Special care nursery (SCN)

Your baby might need to spend time in a special care nursery (SCN). This happens when they need more care than is available on a general newborn care ward.

An SCN is different from a neonatal intensive care unit (NICU). Babies in a NICU are generally more unwell and require a higher level of care than babies in an SCN.

Babies may need to be in a special care nursery because:

• they were born prematurely (early) and need extra care
• they have health issues such as jaundice, low blood sugar, heart or breathing problems
• they have a low birth weight
• they have moved from a NICU as their health has improved

Special care nursery staff

There are many specially trained staff in the special care nursery, including:

• doctors who specialise in looking after premature or sick newborn babies
• nurses and midwives with special training in newborn care
• lactation consultants to help with breastfeeding and expressing breast milk
• allied healthcare providers such as physiotherapists (Opens in new tab), speech pathologists (Opens in new tab) and occupational therapists (Opens in new tab)

As a parent, you are considered an important part of your baby's healthcare team.

It may seem overwhelming the first time you see your baby in this highly specialised area of the hospital. Understanding how the SCN works may help you manage better, so you can focus on looking after your baby and recover from the birth.

Medical equipment

Your baby may start off sleeping in an incubator before moving to a cot.

There may be equipment in the room that monitors your baby's:

• oxygen level
• heart rate
• breathing

There may also be equipment to treat jaundice. Nursery staff will explain any equipment or procedures that your baby needs.

Stimulation control

The special care nursery is likely to be quiet, and you will be asked to whisper or talk quietly. This is because a low noise level is important for your baby's brain development and to keep them calm. Lights might also be dimmed so as not to overstimulate your baby.

There may be a quiet period during the day, when your baby can sleep undisturbed, with little noise or handling.

You can see your baby as often as you like in the SCN. Bonding with your baby and helping to care for them will also help them get well. Staff will encourage you to have plenty of hands-on contact. This includes:

• feeding
• changing nappies
• bathing
• cuddling

You may be able to provide 'kangaroo care', or skin-to-skin care, with your baby. Holding your baby next to your skin is helpful for both parents and babies.

Visitors

Other members of your family can visit your baby. Visitors may be restricted to 2 or 3 people at a time.

Different hospitals will have different rules around visiting. It's best to check with the staff in the SCN.

Hygiene in the SCN

It's important that the special care nursery is clean and free of germs. This is because babies in the neonatal units are more likely to catch infections.

Visitors will need to wash and sanitise their hands (Opens in new tab) before entering the nursery.

You should also avoid visiting your baby if you are unwell, for example, if you:

• have a cold (Opens in new tab) or symptoms of the flu (Opens in new tab) (for example fever, cough or sore throat)
• have diarrhoea (Opens in new tab)
• are vomiting (Opens in new tab)

If you're not sure whether you're well enough to visit, speak with a staff member.

There are a few different ways to feed your baby in the SCN. Your baby may need to feed using a tube. As they get stronger, they may be able to take milk from your breast or a bottle.

Breastfeeding

If your baby is premature or sick, it may take time for them to breastfeed well. In many cases, this may take weeks — this is normal.

Holding your baby skin-to-skin can help them feel secure. It can also help to stimulate your milk supply. Skin-to-skin feeding is a good way to help prepare you and your baby for breastfeeding.

When you hold your baby skin-to-skin you may notice them becoming more alert, sucking their fingers or lips and moving closer towards your breast. These are signs that your baby may be ready to start to feed. Your baby might take some time to learn to breastfeed — try to go at their pace. With time, your baby will start to feed better.

The SCN staff or a lactation consultant may be able to help you to breastfeed.

Expressing milk

The SCN staff may ask you to express breast milk to feed your baby. Your breast milk may be stored in the fridge or frozen to use later. Expressing milk will keep up your milk supply so you are able to breastfeed when you and your baby are ready.

There are a few different ways you can express milk:

• by hand — using your hand to gently massage the breast to push the milk out of the nipple
• using a manual pump
• using an electric pump
• using a double pump — to pump both breasts at the same time

Speak with the SCN staff about labelling, transporting and storing your expressed breast milk.

Read more on expressing and storing breast milk.

Other forms of feeding

If you choose not to breastfeed or breastfeeding is not an option for you, the staff will discuss other options, such as feeding your baby with formula or donated breast milk.

This will be different for every baby.

Your baby may be able to leave the SCN when:

• they can regulate their own body temperature
• they are a suitable weight
• they are feeding well

It’s best to ask the special care nursery staff when your baby may be able to come home.

Having your baby in a special care nursery can bring many different emotions. You may feel worried (Opens in new tab), stressed (Opens in new tab), uncertain or overwhelmed at times. If your baby has moved from another neonatal unit, you may also feel relieved that they are making progress, while still having concerns about the changes in their care.

You can talk to the SCN staff about how you are feeling. They can help to support you, answer your questions and find resources to help.

Practical tips for parents managing their feelings

Here are some tips for getting through your baby's time in the SCN:

• Kangaroo care and talking to your baby can help you bond with your baby.
• Seek support from friends and family.
• Take time to care for yourself — don't ignore your physical and emotional needs.
• Be involved as much as you can with your baby's care.

Professional mental health care can help you manage your feelings and emotional needs.

For advice and to connect to local mental health services, call Medicare Mental Health on 1800 595 212. Check the operating times.

You can speak with the staff in your baby’s special care nursery to answer any questions you have.

The Miracle Babies Foundation (Opens in new tab) provides information and support for families with a baby in the neonatal units.

The NurtureProgram (Opens in new tab) through the Miracle Babies Foundation has many resources to support families with a baby in the neonatal units, including the NurtureLine 1300 622 243 (1300 MBABIES) family support helpline.

The Royal Women’s Hospital has a number of fact sheets (Opens in new tab) on many topics for family members of babies in neonatal care units.

King Edward Memorial Hospital has a video explaining how to hand express breast milk (Opens in new tab).

Languages other than English

The Australian Breastfeeding Association has information and support about breastfeeding in many languages (Opens in new tab).

Information for Aboriginal and/or Torres Strait Islander peoples

Miracle Babies Foundation has information for Aboriginal and/or Torres Strait Islander peoples about the NICU (Opens in new tab).

Raising Children’s Network provides a picture guide on breastfeeding (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples.

Information for sexually and gender-diverse families

Rainbow Families provides a lactation guide (Opens in new tab) for sexually and gender-diverse families.