Why are we receiving Transitional Care (TC)?
TC is provided for babies who are small, born early or require extra care for example antibiotics or phototherapy for jaundice.
What additional care does my baby need?
Your baby may need additional care with:
Establishing feeding – Small, preterm or sick babies take a little longer to establish feeding. We will support you with ensuring your baby has adequate feeds. Whilst your baby is on TC we ask that you feed every 3 hours rather than waiting for your baby to wake. If your baby is well enough to responsively feed we will discuss this with you.
Keeping warm – Babies requiring TC are more vulnerable to getting cold. Follow staff advice on how many layers of clothing and blankets your baby needs and ensure windows are closed and no fans are on in your room. Feel your baby’s chest or the back of their neck to check their temperature (your baby’s hands and feet will usually be cooler, which is normal).
Ensuring they stay well – Your midwife will ensure your baby is well by doing regular observations, however if you have any concerns, speak to one of the team and they will review your baby again.
Support with blood tests – if your baby needs blood tests or a cannula (a thin tube inserted into a blood vessel) then you will be asked to be with them whilst this is done. It may be possible to breastfeed while blood tests are taken. You can also express some colostrum to give for pain relief, if this is not available we can use sucrose, a sweet solution that also helps with pain when a cannula is inserted. After the procedure, skin to skin contact will help calm your baby and you may wish to give a feed.
Phototherapy treatment – We will show you how to look after your baby when they are having light treatment, there is extra information in our leaflet about jaundice.
The team
• You and your birthing partner are the most important members of the team. You know your baby best and are your baby’s voice. You will be part of any discussion around the care of your baby and decisions will be made in partnership with the rest of the team.
• Paediatricians: Your baby will have a named paediatric consultant however you will be seen by the doctor responsible for TC from the paediatric team every day. This doctor will speak with a senior paediatrician if they have any concerns.
• Neonatal nurses are specialists with babies that require transitional care and in the care of sick, small and /or preterm babies, they will oversee the care of your baby with you.
• Midwives support you, as well as your baby following birth. They are skilled in infant feeding, recognising if your baby is well, and managing and supporting you with your baby’s cares.
Ward rounds
Each day there will be a ward round with a doctor from the paediatric team and the neonatal nurse on duty that day. They will review and plan your baby’s care with you, including any tests your baby may require. This is a good opportunity to discuss your baby’s care, however we can ask for a midwife, neonatal nurse or doctor to speak with you at any time if you have concerns.
What we can do to support you
We will do our best to provide a recliner chair for your birth partner to stay, and support you with caring for your baby
If you have other children and you would like to use the play room / outside play area on the paediatric ward let us know and we will see if it is free.
Tell us your car registration number and we will give you free parking for one car for the duration of time your baby is having TC.
Wellbeing
• It’s ok to experience a range of emotions: There is no ‘right’ way to feel. You may feel overwhelmed, sad, or angry. If you feel like you need help then please seek support. We also have access to ‘talking therapies’ which many families find helpful
• Look after yourself: Your birth may have been straightforward or with added complications. Physically and mentally your body will need some time to recover, and you will need to rest. Be kind to yourself.
• You may find feeding and expressing difficult: In the early days, having a feeding plan can be challenging, and tiring, get help with other jobs like nappy changes and settling your baby. It gets much easier in time but please ask for help.
• It’s okay to ask if you need us to explain anything about your baby’s condition or the plans made for them, you are their voice, the more you understand the more support you can give.
• Speak up: You will know about your baby in ways that others don’t. If you are unsure or worried about anything, please tell us.
Supporting your baby’s brain development
Your baby has a unique way of communicating with you and letting you know when they are happy, anxious, or uncomfortable. Learning to understand your baby’s expressions and movements helps support their development.
Your baby’s surroundings: Preterm, small and ill babies can be especially sensitive to light, noise, and smell. Your voice, touch and smell are all comforting and familiar for your baby.
Your baby will tell you when they have had enough stimulus by yawning, sometimes hiccupping, looking away and putting their hands up to say stop.
Skin to skin contact helps regulate their sleep / wake cycles and calms them which supports their brain development
Breastmilk is especially important for small, early or sick babies. It can help contribute to your baby’s development by supporting growth and protecting against infection. Feeding in the early days can be challenging so please ask for support when needed.
Some preterm babies need support with positioning as they may stretch their arms out looking for a boundary (like when they were in the womb). Try to bring their arms in close to their body. Gentle swaddling when bathing, changing nappies can help.
Preparing for home:
Some questions you may want to ask:
• Do I need to give any additional care at home?
• When will my midwife visit?
• Will there be any follow up appointments?
Extra reading
Sensory beginnings ‘The Power of Touch’ and ‘Human Behaviour’ leaflets: