Special Care Nursery at Washington Hospital: Expert Support for Premature Newborns

It can be unsettling for parents to have a premature infant. In addition to being so tiny—some weighing 2 pounds—these babies often have multiple lines and tubes that can make parents uncomfortable picking up and holding them.

The Special Care Nursery (SCN) at Washington Hospital looks after full-term and premature babies born between 32 and 37 weeks, from three to eight weeks early. In most cases, newborns in the SCN need to grow and develop before going home, but some may require respiratory support or a ventilator; IV fluids or medications; incubators and warmers; and cardiorespiratory monitoring.

Washington Hospital’s SCN is a Level II nursery, which means it can care for premature babies who have moderate medical issues. Collaboration with UCSF Benioff’s Intensive Care Nursery in San Francisco, one of the country’s largest neonatal heart programs, gives Washington Hospital’s SCN expanded expertise and advanced technology. The Special Care Nursery is a collaboration between the UCSF Benioff Children’s Hospitals (both San Francisco and Oakland). Its three neonatologists are on the faculty at UCSF. The SCN neonatologists also care for babies at the UCSF Benioff Intensive Care Nursery in San Francisco.

“One of the main goals of the affiliation between Washington Hospital and UCSF Benioff Children’s Hospital SF has been to provide the best possible care for these very special patients and their families without the added stress of a lengthy commute for parents,” says James McGuire, MD, MPH, a board-certified neonatologist, Pediatrics Department chair, and former SCN medical director.
“Having a nursery in Fremont also gives parents the peace of mind that their baby is nearby without having to drive to San Francisco or hospitals out of the area.” He adds, “The need to travel can put an extra strain on a family that is already stressed.”

SCN staff educates and supports parents in understanding their baby’s cues for feeding, stress, and comfort—along with training on holding, changing, and bathing their child.

Expert Training and Experience

The SCN team undergoes continuing education to update skills as trends evolve and standards of care advance. The team continually takes UCSF courses on neonatal nursing care, a skills lab on procedures, and training on how to stabilize newborns who are transported to other hospitals when a higher level of care is needed. The team also participates in a quarterly UCSF clinical care conference and training from the Association of Women’s Health, Obstetric and Neonatal Nurses, among other courses.

Babies also benefit from having a board-certified neonatal therapist on staff, Robin Bonsall, who is a licensed occupational therapist. With more than 30 years in the field, Bonsall is highly experienced in pediatric therapy and early intervention, with additional education and certifications to her credit, including a master’s degree in early childhood education, specialized training in feeding and swallowing, sensory integration and processing, and neonatal touch and massage certification. She recently earned a credential from the Neonatal Therapy Certification Board.

“I do pre-habilitation,” says Bonsall, “preventive work to make sure these premature babies get what they need and avoid problems later. There’s so much evidence in medicine today that supports a proactive approach in promoting short- and long-term development and growth.”

One of the areas she’s passionate about is newborn feeding. Premature babies lack the neurological and muscle maturation to coordinate sucking, swallowing, and breathing. “We work with both breast and bottle feeding based on what works best for the family and their feeding goals,” Bonsall says. It sounds like something very small, but feeding and swallowing are big issues for tiny babies.

Having a baby hospitalized can be a very stressful experience for families, according to Bonsall. “The interactions and experiences they have will remain with them lifelong. One of our most basic forms of attachment is feeding,” she explains. “It is important to support and empower parents for successful feeding experiences for both the parent and the baby.”

Guiding Parents and Caregivers

The SCN team is on hand to guide parents and caregivers every step of the way, even providing overnight accommodations the night before a baby is ready to go home so they can practice baby care with the nursing team nearby. Bonsall and the team also encourage following guidance from the American Academy of Pediatrics, especially on sleep. The team trains parents to prevent sudden infant death syndrome (SIDS), which Bonsall says is on the decline. Parents and caregivers are advised to avoid stuffed animals and extra bedding in the crib and to position a baby on their back to sleep. The team also advises on how to provide tummy time.

Bonsall monitors the babies in the SCN, making sure they’re developing, moving, and functioning as they progress. “I monitor their muscle tone, head shape, and how they respond to their environment, including noise and light,” she notes.

“Parents want to interact with their babies, but it’s hard when babies are hospitalized,” she explains. “I show parents and caregivers how to engage with their hospitalized baby by talking, reading, singing to them, giving a massage, and knowing how to pick up and hold them safely and comfortably.”

Dr. McGuire and Bonsall are proud of the SCN team and the work it does for the community.
“People can trust in the Washington Hospital SCN. We provide quality care. Since we’re a smaller nursery, we have the extra time to give each baby dedicated attention,” says Bonsall.

For more information, visit www.whhs.com/SCN.