Circle Of Care Optimising Outcomes for Newborns (COCOON)

COCOON care guide

    • We encourage you to be as involved in your baby’s care as possible
    • This care guide contains suggestions of appropriate things that you can do with your baby at different stages during their Butterfly journey
    • The suggestions will vary depending on what stage your baby is at in terms of the amount of clinical support they need and their own developmental stage
    • Try to remember that some days your baby may be able to cope with more than other days, depending on how sick or well they are
    • Each day on the morning ward round, the care team will discuss what your baby should be able to manage that day – your involvement in these discussions is strongly supported

    Baby receiving full intensive care

    Care guide image 1 COCOON - The Royal Children's Hospital

    This may be a very frightening time for you, but there are still things that you can do to engage with your baby and let them know that you are there for them. Babies in this category will usually be receiving some form of breathing support from a ventilator via a tube in their upper airway, and lots of medicines to support them and ensure they are not in pain.

    The types of things you can do with your baby at this stage include:

    • being present at their bedside
    • talking, singing and reading to your baby
    • holding your baby's hand; having physical contact with your baby
    • assisting the nurse to clean their mouth
    • taking your baby's temperature (this will often be checked by a member of our nursing team)
    • changing your baby's nappy
    • giving your baby a sponge bath
    • having periods of skin-to-skin time with your baby. Please be mindful that this will be discussed on the daily ward rounds to determine if it's in your baby's best interests on any particular day, for example, if they have certain lines (in the umbilical cord) or tubes (chest drains) it may not be safe to lift them off their bed. 

    Transition from full intensive care to high-dependency

    Care guide image 2 COCOON - The Royal Children's Hospital

    Babies in this category will usually be receiving CPAP or high-flow nasal prong oxygen, they may be having some suck feeds, or feeds via a tube.

    In addition to items listed for babies receiving full intensive care, opportunities to engage with your baby will include:

    • learning how to feed your baby via a tube
    • having regular skin-to-skin care sessions
    • learning how to administer oral medications, and assisting nursing staff with this task
    • learning how to read your babies 'cues' to understand when they want to be comforted, when they are hungry, and when they need sleep
    • working with our allied health team to learn the best ways to do some gentle exercises with your baby.

    Preparation for discharge

    Care guide image 3 COCOON - The Royal Children's Hospital

    Babies in this category are off most breathing support - they may have some low flow oxygen, and their feeds will be increasing.

    In addition to items listed in the previous two categories, opportunities to engage with your baby at this stage will include:

    • feeding your baby - working with our lactation consultants and nursing staff to establish breastfeeding, or learning how to bottle or tube feed your baby
    • attending to all of your baby's care - nappy changes, baths, mouth care, administration of medications, taking temperatures
    • learning how to play with your baby and more about their daily routines
    • taking your baby for walks around the ward or hospital in a stroller
    • having a child restraint fitted in your car.