Welcome to the Evelina London Neonatal Unit
This website page gives you more information about the Neonatal Unit and what you can expect when you come to hospital. If you have any questions or concerns, please speak to a member of the team.
This website page will:
give you an introduction to the Neonatal Unit, who we are and what we do
explain how you will be involved in the care of your baby
give you information on medical conditions and procedures relevant to your baby
explain who will be involved in looking after your baby
describe the facilities that are available to you as a parent
give you some understanding of what you can expect during the care of your baby in the neonatal unit.
Staff at the Evelina London neonatal unit are dedicated to delivering high-quality, family centred care to the babies and families that spend time here. Having your baby admitted to a neonatal unit can be a frightening and worrying time.
Our doctors and nurses will help you manage this experience. They will give you clear information and help you understand the treatment your baby needs. They will also offer you emotional and practical support throughout your baby’s stay.
You may feel anxious about the sound or appearance of the equipment we use here. But the nurse looking after your baby will explain what the equipment does, what the sounds are and how the equipment is helping your baby. We will involve you in your baby’s care as much as possible, encouraging you every step of the way to become confident in caring for your baby, to ensure you can still be parents in what are exceptional circumstances.
Please speak to a member of your neonatal care team if you have any questions about your involvement in caring for your baby.
While your baby is on the unit we will record their weight in grams and kilograms. You are probably more familiar with seeing your baby’s weight in pounds and ounces. Weight conversion charts are available in the neonatal app and can also be found in poster form on the Neonatal Unit.
What is the Neonatal Unit and why might my baby go there?
The Neonatal Unit provides expert care for newborn babies who are unwell. It offers specialised equipment and care for:
- babies who need extra support because they are born prematurely
- babies with health problems diagnosed before birth (antenatally) or after birth (postnatally)
- full-term babies who have become unexpectedly unwell. Levels of care The Neonatal Unit is divided into three areas:
- Neonatal Intensive Care Unit (NICU)
- High Dependency Unit (HDU)
- Special Care Baby Unit (SCBU).
There is a designated neonatal consultant overseeing the care and treatment of babies in each of these areas. Neonatal Intensive Care Unit (NICU) The NICU provides support for babies who have breathing problems and other specialist treatment needs. There is a range of specialist equipment to help care for your baby in the NICU’s rooms and nurseries.
The NICU can be a busy place with unfamiliar sights and sounds. The nursing and medical teams will involve you in the care of your baby and keep you up-to-date about their care needs. However, if you are feeling overwhelmed, it is okay to ask us questions. Once your baby is getting better and needs less support, they will be transferred to either the High Dependency Unit (HDU) or the Special Care Baby Unit (SCBU). High Dependency Unit (HDU) and Special Care Baby Unit (SCBU) The HDU provides support for babies who require less intensive care than babies in the NICU, but who are still not stable enough for the care provided in the SCBU. This may be because they still need some breathing support, special intravenous feeding (directly into a vein) or they are recovering from surgery.
The SCBU provides support for babies who need:
- intravenous fluid for nutrition or hydration
- tube feeding
- additional oxygen support
- light therapy (phototherapy).
Your baby may be admitted straight to the SCBU if they do not need help with breathing. Babies in the SCBU may be receiving treatment for jaundice or low level of sugar in the blood, or they may be:
- establishing a feeding pattern
- growing to be able to control their own temperature
- receiving care from other paediatric specialists
- starting to prepare for going home.
You will be able to get a lot more involved in your baby’s care in the HDU and SCBU and the nurses will be there to help you at every step of the way. They can offer you advice including:
- correct positioning for safe sleeping
- breastfeeding or making up feeds
- bath time
- basic infant resuscitation training.
Transfer of care
The Evelina London Neonatal Unit specialises in looking after babies who need intensive care. When your baby no longer needs intensive care, we will arrange for your baby to be transferred back to your local hospital. This will happen even if you have planned to have your baby at St Thomas’ Hospital, or if you have been referred here for your baby’s specialist care before birth. Transferring your baby back to your local hospital is beneficial for many reasons:
- it makes it easier for you and your family to visit your baby
- it allows the doctors at your local hospital to get to know you and your baby
- it allows for your baby’s follow-up clinic appointments to be organised.
We understand that the idea of your baby being transferred to another hospital can be stressful. Please be assured that we only arrange the transfer when we are sure that it is the right time for your baby. Transferring babies back to their local hospital helps us to provide specialised intensive care to those babies who need it most. It is possible for you to visit your local unit before the transfer. If you would like to do this, please speak to your neonatal care team.
For more information about the networks of care and other hospitals that provide neonatal care, please visit the London Neonatal Network website.
Postnatal ward and accommodation
After giving birth, the new mothers are cared for on the postnatal ward located opposite the Neonatal Unit. There is a large day room with a TV and refreshment facilities for you and your visitors. The daily breastfeeding drop-in sessions are also held here.
When mothers are considered to be medically fit, they are ‘discharged’ from the postnatal ward. This means that you may be leaving hospital while your baby remains in the Neonatal Unit. Unfortunately, there is very limited accommodation for families on the unit, and this has to be prioritised for families of babies who are very unwell or getting ready to go home. Accommodation facilities in the Ronald McDonald House are prioritised for families who do not live locally to the hospital.
The Ronald McDonald House is only a short walk away. It aims to provide a comfortable ‘home away from home’ for families. Please speak to your neonatal care team if you would like more information or if you want to arrange your stay. Please note that the accommodation may not always be immediately available and your name may need to be added to the waiting list. We recognise that being away from your baby can be difficult. Please talk to us if you need further information, support or advice. Visiting the Neonatal Unit Parents We do not think of parents as visitors. You are an essential member of the care team. Parents and siblings are therefore welcome to be on the Neonatal Unit at any time. However there are the following restrictions on visiting the nursery rooms because of the care needs of the babies.
During the nursing handover between 7.15am to 8.15am and 7.15pm to 8.15pm, you are asked to wait in the reception area or parents room. This is to ensure the handover of information between day and night staff is carried out safely and confidentially. During the ward round, you are welcome to join the ward round for your baby but you are asked to wait in the reception area or parents’ room while the other babies and families are seen. Family and friends Friends and family may visit between 8.15am and 7.15pm. We may restrict visiting during busy times in order to keep the nursery rooms safe. Other children (of family or friends) under 16 years old are not allowed to visit the neonatal unit. There is only room in the nursery room at each bedside for 2 visitors at a time. One parent needs to be present while family/friends visit. Parents can authorise up to 4 people to visit without a parent being present. There is a form available from the nursing staff or ward clerk at reception for this purpose, please ask for their assistance.
Each afternoon between 1pm and 3pm the unit has quiet time. During this time lights are turned down, noise is reduced and only urgent or essential procedures are carried out with the babies. It is an excellent time for parents to have cuddles. The purpose of quiet time is to ensure the babies have a good rest period. We would strongly suggest that friends and extended family do not visit at this time. If parents, family or friends need an exception to be made to visiting times, it must be agreed with the nurse in charge in advance who will consider the business of the unit and the impact this will have on the provision of care. Rude or aggressive behaviour to any of our staff will not be tolerated and may result in the withdrawal of visiting permission.
The reception area is often busy. Ward staff will ask family and friends to wait away from the unit during busy times to ensure the safety of the unit. Access to the Neonatal Unit is via a buzzer entry system and the reception desk is staffed 24 hours a day. When you enter the unit, you will need to tell the receptionist who you are visiting and sign in.
Please remove your outside coats and hang them on the hooks provided. Don’t leave any valuables in your pockets. Lockers are provided for you to use – please see the ward clerks to have a locker allocated for your whole stay.You will need to provide your own padlock. You can use your phone in the nurseries to take photos of your baby or send text messages, but please ensure that your phone is switched to silent mode. If you need to make or receive calls, you can do this in the reception area or the lift lobby.
Please do not take pictures of other babies or families on the unit.
Protection from infection
To help us protect your baby from infection, please ensure that you wash your hands at the sink area before coming into the unit. You should also use the antibacterial foam from one of the dispensers outside the cot nursery before entering the room your baby is in.
When leaving the unit, please wash your hands or use the foam by the sinks. If you have touched your baby either for comfort or for care you should wash your hands before doing anything else. Anyone with a cough or cold should avoid visiting the unit. If you suffer from sickness or diarrhoea, you must be symptom-free for 48 hours before visiting the unit. For more information on hand hygiene, please refer to our information leaflet, Help us to protect you – promoting hand hygiene.
The parents’ room is situated next to the main reception and you can use it to rest and to have something to eat or drink. There are facilities for making hot drinks, and storing and heating food. There is a small play area for siblings. A mobile phone charging locker is available with keys at reception. Please return the keys after use. You will need to bring your own charging cable and plug (there is an electrical socket in each locker). Please help to keep the room clean and tidy. It is important that you label any food you store in the fridge with your name and date. Please also throw away anything you are not going to use. The room is exclusively for the use of parents and siblings. Other family members can take a seat in the reception area in between visiting.
Etiquettes of the nursery room
The nursery room is primarily for the care of your babies. It is a shared space for staff and parents who are involved in the care of the babies. It is important to be mindful of the private and confidential nature of the care that is being provided. Whilst staff will endeavour to maintain confidentiality, because of the small size of the nursery rooms, you may overhear information about other babies. Please keep this information to yourself and do not share it. Most of our hospital notes are electronic. You may ask to read your baby’s notes, however because of the nature of the electronic system, it is necessary for you to book an appointment with a doctor or nurse. Parents and family are not authorised to use the nursery computers.
We want you to develop a trusting relationship with the team caring for your baby. Therefore, you can expect us to be open and honest about your baby’s care and treatment. We aim to use jargon free language and clear explanations when giving information. If you aren’t sure about something, please ask. We are constantly reviewing the care of your baby ensuring we are responsive to changes in their needs and condition. There can be ‘grey areas’ when it comes to making decisions or plans.
Parents have told us this can make information seem inconsistent. We will always explain the reasons for changing plans and will involve you in the decision-making wherever possible. Together with you, we have your baby’s best interests in mind at all times. We encourage you to be here on the unit as much as possible to enable you to be part of the hands-on care and decision-making processes for your baby. However, having time away is okay too. Staff may encourage you to take a break; they have your wellbeing in mind. During or after ward rounds is the best opportunity to discuss the care of your baby with the team. We will encourage you to ask questions and give information about your baby to the team at this time. You can, of course, ask questions or discuss the care of your baby at any time.
We also want you to be as hands-on and involved with your baby’s care as possible. This will feel different for each of you so staff will work with you, giving you information and support to make you feel confident and capable. This includes activities such as feeding, mouth care, nappy changing, washing and bathing, weighing and holding your baby. There is lots of written information available in the parents’ room about being involved in these activities.
Who will look after my baby?
The Neonatal Unit is staffed by a highly skilled team who are dedicated to giving your baby the best possible care. This means that in addition to doctors and nurses, there are a number of other specially trained staff members who can offer support to you and your baby. Most of the doctors and nurses rotate between the NICU, HDU and SCBU, but some staff members work exclusively in just one area. There is a photo board of the team just inside the Neonatal Unit for you to refer to. The list below introduces you to different staff who may be involved in your child’s care. It is provided to help you understand the responsibilities of different staff, and for your reference. If you have any concerns about the care or treatment of your baby, please speak to a member of staff.
The following staff are based on the neonatal unit and you are likely to see them every day.
Medical specialist teams
There are a group of specialist doctors and nurses based at the Evelina London Children’s hospital who will come regularly to the neonatal unit to give specific treatment or advice.
Being involved in your baby’s care
Getting ready to go home
Information and support for parents
There are many organisations which offer information and support for parents. You should have received the About neonatal care booklet produced by Bliss – if you have not, please ask us for a copy. It includes contact details and website addresses of organisations and support groups, which can help you while your baby is in the unit, and when your baby goes home. The unit also has a network of volunteers, some trained by Bliss to offer support to parents. Volunteers visit the unit weekly and offer face-to-face, bedside support. Volunteers are often parents that have also had a baby on a neonatal unit and may have had similar experiences to you. Please see the posters around the unit for more information.
We appreciate that having a baby in hospital can add an unexpected strain to your finances. If you are experiencing financial hardship because of you baby’s admission, please speak to a member of staff for more information and advice – there may be some assistance available.
Travel and car parking
St Thomas’ Hospital is a short walk from Waterloo main station which has National Rail, tube and bus service links. It is also a short walk from Lambeth North and Westminster tube stations.
Buses stop outside the front entrance to the hospital on Westminster Bridge Road. It is strongly recommended that you do not bring your car to the hospital. Parking spaces are very limited. If your baby has been admitted from another hospital as an emergency, you may be entitled to help with car parking costs during the first week of admission. It is essential that you speak to the nurse in charge as soon as possible if you have travelled to the hospital by car following your baby’s emergency admission.
If your baby is expected to be in hospital for a long period of time, a car parking subsidy is available at £5 per day or £25 per week. Please ask staff for more information. Please be aware that the hospital is in the congestion charge zone. The congestion charge operates from 7am-6pm, Monday to Friday, at a cost of £11.50 per day. For more details please visit the Transport for London website. If you are receiving benefits, such as Income Support or Jobseeker’s Allowance, and if you are breastfeeding or expressing breast milk, you may be entitled to reclaim travel expenses.
For more information about any of the above, please speak to the ward clerks in the reception area.
Other information about the Neonatal Unit Research
We work alongside an experienced research team who are committed to advancing medical care through improved knowledge and understanding. There are several research studies currently taking place on the unit. A member of the research team may come to speak to you about becoming involved. Please see the leaflet, Neonatal research - Information for parents/guardians about supporting clinical research, in your information pack. Alternatively, you can speak to a member of staff for more information.
Teaching and students
We are proud to be one of the country’s leading teaching hospitals. All staff members, nurses and doctors are committed to their professional development, and are up to date with best practice, knowledge and skills needed to provide your baby with excellent care. We use many different methods of teaching including lectures, simulations and bedside teaching.
We train medical students as part of their basic training in neonatal care and provide placements for qualified doctors as part of their ongoing professional development. Student nurses and midwives also have placements here as part of their training. They are allocated to a nurse and will care for your baby under the nurse’s supervision and with their assistance. If you have any questions about our teaching and training programme, please ask any of our staff.
If you have any questions or concerns about your baby, please contact the Neonatal Unit main reception on telephone: 020 7188 4045.
The address of the unit is: Neonatal Unit, 6th floor, North Wing, St Thomas’ Hospital, Westminster Bridge Road, London SE1 7EH.
Leaflet number: 3998/VER3
Date published: February 2019
Review date: February 2022
© 2019 Guy’s and St Thomas’ NHS Foundation Trust
A list of sources is available on request