Visiting mum out with NNU

• Partnership in care 
• Regular facilitated visits to Mum 
• Bonding and attachment 
• Support of feeding 

This guideline aims to support safe, facilitated transfer and visit of a baby to a ward out with the Neonatal Unit (NNU) in order to promote infant bonding, early skin-to-skin and support feeding where possible.  

Transfer of babies out with the NNU should be agreed with the Nursing Team Leader with support from Neonatal Consultant where appropriate. 

All babies can be considered for visit out with NNU, however is the visit appropriate? 

Consider 

• Can a facilitated visit of Mum to NNU be arranged? 
• Is it safe to transfer baby out of the NNU? 
• Are there staff available to transfer the baby without compromising the care of other babies? 

Be mindful of requirement for timely medical therapies, regular feeding requirements and consider infection risk. 

Be aware of ongoing social concerns (Child protection orders, flight risk etc.), in particular babies that are not to have unsupervised contact with one or other parent. 

Prior to transfer of a baby, ensure the multidisciplinary team is aware of plan for visit out with NNU. Decision for transfer taken in agreement and at the discretion of the  

• Nursing Team Leader or Charge Nurse (NNU) 
• Charge Nurse (Receiving Unit) 
• Neonatal middle grade 
• Consultant/on-call Consultant (if required) 

Ensure temperature stability. Newborn babies are at risk of hypothermia as they are unable to effectively thermo regulate. A hypothermic newborn is more likely to have difficulty feeding, and can develop respiratory problems. 

• When Mum holding baby skin-to-skin refer to appropriate guideline (term babies - postnatal ward skin to skin guideline, preterm babies - neonatal unit Kangaroo care guideline) 
• When Mum not holding baby, they should be appropriately dressed and/or covered for the environmental situation.  

Consider the safety of the environment into which baby will be transferred. Visit of the baby to the Receiving Unit should be in agreement with and at the discretion of the Charge Nurse/Team Lead of the Receiving Unit.  

Is there an agreed “safe space” for infant resuscitation, such as a flat surface with access to gas/oxygen, suction etc? 

If concern regarding infection control (e.g. MRSA, Clostridium difficile or other significant infection) please seek Infection control guidance on a case by case basis. Consider whether this visit is justified. Transfer at the discretion of the Team Leader (NNU) and the Charge nurse/Medical Team of the maternal ward. 

Formal consent does not need to be sought, however clear communication with the parents about the transfer should be undertaken and documented.  

• “2222” call requesting Neonatal Team (Consultant, middle/junior grades) 
• Ensure grab bag taken 

It may be appropriate to involve the Neonatal transport team in providing intensive care in unwell patients. Neonatal transport team have agreed to support internal transport on a discretionary basis. Neonatal transport may be unable to support transfer if clinical priority elsewhere (e.g. inter-hospital transfer of infant) dictates. 

Have you considered? 

1. Is the visit appropriate? 
2. Are there any contraindications to visit? (Consider infection risk, unstable baby, feeding support, significant social concerns etc.) 
3. Have you notified the appropriate members of the multidisciplinary team? 
   1. Team lead/Charge nurse 
   2. Neonatal consultant/Consultant on call 
   3. Acute middle tier and Intensive care junior tier (bleeps 1610 & 1611 respectively) 
4. Who needs to accompany baby? 
   1. Is parent/relative sufficient? 
   2. Does the baby need a nurse? 
   3. Is there requirement for medical input? If so liaise with Neonatal transport team 
5. Have you notified the maternal ward? 
   1. Discussed and agreed with the Charge Nurse 
   2. Is the environment safe for transfer? 
   3. “Safe space” for resuscitation? 
6. Have you agreed the length of visit? 
7. Is there requirement for feeding support (such as bottles/syringe of milk)? 
8. Assess the need for additional equipment. A minimum would be a self-inflating bag and an appropriately sized mask. In some instances the grab bag may be required