Welcome to Al Takhassusi Hospital,Special Care Baby Unit Please be assured that our caregivers are dedicated to supporting you

through this time. As your baby requires special care, observation and/or treatment he/she has been classified as a neonatal inpatient or nursery baby. Please ensure that you: Receive a Neonatal Account Estimate (quote) from the Ward Clerk, St Marys Ward or the Patient Admission Department Sign a hospital Claim Form remember parents only to visit in the Nursery The main reasons for admissions are: Prematurity (36 weeks gestation or less) Respiratory (breathing) difficulties Infections Temperature instability Assistance with feeding (tube feeds) Phototherapy (can be provided in your room) Monitoring ie. glucose, bilirubin (Jaundice)

High dependency
This is for nursery babies requiring more intensive treatment such as: IV therapy (drip) Management of convulsions High levels of oxygen (Oxygen therapy) Resuscitation or ventilation

Nursery fees
Charges will be incurred once your baby is provided with care in our Special Care Nursery. A health fund excess for your baby may apply in addition to your own excess depending on your level of health cover. Our Ward Clerk or Accounts Department will provide information about the fees involved with this care. Transfer to a public hospital may be considered at this time. Please discuss your needs with our clerical staff, your health fund and Paediatrician. Paediatrician charges are separate from the hospitals account, a portion of these consultation fees is claimable from Medicare. Health funds only cover the difference between the fee and the Medicare rebate when the baby is classified as a nursery baby. Check with your health fund as you may need to convert your health cover to a family benefit. While your baby may be classified as a nursery baby, wherever possible, and depending on your babys condition, the baby will stay in your room, returning to the nursery for treatment. This is called rooming-in and will help to build your confidence, and also ease the transition from the nursery to the ward and home.

Your babys caregivers

There are many people involved in the care of babies admitted to the nursery. The team is comprised of:

The Midwifery team

The Manager Midwifery Services is responsible for overall management. Clinical Midwives, Registered Midwives, Registered Nurses and Student Midwives deliver patient care.

Medical staff
Your baby will be cared for by a team of Paediatricians. A member from the team will usually visit your baby every day and are available 24 hours a day. Your own Paediatrician will also visit you in your room to discuss the care of your baby.

 Team approach
Other caregivers in the Maternity Unit include ward clerks, pathology caregivers, pastoral care and patient care assistants.

Parents are welcome

As soon as your babys condition allows, we will support you both to provide care such as feeding, nappy changing, bathing and other routines.

Temperature control
The temperature is set between 26 - 28C to ensure the babies are kept warm. Wearing light clothing may assist in alleviating any personal discomfort.

Equipment Oxygen saturation monitor

Checks the amount of oxygen circulating in your babys blood. This is monitored by a small sensor, which is positioned on your babys hand or foot.

Apnoea mattress
Apnoea mattresses detect pauses of greater than 15 seconds in the breathing patterns of babies. Preterm babies may be prone to this.

Overhead heaters
Help to warm babies and maintain their temperature while they are receiving treatment.

Cardiac monitor
This monitor allows midwives to continuously check your babys heart rate and breathing. The heart rate is monitored through pads which are placed on your babys chest or back.

Isolettes/incubators
Provide a stable environment for babies who have difficulty maintaining a constant temperature or for those who require oxygen therapy. Headbox oxygen or High Flow Nasal Catheter Some babies require extra oxygen and this can be given through a transparent plastic headbox or a nasal catheter.

Weight charts
Premature babies in the nursery are weighed every second day. It is normal for babies to lose weight in the first few days. Preterm babies often take a little longer to regain this weight.

Phototherapy / Jaundice
During their first few days, most babies become jaundiced to some extent. This causes a yellowish discolouration of the skin and the whites of the eyes. This discolouration is caused by bilirubin.All of us make this yellow pigment (bilirubin) as a natural waste product in our bodies and the liver excretes it. Before birth the mothers liver performs this function for both herself and her baby, but when the baby is born it is the babys liver which has to learn to take on this function. This may take a few days. If a babys jaundice level gets too high we can assist the excretion process through phototherapy. Due to the brightness of the fluorescent lights used in phototherapy, we cover the babys eyes to protect them.

Feeding
There are four different types of feeding methods: Intravenous Orogastric/nasogastric tube feeding (via mouth or nose) Breastfeeding Bottle feeding Much of the information in this booklet refers to breastfeeding, however parents will be supported in whatever choice they make.

Intravenous

Babies who are unable to absorb milk through their stomach may be given special fluids via a tube directly into a vein. As their condition improves, it may be possible to give small amounts of expressed breast milk via an oral feeding tube. At this time the intravenous fluids are weaned down as the milk feeds increase.

Orogastric / nasogastric tube feeding

If your baby can tolerate feeds but is too small or unwell to suck, feeds will be given through a tube, which passes down the nose or mouth and into the stomach. When the tube is inserted it does not normally cause discomfort. You may notice your baby clutching at the tubing, however this is a natural response and not due to discomfort. Tube feeds usually commence at one to two hourly intervals which ensures the feeds are absorbed. As your babys ability to absorb feeds improves, the feeds will progress to three to four hourly intervals. Parents are usually able to assist in giving tube feeds.

Breastfeeding
When breastfeeding begins, you will usually start with a graduated regime. This begins with one attempt at feeding, increasing to two attempts, alternate feeds and finally all breast feeds. The rate of progress is determined by the babys weight gain or loss.

Bottle feeding
At times it may be necessary to offer your baby a bottle feed or top-up and this will be discussed with you first. Sucking a bottle also helps to reinforce and encourage a baby to suck to acquire food and to strengthen jaw muscles. Under these circumstances, bottle feeding will not interfere with your ability to breastfeed. Only one brand of formula is used in the nursery. Alternative brands will need to be purchased by the paren

Expressing your milk

Even though your baby may be unable to suck, it is important that your expressed breast milk is used in the tube feeds. Electric breast pumps are available in the nursery and on St Marys Ward. The midwives will show you how to use them, and advise you on the frequency and duration of expressing. You should start expressing as soon as possible after delivery. Expressing may take some getting used to and sometimes it is difficult to let down to a breast pump. To overcome this block, it may help to express near your baby or to look at a photo of your baby as you express. If your baby is not ready to take feeds, your breast milk can be frozen and given at a later date. If your baby needs extra calories, a milk fortifier may be added to your milk. Always wash your hands before and after expressing your breast milk. Relaxation is important as it will help your let down.

Storage of milk in hospital

When you have finished expressing, label your milk with your name, the date and time, and place it in the fridge in the nursery or in your room. When refrigerated, expressed milk will last for 3-5 days. If the milk is not required during this time it can be frozen for up to three months. Plastic containers are recommended for freezing.

Storage of milk at home

Electric breast pumps can be hired to take home and a list of suppliers is available in the nursery. The attachments need to be purchased and they must be cleaned thoroughly each time they are used. When you are visiting your baby in the nursery you are welcome to use the hospitals breast pumps. If you are at home and having problems, please call us at anytime. When transporting milk, it should always be in a chilled container. When you take your baby home, remember to check the freezer for any expressed milk you have stored.

Sleep
Sick or premature babies need rest and sleep to build their energy. All nursing care is planned so as to provide minimal disturbance to your baby and to enhance your time together.

Baby safety
When moving your baby around the nursery, please use the cot. For your own safety, please wear footwear during your visits.You are welcome to accompany your baby for any tests or photographs.

Preventing infections
Hand washing is an effective way to reduce the spread of disease, so always wash your hands before entering the nursery. All babies have their own area in the nursery. This helps prevent microorganisms being passed from baby to baby. For this reason, please do not touch other babies in the nursery and only use the benches and tables allocated to the bathing area. Use bench with change mat or cot when changing nappies. Please do not bring bags or other personal items into the nursery as they may be an infection risk to sick babies.

Visitors
Parents are welcome to visit the nursery at any time. Children, grandparents and visitors are asked not to enter; however, they are welcome to view through the window. If you or anyone in your family is sick, it is important to tell the midwife caring for your baby and for them not to visit.

Confidentiality
Information about your babys condition will be discussed only with you. We are unable to give information about your baby to friends or relatives over the phone.

Discharge
If your baby needs to be in hospital longer than you, you may go home after three to five nights and return during the day for care and feeding.

Breastfeeding room
The breastfeeding room is located in the nursery with comfortable chairs, TV and balcony.

Look after yourself

Giving birth can stress your body and you need time to heal and rest. At home, do a minimum of housework and accept any offers of help with shopping, laundry or meals. Try to rest for at least half an hour during the middle of the day.

Rooming-in and mothercrafting

When your baby is well, he/she will be discharged from the nursery. Leading up to the transfer, your baby may be brought to your room in between feeds or observations to spend time with you. If you are already at home when your baby is ready for discharge, you can be re-admitted to St Marys Ward to mothercraft for one to two nights if you wish. For first time mums it is often a good idea to room-in for a minimum of 24 hours.You can discuss this option with your Paediatrician or midwife closer to the time of your babys discharge.
-IGRUS ERTNEC PERMIT PATHOL OGY PERMIT VISITORS

VISITORS

P TIMRE TIMREP PERMIT TIMREP PERMIT NOT TO SCALE PERMIT T EERTS HT UO S RU M HCOD E VI RD RTNE Y EMERGENCY NIAM E TN RY TO KWINANA FW Y E LT NAM ERF OT DR N OTGNIRRAF OT SOH P ECI HOSPITAL MEDICAL CLINIC PATHOLOGY US -IGR C ERTNE N PERMIT DOCTORS PERMIT DAY PROCEDURE UNIT E VISITORS CIPSOH Foot path to Hospital & Medical Clinic Murdoch Bus & Train Station (350m) Foot Path to Hospice only Bus stops on Murdoch Drive Foot path to whole campus VISITOR PARKING Visitors ACROD Paid visitor parking applies (City of Melville Parking Station #17) on the hospital grounds during business hours as follows: Monday to Friday: 7:00am to 5:00pm. Parking is free of charge in the evenings, weekends and public holidays. All ACROD bays are free for those with ACROD permits. Motorcyclists are requested to park in the motorcycle bays provided.

Should you require any further information on parking within the hospital grounds, please contact the
Security Department on (08) 9366 1093 or email murdoch.security@sjog.org.au.