It might be necessary for your health and/or that of your baby for you to have your baby in a hospital that has neonatal services. Around one in 10 babies require the care of a neonatal unit.
You may become aware of this early in your pregnancy, at a time closer to delivery, or following delivery, if your baby is unexpectedly sick or premature and requires neonatal care. You can be transferred before your baby is born, this is called in-utero or following their birth, ex-utero.
If your healthcare team believe that an in-utero transfer is the best thing to do for you and your baby’s health, they will discuss this with you. They will make sure that you understand all the advantages and disadvantages so that you can make an informed decision.
Across Wales there are two neonatal transport services: CHANTS (Cymru inter-Hospital Neonatal transport service) in South Wales, and the North Wales Neonatal Transfer Service (North Wales NTS). Both teams are highly skilled doctors and nurses who are experienced in stabilising and transferring sick and premature babies.
When they arrive, they will introduce themselves to you and the staff caring for your baby. Their aim is to try to ensure your baby receives their care within one of our nine neonatal units in Wales, appropriate for the care they need and as near to home as possible. However, there may be occasions when the nearest and most appropriate unit is in England.
The transfer of your baby may be a stressful time and these feelings are not uncommon. The transport teams will provide care and support for you, your baby and your family.
It is understandable that you will have questions about the reasons for transferring your baby, and the steps that will be taken to make that happen.
Below are just some questions you may want to ask but please talk to the midwife caring for you, or the nurse caring for your baby, who will find the answer to any more questions you may have.
Doctors and nurses from all units work together to decide where is best for each baby to be cared for, a decision which is made in their best interests and that of the families. Babies are moved between hospitals so that they can access the care they need.
The decision to transfer your baby isn’t taken lightly and your baby will only be transferred when the doctors and nurses on the unit, and the transport team, are satisfied that it is safe to do so.
When your baby is newly born, they may need the most complex levels of care at a Neonatal Intensive Care Unit or the Sub Regional Neonatal Intensive Care Centre (SURNICC) if you live in North Wales. Staff at these units are keen to ensure that the cots are only used for babies who are in the greatest need of highly specialised care.
It is difficult to predict the length of time your baby may need this level of care but once their health improves, they will be transferred to a neonatal unit closer to your home to continue their treatment. A transfer closer to home is a positive sign that your baby is getting better. As well as cutting down on travel it also allows you to get to know the local team who will follow your baby’s progress after they have been discharged home.
Transfers can be made day and night. All units aim to give families as much notice as possible for the transfer of their baby, sometimes though, this is not possible. A cot may become vacant unexpectedly and a transfer will be organised within a few hours. In this situation you will be contacted at home to inform you, but please be assured that your baby will never be transferred to another unit without telling you.
When a decision to transfer your baby is made, the team will have a detailed discussion with the staff looking after them and then prepare thoroughly for the journey, when the team will concentrate on assessing, stabilising and preparing your baby for transfer. Stabilisation of your baby is really important and may take some time so please don’t be alarmed.
This can often be a busy time but the team will keep you informed and provide you with updates. A favourite toy or blanket can accompany them if you wish.
The team will ask you for your contact details so they can contact you as needed. You will also be given contact details and postcodes of the neonatal unit where your baby is being transferred to.
Your baby will travel in an ambulance, using a specially designed transport incubator, providing all the necessary equipment for specialist care whilst on the move.
Occasionally, to shorten your baby’s journey time, transfer may be undertaken by helicopter and the team work in partnership with The Welsh Ambulance Service Trust and The Children’s Wales Air Ambulance to ensure that your baby is transferred safely.
Your baby will be safely secured into the transport incubator using a specially designed harness which ensures safety and comfort. Earmuffs will be used to reduce noise. The incubator allows the teams to keep your baby warm and monitor their heart rate, breathing rate and oxygen levels. They are able to give any drugs or fluids that your baby may need using their pumps. They can also help your baby with any breathing problems that they may have.
A doctor or nurse will be with your baby at all times during the transfer and will be observing and monitoring your baby for any changes in their condition. They will make regular notes during the journey and these will be shared with the team at the hospital when they arrive.
There may be the opportunity for one parent to travel with your baby. This, however, depends on how well or poorly the baby is, if you are well enough and also if there are any infection control restrictions.
The transport team will talk to you about this. You must be fit and well to travel. This will include being able to get in and out of the vehicle unaided. Ambulance travel can cause motion sickness so please inform a member of staff if this is a problem.
If you can travel with your baby you will be expected to remain in your seat with your seatbelt fastened. Due to storage limitations, only one small bag for you can be safely secured on the ambulance. A parent is unable to transfer in the air ambulance.
If you are unable to travel in the ambulance with your baby please do not attempt to follow it. Please ensure that you travel at a safe and steady speed.
Not all parents wish to travel with their baby and this is okay too.
When the team and your baby get to the destination hospital they will explain to the medical and nursing staff what has happened both before and during the transfer and your baby will be moved to their new cot.
Each neonatal unit has slightly different facilities and policies about visiting and staying with your baby. The staff will be happy to discuss these with you when you arrive.
The team caring for your baby and the transport team are happy to discuss any concerns you may have, before or after the transfer.
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