Quality standard

Quality statement 3: Infant health – serious illness

Quality statement

Women or main carers of babies are advised, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Rationale

Babies may experience serious health conditions in the immediate hours, days and weeks following the birth, which can lead to severe illness or in rare cases, death. Providing the mother or main carer with verbal and written information about the symptoms and signs that might indicate their baby has a serious health problem may result in them contacting emergency services more promptly. This information should be provided within 24 hours of the birth.

Quality measures

Structure

Evidence of local arrangements to ensure that women or main carers of babies are advised, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Data source: Local data collection.

Process

The proportion of women or main carers of babies who are advised, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Numerator – the number in the denominator who are advised, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Denominator – the number of mothers or main carers of babies.

Data source: Local data collection.

Outcome

a) Incidence of potentially avoidable infant morbidity and mortality.

Data source: Local data collection. The NHS Digital Maternity Services Data Set collects data on neonatal deaths. The Healthcare Quality Improvement Partnership's perinatal mortality surveillance report (MBRRACE-UK) reports on rates of perinatal death.

b) Women and main carers feel informed about symptoms and signs of serious illness in the baby.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for women or main carers of babies to be advised, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Healthcare practitioners advise women or main carers of babies, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Commissioners ensure that they commission services that advise women or main carers of babies, within 24 hours of the birth, of the symptoms and signs of serious illness in the baby that require them to contact emergency services.

Women or the main carer of the baby are given advice within 24 hours of the birth about symptoms and signs of serious illness in the baby, for which they need to contact emergency services.

Source guidance

Definitions of terms used in this quality statement

Symptoms and signs of serious illness in the baby

The following symptoms and signs are suggestive of serious illness in a baby:

  • appearing pale, ashen, mottled or blue (cyanosis)

  • unresponsive or unrousable

  • having a weak, abnormally high-pitched or continuous cry

  • abnormal breathing pattern, such as:

    • grunting respirations

    • increased respiratory rate (over 60 breaths/minute)

    • chest indrawing

  • temperature of 38°C or over or under 36°C

  • non-blanching rash

  • bulging fontanelle

  • neck stiffness

  • seizures

  • focal neurological signs

  • diarrhoea associated with dehydration

  • frequent forceful (projectile) vomiting

  • bilious vomiting (green or yellow-green vomit).

  • within the first 24 hours after the birth:

    • has not passed urine

    • has not passed faeces (meconium)

    • develops a yellow skin colour (jaundice).

[NICE's guideline on postnatal care, recommendations 1.3.2 and 1.4.9, NICE's guideline on jaundice in newborn babies under 28 days, recommendation 1.1.1 and expert opinion]

Main carers of babies

For the majority of babies, the main carer will be the mother. For some babies, the main carer could be a close relative, for example, the baby's father or grandparent, or for looked‑after babies, this could be a foster parent. [Expert opinion]

Equality and diversity considerations

Communication and information‑giving between women or main carers of babies (and their families) and members of the maternity team is a key aspect of this statement. Relevant adjustments will need to be in place for anyone who has communication difficulties, and for those who do not speak or read English.