We identified that between 3-5% of our term babies (born after 37/40) are admitted to the Special Care Baby Unit (SCBU) each month. We analysed all our SCBU admissions to identify themes and trends. On average, 23% of the admissions were because babies were getting cold during skin to skin contact after delivery and/or were not able to maintain their blood sugars.
A risk assessment tool was introduced which involved assessing both mother and baby.
Mothers and babies were categorised into one of three groups: the ‘green’ group were self-caring (low risk pregnancies, often having had a baby before and felt very comfortable with their chosen feeding method) and discharge could be planned for after six hours of age. The ‘amber’ group may require extra support to establish feeding and observation in the first few hours of life. The ‘red’ group required more extensive input from the multidisciplinary team, and included babies admitted to transitional care. The risk assessment includes guidelines for staff on frequency of observations and when the family could consider going home.
One of the biggest changes introduced was to improve skin-to-skin contact included ensuring that all babies have a hat put on as soon as possible after birth.
These changes showed a reduction in the number of babies admitted to SCBU for being cold or with low blood sugars from 23.75% to 10.5%.
We have called this strategy the ‘bobble hat car bundle’ and are now involving the local community in knitting hats for our babies and local Guide groups who have produced the bobbles.