Neonatal Care: What To Expect In The First 28 Days

Neonatal care is a special type of care for babies who are born prematurely or are born with illnesses. It can be very worrying and emotional for parents, but it can help if you know what to expect.



Why Are Babies In Neonatal Care?

There are many different reasons why babies need neonatal care. The main reasons are because of premature birth, low birth weight, or a specific illness which requires treatment. Hospital staff will be able to offer you reassurance and answer any questions you have about your baby’s specific circumstances.


Premature Birth

A baby born before 37 weeks will be called a premature baby. There are other words that the team in neonatal care may have for premature babies.

– Full term refers to babies born at 37 weeks or later.
– Preterm refers to babies born before 37 weeks.
– Moderate or late preterm refers to a baby born between 32 weeks and 37 weeks.
– Very preterm refers to a baby born between 28 weeks and 32 weeks.
– Extremely preterm refers to a baby born at, or before, 28 weeks .


Low Birth Weight

Babies who are small at birth may need some extra care in the neonatal unit. Again, the staff may use the term low birth weight, or they may use other terms.

– Low birth weight usually refers to babies under 5lbs.
– Very low birth weight usually refers to babies under 3lbs.
– Extremely low birth weight usually refers to babies under 2lbs.


Treatment Of Medical Conditions In Neonatal Care

Neonatal care for medical conditions encompasses a wide range of issues. Some babies need treatment for genetic conditions, and others may need treatment due to issues in development (congenital conditions). The staff will be there to support you and answer your questions.


Levels Of Neonatal Care

There are different levels of neonatal care, and each provides different levels of care.


Neonatal Intensive Care Units

Neonatal intensive care units, or NICU’s are designed to provide care and support for premature babies who need high levels of support and care. They can care for premature babies who were born before 28 weeks. Not all hospitals have a NICU, so in some cases, babies may need to be transferred from the local hospital to a NICU.


Local Neonatal Unit

Local neonatal units, or LNUs are for babies who need a higher level of medical care and support. Babies born between 28 weeks and 32 weeks are often cared for in these units.


Special Care Baby Unit

Special care baby units, or SCBUs usually provide care for babies over 32 weeks gestation. Treatment in a SCBU can include close monitoring, feeding tubes, treatment for jaundice, or giving them oxygen. SCBUs provide treatment for babies who do not need intensive care.


Transitional Care

Transitional care is when the parents of the baby provide most of the care but have support from the neonatal care team. In this circumstance, your baby is well enough to stay with you in hospital.


What You Can Do In The Neonatal Unit

When your baby is in neonatal care, you, as parents, are extremely important. Often, you can come and go whenever you need to. The neonatal care staff will try to make sure that you can stay with them, offer support and keep you involved in your baby’s care.

Some of the things that many parents find intimidating, or overwhelming can be the size of the unit, the equipment in the unit, or the size of the team involved in the care of their little one. The team will be there to reassure you, explain the equipment, treatments, and processes in the unit. They will also help you learn how to provide care for your vulnerable baby.


Decisions In Neonatal Care

You will be included and supported when there are decisions to be made about your little one’s care. You might want to be there during the doctors’ rounds, or you may want to have specific meetings with the medical team. There may be urgent decisions that need to be made immediately, but the medical team will talk to you about any changes, or decisions that have been made in your baby’s care.


Hygiene In Neonatal Units

All neonatal care units will have rules on hygiene. The babies in these units tend to have underdeveloped immune systems and are at greater risk of infection. You will be asked to wash your hands thoroughly on entering the unit, and you may be asked to remove any jewellery. In some units, you may be asked to wear covering scrubs to maintain hygiene.


Overnight Stays In Neonatal Care

Some hospitals have rooms for overnight stays within their neonatal care units. However, there is often difficulty in securing one of these rooms. There are services which can help provide accommodation, including Ronald McDonald houses.


Privacy In Neonatal Care

Privacy while your little one is in neonatal care is important, but it can feel difficult to achieve. Most units will have screens to use for feeding, expressing and allowing treatment, however, they may not always be able to be used if your baby needs constant monitoring.

Units will also take steps to allow parents a private space to discuss treatments, decisions and progress with the doctors and healthcare team.

You will be asked to keep conversations low and quiet, so that babies have quiet time. However, this does not mean that you shouldn’t talk quietly to your baby. Talking softly to your baby can help you to bond, connect and feel reassured.


Support In Neonatal Care

As the parent of a baby under neonatal care, you will need support. You may need emotional support, and there can also be practical matters that you need support with. You are not alone, and there is support available.


Family Centred Support

Family centred support looks at supporting the whole family. Sometimes, partners can feel helpless, and left out as mums need support for feeding or expressing. Family centred care encourages partners and sometimes the wider family to be involved in the care of the little one as well. This can mean changing, bathing, and having skin-to-skin contact.


Financial Support

There can be a lot of unexpected expenses while a baby is in a neonatal care unit. Things like travel, parking, food, and childcare can all add to the financial burden and stress. Talk to the neonatal care staff as some units have financial support available, such as free parking, or food vouchers. There may also be local charities that can offer financial support.


Talk To Someone

Many parents feel alone while their babies are in neonatal care, so talking to someone can help. This could be someone in your family or circle of friends. Some units have counsellors available to offer support, or maybe you would like to have a more in-depth conversation about your little one’s care with their doctor. Some neonatal units have access to advocates, or volunteers who have been trained to help provide emotional support to parents.



Some parents find it helpful to keep a journal. You can use it to write down what has been happening, how you feel, and any questions you might have for the healthcare team. It can help to make your feelings more defined, and therefore, perhaps easier to understand and cope with.