Keeping mothers and babies together clinical pathway

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Royal Free London NHS Foundation Trust has developed a single, simplified, standardised pathway for term and late preterm infants, allowing the neonatal and maternity teams to easily identify more vulnerable babies and provide enhanced postnatal care alongside their mothers.

The Royal Free keeping mothers and babies together pathway reduces unwarranted variation in the care of babies at higher risk of becoming unwell soon after birth. The pathway was co-designed by staff and families to keep parents at the centre of the team looking after these more vulnerable babies.

Separating babies from their mothers after birth has long-term detrimental effects on breastfeeding, mother-baby attachment and mothers’ mental health. 

There are many reasons babies may be at risk of becoming unwell soon after birth (for example, babies of mothers with gestational diabetes or who are at risk of sepsis). Variations in clinical guidelines add to the challenge of looking after this diverse group. This variation extends to late preterm babies (34-36 weeks gestation) who are often separated from their mothers preemptively. 

The Royal Free keeping mothers and babies together pathway adopts a more radical approach and includes first hour care bundle for all babies, a unified observation regime for all ‘at risk’ babies, use of orange hat as a nudge for staff and written information for families including feeding guidance. By simplifying and standardising the approach to all ‘at risk’ babies, more babies are staying with their mothers and avoiding admission to the neonatal unit.

This resource is useful for maternity and neonatal teams working towards reducing avoiding admissions of term and late preterm babies to neonatal units when safe to do so.

Royal Free London keeping mothers and babies together clinical pathway PDF, 1.7 MB

The keeping mothers and babies together pathway is part of the Royal Free London NHS Foundation Trust clinical pathway group model of care.

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