Institute for Women's Health
Transitional Care Unit
Lead: Leticia Thomas-Andrew
Prior to the opening of Transitional Care on 03/06/2003, babies requiring IV antibiotic treatment were taken to the Neonatal Unit (NNU) for the drugs to be given, often without their parents. Well preterm babies had to be separated from their parents in NNU, blocking neonatal cots which are always scarce. In order to utilise cots more effectively, a study was undertaken to determine how many babies would fall into the remit of the proposed unit.Opening initially with just 4 maternal beds, it soon became obvious that an expansion was necessary.
Since the expansion to 8 maternal beds in February 2006, we now are able to admit most women whose babies are born in good condition from 34 weeks gestation, directly following Caesarean section if necessary. Therefore mother and baby are no longer separated just because the baby is preterm.
By using hot water mattresses, naso-gastric tube feeds, and intensive breast feeding support, these small babies are going home more quickly than previously, successfully breast feeding. Babies may require prolonged courses of IV antibiotics such as for Group B Streptococcal sepsis, jaundiced babies with ABO incompatability who may need long periods of phototherapy, and babies who have feeding difficulty due to a difficult delivery, or with a syndrome such as Downs, cleft palate etc. These form the main reasons for admission.
Our ethos is to be proactive, and Transitional Care is essentially a nurse led unit, with medical input as and when required. Speech and Language Therapists, physiotherapy, Mental Health Liasion, midwifery and neonatal input ensure that the family are enabled to care for their vulnerable baby with whatever support is required until they may safely be discharged. In the future there should be a community neonatal service provided through our Network, which may help us to discharge into the community even sooner.
As well as inpatients, we see over 800 outpatients a year. This provides back up to the community midwives who refer babies who either live in our catchment area, but may not have been born at UCLH, as well as those who have already chosen to use the services at the EGA. Most babies are referred with jaundice or poor feeding and weight loss, and we may readmit to TC or NNU as appropriate.
Occasionally babies may still require extra support with phototherapy, or severe anaemia requiring transfusion after 2-3 weeks, when a referral will be made to the Paediatric Team
Since 31/10/2006, there are now up to 13 maternal beds, 5 of which may be for 'normal' mothers and babies, or used as TC beds as required.
In the future there should be a community neonatal service provided through our Network, which may help us to discharge into the community even sooner. In preparation for our planned move into the new Elizabeth Garrettt Anderson Building in 2008, we are thinking of new ways of using our beds more efficiently.
Page last modified on 11 dec 09 12:41