3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> Special Care Baby Units

Special Care Baby Units

The special-care baby unit (SCBU) is a separate ward run by specialist nurses and paediatricians. Although it deals mostly with premature babies, there are other babies who also need to spend some time here. Especially after a full-term pregnancy, it can be a huge shock to new parents to find that their baby has a problem that requires special care.

Parents can find an SCBU quite daunting, because it is full of beeping machines and alarms sounding on cots. Although the staff are used to this, parents tend to assume that every alarm is a sign of something seriously wrong, which is often not the case. Many babies have a fine cable attached to a pad on their foot or hand, monitoring their pulse rate and oxygen levels. If a baby moves or knocks against the pad, it may sound an alarm because it needs to be repositioned.

Special-care babies

The majority of babies are born without problems but, if there is any concern, they are best being cared for by specialist staff. There is a high ratio of carers to babies in SCUBs. The care can range from a few hours of observation to intensive life support. The specialist staff in the SCBU will encourage you to participate in the care of your baby and will explain what is going on so that you feel involved. Some babies develop breathing difficulties soon after birth, making a 'grunting' sound as they breathe. Initially they may just be observed and encouraged to have an early feed, but if the difficulties persist they may have an infection.

The paediatrician will arrange for the baby to have some screening tests, including a chest X-ray, swabs, lumbar puncture, and urine and blood analysis, and may recommend a course of antibiotics. Other babies develop severe jaundice and need a course of light therapy (phototherapy); some have a very low blood-sugar level, a structural abnormality, or they may have inhaled meconium during the birth. How long a baby stays in the SCBU depends on the problem and how well she responds to treatment. SCBUs often have different 'areas', depending on the level of specialist care that the baby needs. As a baby improves she will move areas, until she is ready to go home.

Coping with the news

With so many screening tests available nowadays, parents assume that any significant problems or disabilities will be picked up during the pregnancy, but this is not always the case. Some medical conditions or disabilities, such as cerebral palsy, are not always identified before the birth.

Your initial reaction may be denial, thinking that the professionals have made a mistake. More commonly, the feeling is guilt. What did I do wrong? Did I eat or drink something to affect my baby? Although you will be reassured that you are not to blame, you will still feel guilty and blame yourself. It can help to get in touch with an organization where you can talk to other people with similar experiences. These groups can be a great source of comfort, advice and hope.

Sometimes, despite all the efforts of the medical team, a newborn baby dies. Dealing with this tragedy is one of the hardest things new parents will ever have to do. It is important that both parents are open about their feelings of loss so that they can learn to accept them and can support each other through the grieving process. If your baby dies, you will still be encouraged to spend time with him, having cuddles and building some memories. You will be offered counselling which can help and strengthen you in your bereavement.

My friend's baby was jaundiced and had to stay in hospital for a few days. Is this unusual?
Jaundice is very common in newborn babies and usually appears on the third day after the birth, disappearing by a week. The baby's skin develops a slight yellowish tinge due to the presence of bilirubin, a pigment produced by the breakdown of red blood cells. This is a normal process and, in most cases, does not need treatment. Your baby will excrete the bilirubin as she soils her nappies, so the more she feeds the sooner this will happen. Your midwife may ask if she can take a small amount of blood from your baby's heel to check the level of jaundice. However, if your baby is alert and feeding well, the midwife may not think this necessary.

A few jaundiced babies need to stay in hospital for a couple of days for a course of phototherapy, and this could be what happened to your friend's baby. For this treatment, the baby lies in a cot under a fluorescent light, which speeds up the process of clearing the jaundice. Some babies are more prone to jaundice, for example, premature babies or babies who have had an instrumental delivery. Occasionally, it can indicate an underlying disorder, but it usually clears up without treatment.