Babies who need extra care

Most women have a straightforward pregnancy and birth and their baby's born healthy and well. But about 1 in 8 babies will need some extra care.

Every baby's unique and the care you and your baby get will be individual to you.

How you might be feeling

Finding out that your baby's sick and needs extra care can be a shock. It can be a very distressing and upsetting time for the whole family. It can feel like things are out of your control.

The staff supporting you at such a difficult time understand how hard it can be to cope and will give you whatever help they can. It’s also important to get support from your family and the people close to you.

If you have other children you might feel torn between them and your baby. Try to:

  • get family and friends to help so you can do what you need to do
  • tell your other children what’s happening and include them if you can
  • reassure them as they may have a mix of feelings too

Bliss can provide you with help and support.

Making decisions about your baby's care

You and your partner, or whoever's supporting you, should be involved in the decisions about your baby at all times. Whatever care your baby needs, a healthcare professional will make sure you’re involved and able to be as close to them as possible.

It’s important to be involved as much as you can in the care of your baby and the decisions about their care and treatment. Being with them as often as you can will give you confidence. It can also help you develop the skills you’ll need when you take them home.

Transitional care

Some babies who need extra care don’t need to be moved to a neonatal unit and can be cared for alongside their mums on a postnatal ward or in a dedicated area. This is called transitional care.

However, some babies will need to be admitted to a neonatal unit, particularly those who:

  • arrive earlier than expected
  • have health problems that need specialist treatment or tests

Neonatal care

NHS Scotland neonatal services work closely together to help your baby get support and specialist help at the right time by highly trained healthcare professionals.

Some babies only need neonatal care for a few hours, but for others it will be longer.

If your baby needs extra care

If you know before your baby's born that they’re likely to need extra care, your midwife and doctor will talk to you about:

  • what that care will be
  • where it’s likely to be given

There are 3 levels of care given in neonatal units:

  • Special care - these units give special care and some high dependency care
  • High dependency or local neonatal units - these units give special care, high dependency care and some intensive care
  • Intensive care - these units give a full range of medical and sometimes surgical care for babies who are born very early or unwell - about a quarter of all babies in a neonatal unit receive intensive care

Not all hospitals can give intensive care, so this may affect where you choose to have your baby.

More about choosing where to give birth

Moving hospital

Some babies need to be moved to a different kind of neonatal unit after they're born. A specialist trained team of healthcare professionals will go with them if they need to be moved. Your midwife or doctor will:

  • explain what’s going to happen and why
  • make sure you have the answers to your questions

When your baby's well enough, they’ll be moved back to the neonatal unit at the hospital where you had planned to give birth or a unit as close to home as possible.

Staying with your baby

If your baby needs care in a neonatal unit, you’ll be able to stay with them overnight and you’ll stay together wherever that’s possible.

Sometimes though, you and your baby might be separated for a while. If that happens the staff at your hospital will arrange transport to get you to the new hospital as quickly as possible.

The neonatal unit should be able to organise somewhere for you and your partner to either stay with your baby or be close by.

Neonatal Expenses Fund

You can get financial support to help you spend as much time as possible with your baby while they’re in the neonatal unit.

You can get help with the cost of food, travel and parking through the Neonatal Expenses Fund. The people looking after you and your baby may be able to help you apply.

mygov has more about the Neonatal Expenses Fund

Caring for your baby

When your baby's in a neonatal unit, their emotional needs are just as important.

To help to reassure them and build the bond between you, try to:

  • touch them gently
  • make eye contact
  • pay attention
  • talk and read to them – they'll recognise your voice and it will help them to hear it and filter out other noises

Having you close by and having skin-to-skin contact when you can will help them to feel safe and secure too. The neonatal nurses can help you and it’s okay to ask for their support.

More about bonding with your baby

Feeding your baby

You’re likely to need some extra support to feed your baby and the midwives and neonatal nurses can guide you.

Babies can have formula milk in the neonatal unit, but there are clear advantages to giving a sick or small baby your breast milk to give them the best start in life. A healthcare professional will discuss this with you.

Breast milk

Your baby can have your breast milk while they’re in the neonatal unit. This is particularly important if your baby's been born sick or early.

There are benefits to giving your baby breast milk if you can:

  • It's easy to digest
  • It helps protect your baby from some infections now and into later life

More about breastfeeding your baby

Expressing breast milk

You'll be able to express milk while you’re in the neonatal unit. If you can:

  • start expressing within a couple of hours of birth
  • express 8 to 10 times a day thereafter

This will help to keep your milk supply up so you can carry on feeding your baby as they grow. If you need help with hand expressing or using a breast pump, ask your midwife to show you.

Donor milk

If for some reason you can’t breastfeed, donor milk's the next best. Donor milk can be given to unwell babies whose mums are ill or are finding it hard to produce milk.

Scotland has a donor milk bank which gives safe, pasteurised donated mothers’ milk to every neonatal unit in Scotland. If you have extra milk you can donate it to the milk bank.

One Milk Bank for Scotland has more information about donating and accessing breast milk in Scotland

Taking your baby home

When you take your baby home you’ll probably stay in touch with the hospital doctor directly or through a community neonatal nurse who specialises in newborn babies.

When your baby's ready, you'll be transferred to the care of a health visitor.

How healthcare professionals will support you and your baby after the birth