Neonatal Oral Antibiotics at Home (NOAH)

Why does my baby need antibiotics?

Your baby has an infection which started in the first 72 hours after birth. This type of infection is called ‘early onset neonatal infection/sepsis’. We are giving your baby antibiotics to treat the infection.

Why does my baby have an infection?

Babies are at risk of infections because their immune system is not fully developed. If infections are not treated, it can lead to serious illness. This is why doctors start antibiotics quickly in babies who have an infection.

How are antibiotics given to my baby?

We give the first 36 – 48 hours of antibiotics to your baby in hospital. We give them into their vein using a small tube called a cannula. If your baby is getting better, we will change them to a liquid antibiotic called Amoxicillin. You can give Amoxicillin by mouth to your baby at home. This means you can take your baby home sooner.

Are antibiotics safe for my baby?

Amoxicillin is safe for babies. Some babies may have short-term side effects, such as diarrhoea or vomiting.

How long will my baby need antibiotics for?

Your baby will have a total of seven days of antibiotics. This includes all antibiotics given in hospital and at home. A midwife will show you how to give your baby antibiotics before going home. Please make sure you are happy with this before leaving hospital.

It is very important that your baby completes their full course of antibiotics.

How will I be supported?

You will have a follow up video call with the Leeds Healthier Together at Home (H@H) team the day after you go home from hospital. You will also have a follow-up video call on the last day of the antibiotic course. H@H will arrange a time to video call you. The H@H team are based on the CAT (Children’s Assessment and Treatment) unit at the LGI.

The purpose of the video calls are to check how your baby is. The nurse will ask you;

• How your baby is feeding
• About wet and dirty nappies
• How your baby looks
• If you have any concerns.

A team member will show you how to book a call with H@H. Before you go home you will have a test call with H@H. This is to check your video quality. The hospital uses ‘Attend Anywhere’ to do video calls.

You need to sign the agreement at the end of this leaflet to use the H@H service.

For us to discharge you to follow up with H@H, you will need to:

• Have good internet access on your phone/tablet to connect to Attend Anywhere.
• Stay within Leeds until your baby has finished their antibiotics.
• Bring your baby to the LGI if you or the H@H team have worries about them.

What are signs my baby is becoming unwell?

• A change in behaviour (e.g. crying a lot, sleeping more or difficult to wake up).
• Being more floppy than usual.
• Struggling to feed or being sick a lot.
• Reduced number of wet nappies.
• A temperature below 36°C or above 38°C. If you don’t have a thermometer, check if your baby’s chest feels very cold or hot.
• Fast breathing or grunting noises.
• A change in the colour of their skin (e.g. pale, blue, grey, yellow).

What if I am worried about my baby?

You can contact us any time if you are worried about your baby or you think your baby is becoming unwell.

Between 8:30am – 8pm Monday to Friday call the H@H team on 0113 392 0926.

Between 8pm and 8:30am Monday to Friday and at weekends call the Children’s Assessment and Treatment (CAT) Unit on 0113 392 7437. Your baby will most likely need a face-to-face review at the LGI.

For 24 hours after discharge from H@H you can go to the CAT unit.

If you need help urgently call 999

What if my baby is sick (vomits) after a dose of antibiotics?

If your baby is sick less than 30 minutes after you have given them a dose of Amoxicillin you can give them another dose again.

If your baby is sick more than 30 minutes after having a dose of Amoxicillin you should wait until the next dose is due.

If your baby is sick more than once, seek advice from the H@H team. You may need to bring your baby back into hospital to give them antibiotics.

What if I forget to give the Amoxicillin?

If you remember within one hour of the dose being due, then you can give the missed dose.

If you remember after this time, do not give the missed dose. Wait until the next normal dose.

Medication times

Please note the times your baby is given their antibiotics at home in the table below:

Summary of care

In Hospital (First 1 – 2 days)

• Your baby may have an infection
• Antibiotics will be given through a drip
• If your baby stays well, antibiotics change to liquid medicine (Amoxicillin)
• Total course is seven days

Getting Ready to Go Home

• Learn how to use the Attend Anywhere
• Have a practice video call
• Sign the NOAH agreement
• Plan made for Follow-up calls

At Home – Day one Video Call

• A nurse video calls you
• They ask about feeding, nappies, breathing and colour
• You can ask questions

At Home – Day four Video Call

• A nurse video calls you again
• They check your baby is still well
• They check the medicine is going well
• No further follow up calls

After Follow-Up Ends

• Finish all antibiotics
• For 24 hours after follow up ends you can contact the CAT unit. After this help is from GP / 111 /999 / A&E

Feedback

This is a new service at Leeds Children’s Hospital. We would really welcome your feedback. This is so we can improve the care we offer to families in Leeds. Someone will call you from the service.

If you prefer you can click the links below to complete a short survey.

Thank you in advance.

References:

1. NOAH PIL
2. https://www.medicinesforchildren.org.uk/medicines/amoxicillin-for-bacterial-infection

Healthier @ Home NOAH Agreement

Dear Parent / Carer

Your baby is on the NOAH project – oral antibiotics at home. Once your baby is ready for discharge;

• The H@H team will send you a text message.
• They will then call you to test your video call quality.
• They will arrange a time for two video calls with you. This will be on day one and day four after going home from hospital.

You

• I have good internet connection that supports ‘Attend Anywhere’. This is the programme the hospital will use for the video call.
• I have been shown how to use the system before I go home. You can also find out more here www.leedsth.nhs.uk/patients/appointments/video-consultations/
• I will stay within the Leeds area while under H@H follow up. This is so that I can quickly return to the hospital if needed.
• I will be free for a video call at the pre-arranged time.
• If the doctors or nurses think my baby may need extra treatment I will bring my baby back to hospital straight away.

If we cannot contact you, we may contact the police and social care. This is to check your baby is safe and well.

The Hospital

• We will give you details about how to check if your baby needs medical help from us.
• You can contact the CAT unit any time on 0113 392 7437.
• You can contact the H@H nurses work between 8:30am – 8pm Monday to Friday. Their number is 0113 392 0926.
• We will review your baby via “Attend Anywhere” video call at the agreed times.