Common procedures / tests
When your baby is admitted to the Neonatal Unit, we may need to do tests or procedures for your baby in order to ensure we are giving the best possible treatment. During these we encourage you to comfort your baby. Breast milk or a sucrose solution dropped onto the baby’s tongue will help reduce any discomfort or pain the baby feels during any of these procedures.
Some tests, procedures and treatments your baby may need include:
- Taking blood specimens
- Help with breathing through a ventilator, Continuous Positive Airway Pressure (CPAP) or High Flow machine
- Intravenous lines for fluids or antibiotics
- A feeding tube through their nose or mouth into their stomachs for milk feeds
- To be nursed under a blue light to treat jaundice
While these may look daunting they are designed to help your baby. The nurse caring for your baby will explain all of this and why any treatments are necessary for your baby. Don’t be afraid to ask.
Types of Procedures / Tests
Heel prick blood test - Click into heel to obtain small blood samples.
Venous bloods (IV) - Taken with a small needle, usually in the back of the hand but sometimes elsewhere.
Cannula (IV access) - Small plastic tube placed into a vein with a small needle – this can be used to take bloods too but the plastic tube is left in so that fluids/medicine can be given through this.
Lumbar Puncture (LP) - Needle sample from space in spine at bottom of baby’s back. This can be a very small space so sometimes no fluid able to be obtained.
Nasal cannula oxygen - These small oxygen tubes sit under the nose and provide a measured “trickle” of oxygen to babies needed minimal oxygen support – some babies go home on home oxygen with this.
High flow oxygen - This is like nasal canula oxygen, but also gives a faster flow of oxygen, that helps babies keep their lungs open more easily. Some babies “step down” to this from higher support but some babies are put straight on to this.
CPAP/BiPAP - With either a mask or prongs, this machine provides a higher pressure of oxygen to help keep the lungs open and take the effort to do this off the baby – BiPAP gives a bit more support with this than CPAP but they are similar.
Intubation and ventilation - Sometimes a baby needs more support with a breathing tube – these babies are supported with their breathing on a ventilator, which can either breathe for the baby, or support the breaths they are able to do themselves. Extra support in different ways can also be given with breathing for babies that need this.
Full blood count (FBC) - This checks the levels of cells in the blood that look after carrying oxygen around, helping stop bleeding and reacting to inflammation. It can tell us whether a baby is anaemic or whether they might be reacting to an infection.
Clotting - This looks further at how well the body is able to control blood flow – mainly to prevent bleeding.
Electrolytes (UE), bone group etc. - These look at the different salts and minerals in the blood that are needed to keep our cells working well. They can also check the minerals needed for healthy growth so that we can make these as good as possible with supplements if needed.
Liver function (LFT) - This checks the different chemicals produced by the liver, to make sure the liver is staying healthy - sometimes if a baby is very jaundice, very poorly, or needing IV nutrition for a long time, this can affect how well the liver works.
CRP - CRP is a number that increases when the body is reacting to something – it is not a very accurate number but can give us an idea of whether it is more likely that there is inflammation/infection around, and how this is responding to our treatment.
Blood culture - This is a sample of blood that goes to the lab in a special bottle, to see if any bugs are growing in it – this is our most accurate way to tell if there is a blood infection. It can sometimes come back with small growths of bugs that are more likely to be living in/on the body, rather than causing an infection.
Xray - Chest xrays are used frequently when needed to get a picture of a baby’s lungs. Other areas might also be xrayed if needed – they can give us a picture of where lines are placed, bony structures and some soft tissue.
Cranial ultrasound - Some babies have an ultrasound of their brain – we do this in the same way as the jelly on a tummy during pregnancy, through the soft spot on top of their head. This can show us the main structures of the brain and can be used to check for bleeds, which can be more common in premature babies.
Blood Gas - Blood gases indicate if a baby is able to move air in and out of the lungs well enough to obtain the oxygen they need and dispose of the carbon dioxide. It's important to make sure that babies are getting the very best respiratory support, especially since babies are very sensitive to even small changes in ventilator settings and oxygen levels.
