The Dietitians work as part of the multi-disciplinary team across the Neonatal Unit and in addition provide support for both the transitional care ward (Charles Wolfson Ward) and the Neonatal Community team. Some babies who are born very early will also be followed up as outpatients as part of the Neonatal Neurodevelopmental clinic.
Babies admitted into intensive care or high dependency will all be assessed by the Dietitian who will advise the NICU team on how to best optimise the nutritional care your baby receives in order to meet their requirements and best support their growth and development. Babies in this area will be on a combination of parenteral (i.e. nutrition delivered directly into your babies veins) and enteral nutrition (i.e. nutrition provided via the baby’s gastrointestinal system) which will be closely monitored and adjusted according to your baby’s requirements.
Dietitians will continue to monitor your baby’s growth once they move to the low dependency areas. They also provide advice and support around oral feeding.
Some babies may go home under the neonatal outreach team. These are often babies with a nasogastric tube in place to support their feeding. The dietitian will provide advice and support the outreach nurses and to parents around growth and feeding.
Neonatal Speech and Language Therapists
Speech and Language Therapists (SLTs) play a vital role on the neonatal unit and work closely with parents and the multi-disciplinary team across all levels of care. Here at the Cambridge University Hospitals, our specialist neonatal SLT team focus on supporting early infant feeding and communication development.
The SLT may start working with a baby well before they are ready to have any feeds by mouth, to promote pre-feeding skills and to monitor the baby’s readiness to start breast or bottle feeding. An SLT can carry out an individualised assessment of a baby’s feeding, and provide recommendations to facilitate the development of their sucking and swallowing skills. This may include environmental management, trialling of different positions, bottle teats, pacing, volume and timing of feeds. SLTs continue to support a baby’s oral feeding skills whilst they to transition from tube to breast and / or bottle feeding.
SLTs also support parents to understand their individual baby’s behavioural states, cues and responses. These are early communication attempts that are important for starting “conversations” and to enable the development of a close and loving relationship. The SLT may contribute to a baby’s individualised developmental care plan, alongside parents and other members of the therapy team to promote a baby’s learning and development.
Neonatal Physiotherapists have expertise in the movement and postural control of sick and preterm infants. Using neurodevelopment assessments such as the Prechtl General Movements assessment, physiotherapists provide specialist age-appropriate support, advice, education to promote individualised positioning, and handling strategies to enhance motor, physiological and sensory outcomes.
Working as part of the developmental care team within the NICU, physiotherapists work to optimise brain development and motor organisation. When developmental delay or abnormal movement patterns are identified, physiotherapists facilitate early referral to community therapy teams to ensure that follow up intervention is provided for children identified with long.
Neonatal Occupational Therapists
The environment impacts on everything that we do. Occupational Therapists in the NICU identify stressors and create an environment that promotes healthy development and growth. This can focus on reducing the impact of the environment and working with parents to respond to each baby’s needs, encouraging physiological, sensory and developmental stability. OTs have specialist knowledge of sensory development and processing which is vital for motor and cognitive development.
Using neurobehavioural tools such as the Brazelton Neonatal Behavioural Assessment Scale (NBAS), OTs support parental engagement with education and developmental care to promote bonding.
NICU Family Support Service
We are a specialist team of counsellors and clinical psychologists. We are dedicated to supporting you during your baby’s stay in the Neonatal Intensive Care Unit (NICU) at the Rosie.
The NICU family support team can offer you a confidential space to talk about how your experience is impacting on you as a family and as individuals. We offer informal support by your baby’s cot side or confidential appointments close to the unit. If you would like to self-refer please email us. NICU Family Support
FaB workers (Family & Baby Support)
This can be provided through the Family and Baby support service which is a supportive, non judgemental service, aiming to support families at this challenging time. The service is for all families that have a baby admitted to the neonatal unit. FaB is offered in partnership with Cambridgeshire Children’s Centres and your local hospital. Support can be offered in a variety of ways to fit in with your family’s individual needs and the service is tailored to meet the unique needs of each family. Some of the support/services we can offer are:
- Advice on speech and language development
- Bonding , attachment & emotional support
- Preparing for home & on going support once home to access children centre’s services and groups
- Signposting to relevant agencies
- Helping parents to network and make friend
- Promoting healthy lifestyles
- Practical advice and guidance on caring for your child including plan and communications
Neonatal Pharmacy Service
Pharmacy provides a variety of services to the neonatal department. A daily visit to NICU by two specialist paediatric pharmacist takes place Monday - Friday. The role of these pharmacists is to check all the prescriptions and ensure that dosages and administration of medicines are suitable for each baby. Checking the medicine dosages is extremely important as pre-term babies cope with medicines very differently to term babies, children and adults. Some medicines require blood tests to be taken to check that the correct amount of medication is being given. The pharmacists will check to ensure that these blood tests have been taken and to check the results and if necessary be available to advise on any dose changes.
The pharmacists are available to provide advice to the doctors, nursing team and also parents on any aspects of medicines management e.g. whether a mother can breastfeed or express breast milk if they are taking medication. Many of the medicines which we use for babies will have been designed for adult patients and the pharmacist will advise on how these medicines can be given to babies, or if special liquid preparations can be supplied.
The pharmacists are also qualified as ‘prescribers’ which allows them to prescribe new medicines that may be required or modify existing prescriptions to optimise the dosing for a baby.
As a baby is prepared for discharge the pharmacist will be involved with organising medicines to take home. In some cases the pharmacist may contact the community pharmacist where prescriptions will be dispensed after the baby leaves the hospital to help provide information to ensure that the baby does not run out of medication.
The pharmacists are also involved with assisting nursing and medical staff with reviewing policies and guidelines where medicines are involved to ensure that staff have up to date information and provide information to help staff administer medicines safely.
The neonatal pharmacists are supported by a number of other staff in pharmacy. Some babies may require TPN (Total Parenteral Nutrition) which is a way of feeding the baby by a drip. The TPN is prepared in a specially designed clean room in pharmacy by staff trained to prepare this solution. These staff will check the TPN orders which are requested by the doctors and provide advice to both doctors and nurses on TPN.
The inpatient dispensary is where a baby’s discharge medicines are prepared in addition to some of the inpatient medicines that are not routinely stocked on NICU. A number of different staff types work here including pharmacy assistants, pharmacy technicians and pharmacists. These staff ensure that medicines are dispensed safely and accurately. As the dispensary is involved with supplying inpatient and discharge medicines for the whole Trust, it usually supplies more than 200 prescriptions or medicine orders each day.
Our Central pharmacy department work hard to ensure that the neonatal clinical areas are stocked with the medicines which are commonly used. A pharmacy assistant visits NICU twice a week to check which medicines need to be supplied by pharmacy.
Finally, you may wonder what happens if someone needs a supply of a medicine or advice out of hours. A resident pharmacist is available via a bleep and is able to organise supplies of urgent medicines or provide advice to doctors and nursing staff.
Paediatric Surgery and Urology Clinical Specialist Nurses
The Paediatric Surgery & Urology Clinical Nurse Specialist team consists of 7 nurses. They have many different roles across the neonatal and paediatric service including inpatient wards, outpatient clinics and the emergency department. Our role within the NICU includes:
- teaching and support for parents
- specialist education and training for staff and students
- Liaison with community teams, local dieticians, health visitors, social workers, GP’s and local hospitals to promote effective communication between professionals from a surgical perspective
- specialist nursing procedures such as urinary catheterisation, gastrostomy tube changes / care, bladder scanning and rectal / bowel washouts. We will also undertake the training of parents in all of these procedures
We work Monday-Friday 08.00-18.00. We do not work weekends or public holidays. We aim to be present for the ward round on most days, and are always contactable via bleep; if we cannot come immediately we can arrange a suitable time to meet.