If baby needs admitted in first 10 days - which hospital?

[mears]

I am trying to look at an issue and would welcome your input.

If your baby needed admitted to hospital while you are both still under the care of the midwife, where do you think that should be?

Should it be a readmission back into hospital you delivered in (except stand alone birthing units)

Should it be a paediatric ward?

Babies commonly readmitted are for jaundice or weightloss with feeding problems. Bearing in mind more support in community might help weight loss issue, as a mum, if you had to go back in would you prefer to go back to an environment you know or don't you mind.

Definately back into the unit, DD was admitted back at 18 days, into Paeds, and they were awful, and I was distraught, would have really appreciated the friendly faces I already knew,

DEFFO post natal ward.... without a doubt. No questions asked.

If it was weighthloss around feeding or common newborn problems, then probably mw inhabited environment. But for the benefit of the expertise of the mws. Can't say the 'friendly face' would have been much of an incentive in my case!!
If other independent medical issue, then specialist ward / unit - wherever the best care for the baby is. Might be another hospital.

I dealt with both the paediatrician on the post natal ward, and conultant from the orthopaedic ward. The orto consultannt was better in every single respect than the paed. The ortho treated me like the intelligent mother of a child with a problem, the paed treated me like a poor deluded post-partum woman who had opted for homebirth and was therefore anti-doctors and deserving of much patronisation.

ds4 was readmitted at 3 days old due to jaundice. Although we were seen by a paed we had never met before, everyone was very friendly and supportive. Being on the neonatal ward even for a very short time meant my community mw popped in to see me when she found out we were there.

Thanks for responses. My gut feeling is that new mums should be readmitted to postnatal ward, especially if there are ongoing feeding problems. Is the community midwife popping in good enough? Should there be 24 hour midwifery support? Are paediatric nurses good enough? For you QE2 that seems to have been fine. Anyone have any other experiences?

Sorry QE2, that last post was a bit rushed. Did you have any other concerns that were not addressed by paediatric staff? Did you have any feelings about being in a paediatric ward with ill babies or do you think that didn't make any difference?

Bck to the Maternity unit where the baby was delivered i'd prefer.

Was admitted to paed ward with my second when he was 10 days old for weightloss problem. We were BOTH looked after extremely well for the three days we were there.

Little one (now 9) was well cared for by the paed staff, and I had maternity care. We were put in a private room (with a bed for me) and I was supported completely in my efforts to continue breastfeeding by both paed and mat staff.

Was admitted to paed ward with my second when he was 10 days old for weightloss problem. We were BOTH looked after extremely well for the three days we were there.

Little one (now 9) was well cared for by the paed staff, and I had maternity care. We were put in a private room (with a bed for me) and I was supported completely in my efforts to continue breastfeeding by both paed and mat staff.

Well, DS1 was admitted at 11 days with streptococcal cellulitis (very aggressive) and we were admitted to paediatrics. It was a nightmare because he couldn't feed - too ill - and I had to go miles to SCBU to find a breast pump to dump the milk. But the baby unit would have been completely impossible for his condition.

The paed consultant was useless too and it was only thanks to a helpful urologist, called to check ultrasound, that he was transferred to PICU at a tertiary hospital. And that he is with us today.

My experience probably isn't normal but for me I'd go for paediatric every time because my mw's were really unhelpful and treated me like something to be processed and shoved out of there, as if I was just taking up space and didn't need any help of any kind, even though dd was quite ill. The paediatric ward however were fantastic, treated me like a human, consulted me instead of acting like I wasn't there and really did their best to help. They were open and frank which is really reassuring if you're worried about your baby, and were so frank they were willing to admit to me things the mw's had done wrong (which i knew about anyway and just wanted out in the open) which had contributed to the messy state of affairs, which I thought was fantastic - putting patient care above 'company' loyalty. I wouldn't have wanted to go back to see the mw's, I was glad to see the back of them. If I'd been sent back to them I'd have gone out of my mind.

It would be nice if it was down to the parent to decide based on their experiences, subject to space and what the baby needs obviously.

my dd was admitted when she was 11 days old cos she stopped breathing and i was pleased i was sent to local hospital as it was so much closer. the docs and nurses (bar 1) were fantastic and really helpfull. i know this is different but either way i would always have prefered the local hospital

I would think SCBU, not peadiactric unit, unit specialising in care of the neonate. Most SCBUs (I believe) also have community nurses to follow up on care once discharged from hospital to home.

my DD was admitted at 9 days old with bhronchiolitis into a childrens unit. I had to stay with her due to breast feeding and to be honest was shocked at how little support i recieved and how little the staff cared that i had had a section 9 days before. I was expected to carry all DDs and my belongings when they kept moving us and until i completely went loopy after 3 days no member of staff even asked how i was coping. After a 3am rant at a nurse they finally called in a midwife to offer me support, unfortunately by this time my milk had started to dwindle and i was completely exhausted emotionally and physically. Definately think a baby THAT young needs to be admitted to the hospital you delivered in. Its not just the baby who needs caring for when a baby gets ill its the mum too, it is so horrid seeing your precious newborn on oxygen and with horrid machines attached to them that bllep ALL the time and noone thinks to explain what it all is!!

I gave birth to DS at a hospital in central London. I live in the far reaches of East London. When I was told we had to go back in with DS I chose to go to the nearest hospital. We went to post natal ward. Care was shocking as I have posted before. Wish sooo much we had gone back to my hospital. Don't know if it would have been better, but hospital, in reality, was not much closer in the end. I know I didn't need to panic but my milk had come in and I was an emotional, trembling wreck.

I kept getting told by the childrens ward nurses that they were there for the baby and not to care for me. It was not there job to arrange midwife support etc. Also had trouble getting hold of breast pump and sterilising equipment and found that it was hard to get privacy to breast feed as curtains had to be open so nurses could see monitor DD was on.

we went back to the paediatric unit

I was relieved to be there as I felt it was the best place for the baby. I hated being on the post natal ward after I'd given birth and I can't imagine how the midwives/nurses would have coped with a poorly baby + me and all the other women that had just given birth (given that they were rushed off their feet as it was). In the paediatric unit, it was clear that they were completely focused on the baby's health (with specialist paed nurses etc.) and at that time, that's what I wanted.

Post natal ward - where you have the midwifery experience if it was for issues such as feeding problems or jaundice etc.

I can say that when we moved and dd1 was under hte paed community nurse prior and post surgery - she was fabulous as was the local health visitor. I would have been happy staying at home with them checking in regularly if it was for those issues rather than being back in hospital unless it was absolutely necessary. HOWEVER that is okay of your HV and your paed community nurse are fab. In the area where we lived for a week or so after dd came out of hospital - they were horrid and I would have wanted to stay under the fab midwifes care or go back to postnatal ward iyswim.

post natal ward

Thanks for your responses.

For me I think the maternity unit should be the place (lets assume the staff are nice ) when the issue is a feeding one or jaundice. Paediatric wards often have campbeds for mums and they have to trail to the canteen for food. Community midwives still need to come to ward to visit mum. Maternity units would look after baby AND mum which can only be good.

Interesting topic, Mears.

I think it would depend on the level of care we had recieved on the post natal ward. If I was happy with it, I would go back there. If I wasn't I'd go somewhere else. I suppose I think the mum should be able to show up where she chooses, including but not limited to the post natal ward she recently left.

Post natal wards to tend to be rather understaffed so I do wonder if they are equipped to handle people coming back in with urgent/serious problems.

If baby was urgent or serious then it would need transferred to specialist unit. The most common reason for readmission in first 10 days is weighloss or jaundice. Weightloss could be much better managed in the community I think (stop weighing in 1st 10 days for a start unless clinically indicated).

Oh right, so you mean just for something minor like feeding problems, etc. (not that that is all that minor to a new mum)?

yse - like breast feeding baby losing weight. Or baby with jaundice needing phototherapy.