Working together to care for your baby

This information is for families with a baby in the Neonatal and Intensive Special Care or NISC at the Royal Women’s Hospital.

Working together

With so many staff caring for your baby, it can be hard to know how to be involved yourself. We believe your involvement in your baby’s care is important to your baby’s health and well being. This is supported by research, with studies showing that your active involvement may improve your baby’s health outcomes. Your ideas, beliefs and values, are all considered when we are making decisions about your baby’s care. We understand that this is a very stressful time for you. The activity in the NISC, the equipment and noise can take some time to adjust to. We encourage you to ask questions and discuss any concerns with staff. We can also provide you with referrals to other services such as social work to help you with practical matters and emotional support.

Remember, it is your right to ask for an interpreter to help you to communicate with staff. You can contact the interpreter service on 8345 3054 or ask the nurse to organise an interpreter for you.

Our staff come from many rich and varied backgrounds and will bring their own experience, expertise and range of opinions to the care of your baby. We are always aiming to improve our communication with you. We want you to know what is going on at all times and to feel confident to ask questions or to seek out further information. Your feedback is important to us. There may be times when you feel concerned, frustrated or confused by the range of information you receive with regard to your baby’s care. If you find yourself in this situation:

Continue to talk with your carer Ask for support from your baby’s care manager Talk with the social worker who is available to listen to your concerns and to provide support Use the Family Care Plan to tell us how you want us to care for your baby Ask if you can speak with the nurse in charge or your baby’s doctor Please try to acknowledge your own stress and try to remain calm.

For further support you can:

Arrange with the Nurse Manager or with the Medical Director of Nurseries

Contact the Consumer Advocate at the Women’s who can help you resolve any concerns. Telephone 8345 2290 / 2291 or visit their office on level one of the hospital

You can also talk with a parent who has had a preterm or sick baby. Contact Life’s Little Treasures, 1300 mypremmie or email contact_us@lifeslittletreasures.org.au

Visiting

Due to restricted space on the unit only a small number of family members can usually be at the bedside at one time. We are happy to assist your family to be involved to the best of our ability. Family members can include the baby’s parents, siblings, grandparents, other relations and close friends.

Being involved in your baby’s care

Having an unwell or premature baby can affect your confidence as a parent. It is not unusual to feel nervous when you are trying to care for your baby. We want to support you as much as possible.

There are many ways you can help with your baby’s care. This will change as your baby develops, and includes being with your baby, watching, touching, talking, humming, singing, feeding, holding, comforting, changing nappies, washing or bathing. Do things in your own time. It may take a while to do things like changing your baby’s nappy. Please talk to your baby’s nurse about the care your baby may need and the ways in which you can be actively involved in your baby’s care. Nurses can support you as you gain confidence in handling your baby. If your baby is going to be in hospital for a awhile, you may find it helpful to bring things from home to make the space more familiar. Below are some suggestions:

Place toys outside your baby’s bed Bring music (for older babies) Coloured sheets, blankets and clothes are provided but, if you like, you can bring in some of your own. (They will need to be labelled and you will need to take them home to be washed.) Place photographs of your family beside the bed Put a small piece of material that you have slept with (so it has your smell on it) in your baby’s cot, so that your smell is close to your baby You can provide your own cot cover if you like Use the message board to write messages for staff or to your baby (invitations and messages will be left there for you as well) If religious symbols are important to you, such as photos, crosses or beads, you can place them on your baby’s bedside table. Keep a colourful box for the baby’s belongings under or near the cot Put a small laundry bag near the cot for things to be taken home and washed.

Patterns to make very small baby clothes are available in the NISC.

Suggestions from other parents

Take lots of photos. Put the photos in an album with dates and comments. Keep a diary or journal and include your feelings, what your baby is doing, who came to visit. You might like the nursing or medical staff to contribute something as well. Email photo updates to family and friends. Collect cards, letters and other mementos in a journal or special box. Let staff know if you would like to collect any of the things used for your baby, for example the chest leads. Staff usually place the cord clamp or old identification bracelets in your baby’s cot.

When you can’t be here

Ring in anytime and talk to staff caring for your baby. Have a diary by the cot for staff to fill out day by day. Put your photo on the cot. Record your voice on tape. Leave a disposable camera and ask staff to take pictures. Siblings may wish to make cards, pictures, etc for your baby. There are volunteers who are specially trained to cuddle babies when parents can’t be around. Ask the staff for more information.

The Daily Care Plan

There are things that will be very important to you about the care of your baby. We encourage you to tell us so that your baby is cared for in a similar way by the many staff involved in your baby’s care. The Daily Care Plan is used to communicate in writing to staff. You can ask for a hospital interpreter to help you to communicate your thoughts in the plan. You can use the plan to tell staff:

how you wish to be involved in your baby’s care (such as washing your baby) what you want staff to do when you can’t be there about your baby’s behavioural cues what positions your baby prefers for settling your baby’s feeding plans how your baby communicates.

These things may change on a daily basis which is why we encourage you to regularly update the plan with the help of an interpreter if you wish. Once the plan is completed give it to the nurse who will place it with your baby’s charts. If you need a new copy of the plan, the nurse can give you one. Each time you complete a new plan, you can keep the old one for your own records if you wish.

Developmental Care – understanding your baby’s needs

Babies, including very premature or unwell babies, are able to show how they are coping with what is happening around them. It is possible to get to know your baby’s signs and to respond to your baby’s needs. “Developmental care” aims to help your baby’s development. It takes into account your baby’s gestation (age in weeks) and ability to cope with his or her surroundings. There are physiotherapists and occupational therapists in the NISC who specialise in developmental care and other staff who can talk with you about it. If you wish to speak to one of the therapists, please ask your care manager, nurse or doctor. There are also other fact sheets available on developmental care.

Breastfeeding

Breastfeeding provides the best nutrition and has a number of other benefits, such as protecting your baby from infections, allergies and particular diseases that occur later in life. It is particularly good for premature babies who can digest breast milk better than substitutes. If your baby is still too small or unwell we can support you to express your breast milk until your baby is strong enough. The breastfeeding resource nurses and the lactation consultants can help you with expressing, starting to breastfeed and continuing to breastfeed if you have problems.

Kangaroo Care / Skin to skin contact with your baby

“Kangaroo care” encourages skin to skin contact and an opportunity for physical attachment with your baby. For mothers, it may improve milk supply and help breastfeeding. For all parents, it is another way to be involved in your baby’s care. The nursing staff will help you prepare yourself, your baby and the environment for kangaroo care. Your baby needs to be medically stable before kangaroo care can begin. The nursing staff can give you a fact sheet about kangaroo care if you would like further information.

Newborn screening investigations

It is recommended that all babies in Victoria have a heel prick blood test that checks for some very rare diseases that can be present. These diseases can cause serious complications. In most cases, if the diseases are found in the newborn they can be treated and the baby will grow and develop normally. A hearing test is also recommended. A small number of babies are born with a hearing loss that could affect their speech and language skills. Hearing loss may not be obvious in the first few weeks of life, but can be detected by a hearing screen.

Contacting NISC

Please ask the nurse to write the telephone number that you can use day or night to check on your baby.