Tests and care your baby might be given

It is likely that your baby will have different tests whilst they are in the unit. This is so that your baby’s needs can be met as they change. They allow the neonatal team to see how they are responding to their care.

This helps with making decisions about whether to continue with a treatment, try something new, and whether your baby needs to be moved to a different hospital for more specialist care.

During these procedures you may be able to comfort your baby to reduce their discomfort. This can be done through comfort holding (cradling their hands and feet), skin-to-skin or giving them a dummy and some expressed milk.

Tests and procedures will only be done when your baby needs them. The neonatal staff will always try to reduce pain, discomfort and the disturbance caused to your baby.

There are some common tests and procedures you might come across. You can read more about the tests and care your baby may receive on this page.

Blood is the body’s transport system, moving oxygen, nutrients, waste products and chemical messages to all the right places. Your baby’s blood does many jobs, including fighting infection. Because of this, blood tests can show how your baby is progressing.

Most blood samples are taken by pricking the skin to get blood from the back of your baby’s hand or heel.

The team might check the following things:

Sugar levels

Blood carries energy in the form of sugar. This test tells the doctors whether your baby’s blood sugar levels are being properly controlled.

There are many reasons why your baby may need their blood sugar monitored. Most commonly, babies born to mums with diabetes (a condition which causes blood sugar levels to be too high) or babies born with a very low birthweight will be monitored more closely.

This is because they may have problems keeping a healthy blood sugar level.

Blood gases

As well as carrying oxygen from the lungs, blood also carries carbon dioxide back to the lungs so we can breathe it out as waste gas.

Measuring the levels of carbon dioxide, as well as other waste chemicals carried by the blood, can give information about how your baby is breathing. Blood gases can also help tell how other organs, such as kidneys, are working.

Platelets

These are important for controlling bleeding. In premature and sick babies, the platelet count can be too low. This is why it is monitored. If the level does get too low, your baby might need a platelet transfusion.

Haemoglobin (pronounced hee-mo-glow-bin)

This chemical helps blood to transport oxygen. It is carried by red blood cells. If your baby does not have enough red blood cells, the body may not get enough oxygen. This is called being ‘anaemic’ (pronounced an-ee-mick).

If your baby’s haemoglobin gets very low, they might need a blood transfusion.

White blood cells

These cells play a big role in fighting infections. You may hear your care team talking about ‘C-reactive protein’ or ‘CRP’. These are part of your immune system and their levels go up with infection. Checking these levels helps to see how well your baby is fighting an infection, or if an infection is starting.

Multiple tests

Sometimes, your baby might need to have multiple blood samples taken over a short period of time. This might mean that they need a blood transfusion to replace the blood that is used for testing.

This is nothing to worry about and you can ask the care team about comfort holding and other forms of parental touch to help soothe your baby during these procedures.

Scans can help doctors to see inside your baby’s body. Your baby may have one or more of the following types of scan:

X-ray

X-rays are often used to look at your baby’s chest, especially when they are having breathing support. They are also sometimes used to check for problems in the gut if your baby is not feeding well.

X-rays use tiny amounts of radiation, so they are only used when they are really needed. You might need to leave the room when the X-ray is taking place but they are not harmful to your baby.

Ultrasound

This type of scan uses ultrasound waves to build a picture of inside the body. A common use of these scans is to see if there is bleeding or other problems on your baby’s brain. You can stay with your baby when they have an ultrasound scan.

Magnetic resonance imaging (MRI)

Many units have access to an MRI scanner, which uses a magnetic field to show pictures of your baby’s internal organs. These scanners are usually in a different part of the hospital from the neonatal unit.

Sometimes they may be in a different hospital altogether and your baby will need to be transferred. This means your baby might have to wait until they are ready to be moved.

Sometimes, your baby might need to be sedated for their scan to make sure they stay still enough for the scanner to work.

All babies will have vision and hearing tests after they are born. Babies who are born prematurely are more likely to have problems with their sight and hearing, so they may have some extra tests.

Some babies with particular medical conditions may also have their sight and hearing tested whilst on the neonatal unit.

Babies born before 31 weeks’ gestation or below 1500g of weight at birth will be screened for a condition called ‘retinopathy of prematurity’, or ‘ROP’. This can be a serious eye condition if it isn’t picked up and treated quickly.

Babies who are at risk are screened as soon as their eyes have developed enough. The specialist doctors who carry out these tests, called ophthalmologists (optal-molo-gists) can also look for other eye problems.

Babies born prematurely or with other medical conditions can also be at higher risk of hearing problems. Their hearing will be tested before they leave hospital.

Screening for genetic conditions

Sometimes, the neonatal team might want to check to see if your baby could have a condition they were born with. These can be passed on genetically – which means they are passed down from parents to their children. They can also develop on their own for other reasons that are not genetic. The doctors will talk to you about these tests, if they think they are needed.

Lumbar puncture

Some babies can get a very bad infection around the outside layers (called meninges) of their brain and spinal cord. This infection is called meningitis. If doctors are worried your baby might be getting this condition, they will take action quickly, as it can become serious.

In a lumbar puncture, the liquid around the spinal cord is taken and sent for testing. To do a lumbar puncture, the doctor or nurse will gently put your baby in a curled position on their side – this helps to make the space between the bones in their spine bigger.

Then, whilst a nurse is watching your baby closely, a doctor or nurse practitioner will put a small needle into one of the spaces low down in your baby’s back. The team will offer your baby things like expressed breast milk to help ease any pain.

Emergency resuscitation (pronounced ree-sus-a-tay-shon)

It is possible that your baby might need urgent help with their breathing if they are not breathing by themselves. If your baby can’t breathe for themselves, this can mean that their heart stops beating properly. This can happen straight after they are born, or during their time on the unit (if they have a serious infection, for example).

Resuscitation is where doctors help your baby to start breathing again and for their heart to start beating properly. This is usually done with equipment on the unit which focusses on your baby’s airway and breathing.

Sometimes, doctors might press on your baby’s chest in a special rhythm which can help start their heart again. These are called cardiac (pronounced car-dee-ack) compressions.

Important to remember

If you think that your baby has stopped breathing, there will be a red button somewhere around their incubator or cot that you should press. This will sound an alarm that immediately calls the care team to come to your baby.

The best way to help in this situation is to make sure you give the care team space to work. This can be extremely difficult but it is vital to allow space for them to help your baby.