Newborns may be at risk due to pressure on hospitals, warn consultants

Consultants have warned vulnerable newborn babies could become the casualties of pressures on hospital as backlogs caused by Covid-19 persist.

Four neonatal units do not have adequate isolation facilities, with neonatal cots being placed too close together, increasing the risk of cross-infection between infants in these units, according to a recent report.

The Irish Hospital Consultants’ Association says these isolation facilities are now critical for managing care for infants and parents in a Covid-19 environment in line with international guidelines.

Infants of Covid-19-infected or Covid-19-suspected mothers should initially be isolated if they require admission to a neonatal unit, according to international best practice. About one in 10 newborns requires admission to a neonatal unit.

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However, without adequate investment to create the additional space, consultants warn that the risk of transmission of infection will remain dangerously high.

‘Huge stressor’

"Having a baby is one of the most momentous experiences of anybody's life, and if you add a huge stressor like giving birth at 25 weeks into that, it's full of uncertainty and worry," according to Dr Michael Boyle, consultant neonatologist at the Rotunda Hospital in Dublin.

“There are significant challenges such as access to intensive care beds. We would occasionally find that we are unable to accept a referral from another hospital because we don’t have the space or the staff to care for them and that is an awful position to be in.

“We are firefighting, we’re dealing with the issues as they present on the day. It’s a challenge to improve a service when you can’t focus on the longer-term elements that you’d like to develop.”

Staffing levels

Capacity issues in Ireland’s neonatal services are further compounded by severe consultant shortages, the IHCA claims.

None of the specialist maternity hospitals – the National Maternity Hospital, Rotunda, Coombe Woman and Infants University Hospital, and Cork University Maternity Hospital – have achieved the recommended levels of staffing, according to inspectors. Difficulties and delays in recruitment are impacting the implementation of maternity policy, the group says.

Ireland has a lower number of consultant paediatricians on a population basis (5.4 per 100,000) than England, Scotland, Australia or New Zealand.

The IHCA is calling on the Department of Health and the Health Service Executive to immediately fill hundreds of permanent hospital consultant posts and fast-track the opening of thousands of beds needed across the health system.