At St Peter's Neonatal Intensive Care Unit, we believe Family Integrated Care (FICare) is the only way to care for babies and their families.
"Evidence shows that outcomes for babies are improved when parents and carers are partners in their baby’s care. FICare aims to ensure parents and carers can become confident primary caregivers and partners with the healthcare team."
"FICare encourages neonatal healthcare teams to listen to parents, carers and families, to understand and respond to their needs, so they can create partnership with them in caring for their baby.” What is FICare? | Bliss
During your baby's stay we will involve you in your baby’s day to day care. We will support you in learning how to change your baby’s nappy, help with cleaning him/her, help with feeding and soothing and much more. This will help you and your baby to get to know each other and it will help build your confidence. This can be supported at your own pace as your confidence grows.
As well as providing the day-to-day care for your baby, another important role of being a partner in your baby’s care is to attend and participate in the daily ward rounds.
We usually commence the morning ward round from around 09.30am every morning. This is a great opportunity to meet the doctors and consultant helping to look after your baby that day. You can get involved in the plan for your baby’s care for the day as well as ask any questions you may have.
There will also be an opportunity for parents of babies in the intensive care area to speak to the doctors during the consultant’s handover. This usually starts from around 16.30.
Whilst it is important for you to attend as many daily ward rounds during your babies stay, we understand this is not always possible and there will be opportunities to speak to your babies’ doctors when you attend the unit outside of the ward round.
By discussing 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.
Parent Support on the Neonatal Unit at St Peter’s Hospital
Most parents describe a feeling of their world having been turned upside down when their baby is admitted to NICU. This journey is likely to be like no other you will have experienced, and of course your baby needs you above everything. You may find that speaking to your baby about all that is going on may help him or her to cope better with what is happening. This might seem extraordinary that one so young can be helped by talking. It may also help you and your partner, or those closest to you to talk together about what is happening. The unit offers emotional support to parents.
| Fiona England Family Care Coordinator |
Available to offer support and is based on NICU Monday to Thursday. |
Mouth Care
Mouth care is an important part of your baby’s daily care.
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.
Colostrum and breast milk have unique properties which promote babies' health and development, including maternal antibodies and anti-inflammatory substances which offer protection against disease and infection.
You can use sterile water for your baby's mouth care too when your breastmilk is not available
Nappy Changing
When you feel ready, we can support you to provide all your baby’s nappy cares. At the start of your baby's journey, you might be scared as he/she is so very small or very sick so you may prefer to observe a nappy change first. Our staff are here to support you throughout the process until you feel ready. You will be amazed at how quickly you become confident at nappy changing.
Comfort Holding
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.
Comfort holding and skin-to-skin not only helps your baby to experience your loving touch, but it also helps to increases your oxytocin levels. Increased oxytocin levels not only lower your stress levels but can also help to “switch on” your milk making cells making it beneficial for you and baby.
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 recognise signs from your baby’s behaviour, that will guide you on how and when to do it.
Skin-to-Skin
Skin to skin is a way of re-establishing the intimacy and close and loving bond that can be interrupted when you have a baby on the neonatal unit. Having 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.
Your baby will have the chance to get to know your voice, your smell and your heartbeat.
Skin to skin can help baby 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 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.
The more time your baby spends in skin to skin the better, but we recommend at least an hour of skin to skin every day your baby is clinically well enough. Watch this video of a parent having skin to skin cuddles with their premature baby and remember the NICU team are always by your side to support you.
Reading
Reading to your baby whilst they are on NICU is great for stimulating your baby’s brain development…and for you! Your baby can recognise the sound of your voice from 22weeks gestation and is a familiar voice that can help to calm your baby and reassure them that you are close ... especially at times when a cuddle might not possible. Reading to your baby can help to strengthen the bond between you and can help to reduce your stress levels.
You can read to your baby anytime, whether they are having skin to skin or in an incubator.
You can read ANYTHING to your baby in any language, from children’s books, fictional books you enjoy or the newspaper. It’s the changes in your voice and the tone and interaction with you that is most important rather than what you are saying!
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 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
- swaddling
- cuddling
- 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 see the NICU Padlet for the - "Look at me I'm talking to you" leaflet
Lullaby Hour
Whilst you and your baby are on the NICU you may have a professional musician come and sing and play to you. This is funded by Little Roo Charity.
Recent research has shown that music therapy consisting of a played instrument and singing can offer a way to help parents form a loving close bond with their baby.
- News Article: Lullaby Hour at St Peter’s Hospital
Baby Diary
Please ask the nurse looking after you and your baby about the Baby Diary Link where updates and pictures of your baby can be uploaded for you by our staff. You will need an active email address and will receive an email invitation.
