TCI Hospital seeks to become ‘Baby-Friendly’
What is the baby friendly hospital initiative?
This is a worldwide program sponsored by the World health Organization and UNICEF to encourage hospital and birth centers to promote, support and protect breastfeeding.
At the Turks & Caicos Islands Hospital, our goal is to provide every prenatal patient with breastfeeding information so that our patients and their families can make an educated decision about breastfeeding and caring for their babies.
We want our patients to consider breastfeeding for their infants except in cases where breastfeeding is not recommended. Some instances where breastfeeding is not recommended would be in cases of: – mothers with HIV, mothers on street drugs or taking medications such as chemotherapeutic medications.
If you have specific questions about medications or health conditions you may discuss this with your doctor, Midwife or NICU nurse.
Every facility providing Maternity services and care for newborns should:-
- Have a written breastfeeding policy that is routinely communicated to all health care staff.
- Train all health care staff necessary skills needed to implement this policy
- Inform all pregnant women about the benefits and management of breastfeeding.
- Help mothers how to breastfeed, and how to maintain lactation even if they should be separated from their infants.
- Help mothers initiate breastfeeding within half hour of birth,
- Give newborn infants no food or drink other than breast milk, unless medically indicated.
- Practice rooming-in allows mother and babies to remain together- 24hrs a day.
- Encourage breastfeeding on demand(allow babies to feed when hungry)
- Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.
- Foster the establishment of breastfeeding support groups and refer mothers to them on discharge from the hospital.
Human breast milk has everything your baby needs for the first 6 months of life. This means that your baby does not need water, formula, tea or any other food unless you received specific instructions from your doctor. Breast milk is the best food for your baby.
Why is breastfeeding good for your baby?
- Your breast milk changes as your baby grows to meet the nutritional needs of your baby.
- Breast milk helps to protect baby from infections by promoting early development of the baby’s immune system.
- Breastfeeding babies have less asthma, colds, ear infections and allergies.
- Breastfeeding babies tend to have less hospital admissions because of serious illness.
- Breast milk has proteins and other nutrients that are easily digested by the baby’s system.
- Breast milk helps baby’s brain develop to make your baby smarter. Breast feeding your baby reduces the risk for SIDS(sudden infant death syndrome)
Why is breastfeeding good for mother?
- Helps mother to burn about 500 extra calories so that she is able to get back to her pre-pregnant weight sooner.
- Reduces blood loss after delivery of baby.
- Helps the uterus to return to its normal size quickly
- Helps mother to get rest because she is able to sit or lie down with baby every few hours to feed.
- Reduces the risk of osteoporosis and bone fractures, ovarian and uterine cancers. Helps mother to feel better about herself and her baby and helps to form a special bond between mother and baby.
What are other benefits of breastfeeding?
- Breast milk is free helping families to save hundreds of dollars.
- Having a well-baby means fewer visits to emergency rooms, less money spent on prescriptions and less time staying at home from work with a sick child.
- Convenience-Breast milk is the right temperature and does not need any special mixing or storage.
Learn more about the Maternity Department at TCI Hospital.
Read Car Seats for Children with Special Needs - Premature Babies from the American Academy of Pediatrics.
- Small plastic or rubber toys
- Musical toys
- Pictures of family members or those colored by brothers and sisters.
Kindly note, small stuffed animals are not permitted due to infection control protocols. Remember, the isolette is small, therefore due to limited spaces; toys cannot be stored in-hospital.
When your baby is ready, he or she will begin cup-feeding. When cup-feeding, a nurse gives the ﬁrst feed and arranges times that you can feed your baby. Cup-feeding may be particularly useful when small volumes of breastmilk/colostrum are being given and during emergency situations.
For a full-term baby, cup-feeding can be used when:
- You and your baby are separated for a period of time.
- You need to give your nipples time to heal.
- Your baby is refusing to breast feed.
- Your baby has a minor cleft of lip and/or palate.
We hope this allows you to become more familiar with your baby’s care and that it gives you some special time with your baby. Our NICU nurses assist mothers with the retrieval of express milk, whether manually or via breast pump.
If you planned to breast feed your baby, we encourage you not to change your plans. We help you learn how to collect and store your milk if your baby is not yet ready to nurse at your breast. Then, when your baby is ready, we will help you with breastfeeding or the change from cup-feeding to breastfeeding. There is an electric breast pump available for you to use while you’re in the hospital or visiting your baby. If your baby will be hospitalized for a long time, you may want to get a pump to have at home. Ask your baby’s nurse, for more information. TCI Hospital has commenced steps to join the Global Baby-friendly Initiative which promotes breast-feeding.
Kangaroo care, also called skin-to-skin, is a wonderful way to be close to your baby.
What is kangaroo care?
Kangaroo care means holding your diapered baby on your bare chest (if you're the father) or between your breasts (if you're the mother). Be sure to put a blanket over your baby's back to keep him warm. Kangaroo care is great for you and your baby.
How can kangaroo care help your baby?
- Keep his body warm
- Keep his heart and breathing regular
- Gain weight
- Spend more time in deep sleep
- Spend more time being quiet when awake and less time crying
- Have a better chance of being able to breastfeed
How can kangaroo care help you?
- Make more breast milk
- Reduce your stress
- Feel close to your baby
Kangaroo care has emotional benefits for you, too. It builds your confidence as you provide intimate care that can improve your baby's health and well being. You are giving something special to your baby that only you can give. By holding your baby skin-to-skin, you will feel the experience of new parenthood and closeness to your baby. Kangaroo care is healing in many ways, for both you and your baby.
When can you start kangaroo care?
Ask your NICU staff about its policy on kangaroo care. Some NICUs postpone kangaroo care until the infant is medically stable, while others use it from birth onward. Kangaroo care is safe and beneficial, even if your baby is connected to machines. Whatever your situation, kangaroo care is a precious way to be close to your baby. You will cherish this time.
- Take all feeds by mouth
- Maintain his/her temperature in an open bed
- No longer requires oxygen or monitors.
Some of your Rights:-
1. You should be told about any possible risks of drugs or test ordered for you or your baby.
2. You should be told if there are pregnancy education classes that could help you in labor.
3. You have the right to make your own decisions about any tests your doctors, Midwife want you to have.
4. You have the right to know the names of all the people taking care of you.
5. You have the right to have someone you care about with you while you are in active labor.
6. You have the right to have a copy of your medical records.
Some of your responsibilities:
1. You are responsible to for learning all you can about pregnancy so that you can make better decisions about what you want.
2. You should find out the rules of the place where you plan to have your baby (how long you will be there, whether the baby will be in your room, who can visit you, etc.)
3. You should ask questions when you don’t understand why something is being done.
4. You are responsible for listening to your doctor, Midwife, or nurse and deciding what to do after hearing your choices.
5. If you decide to change to a different birth site, or provider, you are responsible for notifying us so we can give you a copy of your medical record.
6. You are responsible for learning all you can for you and your baby at home.
Blood type and Rh factor
Screen for Anemia
Check for Sexually transmitted disease (STD’S)
HIV test for the virus that causes AIDS
HBV test for the virus that causes Hepatitis B
Screen for Lead
Tuberculin skin test Or Quantiferon (TB) blood test.
After about 12 weeks:-
Your provider will listen to your baby’s heartbeat; you will be allowed to hear the heart beat.
Quad Screen: for patients who are age 35 years and over, these test measures levels of four substances in the woman’s blood. Results of the quad screen indicate your risk of carrying a baby who has certain developmental or chromosomal conditions such as spinal Bifida or Down syndrome not whether your baby actually has these conditions.
Ultrasound 18-20 weeks It can be used to measure growth, estimated age, check for more than one baby, determine the baby’s position, and locate the placenta.
Diabetes Mellitus Screen (DMS) checks for high blood sugars, a 1hr GCT is done if the blood sugar is high then a 3 hrs. GTT is done.
Urine:- Done on every visit.
A check for sugar is done in the urine, which can be a sign of diabetes. A check for protein, increased levels may indicate problems such as problems with the Kidneys, high blood pressure or preeclampsia. Bacteria may reveal a urinary tract Infection.
Blood Pressure:- Every visit
High blood pressure may indicate hypertension or pregnancy induces hypertension.
First visit: Pap test is done during examination of the cervix (opening of the uterus) this test screens for cervical cancer.
The following tests are performed:
Blood is sent for CBC and Syphilis (RPR)
HIV is repeated.
Gonorrhea and Chlamydia
Bacterial culture of the vagina/rectum is sent to check for Group B Streptococcus (GBS), this bacterium can cause a newborn to become sick, mother can be treated with antibiotics during labor.
A non -stress Test (NST) is performed bi-weekly to weekly at 41 weeks of pregnancy according to the circumstances, a fetal monitor evaluates the baby’s current heart rate patterns.
How often should I see my doctor during pregnancy?
The guidelines are as follows:-
Once a month until 28 weeks (7 months) Twice a month from 28 weeks- 36 weeks Weekly from 36 weeks until delivery.
BP (blood pressure): A type of measurement. BP is the force of the blood on blood vessel walls. This is caused by the heart beating.
mL (milliliter): A metric unit of volume. 30 mL equals about 1 fluid ounce.
CNS (central nervous system): The brain and spinal cord.
CPAP (continuous positive airway pressure): A breathing machine. It gives a steady, gentle supply of air.
CPR (cardiopulmonary resuscitation): A way to get the heart and lungs working again if they have stopped.
ET or ETT (endotracheal tube): A breathing tube. It goes through the mouth or nose into the windpipe.
Grams and kilograms: Metric units of weight. 100 grams is about 3.5 ounces. 1 kilogram is about 2.2 pounds.
HFV (high-frequency ventilator): A machine that gives hundreds of tiny breaths per minute.
IMV (intermittent mandatory ventilation): A type of ventilator. It gives a set number of breaths per minute.
IV (intravenous): Given by vein.
IV pump: A machine used to give IV fluids.
LP (lumbar puncture): A small needle is used to remove fluid from around the spinal column for testing.
NG tube (nasogastric tube): A feeding tube. It goes through the nose to the stomach.
NICU (neonatal intensive care unit): Part of the hospital for newborns with extra medical needs.
NPO (nil per os): No food or liquid given by mouth. (It is a shortening of a Latin term.)
O2 (oxygen): A gas in the air we breathe. It is needed for life.
OG tube (orogastric tube): A feeding tube. It goes through the mouth into the stomach.
Peripherally inserted central catheter (PICC) or percutaneous central venous catheter (PCVC): A type of tube that is put into a central (large) vein.
Radiant warmer bed: An open bed with a heating device.
SIMV (synchronized intermittent mandatory ventilation): IMV timed with the baby’s breaths.
TPR: Temperature, pulse, and respiration.
TPN (total parenteral nutrition): Nutrition fed straight into the bloodstream.
UAC (umbilical arterial catheter): A tube put into an artery. It is put in at the stump of the umbilical cord.
UVC (umbilical venous catheter): A tube put into a vein. It is put in at the stump of the umbilical cord.
VS (vital signs): Temperature, pulse, respiration (breathing), and blood pressure.
Anemia: A low number of red cells in the blood. Anemia is a common occurrence in premature infants.
Apnea: A temporary stop in breathing. For small babies and premature infants, apnea is a normal behavior. Babies usually start to breathe again on their own, however sometimes they will need stimulation by gently touching to “remind” them to breath.
Antibiotic: Medicines used to kill bacteria. Used to treat infections.
Asphyxia: A loss of oxygen
Aspiration: The act of breathing in material into the windpipe or lungs
Axillary: Armpit. This is the preferred way to take your babies temperature.
Bacteria: Tiny one-celled organisms that can cause infection or disease.
Bagging: Putting breaths of oxygen into the lungs with an oxygen bag and facemask.
Billilights: Fluorescent lights used to treat jaundice. The lights help break down the bilirubin so it can be excreted.
Bilirubin: A substance made by the normal breakdown of red blood cells. It is broken down by the liver and leaves the body in the stool. Extra bilirubin in the blood causes jaundice, a yellow skin color.
Blood Gases: A blood test that measures the concentration of oxygen, carbon dioxide and the acidity of the blood. Blood gases help determine how well your baby is breathing.
Blood Transfusion: Giving blood from a donor to the baby through an IV catheter
Bradycardia: A slower than normal heart rate
Breathing tube: A tube that is placed into the windpipe (trachea) through the mouth. This is used to help the baby breath.
Bulb Syringe: A device used to suction the nose and or mouth of an infant.Cardiac and respiratory monitor: Used to record breathing and heart rates. Most babies in the NICU will be on a monitor until they are discharged.
CBC: Complete Blood Count. This is a laboratory test done to determine the number of cells (red cells, white cells and platelets) in the blood.
Central line: A special intravenous (IV) catheter that is longer than usual and is inserted through a vein in a position that is close to the heart. Central Lines can stay in a longer time than a regular IV.
Chest Tube: A tube that is put into the baby’s chest to remove extra air and/or fluid.
Congenital: Present at birth.Congenital Heart Defect: A malformation of the structures of the heart that is present at birth.
Corrected Age: The age the baby would be if they had been born at full term. For example, if a baby is born one month early, when the baby reaches six months of age, the baby will developmentally be behaving as a five month-old. This method is used for the first two years.
CPAP: Abbreviation for Continuous Positive Airway Pressure. Air and/or oxygen pressure that helps keep the longs sacs partly open after each breath to make breathing easier.
Cyanosis: when the skin and lips have a bluish or dusky color. Cyanosis is caused by not enough oxygen in the blood.
Desat/Desaturation: when the amount of oxygen in the blood is less than normal.
Developmental: refers to the growth and maturation process. Developmental care refers to ensuring the baby is growing and maturing as normally as possible while providing the necessary medical care.
Distention: Enlargement or swelling, usually caused by pressure from air or fluid.
Dusky: Bluish color of skin and mucous membranes when there is not enough oxygen in the blood.
Difficult transition: when babies have a hard time adapting to life outside the womb.
ECHO: Abbreviation for echocardiogram. An ultrasound of the heart.
Edema: Swelling of the body caused by extra fluid in the tissues.
Electrodes: A sensor with an adhesive, gel backing that is placed on the baby and is connected to the monitor that shows the heart rate and breathing rate. Also called a lead.
Electrolytes: Sodium, potassium and chloride levels in the blood, which must be maintained for normal body function.
Endotracheal Tube (ET Tube): A soft plastic tube put into the baby’s windpipe (trachea) through the mouth. This tube is connected to a ventilator to provide oxygen directly to the longs to help the baby breath.
Extubate: To remove the endotracheal tube from the windpipe.
Feeding Tube: A small tube that is put into the baby’s nose or mouth that goes to the stomach. Breast milk or formula is given to the baby in this way when they are unable to take a bottle.
Gestational Age: The age of the baby since conception. Counted in number of weeks.
Glucose: A sugar that the baby uses for energy. Can be measured in the blood by a laboratory test (blood sugar or accucheck). Also the sugar that is in IV fluids given to babies.
Gram: A metric measurement of weight. 30 grams equals 1 once, 1000 grams equals 2.2 pounds.
Grunting: The noise a baby makes when they have to work hard at breathing.
Head Hood: A plastic “box” that is put over a baby’s head to give extra-humidified oxygen when the baby is having problems breathing.
Hearing screen: A test to examine the hearing of a newborn infant.
Heart Murmur: Extra sound sometimes heard when listening to the heartbeat. A heart murmur is common in premature infants and does not indicate a heart problem.
Heat Rate: A baby’s heart rate is usually 120 – 160 breaths per minute, about twice as fast as an adult’s heart rate.
Heelstick: A small prick to the heel of a baby to make it bleed in order to obtain blood for laboratory testing.
Hematocrit: The amount of red blood cells in the bold. Used to check for anemia.
Hemoglobin: Part of the red blood cell that carries oxygen from the longs to tissue.
HFOV: An abbreviation for High Frequency Oscillating Ventilator, a breathing machine that provides oxygen and support to help a baby breath.
Hyperal: Abbreviation for Hyperalimentation. A type of IV fluid that gives the baby nutrition (protein, fats, sugar, vitamins, and minerals) when the baby is not eating by mouth
Hyperglycemia: A higher than normal blood sugar level.
Hypoglycemia: A lower than normal blood sugar level.
I&O: intake and output. Measuring all of the fluids that go into and out of the baby.
Incubator: Also called an isolette. A special clear plastic box-like bed that is heated to help keep the baby warm.
Isolette: Another name for an incubator, a special clear plastic box-like bed that is heated to help keep the baby warm.
Intraventricular Hemorrhage (IVH): Bleeding in the brain. May also be called a bleed.
Immuno-Compromised: Lacking the body’s usual resistance (ability to fight off) of antibodies to infections.
IV: A tiny plastic tube that is put into the blood vein of the baby. Is used to give fluids and medication. May be in an arm, leg and/or scalp of the baby
Jaundice: the yellow skin color that is caused by extra bilirubin in the blood.
Kangaroo Care: Holding the baby skin-to-skin on the chest of the mother or father
Lead: A sensor with an adhesive patch that is placed on the baby and is connected to the monitor that shows the heart rate and breathing rate. Also called an electrode.
Lethargic: Lack of energy. Sluggishness.
Lipids: Milky white IV solution containing fats that are necessary for optimal growth.
LP: Lumbar Puncture. Putting a needle into the lower back to remove spinal fluid for testing. Also called a spinal tap.
Meconium: Dark green or black stools that are made before birth and are the first stools passed by the baby
ML’s: A unit of measure used when discussing amount of breast milk, formula, medications or IV fluids. 5 ml’s equals one teaspoon, 30 ml’s equals one once.
Monitor: A machine that shows the baby’s heart and breathing rate. Also shows the oxygen saturation (how well the baby is using oxygen)
Mottled: a blotchy appearance of the skin
Murmur: A swishing sound made by blood flowing through the heart. Heard by using a stethoscope. May be normal or could indicate a problem
Nasal Cannula: Soft plastic tubing that is used to give oxygen to a babyNG Tube: See feeding tube
NEC: Necrotizing entercolitis. A serious disease of the bowel and/or intestines.
Nest: Surrounding the baby with rolled blankets and/or other soft support to create boundaries that allows the baby to feel safe and snug. Helps to keep baby calm
Newborn Screen: A blood test required by the state of Illinois for all infants. This is a test to screen for certain metabolic and genetic or endocrine disorders.
Non-nutritive Suck: Sucking on a pacifier or finger. Helps calm the baby and prepare them for taking feedings by mouth. Sucking that is not used to give nutrition
NPO: Nothing by mouth. The baby is not getting any food or fluids through the mouth
Open Crib: A regular hospital bassinet. Does not have any heating devices.
Open Warmer: An open bed with an overhead heater to keep the baby warm also known as a radiant warmer. The heater is regulated by a probe taped to the baby’s skin that responds to changes in the baby’s temperature.
Oral: by month or having to do with the mouth
Oxygen: is in the air and taken in when breathing. Oxygen levels are monitored closely in the NICU. Babies with respiratory or heart problems may need extra oxygen from an oxygen hood, bag or ventilator
Oxygen Saturation: The amount of oxygen that is in the blood. Shows how well the baby is breathing.
PDA: Patent ductus Arteriosus. An opening between the major arteries of the heart and lungs, which allows blood to bypass the lungs before birth. This opening usually closes soon after birth
Phototherapy: treatment for jaundice (yellow skin color) that is done by bright lights. Can be done overhead lights or by a bili-blanket (a special lighted pad that the baby lays on)
PICC: Peripherally Inserted Central Catheter. A special tiny IV that is long and threaded through the blood vein to near the heart. Used for special medications and IV Fluids. This IV can stay in for a longer time than a regular IV
Platelets: A part of the blood that is needed for clottingPneumonia: An infection in the lungs
PO: Given or taken through the mouth
Pulse Ox: Pulse Oximeter. A monitor that measures the amount of oxygen in the blood. A sensor that wraps around the hand or food and uses a light sensor to measure the amount of oxygen in the blood
RDS: Respiratory Distress Syndrome. A disease that affects the lungs of premature babies and causes them to have difficulty breathing. RDS is caused by a lock of a chemical called surfactant, which lines the small air sacs in the lungs. This is necessary to keep the lungs expanded
Reflux: Gastroesophageal Reflux – When the content of the stomach backs up into the esophagus (throat or windpipe). Can cause apnea and / or bradycardia in babies
Residual: Food that is left in the stomach from a previous feeding. Is pulled out through the feeding tube before a new feeding is given to determine how well your baby is digesting their food.
Retractions: Indentations in the chest indicating that a baby is having difficulty breathing.
ROP: Retinopathy of prematurity. A disease that affects the retina (the interior part of the eye) of a premature baby’s eye.
Security Tag: A device that is connected to a band on the baby’s leg. This is connected to the hospital security system and will activate an alarm system if the baby is removed from the hospital unit. These are used in our newborn nursery as well as NICU south
Sedate: The use of medication to help keep a baby calm and/or sleeping
Seizures: Changes in the brain’s electrical impulses that may cause spasms (jerking) of the baby’s arms and/or legs
Small for Gestational Age: Children who are below the 10th percentile
Tachycardia: A faster than normal heart beatTachypnea: A faster than normal respiratory rate
Transient Tachypnea of the newborn (TTN): Fast breathing that slowly becomes normal. It is caused by slow or delayed reabsorption of fetal lung fluid and is more common in babies delivered by cesarean delivery and in those who are slightly preterm.
Umbilical Arterial Catheter (UAC): A small flexible catheter is placed into the umbilical artery. It is used to check blood pressure, draw blood samples and give IV fluids.
Umbilical Venous Catheter (UVC): A small flexible catheter is placed into the umbilical vein. It is used to give IV fluids and medications.
Ventilator: A machine that assists your baby to breath
Very low birth weight (VLBW): A birth weight of less than 1500 grams.
Warmer: a bed that allows maximum access to a sick baby. Radiant heaters above the bed keep the baby warm. Generally babies progress from a warmer to an isolette and then an open crib.
Neonatologist: A paediatrician who specialises in the care of sick and premature newborns
Nurse manager: A registered nurse who oversees all unit operations Neonatal nurse: A registered nurse who specialises in the care of sick and premature newborns in the NICU.
Radiology technician: A health team member who takes medical images of your baby. This may be done in the NICU or in the radiology department.
Social Worker: A health team member trained to help families cope with problems related to their baby’s hospitalisation
- During the nursing change of shift (7:00am-7:30am and 7:00pm-7:30pm)
- During morning medical rounds on other patients (parents may stay during discussion of their baby)
You will be asked to leave during these times.
Brothers and sisters over 3 years of age may visit under the established sibling visitation guidelines. Sibling visitation is permitted from the hours of:
▪ 2.30 p.m. – 4.30 p.m., 7 days a week.
Brothers and sisters 12 years of age and older may also visit from:
▪ 2.30 p.m. – 4.30 p.m. and 6.30 p.m. – 7.30 p.m.
Sibling visits are a maximum of 30 minutes.
Two extended support people over 14 years of age can visit each day. Grandparents are not included in this number. The visitation hours for extended support people are:
▪ 2.30 p.m. – 4.30 p.m. and 6.30 p.m. – 7.30 p.m.
Parents must accompany these extended support people on NICU visits.
- No more than 1 adult at the bedside at any time.
- In order to protect and respect the privacy of all our patients, please remain at your infant’s bedside when visiting.
- Although you will meet other families during your NICU stay, visiting with these families will need to take place outside of the patient care area (i.e., NICU waiting room).
- Visitors who have colds, coughs, vomiting, diarrhoea, fever, or other infections may not visit.
- All visitors must perform a 3-minute Hand wash before entering the NICU.
- All visitors must wear a yellow gown before entering the unit.
- At all times the medical and nursing staff reserve the right to ask visitors to leave if the need arises.