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.

What about transportation problems? Like how is a mum post c-section going to get to the hospital? Isn't she better off with a mw/health visitor coming to her?

Mears.... I totally believe the MW popping in every other day/3rd day is NOT good enough. With Jess, my DH had just been sent back to Iraq, I was on my own, scared and felt totally unable to cope. Although I was lucky in that Jess did not need to be readmitted, I still feel that post-natal care of the MW is NOT substantial enough, especially to 1st time mums.

With Rebecca (2nd baby) my MW came to see me 3 times in 10 days.... says a lot me thinks.

Always better to have care at home, however lets say baby is jaundiced after getting home and needs phototherapy in hospital. Mum and baby will go to hospital but which one should it be,. Back to maternity unit where mum gets a bed and can be cared for midwives too, or admitted into paediatric ward where mum has to sleep on a campbed and only sees midwife when they visit

Hmmm. I might be generalising from the particular here, but I think there may be a link between poor postnatal practise re supporting breastfeeding in postnatal wards and babies who are subsequently readmitted with drastic weight loss. I know there was in my case. In which case, I don't think there is much point in going back to the ward which allowed the problem to develop in the first place.

However, it is more complex than that as the failure extended into my community midwifery team (I wasn't given any advice on breastfeeding, nor seen by the same midwife two days in a row for 7 days, by which time DS had lost 25% of his body weight and turned dark yellow).

DS was readmitted to the specialist NICU at our local hospital (although these days he would go to the pead ward) and then we were transferred down to a specialist ward supporting postnatal mothers with problems. They seemed to have a totally different set of midwives there who were frankly much more clued up. If I'd gone back to the postnatal ward, my breastfeeding days would have been over.

This is obviously a resource hungry solution, though (as evidenced by the fact that the postnatal support ward is now shut )

dsis was admitted with her dd for jaundice at 3 days, to paediatric ward for 4 days. she really appreciated being in that ward rather than the post-natal ward because her DP could stay overnight too in the paediatric one. They had to wake and feed the baby every 2 hours for several days and she was exhausted after a terrible 40 hour labour. so she'd certainly vote for a ward which permitted fathers to stay. of course that could be a post-natal ward if they let fathers stay overnight, but they don't.

I agree with you jessicaandrebeccasmummy. Midwives used to visit daily for 1st 10 days. Then selective visiting was intoduced so that women who were fine did not get a visit every day so that those who needed extra time got it. Some women need very long visits or more than one visit a day, especially when there are feeding problems. It is recognised as a real problem and many places are looking to introduce maternity care assistants who can go and give extra support that the midwife has identified.

i have had this and my baby was readmitted to the hospital she was born in, due to feeding problems(prem baby)she was admitted onto the childrens under five ward.

DS was admitted at 17 days to local children's hospital. Ironically the food was much better (was allowed meals as bfign mother) and the breastfeeding support was much better - a lovely lovely nurse who wasn't even allocated to care for DS but had previously trained as a bfc gave me lots of advice. So although in theory I would have said the maternity hospital, in practice the paediatric hospital was much better. I found the level of care provided by nursing staff and HCAs far far superior.
agree with tangocharlie - the staff on the paed ward were so much kinder and caring than the postnatal ward staff.