soon as it is no longer essential
  • Pumps are usually used to give fluid and or drugs to a baby.
    The pump may be called a syringe driver or an intravascular (IV) infusion device. The syringe driver pushes fluids or drugs from a syringe into the IV line; with the IV infusion device, an intravenous line is threaded through the pump and the pump allows a measured amount of fluid to infuse into baby each hour. Sometimes pumps are used to give milk continuously to a baby.

Connecting with Baby

How do I connect (bond) with my baby in the NICU?

Connecting with your baby to develop strong emotional bonds is important for both you as parents and your baby. How you do that in the NICU environment will depend very much on your baby, and for mothers, your health.

 

The nurses will help you to connect and bond with baby and guide you on what is safe to do, given baby’s gestation (weeks of development) or degree of illness.

  • Scans and x-rays
    May be needed on babies when they are too ill to be taken to the x-ray department. For this reason the ultrasound scanner and x-ray machine stay permanently on the unit; they can be used for routine investigations or quickly in the event of an emergency. Staff can view the image at baby's cot side before a report is made by the Radiologist.
  • X-rays
    X-rays use radiation to give a picture of part of the baby's body and are carried out to check out placement of tubes or to check for problems within the heart, chest, abdomen or with bones. The amount of radiation is very small and no more than we are exposed to through normally daily life. Every attempt to minimise the radiation exposure your baby gets by only doing x-rays when absolutely needed.
  • Ultrasound scans (USS)
    USS use sound waves to give a picture of part of the baby's body and may be carried out to check your baby's brain, heart or other organs. The process is the same as when you received scans during your pregnancy.
  • Incubator
    Is a type of cot made from clear plastic and that has a lid. It is specially adapted to allow baby to be nursed naked (except for a nappy) in a warm and sometimes humidified environment; this permits staff to closely monitor your baby. Depending on baby's needs, oxygen can be given directly into the incubator. The incubator is used most often for babies born prematurely or those who require phototherapy.
  • An open bed with radiant warmer
    Is a flat mattress with an overhead heater. It is used for babies who are usually nursed in cots but have become unwell and need investigations or treatments that cannot be given in the cot. Babies who require eye treatment will also be nursed on this type of bed.
  • A warming cot
    This might either be a babytherm or Kanmed/Cosytherm cot. With both of these devices, baby receives additional warmth from beneath the mattress. These types of bed/cot are used with babies who need less observation and are able to be dressed and wrapped.
  • Regular cot
    This is used for babies who do not need any additional warmth to enable them keep their temperature within the normal range.
  • There are several different types of monitor used in the support of a baby
    Took a look over the following types.
  • Cardio-respiratory monitor
    Measures a baby's heart rate, respiratory rate, oxygen level, temperature and blood pressure Heart rate and respiratory rate are measured using 3 electrocardiograph (ECG) leads are attached to his chest/abdomen. Oxygen levels are measured using a saturation probe (this looks like a little plaster with a red light) that is attached to baby’s hand or foot. Temperature is measured using skin temperature probes placed on baby's chest/abdomen and on a foot. Blood pressure is measured in 2 ways: by wrapping a cuff around baby’s arm or through an arterial cannula/catheter placed into baby’s umbilical or peripheral artery
  • Saturation monitor
    Measures a baby's heart rate and oxygen level (see above).
  • Temperature monitoring
    Temperature is measured in 3 ways: In the axilla (armpit) with a digital thermometer With skin temperature probes placed on baby's chest/abdomen and on a foot. The probes are attached to a monitor and the temperature measurements are continuously displayed. Comparing these two measurements can help in determining if baby is becoming unwell. In the rectum (in baby’s bottom) to give a recording of the internal body temperature. This is us for babies receiving therapeutic hypothermia (cooling).
  • Apnoea monitor
    Measures baby's breathing. A small disk is attached to baby’s tummy and when baby breathes, this triggers a signal to a machine. If baby stops breathing for longer than 20 seconds or the disk falls off of baby, the machine gives off an alarm.
  • CFAM monitor
    This is a monitor measuring baby's brain electrical activity. Four tiny electrodes are inserted into baby’s scalp.
  • NIRS monitor
    NIRS stands for Near-infrared spectroscopy and is a means of measuring the oxygen levels in the region beneath the skin probe, which typically is attached to the forehead.
  • Breathing Support
    Many babies are able to breathe spontaneously without the need for help. For others, this may be impossible and they may need one or more of the following: Oxygen pressure via prongs or a nasal mask, or a breathing tube and machine (ventilator)
  • Oxygen
    Oxygen can be given directly into an incubator or through small plastic tubes that are placed just within the nostrils; these are called nasal prongs or nasal cannulae. Oxygen may also be given with machines that give extra pressure or additional breaths.
  • Pressure
    Sometimes a baby requires a little extra background pressure to help him breathe more easily. To receive pressure, baby needs to wear nasal prongs or a small face mask covering his nose which is then attached to a machine that pushes a continuous flow of air or oxygen (creating pressure) to the airways to help keep open the tiny air passages in the lungs. The machines in the NNU that deliver a continuous flow of air or oxygen are called CPAP (continuous positive airway pressure) machines and high flow nasal cannula (HFNC or Vapotherm) machines.
  • Breaths
    Some very immature and/or sick babies are unable to breath often enough or deeply enough and so need additional help. Help is given by placing a small plastic tube (endotracheal tube [ET Tube]) through baby’s mouth into the top portion of their airway; this tube is then attached to a breathing machine or ventilator. The ventilator can give oxygen, pressure and additional breaths depending on baby’s needs.
  • Humidification
    When a baby breathes naturally, the nose and upper airways warms and humidifies the air baby breathes. This stops the airway from drying out and the mucus becoming thick and sticky. Therefore air or oxygen given to baby by equipment that delivers pressure and breaths is also warmed and humidified to help the airways to work effectively.
  • When a baby is born, they usually have many more red blood cells than they need.
    This a treatment for jaundice. The body deals with this by breaking them down; this process releases a substance called bilirubin which is removed from the body in urine and stool. Immature or sick babies sometimes find it hard to get rid of all the bilirubin so builds up in baby’s skin, eyes, and other tissues turning them yellow or jaundiced. Jaundice can also develop because of other problems. Treatment for jaundice depends on how severe it is but usually babies will be started on Phototherapy. Phototherapy is blue spectrum light. It can be given a by special lamps or blankets; babies will wear patches to protect their eyes from the bright lights and usually be nursed naked other than wearing a nappy.
  • Gastric tube
    Some babies admitted to the NNU are too immature or unwell to breast or bottle feed but they may be well enough to receive mother's breast milk or formula milk. To be able to give a baby milk, a small tube is passed through the nose or mouth into their stomach. This tube is called a gastric tube. Every time the tube is used it is checked to be in the correct position.
  • Cannulae
    There are a few types of cannulae but when staff in the unit talk about cannulae, they are usually referring to a small tube (no more than a few centimetres long) that is inserted into a vein in baby's hand, forearm or foot. This might also be called a peripheral intravascular (IV) cannulae or line. Peripheral IV cannulae enables fluid/nutrients and medicines to be delivered directly to your baby's blood stream. Sometimes these solutions are very irritant to the vein and need to be changed frequently; if this is the case the medical team may decide that your baby will need a central line.
  • Central line
    A central line is a long, thin plastic tube (catheter) that is positioned in a large vein close to your baby's heart. There are a number of types of central line: The most common is a fine catheter that is passed into a vein (usually in the arm or leg) and then threaded up the vein until it's tip lies in a large vein close to the heart. The position is checked with an X-ray. This type of line is often called a PICC line. These lines and can be inserted into baby without him/her leaving the neonatal unit. An umbilical venous catheter is a very fine tube that is passed into the vein in the umbilical cord which previously brought blood from the placenta to the baby. This line is called a UVC and can be inserted within the neonatal unit. Central lines can also be placed into the larger veins in the chest, neck or groin. These are surgical lines and your baby will be transferred to the Royal Hospital for Children and Young People, Edinburgh, for the insertion of these lines. The benefit of a central line is that it can be left in place for 2-3 weeks or longer, whereas peripheral intravenous lines are likely to need replacing every 2-3 days. There are risks associated with lines but on balance the benefits to baby outweigh these risks and we feel that their use is a definite advantage. The main risk is the introduction of infection. This risk is reduced by care in the way we handle the lines. There are other problems that have been reported but with correct positioning of the lines these are extremely rare.
  • Arterial line
    An arterial line is a fine tube (catheter) that is passed into an artery; it may be placed peripherally, in the arm or centrally via the artery in the umbilical cord which previously took blood from the baby to the placenta. This line is called a UAC. These catheters allow your baby's blood pressure to be monitored continuously and can also be used for taking blood samples that are needed to monitor baby's condition. Arterial catheters have risks associated with them which are not always avoidable. However these risks are small compared with the benefit baby will get from their use. Very occasionally these catheters can disturb the blood supply to the hands and legs and we will monitor that closely. Infection is always a risk with any line in a small baby. Again we will monitor for infection closely. The arterial catheter will be removed as soon as it is no longer essential
  • Pumps are usually used to give fluid and or drugs to a baby.
    The pump may be called a syringe driver or an intravascular (IV) infusion device. The syringe driver pushes fluids or drugs from a syringe into the IV line; with the IV infusion device, an intravenous line is threaded through the pump and the pump allows a measured amount of fluid to infuse into baby each hour. Sometimes pumps are used to give milk continuously to a baby.
  • Scans and x-rays
    May be needed on babies when they are too ill to be taken to the x-ray department. For this reason the ultrasound scanner and x-ray machine stay permanently on the unit; they can be used for routine investigations or quickly in the event of an emergency. Staff can view the image at baby's cot side before a report is made by the Radiologist.
  • X-rays
    X-rays use radiation to give a picture of part of the baby's body and are carried out to check out placement of tubes or to check for problems within the heart, chest, abdomen or with bones. The amount of radiation is very small and no more than we are exposed to through normally daily life. Every attempt to minimise the radiation exposure your baby gets by only doing x-rays when absolutely needed.
  • Ultrasound scans (USS)
    USS use sound waves to give a picture of part of the baby's body and may be carried out to check your baby's brain, heart or other organs. The process is the same as when you received scans during your pregnancy.
  • Incubator
    Is a type of cot made from clear plastic and that has a lid. It is specially adapted to allow baby to be nursed naked (except for a nappy) in a warm and sometimes humidified environment; this permits staff to closely monitor your baby. Depending on baby's needs, oxygen can be given directly into the incubator. The incubator is used most often for babies born prematurely or those who require phototherapy.
  • An open bed with radiant warmer
    Is a flat mattress with an overhead heater. It is used for babies who are usually nursed in cots but have become unwell and need investigations or treatments that cannot be given in the cot. Babies who require eye treatment will also be nursed on this type of bed.
  • A warming cot
    This might either be a babytherm or Kanmed/Cosytherm cot. With both of these devices, baby receives additional warmth from beneath the mattress. These types of bed/cot are used with babies who need less observation and are able to be dressed and wrapped.
  • Regular cot
    This is used for babies who do not need any additional warmth to enable them keep their temperature within the normal range.
  • There are several different types of monitor used in the support of a baby
    Took a look over the following types.
  • Cardio-respiratory monitor
    Measures a baby's heart rate, respiratory rate, oxygen level, temperature and blood pressure Heart rate and respiratory rate are measured using 3 electrocardiograph (ECG) leads are attached to his chest/abdomen. Oxygen levels are measured using a saturation probe (this looks like a little plaster with a red light) that is attached to baby’s hand or foot. Temperature is measured using skin temperature probes placed on baby's chest/abdomen and on a foot. Blood pressure is measured in 2 ways: by wrapping a cuff around baby’s arm or through an arterial cannula/catheter placed into baby’s umbilical or peripheral artery
  • Saturation monitor
    Measures a baby's heart rate and oxygen level (see above).
  • Temperature monitoring
    Temperature is measured in 3 ways: In the axilla (armpit) with a digital thermometer With skin temperature probes placed on baby's chest/abdomen and on a foot. The probes are attached to a monitor and the temperature measurements are continuously displayed. Comparing these two measurements can help in determining if baby is becoming unwell. In the rectum (in baby’s bottom) to give a recording of the internal body temperature. This is us for babies receiving therapeutic hypothermia (cooling).
  • Apnoea monitor
    Measures baby's breathing. A small disk is attached to baby’s tummy and when baby breathes, this triggers a signal to a machine. If baby stops breathing for longer than 20 seconds or the disk falls off of baby, the machine gives off an alarm.
  • CFAM monitor
    This is a monitor measuring baby's brain electrical activity. Four tiny electrodes are inserted into baby’s scalp.
  • NIRS monitor
    NIRS stands for Near-infrared spectroscopy and is a means of measuring the oxygen levels in the region beneath the skin probe, which typically is attached to the forehead.
  • Breathing Support
    Many babies are able to breathe spontaneously without the need for help. For others, this may be impossible and they may need one or more of the following: Oxygen pressure via prongs or a nasal mask, or a breathing tube and machine (ventilator)
  • Oxygen
    Oxygen can be given directly into an incubator or through small plastic tubes that are placed just within the nostrils; these are called nasal prongs or nasal cannulae. Oxygen may also be given with machines that give extra pressure or additional breaths.
  • Pressure
    Sometimes a baby requires a little extra background pressure to help him breathe more easily. To receive pressure, baby needs to wear nasal prongs or a small face mask covering his nose which is then attached to a machine that pushes a continuous flow of air or oxygen (creating pressure) to the airways to help keep open the tiny air passages in the lungs. The machines in the NNU that deliver a continuous flow of air or oxygen are called CPAP (continuous positive airway pressure) machines and high flow nasal cannula (HFNC or Vapotherm) machines.
  • Breaths
    Some very immature and/or sick babies are unable to breath often enough or deeply enough and so need additional help. Help is given by placing a small plastic tube (endotracheal tube [ET Tube]) through baby’s mouth into the top portion of their airway; this tube is then attached to a breathing machine or ventilator. The ventilator can give oxygen, pressure and additional breaths depending on baby’s needs.
  • Humidification
    When a baby breathes naturally, the nose and upper airways warms and humidifies the air baby breathes. This stops the airway from drying out and the mucus becoming thick and sticky. Therefore air or oxygen given to baby by equipment that delivers pressure and breaths is also warmed and humidified to help the airways to work effectively.
  • When a baby is born, they usually have many more red blood cells than they need.
    This a treatment for jaundice. The body deals with this by breaking them down; this process releases a substance called bilirubin which is removed from the body in urine and stool. Immature or sick babies sometimes find it hard to get rid of all the bilirubin so builds up in baby’s skin, eyes, and other tissues turning them yellow or jaundiced. Jaundice can also develop because of other problems. Treatment for jaundice depends on how severe it is but usually babies will be started on Phototherapy. Phototherapy is blue spectrum light. It can be given a by special lamps or blankets; babies will wear patches to protect their eyes from the bright lights and usually be nursed naked other than wearing a nappy.
  • Gastric tube
    Some babies admitted to the NNU are too immature or unwell to breast or bottle feed but they may be well enough to receive mother's breast milk or formula milk. To be able to give a baby milk, a small tube is passed through the nose or mouth into their stomach. This tube is called a gastric tube. Every time the tube is used it is checked to be in the correct position.
  • Cannulae
    There are a few types of cannulae but when staff in the unit talk about cannulae, they are usually referring to a small tube (no more than a few centimetres long) that is inserted into a vein in baby's hand, forearm or foot. This might also be called a peripheral intravascular (IV) cannulae or line. Peripheral IV cannulae enables fluid/nutrients and medicines to be delivered directly to your baby's blood stream. Sometimes these solutions are very irritant to the vein and need to be changed frequently; if this is the case the medical team may decide that your baby will need a central line.
  • Central line
    A central line is a long, thin plastic tube (catheter) that is positioned in a large vein close to your baby's heart. There are a number of types of central line: The most common is a fine catheter that is passed into a vein (usually in the arm or leg) and then threaded up the vein until it's tip lies in a large vein close to the heart. The position is checked with an X-ray. This type of line is often called a PICC line. These lines and can be inserted into baby without him/her leaving the neonatal unit. An umbilical venous catheter is a very fine tube that is passed into the vein in the umbilical cord which previously brought blood from the placenta to the baby. This line is called a UVC and can be inserted within the neonatal unit. Central lines can also be placed into the larger veins in the chest, neck or groin. These are surgical lines and your baby will be transferred to the Royal Hospital for Children and Young People, Edinburgh, for the insertion of these lines. The benefit of a central line is that it can be left in place for 2-3 weeks or longer, whereas peripheral intravenous lines are likely to need replacing every 2-3 days. There are risks associated with lines but on balance the benefits to baby outweigh these risks and we feel that their use is a definite advantage. The main risk is the introduction of infection. This risk is reduced by care in the way we handle the lines. There are other problems that have been reported but with correct positioning of the lines these are extremely rare.
  • Arterial line
    An arterial line is a fine tube (catheter) that is passed into an artery; it may be placed peripherally, in the arm or centrally via the artery in the umbilical cord which previously took blood from the baby to the placenta. This line is called a UAC. These catheters allow your baby's blood pressure to be monitored continuously and can also be used for taking blood samples that are needed to monitor baby's condition. Arterial catheters have risks associated with them which are not always avoidable. However these risks are small compared with the benefit baby will get from their use. Very occasionally these catheters can disturb the blood supply to the hands and legs and we will monitor that closely. Infection is always a risk with any line in a small baby. Again we will monitor for infection closely. The arterial catheter will be removed as soon as it is no longer essential
  • Pumps are usually used to give fluid and or drugs to a baby.
    The pump may be called a syringe driver or an intravascular (IV) infusion device. The syringe driver pushes fluids or drugs from a syringe into the IV line; with the IV infusion device, an intravenous line is threaded through the pump and the pump allows a measured amount of fluid to infuse into baby each hour. Sometimes pumps are used to give milk continuously to a baby.
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