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What to expect whilst on the neonatal unit

    At Frimley Health we believe in family integrated care where parents are welcomed as partners in care. Our aim is to work together with you to provide the best possible care for your baby. 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 which 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 on each shift  - you may be nervous at first but with our support and practice you will soon feel confident. 

    Skin-to-Skin

    Skin to skin is a way of re-establishing the intimacy that was cut short by premature birth. Ideally skin to skin should be carried out for at least an hour (longer if possible) for you both to gain the full benefits. Having skin to skin with your baby will help you build up the self-confidence you need to form the close bond that is so important for you and your baby. Your baby will have the chance to get to know your voice, your smell and your heart beat. With skin to skin your baby will sleep more peacefully 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 the majority of cases, a baby's heartbeat 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.

    See this video for some more information from parents and health professionals about skin to skin.

    You will be offered two bonding squares on admission to the unit. These support connection by having one kept against a parent’s skin, and the other close to your baby, and then they are swapped regularly. The scent transference between the parent and baby has been proven to be beneficial for developing a bond even when separated.

    Comfort Holding

    Comfort holding is one of many ways for you and 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. 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. You will learn to watch for signs from your baby that will guide you on how and when to do it.

    Reading

    Your baby knows your voice so reading will support with bonding. Hearing your voice gives your baby reassurance. 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/she will be observably calmer because he/she knows you are there.

    Nappy changing

    Whilst your baby is in the neonatal unit you will be able to provide basic care like changing nappies. The neonatal staff will be keen to support you to learn how to do this. If your baby is small or unwell you may feel a bit nervous at the beginning but we will do all we can to reassure, support and provide you with the confidence you need.

    Mouth Care

    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.

    Behavioural cues

    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 put his/her hands to mouth. They will hear the parent's voices and other sounds from outside. The baby will sleep and be active according to the mother's daily pattern of activity.

    The newborn preterm baby has to quickly accommodate to their new surroundings. These surroundings 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 newborns use widely to express their needs and wants.

    Frimley and Wexham Park are both UNICEF Baby Friendly Accredited Hospitals. Baby Friendly accreditation is based on a set of interlinking evidence-based standards designed to provide parents with the best possible care to build close and loving relationships with their baby and to feed their baby in ways which will support optimum health and development. As part of the National Neonatal Project both Units are now also working towards Neonatal accreditation which focuses on specific ways to transform care for families.

    Breast milk is especially beneficial for babies on the Neonatal Unit as these babies are premature or unwell. Every drop of breast milk you can give your baby has value, even if you are not able to exclusively breastfeed.

    We can support you with correct position and attachment, and support you to understand when a baby has poor attachment. Many mothers find it useful to learn to hand express - whether their baby need care on the neonatal unit or not. 

    However, we want you and your baby to enjoy a responsive, positive and rewarding experience and support families, however they choose to feed their babies.

    We also recommend looking at our breastfeeding video and specially developed Infant Feeding Interactive Antenatal Education Package.

    For further information, see Unicef's Baby Friendly Responsive Feeding Infosheet and information about responsive formula and bottle feeding

    Positive touch

    This is a way for you to bond with your baby and to comfort them. This can be done in a number of ways including:

    • containment holding
    • skin to skin/kangaroo care
    • cuddling
    Light

    Your baby’s eyes are still developing, so it is important to make sure they are not exposed to too much light for long periods of time.

    • Make sure your baby’s incubator is always covered
    • If your baby comes out for skin to skin or a cuddle, ask one of the nurses to reduce the lighting at your baby’s bed space
    Sound

    Lots of noise can overstimulate your baby and can affect their quality of sleep and how well they grow.

    • Try to keep noise to a minimum
    • Limit noise from electronic devices
    • Close the incubator portholes quietly
    Positioning

    This is important to help your baby’s posture and muscle development as they grow. You will notice that your baby will always be lying in a ‘nest’ or with a ‘bumper’ around them. Your baby should have:

    • Head and neck in line with the body
    • Shoulders brought forward
    • Arms and legs contained near the body
    • Hands up by face/mouth

    For information about safer sleeping, see here.

    As part of our commitment to family-centred care, we have a period of quiet time each day in our nurseries. The neonatal unit can be a stimulating environment for babies and their families. Quiet time is from 12.00hrs - 14.00hrs daily at Frimley, and 14.00-16.00hrs at Wexham unless otherwise noted by the staff.

    During this time you are encouraged to spend time with your baby. This can be a good time for you to have some quality time with your baby, have skin to skin or just some quiet cuddles. We suggest that you ask your visitors to avoid this special time. We recommend that this should be time just for you as parents.

    During quiet time the blinds will be closed and the lights dimmed. Nurses will have planned routine cares for before and after this time and the medical staff will avoid unnecessary procedures at this point. The nursing staff will endeavour to cancel alarms as quickly as they can to avoid extra noise. However, due to the nature of intensive care and unexpected admissions happening, there will be times where quiet time is postponed or suspended in order to prioritise and provide appropriate care in a nursery.

    Mobile phones are allowed on the unit for taking photos and videos of your baby (remember to turn the flash off) but we ask that they are used for taking calls in the corridor or family room and not at the cot side and are kept on silent mode.

    Your baby will be allocated to a consultant paediatrician at birth who will oversee your baby’s care whilst in the Neonatal Unit. The medical team will visit the unit on a daily basis for ward round, and more often if necessary. They will be happy to discuss your baby’s care and progress with you and answer any questions that you may have.

    We would encourage you to attend the daily ward round which will give you the opportunity to discuss any aspect of your baby's care with the medical team (normally at about 9.00/09.30am, depending on workload). Please bring headphones and a device which allows you to listen to music whilst the doctors discuss the other babies. This ensures confidentiality is maintained and you can continue caring for your baby whilst ward round is carried out. If you are unable to be present at ward round, please ask the nursing staff and they will do their best to arrange an alternative time to discuss your baby with the medical team.

    vCreate is an NHS Trusted Secure Video Messaging service that allows nurses in the Neonatal Unit to send video updates to parents for those times when they are unable to be with their babies. The use of regular video updates provides reassurance at a very worrying time for parents and is available to access via email, 24 hours a day. Siblings, grandparents and extended family can also access videos, with parental permission, to allow them to view the lovely videos the nurses have sent. There has been a very positive response to this service both from parents, who love receiving regular video updates and from staff who enjoy the experience of enabling parents to continue to see their babies when they are not able to attend the unit. Parents have commented that this makes the painful separation from their baby much more bearable whilst continuing to be updated on their progress.

    The role of the Neonatal Outreach Nurse is to facilitate the early, safe discharge of babies and provide a smooth transition from hospital to home.

    The Neonatal Outreach Nurse normally visits babies who were born at less than 34 weeks or weighed less than 1.8kg but also visits babies who may have had surgery and some full term babies if there is a need.

    The Neonatal Outreach Nurse liaises with Midwives and Health Visitors to ensure any questions or concerns parents may have about their baby or babies are answered.

    A vital part of the role is providing infant resuscitation teaching for the parents of babies on the unit. This provides reassurance to parents on basic life support skills.

    A QR link is available and practical teaching sessions are carried out using mannequins on the unit or at home.

    A welcome board in the entrance will display photos of staff, but you will soon get to know us all. All hospital staff are issued with photographic identification badges that should be visible at all times. Staff will introduce themselves to you so that you know who they are and what role they have in looking after your baby. If you are unsure who someone is then please do ask.

    All newborn babies are at risk of infection and prematurity or illness puts these babies at increased risk due to an immature immune system. All visitors must wash their hands with soap and water on entering the nurseries and gel their hands before touching babies. Outdoor coats must be left in the waiting area near reception. Please discuss with nursing staff if you are unsure of correct procedures.

    We would ask you not to visit if you have cold/flu symptoms, diarrhoea and/or vomiting. If you are unsure please discuss with the nurse looking after your baby.

    During the last year there have necessarily had to be some modifications to our visiting policy as the world has changed in response to the pandemic. We have worked hard with the wider hospital to agree a policy that maintains safety for our staff and patients; whilst allowing as much access as possible for parents.

    Please call the unit for updated guidance.

    Doors to the Neonatal Unit are locked at all times. To gain access, please use the doorbell and a member of staff will release the door. You will be asked to identify yourself and the name of the baby you have come to visit.  Do not allow people to enter the unit when we open the door to you.

    The Trust is not responsible for loss of valuables and personal belongings. Lockers are available at reception for parents, please bring your own padlock and key if you wish to make use of a locker.

    The work of Frimley Health Charity helps to improve lives across all Frimley Health Trust hospitals – Frimley Park, Wexham Park, Heatherwood and their community sites for patients, staff, and visitors. Frimley Health Charity relies on supporter donations which enable them to fund pioneering research through to specialist service.

    One of the projects the Frimley Health Charity team support is the Neonatal unit at Wexham Park.

    The Neonatal team and Frimley Health Charity want to provide the very best for parents and babies. Providing the latest equipment to care for the children as well as a relaxing and welcoming environment for parents.

    To continue to provide the very best for families Frimley Health Charity needs donations to be able to continue their work – please donate to Wexham Park’s Neonatal unit here:

    https://www.frimleyhealthcharity.org/donate/

    Frimley Park Neonatal Unit has also a charity dedicated to the neonatal unit: Little Stars – Frimley Park.

    The team in the unit want to provide the very best for parents. Providing a relaxing and welcoming environment for parents so they can have a space of much needed comfort whilst remaining close to their child.

    Please click and reference Little Stars if you would like to make a donation.

    If you have any suggestions or concerns regarding the neonatal unit, nursing or other issues, please make these known to a member of staff immediately as we can often resolve issues for you. Alternatively you can ask to speak with the Senior Sister on the Unit or contact the Patient Advice and Liaison Service (PALS). We are always looking for ways in which we can improve our service and would appreciate parents completing a Friends and Family questionnaire on the day of your baby’s discharge. This will only take a few minutes and can be left at reception when you depart.

    We also love positive feedback so we can pass your messages on to our hard working staff!