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Special Care Babies
Premature babies born before 34 weeks often need admission to the Special Care Baby Unit; they may have feeding and breathing difficulties and an inability to maintain their temperature and blood sugars. Full term babies may need to be admitted too.
Most babies born before 34 weeks will be admitted to the Special Care Baby Unit as they have an immature suck reflex, which can cause feeding difficulties. Premature babies tend to have problems maintaining their sugar levels and body temperature. They are also at an increased risk of developing respiratory complications, as their lungs are still relatively immature.
Other reasons babies are admitted to Special Care:
Low Apgars at delivery: babies with a low Apgar score have normally had reduced oxygen for a prolonged period and therefore will need careful observation in the Special Care Baby Unit.
Meconium aspiration: some babies have their first bowel movement before birth, fouling the amniotic fluid. Babies who are born in this meconium liquor are at risk of inhaling some at the birth. This can cause severe breathing difficulties or pneumonia and the infant may need to be ventilated in the Special Care Baby Unit.
Respiratory distress syndrome (hyaline membrane disease): this is the major cause of respiratory problems in premature babies and is caused by the incomplete development of their lungs at birth. The immature lungs are deficient in a substance called surfactant, which helps to keep the air sacs in the lungs open. Babies with respiratory distress syndrome (RDS) don't produce enough surfactant and as a result can't breathe properly.
The symptoms of RDS (very rapid breathing) can be delayed for a few hours following the birth, but then get progressively worse during 24-48 hours. Babies usually start to get better after about 72 hours when their lungs start to produce surfactant.
Poor feeding and blood sugar levels: this is not exclusively a condition of premature babies, even full term infants may suffer with this problem which affects babies unable to maintain their sugar levels and can be due to a maternal history of diabetes.
The Special Care Baby Unit
The special care baby unit is made up of two sections:
Intensive care section
This section of the unit can be quite daunting for new parents. There is a lot of equipment and it can be frightening to see your tiny baby hooked up to machines by wires and tubes when you don't know what they do. The following is a list of equipment that you can expect to see:
Incubator - The incubator is a portable cot surrounded by a strong clear plastic covering. It incorporates an in-built alarm system, which monitors your baby's temperature to ensure that he/she does not become too cold or hot.
Pulse oximeter - This is a small pad that is attached with tape to your baby's foot monitoring how much oxygen is circulating around the body. It is attached to a processing unit with a display unit with pre-set alarm levels.
Cardiac and blood pressure monitor - This monitor is attached to your baby with small electrodes on the chest wall and can monitor the infant's blood pressure and respiration.
Intravenous infusion with or without pump - This infusion is attached to a small venflon or needle in your baby's hand or foot and allows essential fluids and drugs to be administered.
Phototherapy - Jaundice commonly occurs in premature infants and treatment with the use of a Phototherapy unit can help break down the yellow pigmentation caused by jaundice. These units are like mini sun lamps that shine light (often blue) on your baby. During the treatment a soft mask will be used to cover the baby's eyes.
Umbilical artery catheter - This is inserted into the artery in the umbilical cord stump by the paediatrician and is vital to obtain blood samples for the blood gas values, which evaluate how well the lungs are functioning.
Ventilator - This is a machine sometimes called a respirator, which substitutes or helps your baby to breathe. There are two types of ventilation. One helps your baby to breathe in a static mechanical way and the other takes account of your baby's efforts and is called 'patient triggered ventilation'.
Naso-gastric Tube - This tube is inserted through the nose into the stomach and is used to feed your baby milk through a syringe.
Special Care section
This section is for those babies who do not need intensive care but still have problems with feeding and maintaining their sugar levels.
Bonding
It can be harder to bond with your baby in the special care unit. This is especially true if your baby is in an incubator and attached to various machines. There are, however, things you can do which will help you bond and benefit your baby and babies in special care have been found to do better when exposed to touch or other physical contact
Breast feeding - This is a vital part of bonding and even if your baby cannot feed from you due to prematurity or medical reasons you can still express your milk which can be fed via the feeding tube or cup feed. It is a good idea if possible to let your baby nuzzle at the breast prior to the tube feed for example so he/she can get used to breastfeeding as well as aiding bonding.
Kangaroo care - This is 'skin-to-skin' contact, when an undressed baby is held against the bare chest of a parent. This has been found to have various benefits to the infant by reducing oxygen requirements, maintaining temperature control and stabilising the baby's heartbeat. This has also been shown to improve recovery rates with premature infants of less than 34 weeks gestation.
Touch - Touching your baby is vital to help you get to know your child and vice versa, but you may need to check with medical staff first as to the most appropriate way of touching your baby depending on their medical condition.
Further Information
- The new parent guide to the first ten days, brought to you by Johnson's baby
