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Hospital work experience: neonatal ward part 1

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I had the opportunity to shadow a pharmacist on a neonatal ward which was classed as a level 2 unit, meaning that they take babies from the age of 27 weeks. A baby more premature than this would go to a level 3 unit. When I was visiting the ward they had four sets of twins – this was not surprising as twins are commonly born prematurely. A problem that is often encountered in premature babies under 35 weeks is the inability to co-ordinate sucking and swallowing. This influences how the baby can be fed and how medicines can be administered. In some cases the baby is encouraged to use a dummy as this helps to improve the ability to suckle. Many of the babies are fed using total parenteral  nutrition (TPN) which is complicated to manage. However, if a baby can be fed with breast milk the mother, in most cases, will have expressed milk previously and the milk is then frozen for when the baby can tolerate it. In some cases donor breast milk is used for babies.It is important to monitor the growth of the babies and each baby is given a growth chart. There are different ones for boys and girls and as long as a baby remains along its projected growth line its growth is deemed satisfactory. If, however, its weight falls below its projected growth line this may indicate a problem with feeding or development. Each baby is weighed twice a week to track its progress. One of the babies on the ward weighed approximately 680g when she was born! It is common for a baby to lose some weight after birth due to the stresses of having to support itself during the first few weeks of life outside the womb.

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