Going Home From SCBU Special Care Baby Unit - Waitemata DHB
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Going Home From SCBU
Special Care Baby Unit
Issue Date: August 2018
Review Date: August 2021
Classification No: 010-02-06-002
1|P a g eCongratulations!
Your baby is ready to go home.
You may have some concerns or questions. This booklet will answer some of those questions.
Waitemata Homecare For Kids Service
If your baby was born before 34 weeks gestation, is under 2.3kg or has been unwell you may be referred to the
Homecare For Kids service (HC4K).
This team includes expert Nurses, Dietitians and Speech Language Therapists.
Your Homecare Nurse will visit you at home soon after baby’s discharge from the hospital. He/she will be able to
give you advice on feeding, routines, care of a small baby and is someone ready to listen to your concerns.
You will be visited every two or three days in the first week. Most families will be visited for 3-4 weeks after
arriving home.
Your Homecare Nurse will try to meet you and your family before you take your baby home.
Feeding your Baby
Breastfeeding may not be fully established when you take your baby home. It may take several weeks for your
baby to be more consistent with feeds. Try to make this time for you and your baby. You may need to rest when
baby sleeps.
One Breast or Two
• Offer one side until baby falls asleep or comes off.
• If baby has had a long feed from first side and comes off but still wants more, offer second breast.
• As baby matures, you may notice changes in the sucking pattern.
• As baby increases in weight he/she may require both breasts per feed.
Early Cues for baby wanting to breastfeed
• Rapid eye movement
• Beginning to stir
• Soft cooing or crying sounds
• Sucking fingers
• Turning head, searching for breast
• Licking out with tongue
Crying is a very late cue, try to pick baby up and be ready to feed before this stage
How do I know my baby is getting enough?
• Baby attached well at the breast .
• Long, slow rhythmical sucking, you should be able to hear swallowing.
• Stays on breast with relaxed posture.
• Passes frequent pale urine – at least 6-8 times a day.
• Passes yellow, soft bowel motions. This may be several or many times a day or once every few days.
• Baby gaining weight. The initial gain may be static or slow, but if baby latches and feeds well it should
• quickly improve.
2|P a g eWeaning Off Expressing When Establishing Breastfeeding
Because premature babies have a weaker suck than term babies, they do well if you have a milk supply
greater than what your baby needs. It is therefore important
to continue expressing until your baby is gaining weight well. Take care to wean off pumping slowly to
avoid blockages, mastitis, and a drop in milk supply. It is best done over 2 to 3 weeks.
• Continue expressing after each breastfeed.
• Usually this only needs to be a short express but you may need to pump a few minutes longer on the full
side if baby has fed on one breast. The main thing is to ensure your breasts are comfortable.
• Once your baby is gaining weight, drop one expressing every 2 to 3 days.
• If you need to return an electric breastpump you can continue pumping with a hand pump.
• Depending on your supply and your baby’s health and weight gains this plan may be adjusted to suit you.
Giving Breastmilk by Bottle
It is preferable to just breastfeed and not give a bottle. WHO (World Health Organisation) recommends
EXCLUSIVE breastfeeding for 6 months and then with
the introduction of solids to continue breastfeeding for up to 2 years or beyond.
If you choose to give your stored frozen breastmilk by bottle you will eventually run out. You will need to
continue expressing ahead to ensure you are producing
enough to meet your baby’s needs and do not need to introduce formula.
Ways Fathers can be involved with your Breastfeeding Baby
• Winding and settling baby after feeds
• Taking baby for walks
• Looking after baby while you rest
• Practical household chores.
• Bathing and dressing baby
• Changing nappies
• Bringing baby to you in the night
• Supporting and praising you
What Is Normal Breastfeeding Behaviour
Once your baby is around term and gaining weight well he should be feeding totally on cue.
• This means you watch the baby for hunger signs not the clock
• This may be anything from 7 to 12 times in 24hrs.
• Feed times will vary. Some feeds will be short and others may be longer bigger feeds (just as your appetite
varies through the day.)
• Cluster feeding is common. This is when he may feed 3 or 4 times in a 3 or 4hr period and may not sleep
or sleep very little in this time.
• Baby will have growth spurts during which time he will feed much more frequently and you will find your
milk supply will increase to meet his needs. This is NOT a sign that your milk is weak, insufficient or poor
quality.
Remember mothers have been successfully breastfeeding their babies for 8 million years!
It is not normal to have sore nipples or breasts. Any problems discuss with yur Homecare Nurse or Lead
Maternity Carer (LMC).
3|P a g e‘Back to Sleep’
Reduce the Risk of Cot Death by:
• Placing your baby to sleep on his/her back. All babies should be placed on their backs, with the bassinette
flat unless your Paediatrician or homecare nurse have advised otherwise because of a medical condition.
• The side is not safe for babies because they can roll onto their tummies.
• If babies vomit or spill they will swallow anything in their mouths just as if they were feeding.
• Ideally babies should sleep in their own beds, particularly if you or your partner smoke or you smoked
during pregnancy. It is best if the baby is in the same room as you. Place the babies cot/ bassinet beside
your bed.
• Do not raise the bassinette unless first discussed with your home care nurse.
• Never sleep with your baby in an armchair or sofa.
• Falling asleep with your baby can be dangerous particularly if you have drunk alcohol, taken any drugs
(legal or illegal) or if you are unwell.
• Breastfeed your baby
• Do not smoke. It is best for you & your baby
Caring for Your Baby
Vaccinations
The vaccination schedule is a very important part of keeping your baby well. It starts at 6 weeks from birth and is
done by your GP.
If you have any concerns or questions about vaccination, please discuss with your homecare nurse or doctor.
Your hospital Paediatrician may recommend your baby also has a BCG vaccine for Tuberculosis, this will be
discussed with you if it is advised.
Car Seat
• Always use a car seat when the baby is in the car.
• Use a car seat suitable for a 0-6 month old baby.
• The seat should be rear facing. The safest place for this is in the back seat of the car. Never use in the front
seat if your car has a passenger seat airbag.
• Use the car seat for car transport only. Place baby in a safe sleeping position on arrival at destination.
• Do not wrap your baby whilst in a car seat. Strap him/her in and then cover with a blanket.
Premature Baby Clothing
A selection of premature baby clothes is available at The Warehouse and The Baby Factory.
You can also hire premature clothing through Parent care at Auckland hospital. You can contact them on Tel: 307
4949 Ext. 25469 or http://neonataltrust.co.nz
4|P a g eTemperature Control
Keep your baby nice and warm.
Warm babies use the energy from their food to grow.
Now your baby is ready to go home, the SCBU team are happy he/she can maintain his/her own temperature.
It’s important to remember that small and early babies cannot regulate their body temperature as well as adults.
Parents can help by:
1. Keeping the room warm (18-20º C).
2. Dressing baby warmly and having at least one layer of wool. Your baby should have one more layer of
clothing than you are wearing.
3. Providing warm bedding such as wool under blanket and wool blankets.
Get used to feeling your baby’s temperature by feeling the back of your baby’s neck. The baby should feel very
warm. If baby is too cold add more clothes and kangaroo cuddle. If baby is too hot take some layers of clothing off.
Remember, a sick baby could be either too hot or too cold.
Winter babies need special attention. Hats may also need to be worn in the day, though not recommended at
night. An unsettled baby may be a baby who needs more warm clothing. Never put a hot water bottle or an
electric blanket in bed with your baby.
Summer babies who are too hot will fuss and use up energy to keep themselves cool. Auckland summer and the
humidity means that woollen cardigans and hats may not be the best clothing on our really hot days.
Bedding - Recommendations
• Do not use a pillow in your babies bed.
• Use a clean, firm fitting mattress.
• Use natural fabrics such as cotton sheets (flannelette sheets) and woolen blankets. (Babies
• need one more blanket than an adult)
• Air bedding 2-3 times a week.
• Make sure the covers cannot cover the baby’s face.
• Sheepskins are not recommended but if you do chose to use one, cover it with a sheet, air it 2-3 times
weekly and wash it regularly
Keeping your Baby Healthy
Is My Baby Well?
A Healthy Baby
• Feels warm – you may need to adjust clothing/ blankets/room temperature if your baby feels cold.
• Is pink around lips and tongue.
• Has his/her usual breathing pattern.
• Is alert, with regular feeding and sleeping patterns.
• Has frequent wet nappies, approximately 6-8 cloth nappies or 5-6 disposable in 24 hours.
• Has bowel motions that are soft and easy to pass. This may be several times a day or once every few days.
He/She should have a soft tummy it should not be tight or distended.
5|P a g eIs My Baby Unwell?
A Sick Baby
• Feels hot or cool to touch. You may need to adjust clothing/bedding.
• When taking your baby’s temperature, place the thermometer in the armpit for 3 minutes (or
recommended time for digital thermometer). A normal temperature is 36.6 – 37.2º C.
• May look pale and dusky (blue) especially the lips and tongue.
• Is sleepy and not wanting to feed lethargic and listless.
• May not want to feed or may be vomiting.
• Is often fussy and irritable (more than usual).
• May have a decrease in wet nappies (that is two dry nappies in 6 hours). The usual is 6-8 wet nappies/
24hours. The urine is dark yellow or even orange
• May have diarrhea. This will be watery and/or green bowel motions. Bowel motions may be less frequent
If you are worried that your baby is sick call your Homecare Nurse/Midwife or Family Doctor for help.
Refer to last page for contact details.
If your Baby Stops Breathing
CHECK DANGERS
CHECK RESPONSIVENESS
SHOUT/SEND FOR HELP
OPEN AIRWAY
CHECK BREATHING
(NO LONGER THAN 10 SECONDS)
COMMENCE CPR
30 CHEST COMPRESSIONS / 2 VENTILATIONS
(FOR 1 MINUTE)
GO FOR HELP
Phone 111
Ask for ambulance
SCBU staff strongly advise that you attend a CPR class before you go home. Please learn this life saving
skill – it may save your baby’s life!
6|P a g eYour Homecare Nurses
Waitemata Homecare for Kids is a 7 day service from
8:00 am – 5:00 pm, Monday – Friday
8:30 am – 4:30 pm, Saturday & Sunday
North: 09 442 7158
West: 09 839 0593
If no-one is there to take your call, please leave a detailed message and contact number on the voicemail and a
nurse will ring you as soon as possible. Alternatively you can press ‘0’ and you will be put through to the nurse’s
cell phone.
For urgent advice after hours, please phone the SCBU your baby was in and ask to speak to a nurse. The Nurse will
be able to assist and refer you to a doctor or LMC if necessary.
North Shore SCBU: 486 8920 Ext. 42268/42269
Waitakere SCBU: 839 0000 Ext. 47993
For emergencies phone 111 or take your baby to a Medical Centre, to STARSHIP Hospital
Emergency Department or Waitakere Emergency Department
7|P a g eYou can also read
