Child and Maternal Health
Best Start focus on: Transitional Care
Best Start Factsheet – Transitional Care
What is it?
The Best Start recommends the development of transitional care to keep mothers together with their baby wherever possible. The majority of babies currently admitted to neonatal units are late preterm (34 – 36+6 weeks gestation) and full-term infants with moderate additional care needs, for example, they may require nasal gastric tube feeding or a course of antibiotics etc. Currently, many of these babies are admitted to neonatal units but, most of them could be cared for with their mother on postnatal wards, or even at home, with additional support. This type of transitional care arrangement would keep mother and baby together and reduce neonatal unit admissions of both late preterm and term infants.
Why are we doing it?
Units which have already put in place transitional care support report shorter stays for mother and baby, increased breastfeeding rates and improved feedback from mothers and their families. The immediate post birth period is a critically important time for bonding and attachment and evidence also shows that improving bonding and attachment between parents and children reduces risk in later life, as well as improving educational attainment at school.
How are we doing it?
Five Early Adopter Boards (EAB) were identified in September 2017 to lead the way across Scotland in implementing a suite of recommendations relating to continuity of carer and local delivery of care. One of these recommendations is the development of Transitional Care within their Maternity Units. To date three EABs – NHS Lanarkshire, NHS Lothian and NHS Forth Valley and two non EABs – NHS Ayrshire and Arran and NHS Tayside have introduced transitional care services and learning from these NHS Boards will be shared with the remaining Boards.
Boards have taken slightly different approaches on delivering this service. Some, like NHS Lanarkshire, have developed a separate transitional care unit alongside their existing Special Baby Care unit with dedicated transitional care rooms and facilities for parents to stay with their babies. Other NHS Boards have created dedicated areas for transitional care within their existing postnatal wards where families can stay together.
What have the results been?
Boards that have implemented transitional care have had positive feedback from parents who have appreciated being able to stay with their baby in the critical early period as well as acquiring the skills and confidence to look after them at home once they have been discharged. Fathers, partners and in some cases, family members, have also appreciated being able to stay in the maternity unit to provide ongoing support. As well as positive feedback from local families, Boards who have implemented these arrangements have experienced a reduction in admissions to neonatal care (ranging from 10 – 33% in some months). This has helped free up capacity for babies with more complex medical and care needs.
Hear what this means to women and their families –
Find out more
British Association of Perinatal Medicine Framework for Transitional Care: