CPAP is used to help your baby’s breathing by keeping the lungs partially inflated. This helps your baby to breathe easier. It also helps get more oxygen in baby’s blood and stops the lungs collapsing when baby breathes out. CPAP is an extremely safe and effective way to treat babies with sick lungs without causing damage to the lungs. The CPAP is given through short prongs in the baby’s nose and is achieved by the bubbling of water in the special bottle that one of the tubes is inserted into (this is the bubbling sound you will usually hear when you are beside your baby). Depending on your baby’s age or condition, your baby may require CPAP for a few hours or many weeks. Your baby may also require some oxygen while on CPAP, which is given through the CPAP system and the amount is safely monitored through an oxygen analyser. A tube (orogastric) is inserted into baby’s stomach through the mouth, as CPAP is achieved by a flow of air which can cause the tummy to distend/fill with air. We can remove any excess air from the stomach through this tube if required. Once your baby has been stabilised on CPAP, you will be able to cuddle your baby and feeding may be commenced through the orogastric tube. While your baby is on CPAP, it is important for the nursing staff to regularly suction down your baby’s nose and mouth. This will usually be done 2-3 hourly or as required in special cases. Babies do not like this sensation but it is a quick procedure and is vital in clearing their breathing passages and, therefore, reducing the work of breathing. The nursing staff will regularly check to make sure that the CPAP prongs are not rubbing against the nose, as this can cause injury to the area. What can parents do for their baby while on CPAP? You can help with the care of your baby by assisting the nursing staff at care times. You can help your baby at suction times by soothing and touching your baby. You can change baby’s nappy. You can learn how to do eye and mouth care. Mothers will be shown how to express their milk to give to their baby. Once feeding has commenced, you can hold the feed. If you are not always visiting at care times, you can simply hold your baby’s hand, or just talk to your baby. Ventilation Some babies require more help to breathe. When this is the case a tube will be put into your baby’s throat and connected to a machine which will then do all the breathing for your baby. The care for your baby is similar to when he/she is on CPAP.

Your baby may need to be tested or treated for jaundice. Many babies become jaundiced soon after birth. Levels of jaundice we are concerned about depend on how old your baby is or if it was born prematurely. What is wrong? Jaundice is the name for the yellow skin that some babies get. The yellow substance is called bilirubin and comes from the normal breakdown of blood cells. After birth some babies are slow to get rid of the bilirubin. Who is at risk? Pre-term babies. Babies whose blood group is different from that of their mother. Tests Blood tests are taken from a prick in your baby’s heel to check the bilirubin level. Blood tests or scans may be done to find the cause of jaundice if it lasts for more than 2 weeks. Treatment If the bilirubin level is high, the baby is put under special lights. The lights break down bilirubin and it will come out in baby’s wees and poos. A drip or extra feeds may be given. A special blood transfusion may be needed for some extreme types of jaundice. How long? The baby will need tests until the bilirubin level is going down and nearly back to normal. Babies may be able to stay in the ward with their mothers. Special checks Most babies who had jaundice do not need any checks after they leave hospital. Some babies need a blood test at about 4 weeks. Babies who had a very high level of jaundice will need a hearing test.

Your baby may be tested or treated for low blood sugar. What is wrong? Sugar is the food used by the baby’s brain and other organs. If the sugar in the blood gets low and stays low for too long, it may cause damage. Who is at risk? Babies whose mothers had diabetes in pregnancy. Small babies, less than 2500 grams, especially babies who are smaller than average for the stage of pregnancy (small for dates). Big babies, over 4500 grams. Sick babies, such as those with an infection. Is it serious? Hardly ever! The blood sugar needs to be low for a long time to be harmful. We will test the blood sugar and give treatment if it is low. What are the tests? Blood tests are taken to check the sugar level. The blood is taken from a prick in your baby’s heel. The normal blood sugar in babies is 2.6 or more. Usually a test is done just before a feed. What is the treatment? If the sugar is a little bit low, we may give extra feeds. If the sugar is very low, or it doesn’t get better with feeding, we will put in a drip to give the sugar. How long? Many babies can be on the ward with their mother. The baby will need tests until the blood sugar remains normal with normal feeding. Usually we want to see three normal blood test results with normal feeding. Special checks A baby who had low blood sugars does not need special checks after going home.

Your baby may be in the Neonatal Unit because they were exposed to meconium. Your baby is being treated or tested because of the risk of problems caused by meconium. Meconium is sometimes seen in the waters before the baby is born. What is wrong? Meconium is the name of the baby’s first poo. A baby who is sick or under stress before birth may pass meconium. This is a problem because: the meconium may get into the lungs and cause breathing problems the stress may have been severe. Is it serious? The breathing problems caused by meconium are not always serious but in some cases can cause severe breathing problems. The stress or sickness that caused the meconium can be serious. What are the tests? Some babies are just watched for a few hours. Sicker babies will have blood tests and a chest x-ray. What is the treatment? Most babies need a drip and antibiotics. Babies who are breathing too fast may need help with their breathing e.g. CPAP. Sicker babies may need oxygen and possible ventilation to breathe for them. How long? Mild problems usually get better in 1-2 days and the baby can be with the mother. Severe problems take longer. Special checks Babies who are not very sick do not need a special check after going home. Babies who were very sick babies will need special checks after they go home.

Your baby may be tested or treated because of the risk of infection. The usual reason for this check is if your baby has some problem like a temperature, fast breathing, lack of energy or poor feeding. What is wrong? Babies can develop an infection, just like adults. For example, they may get pneumonia or a urine infection. Because babies are small and cannot tell us what is wrong, we prefer to give them treatment (e.g. antibiotics) to prevent problems rather than wait and see. Who is at risk? Babies are more likely to get an infection if: the waters broke more than 24 hours before birth the mother had a high temperature during labour the baby is born before it is due. Is it serious? Most infections are not serious for the baby. The doctors will tell you if they think an infection is serious. What are the tests? A blood test and urine test to see if any bugs grow. A chest x-ray. Lumbar Puncture (a spinal fluid test to see if any bugs grow). What is the treatment? Your baby will have a drip and be given antibiotics. Sometimes a baby may need other treatment like oxygen or CPAP. How long? Some babies will turn out not to have an infection and will only be given antibiotics for 48 hours. All other babies are given antibiotics for as long as is needed. This is usually 5 days but can be longer. Any baby who is feeding normally and is not too sick can be with their mother on the postnatal ward. Special checks Unless the baby has been very sick, there will be no need for special checks after going home.