Neonatal Special Care/High Dependency - Unit V4.3 (EN) Neonatal Special Care/High Dependency - Unit V4.3 (EN)
Medium/high care neonatologie (V4.3)
Information for parents and carers.
Babies who require special care are cared for in Isala’s neonatal special care/high dependency unit. The babies are cared for in incubators or cribs. This leaflet provides information on the care of infants and the way things work in this unit.
If you have any questions, please ask the nurse who is caring for your baby. Naturally, the treatment team will keep you up to date on your baby’s care.
For identification purposes and to prevent errors, your baby will be given a wristband around his/her wrist or ankle, stating his/her name, date of birth and patient number. The name and date of birth are also written on the card attached to the incubator or crib.
Parents receive a badge with their baby’s name. Please wear this badge visibly when you are in the unit.
Because the babies in our unit are very vulnerable, you must observe the following hygiene rules:
- Hang your coat on the coat rack in the corridor.
- Take off your watch and any bracelets or rings.
- Wash your hands or use alcohol hand gel before visiting your baby.
- Wash your hands or use alcohol hand gel again when you leave.
- Do not place more than two stuffed toys in your baby’s incubator or crib. These stuffed toys must be washed.
Spread of infection
The babies in the neonatal special care/high dependency unit are highly vulnerable to infections. If you have a cold or a fever, diarrhea or skin rash, check with the nurse whether it is sensible to visit your baby.
If people in your immediate vicinity (family, school, friends) have an infectious disease, such as flu, or a childhood disease, such as mumps, rubella, measles, scarlet fever, chickenpox or whooping cough, check with the unit nurse by telephone before visiting your baby.
As parents you are, of course, always welcome to visit your baby. The neonatal special care/high dependency unit is not located adjacent to the maternity unit. You will be brought to and from your baby if desired. If a mother’s condition is such that she is unable to visit the neonatal special care/high dependency unit, depending on the condition of the baby we will try to bring the baby to the maternity unit.
To ensure that your baby can rest, a maximum of three people may visit your baby at any one time. Other visitors can wait in the parents’ room. Visitors may alternate once per visit. This rule is not enforced so strictly if siblings or grandparents are visiting the baby for the first time.
The baby’s siblings are welcome, provided that they have not been in contact with a child with a childhood illness in the last three weeks. Unfortunately, other children up to 13 years of age are not permitted to visit. Your family should not visit your baby without you, unless you have indicated this to the nurse yourself.
The temperature in our unit is a few degrees higher than elsewhere in the hospital, so do not dress too warmly when you visit.
Facilities for parents
Parents can use the Ronald McDonald Family Room (V4.3) to take a break and have a cup of coffee. Siblings can play or watch television in this family room. You can also use the parents’ room in the unit itself, opposite the reception desk. There are special toilet facilities for new mothers.
Examination, treatment and nursing
The team that cares for your baby consists of: pediatricians, residents, nurse practitioners, pediatric nurses, neonatal counselors and other care providers if necessary, such as physiotherapists, speech-language pathologists and social workers.
Various examinations can take place throughout the day. You may be present during most examinations. If you are not able to be there yourself, a nurse or the neonatal counselor will stay with your baby to comfort him/her if necessary.
This one-time test takes place either six weeks after birth (at home) or earlier (if necessary) in the pediatric unit. The test takes place while your baby is sleeping or resting. It takes five to ten minutes and is not uncomfortable or painful. During this test, your baby will hear some soft sounds, after which the signals received by the brain are assessed.
You can read more about this test on the ‘Newborn Hearing Screening’ page (Gehoorscreening bij pasgeborenen, see below).
On the fourth day after birth, blood is taken by means of a heel prick to screen for metabolic disorders or carrier status. This heel prick is performed on all newborn infants in the Netherlands. Early detection of these disorders is essential. If you would like more information about this, please ask your nurse.
Contact with the doctor
If you would like to take some time to discuss everything that has happened with the attending physician, or if you wish to speak to him/her for another reason, the nurse can arrange an appointment for you. In urgent cases, the doctors will act in your baby’s best interest first and will inform you afterwards.
Contact with the nurse
The nurses are available day and night, so you can call them at any time. The nurse on duty will provide you with the latest information. While you are with your baby, you will have plenty of opportunity to receive information. You can also view the daily chart, which contains information such as weight, feeding, etc.
In addition to the assistance provided by you or the nurse, the neonatal counselor provides support during care and stressful procedures. The reduction of stress and the facilitation of contact and your baby’s wellbeing play an important role in good development.
The neonatal counselor will support you in this, for example by teaching you baby massage. The neonatal counselor also pays attention to everyday and more unusual events during your baby’s hospitalization, such as drawing up a daily schedule.
Speech-language pathology is the field of expertise that concerns voice, speech, language, hearing and primary oral functions. The speech-language pathologist (i.e. speech therapist) examines and treats infants with regard to primary oral functions. Premature and sick infants often have difficulty breastfeeding or drinking from a bottle. If necessary, the speech-language pathologist will observe and assess how the baby drinks and give nurses and parents advice on feeding.
The pediatric physiotherapist will follow your baby’s motor development if necessary. If your baby needs to be stimulated in certain positions or movements, the pediatric physiotherapist will contact you.
If your baby’s hospitalization involves difficulties, such as concerns about your situation at home, work or travel expenses, the social worker can help you find a solution. The social worker can also help by simply providing a listening ear. The nurse will offer to put you in contact with the social worker, or you can request this yourself.
The unit has a lactation consultant: this is an expert on breastfeeding (lactation). You can turn to her with any breastfeeding problems you may have. She provides guidance and training to nurses as well as mothers.
The unit has a spiritual carer who you can turn to for ‘simply’ a good chat about what you experience when your baby is hospitalized. You can also talk to the spiritual carer about something special, such as a difficult decision, a major procedure or concerns about the future.
The spiritual carer is also available for rituals (naming, baptism, blessing). Spiritual care is available to everyone, regardless of religious beliefs. If you wish, the spiritual carer can help you find someone who shares your own religion. If you would like to talk to the spiritual carer, the unit nurse can arrange an appointment for you.
Contact with your baby
Caring for your baby yourself
Because it is important for you to have contact with your baby, we encourage this in many different ways. The form this takes depends on the condition of your baby and of yourself. You may always touch and stroke your baby; this is an easy and nice way of making contact and expressing love. If possible, you can also hold your baby in your lap.
It is also possible for you to take on some of your baby’s care, such as changing diapers, temperature taking, washing/bathing and oral care. Helping to care for your baby is very important, as it helps you and your baby get to know each other.
You may always photograph and film your own baby. Another way of recording something about your baby is by keeping a journal. The unit nurses will start a journal, because parents often miss a lot during the first few days. You and your baby’s visitors can also contribute to the journal.
You can bring your own clothes, a stuffed toy or baby blanket, provided that they have been washed.
Being with your baby
You can be with your baby 24 hours a day. You can also spend the night, which we refer to as ‘rooming-in’. Another possibility is to stay at the Ronald McDonald House.
Kangaroo care is a form of skin-to-skin contact between a baby and his/her parents. The baby is placed on the mother’s or father’s bare chest one or more times a day.
Kangaroo care is also possible if your baby is lying in a crib, for example after bathing or being weighed.
Breastfeeding or bottle feeding
If your baby is able to drink on his/her own, you may breastfeed or give him/her a bottle if you would like to. The unit encourages breastfeeding and provides advice on pumping. You may bring your own bottle, teat (nipple) and pacifier (dummy).
Our nurses often recommend a bottle they have good experience with for babies born prematurely or too small. We can then lend you a bottle to use until you have time to purchase a replacement from the pharmacy in the hospital.
Facilities in and around the hospital
Ronald McDonald House
The Ronald McDonald House is available to families of children hospitalized in the Amalia Children’s Center. The Ronald McDonald House is located about a five-minute walk from the hospital. The address is:
Dr. Hengeveldweg 5
8025 AK Zwolle
(038) 455 46 70
The shop in the Main Lobby sells newspapers, magazines and other items. The opening hours are in line with the visiting hours.
There is a restaurant for visitors in the Main Lobby. The opening hours are:
Monday through Friday: 8:00–20:00 hours.
Weekend: 10:00–20:00 hours.
Outside of opening hours you can use the vending machines.
When your baby is allowed to go home, you will be informed as soon as possible. You will be given advice and an opportunity to ask questions about caring for your baby at home. In some cases delayed maternity care is possible. This depends on your health insurance policy or home care organization membership.
Premature babies are allowed to go home when they:
- no longer require any monitoring equipment;
- can maintain their own body temperature;
- drink all feedings themselves (exception: PreVOS, see below).
The PreVOS working group operates in our unit. PreVOS stands for Prematuren Vervroegd Ontslag met Sondevoeding (‘Early Discharge of Premature Infants with Parenteral Nutrition’), and offers the option of bringing your baby home while receiving parenteral nutrition and allowing him/her to learn to drink at home. You will receive intensive supervision from the nurses of the Amalia Children’s Center as well as your own district nurse. The working group also provides extra supervision after your baby is discharged in a number of other situations.
When your baby is discharged, an appointment for a check-up with the pediatrician will be scheduled for you, and you will receive papers with the necessary information for your district nurse. In many cases, the district nurse will contact you while your baby is still in the hospital. Once you have brought your baby home, the district nurse will provide you with further guidance and schedule an appointment with the child health clinic (consultatiebureau).
Your family doctor will automatically be notified about your baby’s hospitalization by the pediatrician.
Rights and duties
Information and consent
A patient (or his/her parents) has a right to clear information from healthcare providers on:
- the disease or disorder and its consequences;
- possible examinations and treatments;
- side effects and risks of the examination or treatment;
- other treatment options, if applicable.
In principle, the information is made available only to the parents. However, exceptions can be made at the parents’ request. If you find the information difficult to understand, ask for a more detailed explanation.
The doctor may only treat and examine a patient if the patient has provided consent. The consent of the parents/legal representatives is required for children less than 12 years of age. You can request a second opinion in consultation with the doctor. You can also choose not to have your baby undergo a particular examination or treatment.
Privacy and access to patient records
For privacy reasons, we ask that you do not look closely at the other babies in the room. The healthcare providers who treat and care for your baby will record the necessary information in a patient record. You have a right to view these records. The only other people with access to these records are the care providers directly involved in treating your baby.
If a treatment or examination has been agreed in consultation with you, you are expected to cooperate with the healthcare providers. You also have a duty to inform the doctor clearly and completely, so that he/she can properly diagnose your baby and provide him/her with the right treatment.
For more information, please refer to the leaflet ‘Rights and duties of minor patients’ (see below).
Complaints or problems
If you have comments, complaints or problems, please discuss them with the people responsible if possible, such as the nurse, the head of the unit or the specialist. If you do not wish to speak to them or are not happy with the proposed solution, you can turn to the hospital’s complaints officer. The complaints officer will help you file your complaint.
More information on complaint handling can be found in the leaflet ‘What to do if you have a complaint’ (Een klacht, en dan?; only in Dutch available, see below).
Child and Hospital Association
The Child and Hospital Association (Vereniging Kind en Ziekenhuis) promotes the wellbeing of children before, during and after hospitalization. You can contact this association for information on parent participation, preparing your child for hospitalization, rooming-in, etc. The association also has a telephone helpline: (078) 614 63 61.
More information can be found at www.kindenziekenhuis.nl (in Dutch).
Clothes for your baby
Address for information on and ordering baby clothes:
M. van den Berg-de Jong
De Kolk 6
9078 VH Bildzijl
(0518) 42 18 31
You can also purchase baby clothes in the unit itself.
Registration of birth
Remember that you have to register your baby’s birth yourself, within three working days and in the city/town in which your baby was born. It is also possible to register a birth in the hospital (V4.1). This can be done by appointment only, which the maternity unit nurse can schedule for you.
You may use your mobile phone (cell phone) in the unit. Please remember to set your phone to silent mode.
There is an ATM in the Main Lobby.
Paid parking facilities are available six days a week. Parking is free of charge on Sundays and public holidays. Regular visitors can purchase a one-week parking pass from the reception desk in the Main Lobby.
Recommended reading (in Dutch)
- Cora de Vos,‘Vroeggeboorte’ (publisher: Van Holkema en Warendorf).
- Richard de Leeuw and Maya Hugenholz,‘Wij houden uw kindje nog even hier’ (publisher: Bert Bakker).
- Lilian Bakker and Richard de Leeuw, ‘Te vroeg geboren’ (publisher: Zomer en Keuning)
- Ingrid Kluwers and Jozien Holm,‘Eén plus één is tweeling’ (publisher: Meulenhoff).
- Sheila Kitzinger, ‘Alles over borstvoeding’ (publisher: Bert Bakker).
- Jetske Spanjer et al.,‘Bevallen en opstaan’ (publisher: Bert Bakker).
- Maaike Sigar, Dick Bruna and Richard de Leeuw, ‘Ik heb een zusje, maar ik mag alleen maar naar haar kijken’ (publisher: Middernacht Pers).
In addition to the information you receive from experts, you may take support from people who have gone through similar experiences, for example through the Dutch Association of Parents of Babies in Incubators (Vereniging van Ouders van Couveusekinderen) (see below).
Information on premature and/or sick babies is also available in the unit. You can also obtain information from:
Association of Parents of Incubator Children
Vereniging van Ouders van Couveusekinderen (VOC)
Postbus 1024, 2260 BA Leidschendam
(070) 386 25 35
Dutch Breastfeeding Association (Vereniging Borstvoeding Natuurlijk)
Postbus 119, 3960 BC Wijk bij Duurstede
(0343) 57 66 26
Dutch Association of Parents of Multiples (Vereniging van Ouders van Meerlingen)
Postbus 14, 1300 AA Almere
(078) 615 57 81
Child and Hospital Association (Vereniging Kind en Ziekenhuis)
Korte Kalkhaven 9, 3311 JM Dordrecht
(078) 614 63 61
If you have any questions after reading this information or would like to know more, the doctor or unit nurse will be happy to assist you. You may find it useful to write down your questions beforehand.
You can also contact unit V4.3 by telephone at (038) 424 14 35, or contact the Neonatal Special Care/High Dependency Unit directly at (038) 424 53 50.