Newborn Services Clinical Guidelines

Information from the ADHB Newborn Services site is transitioning over to the Starship website. Some information, including the calculators and drug dosage protocols have yet to be moved over. To return to the ADHB Newborn Services site, follow this link

• A

  • Abbreviations for use in NICU

    ADHB staff only

  • Abdominal wall defects in the neonate
  • Updated Oct 2018 Admission to Newborn Services from home

    Home delivery or early discharge

  • Adoption policy

    ADHB staff only

  • Updated May 2016 AED use in pregnancy - management of babies exposed to anti-epileptic drugs in utero

    Guidelines for the management of babies whose mothers are on anti-epileptic drugs

  • Updated Sep 2018 Alcohol - Fetal Alcohol Spectrum Disorder (FASD)

    Management of the neonate whose mother has been using or abusing alcohol during pregnancy

  • Allow natural death

    Links to ADHB policy

  • Updated Aug 2015 Ambiguous genitalia in the newborn

    Initial assessment and investigation

  • Analgesia - Sucrose analgesia for simple neonatal procedures

    Links to Starship Clinical Guideline on Sucrose Analgesia

  • Updated Dec 2005 Ankyloglossia (Tongue-Tie)

    Diagnosis, assessment and management of tongue tie in Newborn Services

  • Antenatal renal dilation guideline

    Links to Starship Clinical Guideline

  • Updated Sep 2017 Antibiotics - for neonatal sepsis

    Includes risk factors, investigations and antibiotic therapy

  • Updated Oct 2018 Antibiotics - surgical wound prophylaxis in neonates

    Surgical antimicrobial prophylaxis

  • Updated Aug 2015 Apnoea monitoring and caffeine treatment

    Includes differential diagnosis of apnoea, apnoea of prematurity and caffeine citrate therapy

  • Updated Aug 2016 Apnoea monitoring on discharge from Newborn Services

    Criteria for considering home apnoea monitoring

  • Aseptic non-touch technique in Newborn Services

    Links to the Newborn Services Central Line Care for a Neonate guideline

• B

  • BCG immunisation

    links to BCG Immunisation in Newborn Services

  • Updated Apr 2015 Bilious aspirates and vomiting - assessment in the neonate

    Assessment of Bilous vomiting and/or aspirates. Includes criteria for witholding nasogastric feeds

  • Updated Jan 2016 Blood pressure - hypertension in neonates
  • Updated Apr 2012 Blood pressure - hypotension in neonates
  • Updated Aug 2018 Blood products - albumin (Newborn Services)

    Includes TM4 and TM20

  • Updated Aug 2018 Blood products - cryoprecipitate (Newborn Services)
  • Updated Aug 2018 Blood products - fresh frozen plasma FFP (Newborn Services)
  • Updated Aug 2018 Blood products - immunoglobulin IVIG (Newborn Services)

    includes information on prescribing, ordering, indications and dose, safety precautions and adverse effects

  • Blood products - Newborn Services outpatient blood transfusion (pdf, 199.48KB)
  • Blood products - Newborn Services outpatient blood transfusion checklist (pdf, 58.29KB)
  • Updated Aug 2018 Blood products - platelets (Newborn Services)
  • Updated Jul 2018 Blood products - red cell transfusion in the neonate
  • Blood products - transfusion handbook

    For ADHB staff only

  • Updated Apr 2014 Blood sampling in NICU

    Includes laboratory specimen requirements

  • Updated Sep 2013 Brain monitoring in the neonate - Brainz BRM aEEG
  • Updated May 2015 Brain monitoring in the neonate - Video aEEG
  • Breastfeeding - administration of incorrect breast milk
  • Updated Dec 2015 Breastfeeding - Breast Milk Sharing in Newborn Services
  • Breastfeeding - disorganised feeding patterns in the neonate
  • Updated Nov 2018 Breastfeeding - expressing
  • Breastfeeding - feeding policy in Newborn Services
  • Breastfeeding - medications in breastmilk
  • Updated Mar 2009 Breastfeeding - preterm infants
  • Breastfeeding code

• C

  • Calculators
  • Updated Jun 2013 Cardiac - management of antenatally diagnosed major congenital heart disease at delivery and in NICU

    Includes screening of first degree relatives

  • Updated Dec 2018 Cardiac - management of balloon atrial septostomy for congenital heart defects in NICU
  • Cardiac - PDA in the newborn
  • Updated Apr 2018 Cardiac - pre-operative cardiac care in NICU
  • Cardiac - transposition of the great arteries (pdf, 147.00KB)
  • Cardiology Guidelines

    Links to the Paediatric and Congenital Cardiology Service at Starship

  • Updated Oct 2018 Central Line Care - bundle of care for the neonate

    Bundle of care for Central Lines  (Longline, UVC, UAC and Surgically-inserted CVL)

  • Updated Mar 2017 Central Line Care - PICC insertion in the neonate
  • Central Line Care - Umbilical line insertion in the neonate
  • Updated Oct 2018 Chest drains in the neonate

    Includes sites for insertion of pleural drains

  • Updated Oct 2009 Chickenpox in neonates
  • Child Development Unit at Newborn Services
  • Updated Aug 2017 Chronic Lung Disease discharge planning in Newborn Services
  • Updated Sep 2018 Cleft Lip and Palate

    Includes feeding guidelines and information on management in the newborn

  • Updated Oct 2012 Collapsed ventilated infant in Newborn Services

    Aids to diagnosis and treatment

  • Congenital diaphragmatic hernia - postnatal management

    Links to PICU Guideline

  • Updated Aug 2007 Conjugated Hyperbilirubinaemia in the neonate
  • Updated Nov 2013 Conjunctivitis in the neonate
  • Consent

    Links to ADHB guideline on informed consent

  • Updated Nov 2018 Continuous Positive Airway Pressure (CPAP)

    Includes information on set-up and commencement, troubleshooting and complications.

  • Updated Oct 2018 Cooling - therapeutic hypothermia in the neonate

    Includes Criticool instructions

  • Coroner's Referral

    ADHB only

  • Cranial ultrasound scans
  • Updated Sep 2013 C-Reactive Protein (CRP)

    Indications and Interpretations for newborns

  • Updated Sep 2018 Cytogenic and Molecular Genetic Studies in the Neonatal Period
  • Cytomegalovirus

• D

  • Updated Jun 2017 Death of an infant in NICU
  • Updated Mar 2016 Delivery - attendance at high risk delivery by specialist neonatologist
  • Updated Sep 2012 Delivery - attendance at low risk, elective caesarean deliveries
  • Updated May 2016 Delivery - attendance by paediatric staff at delivery
  • Updated Dec 2004 Developmental Care - an overview

    Includes information on referral to NICU developmental therapists, sensory pathway development, positioning, noise levels in NICU and music therapy

  • Updated Dec 2004 Developmental Care - the Developing Preterm Infant

    28-32 weeks gestation

  • Updated Dec 2004 Developmental Care - the Early Preterm Infant

    24 to 27 weeks gestation

  • Updated Dec 2004 Developmental Care - the Growing Preterm Infant

    33 to 36 weeks gestation

  • Updated Dec 2004 Developmental Care - the Older Preterm Infant

    37 plus weeks corrected gestation

  • Updated Jan 2009 Developmental dysplasia of the hips (DDH)
  • Updated Apr 2015 Dietitian referral - neonatal nutritional risk screening criteria
  • Updated Sep 2018 Down Syndrome - management of the neonate
  • Updated Aug 2018 Drug dependency - infants born to drug dependent mothers

    includes treatment of narcotic depression in the newborn infant

  • Drug incompatibility for IV Y-site Administration in Neonates
  • Drug protocols for neonates

    Links to the drug protocols remaining on the Newborn Services website

  • Drugs in breastmilk

    Information for health professionals from Medication and Mothers Milk online

  • Duodenal obstruction in the neonate

• E

  • ECG - the neonatal electrocardiograph
  • Updated Oct 2013 ECMO - guidelines for consideration in newborn
  • Updated Jun 2010 Endotracheal tube management in NICU
  • Enteral feeding - medicina enteral feeding pump

    ADHB only

  • Updated Apr 2010 Enteral Feeding of the Neonate

    Includes short term enteral feeding in NICU

  • Epidermolysis Bullosa (EB) (pdf, 120.16KB)
  • Updated Oct 2018 Exchange Transfusion in the Neonate

• F

  • Family Violence

    For ADHB staff only

  • Updated Oct 2004 Feeding - bottle feeding
  • Feeding - breastfeeding the preterm infant
  • Feeding - cleft lip and palate
  • Updated Dec 2004 Feeding - disorganised feeding patterns in the neonate
  • Feeding - enteral feeding in newborn with a stoma (pdf, 93.86KB)
  • Feeding - enteral feeding of neonate
  • Feeding - expressing breastmilk
  • Updated Sep 2018 Feeding - feeding policy in Newborn Services

    Includes breastfeeding and artifical feeding

  • Feeding - first foods for preterm babies (pdf, 196.19KB)

    Solid foods for premature infants

  • Updated Apr 2015 Feeding - handling powdered formula and breast milk with additives
  • Feeding - medicina enteral feeding pump

    ADHB only

  • Feeding - newborn babies on postnatal wards
  • Fetal Alcohol Spectrum Disorder
  • Fluid calculator

    Fluid and electrolyte calculator

  • Updated Jan 2007 Fluids - Electrolyte and Arterial line fluids
  • Updated Jan 2007 Fluids - Fluid and Glucose requirements
  • Follow-up - neonatal follow up service
  • Form - exchange transfusion record (pdf, 35.73KB)
  • Form - pain scoring chart (pdf, 65.84KB)
  • Form - telephone advice sheet (pdf, 34.18KB)

• G

  • Updated Mar 2015 Genital, inguinal and scrotal problems in the neonate

    Includes information on undescended testes, hydrocoele, inguinal hernia, testicular torsion

• H

  • Updated Sep 2016 Haematological disorders in neonates
  • Handling small babies

    For ADHB staff only - links to nursing tools

  • Head ultrasound scans
  • Hepatitis B immunisation
  • Updated Aug 2018 Hepatitis C - maternal infection, vertical transmission and nursing care of baby
  • Updated Apr 2014 Herpes Simplex Virus
  • Updated Oct 2018 HFOV - an overview of High Frequency Oscillatory Ventilation
  • HFOV - inline circuit suctioning
  • HFOV - nitric oxide

    Links to Nitric Oxide guideline

  • Updated Mar 2011 HFOV - nursing management of the neonate
  • Updated Oct 2018 HFOV - on the VN500
  • Updated Aug 2018 HFOV - SensorMedics 3100A
  • High risk deliveries
  • Hirschsprungs' disease in the neonate
  • Updated Aug 2018 HIV - management of infants born to HIV+ pregnant women

    Includes nursing care of baby whose mother is HIV positive

  • Updated Sep 2010 Home oxygen - care of babies following discharge from NICU
  • Updated Jul 2010 Humidification for neonates
  • Humidified high flow oxygen or air for neonates
  • Updated Feb 2018 Hydrops fetalis
  • Updated Apr 2013 Hyperglycaemia in the neonate
  • Updated Aug 2015 Hyperkalaemia in the neonate
  • Hypertension in the neonate
  • Updated Dec 2018 Hypoglycaemia in the neonate
  • Updated Mar 2015 Hypospadias
  • Hypotension in the neonate
  • Updated Apr 2015 Hypothermia prevention in infants less than 30 weeks gestation
  • Updated Jul 2018 Hypotonia in neonates
  • Hypoxic Ischaemic Encephalopathy (pdf, 420.02KB)
  • Hypoxic Ischaemic Encephalopathy - cooling in NICU infants

• I

  • Updated Oct 2018 Immunisation - an overview for Newborn Services
  • Updated Oct 2015 Immunisation - BCG

    Information on BCG vaccines in Neonates

  • Updated Sep 2015 Immunisation - cold chain management for newborn services

    Includes review of fridges in NICU

  • Updated Sep 2015 Immunisation - Hepatitis B
  • Updated Sep 2015 Immunisation - Infanrix-hexa

    Includes information on the vaccine and administration details in the newborn

  • Updated Sep 2015 Immunisation - Prevenar

    Information on Pneumococcal conjugate vaccine, 7-valent

  • Updated Feb 2018 Immunisation - Rotavirus

    Information about Rotavirus vaccine including full administration details for newborn

  • Immunisation schedule (national)

    Links to Ministry of Health Immunisation Schedule

  • Updated Dec 2010 Incubator - care of baby in incubator
  • Infanrix-hexa immunisation
  • Updated Oct 2018 Infection (congenital)

    Investigation of suspected cases

  • Updated Jun 2005 Intracranial haemorrhage

    Detection of Germinal Matrix-Intraventricular Haemorrhage and Periventricular Leukomalacia

  • Updated Sep 2018 Intravenous Cannulation

    Includes information on recognition, prevention and management of IV infiltration injuries including clysis therapy

  • Intravenous nutrition
  • Intravenous nutrition - IVN and Fluid Calculator preterm infant
  • Intravenous nutrition - IVN and Fluid Calculator term infants
  • Intubation - ETT management in NICU
  • Updated Jun 2015 Intubation - premedication for intubation in neonate
  • Isolation procedures

    For ADHB staff only - links to policies and guidelines library. For NICU specific procedures, see Nursing Tools

• J

  • Jaundice - administration of phototherapy
  • Updated Jul 2018 Jaundice - Management of neonatal jaundice

    Includes management of atypical jaundice - late onset and prolonged

  • Jehovah's Witness - medical management

• K

  • Updated Sep 2015 Kangaroo care

• L

  • Low flow oxygen/air for the neonate

• M

  • Updated May 2016 Meconium-stained liquor and meconium aspiration
  • Metabolic bone disease - Osteopenia of prematurity
  • Updated May 2016 Metabolic Disease in the newborn

    Investigation and treatment of suspected metabolic disease

  • Metabolic Screening

    Links to ADHB policy

  • Metabolic Screening - information for parents

    Links to National Screening Programme information for parents, including downloadable pdf brochure and video on heel prick testing

  • Milk - drugs in breastmilk
  • Milk sharing in Newborn Services

• N

  • Updated Aug 2009 Nappy Rash
  • Narcotic depression in the neonate
  • Updated Sep 2018 Nasal Intermittent Positive Pressure Ventilation (NIPPV)
  • Updated Apr 2005 Necrotising Enterocolitis (NEC) in the neonate
  • Updated Aug 2015 Neonatal Alloimune Thrombocytopenia (NAIT)
  • Neonatal Encephalopathy (pdf, 420.02KB)
  • Updated Sep 2016 Neonatal Thrombocytopenia
  • Neonatal withdrawal
  • Updated Mar 2017 Neural Tube Defects - management of infant
  • Newborn examination (pdf, 84.54KB)

    Links to RACP document

  • Newborn screening - heel prick test

    Links to Newborn Screening programme leaflet on heel prick testing

  • Updated Oct 2018 Nitric Oxide
  • Nutrition - ADHB nutrition site

    For ADHB staff only

  • Nutrition - dietitian referral and neonatal nutritional risk screening criteria
  • Updated Jul 2008 Nutrition - intravenous nutrition
  • Updated Sep 2017 Nutrition - neonatal nutrition guideline

• O

  • Oesophageal atresia in the neonate
  • Ophthalmology referral form for NICU (pdf, 80.07KB)
  • Updated Nov 2013 Orthopaedic problems in newborns
  • Updated Apr 2013 Osteopenia of Prematurity

    Metabolic bone disease

  • Updated Apr 2010 Oxygen - calibration of the MAXO Oxygen Analyser in NICU
  • Oxygen - care of babies on home oxygen
  • Oxygen - high flow audit tool in NICU (pdf, 33.10KB)
  • Updated Apr 2013 Oxygen - humidified high flow oxygen or air for neonates
  • Oxygen - low flow calculator
  • Updated May 2009 Oxygen - low flow oxygen/air (or combination) for neonates
  • Oxygen - pulse oximetry screening in the newborn
  • Oxygen - Waitemata oxygen request (pdf, 79.20KB)
  • Updated Feb 2013 Oxygen therapy and monitoring in neonates

    Includes oxygen saturation targets and standing orders for nursing staff

• P

  • Pain assessment of the neonate

    For ADHB staff only

  • Updated Dec 2016 Palliative care pathway in NICU

    Management and referral of infants on a palliative care pathway in NICU

  • Updated Sep 2011 Patent Ductus Arteriosus (PDA) in the newborn
  • Updated Oct 2006 Peripheral Arterial Lines
  • Periventricular Leucomalacia
  • Updated Dec 2013 Persistent Pulmonary Hypertension of the Newborn
  • Updated Aug 2018 Phototherapy for the jaundiced baby - the use of lights and biliblanket

    Includes administration and monitoring and guidelines for use on the postnatal ward

  • PICU guidelines
  • Pneumothorax - chest drains in the neonate
  • Updated Oct 2018 Pneumothorax in the neonate

    Includes information on types of ectopic air leaks and clinical presentation, as well diagnosis

  • Updated Oct 2016 Postnatal wards - management of infants under paediatric care
  • Prevenar immunisation
  • Prevention of hypothermia in infants <30 weeks gestation

    Includes plastic wrap of babies

• R

  • Radiography requirements in NICU

    Links to the Starship Radiology Procedures guideline

  • Updated Aug 2008 Regional cot management - back transfer from ADHB

    Transfer of Neonates from Level 2 centres

  • Updated May 2012 Regional cot management - transfer out of Auckland region
  • Updated Sep 2018 Renal failure - care of the neonate with severe renal failure at birth
  • Renal tract anomalies
  • Research

    Links to active research at Liggins Institute

  • Respiratory - CPAP
  • Respiratory - high flow oxygen/air (humidified) for neonates
  • Respiratory - low flow oxygen/air for neonates
  • Respiratory indices calculator
  • Updated Apr 2007 Restraint of infants for treatment or procedures

    Includes restraint for treatment or procedures including umbilical artery or venous catheter insertion

  • Updated Oct 2007 Resuscitation drugs quick reference guide for Newborn Services
  • Updated Sep 2018 Retinopathy of prematurity - information on screening
  • Updated Aug 2007 Retinopathy of prematurity - laser treatment
  • Retinopathy of prematurity - opthalmology referral form (pdf, 80.07KB)
  • Rotavirus immunisation

• S

  • Safe sleeping information

    Available in the ADHB policies and guidelines library for ADHB staff only

  • Seizures - brain monitoring
  • Seizures - management in the neonate
  • Sepsis in neonates
  • Single Umbilical Artery
  • Skeletal surveys
  • Updated Oct 2018 Skin disinfectants
  • Solid foods for premature infants (pdf, 196.19KB)
  • Spina bifida and meningomyelocoele
  • Subgaleal haemorrhage (pdf, 635.37KB)
  • Sucrose analgesia for neonates
  • Updated Nov 2015 Suctioning - Endotracheal suctioning in the neonate
  • Suctioning - Hudson CPAP Suctioning
  • Updated Nov 2018 Suctioning - Inline circuit
  • Updated Jul 2006 Surfactant administration in NICU

    Guidelines for the use of Exogenous Surfactant in NICU

  • Surgery - bowel washout for a child

    ADHB staff only

  • Updated Apr 2005 Surgery - management of abdominal wall defects in the neonate

    Includes initial management of the neonate born with gastrochisis and omphalocoele

  • Updated Apr 2005 Surgery - management of Duodenal Obstruction in the neonate
  • Updated Jan 2005 Surgery - management of Hirschsprung's Disease in the neonate
  • Updated Apr 2005 Surgery - management of Inguinal hernia in the neonate
  • Updated Jan 2005 Surgery - management of Intestinal malrotation in the neonate
  • Surgery - management of NEC in the neonate
  • Updated Sep 2018 Surgery - management of oesophageal atresia with a distal TOF in the neonate
  • Updated May 2005 Surgery - pre-operative and post-operative care of the neonate

    Also includes the process for surgical transfer to Starship Theatres

  • Updated Jul 2016 Surgery - stoma care for the neonate

    Includes feeding guideline for infant with stoma

  • Surgery - surgical wound prophylaxis for a neonate
  • Updated Nov 2004 Surgical neonates - pathway for provision and location of intensive care
  • Syphilis - congenital infection

• T

  • Thrombocytopenia - neonatal
  • Updated Oct 2002 Thyroid - management of infants born to mothers with thyroid disorders
  • Tongue tie - ankyloglossia
  • TORCH infections
  • Toxoplasmosis
  • Transfers - neonatal back transfer from ADHB
  • Transfers - neonatal transfer out of Auckland region
  • Transfusion handbook
  • Updated Jul 2015 Transport - neonatal
  • Updated Feb 2016 Transport - neonatal on humidified high flow oxygen

    Neonatal transport on humidified high flow (HHF) via nasal cannulae

• U

  • Updated Nov 2018 Umbilical artery and vein catheterisation in the neonate

    Also contains information on Single Umbilical Artery

  • Updated Sep 2018 Urine measurement, urinary catheterisation and urinalysis in newborns
  • Updated Sep 2018 Urine specimens - collection in newborn

    Includes information on collection to exclude urinary tract infection and bladder stimulation technique

• V

  • Updated Apr 2015 Ventricular reservoirs in the neonate

    Drainage of ventricular reservoirs in newborns

  • Virus - Hepatitis C
  • Virus - Herpes Simplex
  • Virus - HIV
  • Virus - Zika virus
  • Updated Oct 2018 Vitamin K deficiency bleeding and prophylaxis in the newborn

• W

  • Updated Oct 2018 Weighing babies in NICU
  • Weight loss in newborns (pdf, 74.92KB)
  • Withholding feeds in NICU

• Z

  • Updated Aug 2017 Zika virus - exposure in pregnancy

    Management of infants exposed to Zika virus in pregnancy

  • Updated Sep 2018 Zinc deficiency in the newborn