Grace Centre for Newborn Intensive Care at The Children's Hospital at Westmead
Ph: (02) 9845 2715
Fax: (02) 9845 2251
The Grace Centre for Newborn Intensive Care is a specialised unit where more than 600 premature newborns, neonates, and critically ill infants with complex medical conditions, such as serious cardiac and surgical disorders are treated.
Originally named after Grace Bros Staff Aid to Charities, the Grace Centre is not a maternity ward. It is a specialised centre providing tailored care to the medical or surgical needs of the state’s sickest infants—some as young as 23 weeks gestation.
Babies who are born at the maternity ward in Westmead Hospital can be immediately transfered to Grace. Other babies are flown to the nursery within hours of birth from across NSW, ACT and Pacific Rim region for urgent life-saving care not available anywhere else in the state.
We are the only accredited NIDCAP (Newborn Individualised Developmental Care and Assessment Program) training centre in Australia and lead the way in neonatal developmental care.
The wellbeing of parents is a high priority and round-the-clock support is provided.
Download our Parent's Guide to the Grace Centre
Our patient stories
We are delighted to share the stories of our patients whose parents have been inspired to say thank you - in their own unique way expressing gratitude and appreciation.
- Read Ben's story: Our little fighter.
- Read Levi's story: Brand new and really well looked after!
- Read Dimi's story: Miracles happen behind those doors
Caring for critically ill babies
To help make your time in Grace as comfortable as possible we recommend you download the Parent's Guide which has loads of useful information. Here's a few quick tips:
If you know before birth that your baby requires urgent surgery, come in and tour the Grace Centre and meet some of our staff. It may help reduce your anxiety and once your baby has arrived help you feel more comfortable about with what goes on here.
Babies need skin-to-skin contact. We encourage parents to hold their baby against bare skin. This soothes the baby, helps development and sleep, and has been shown to reduce infections, encourage feeding and promote bonding. It helps develop the relationship between the baby and parents.
This is extremely important in this critical care environment, so please remember to remove your watch, always wash your hands and ensure visitors do the same.
Your baby's diary
A great way to record your baby's progress, milestones, activities as well as your questions and answers during your time in Grace. We can help with digital photos too.
We have an outside patio area, just near reception as you enter Grace, available for your use.
Every day our medical teams visit to check on your baby's progress. It's a good time to ask the specialists any questions or raise any issues.
Collaborating in care
The Grace Centre shares a close working relationship with all specialty departments in the Hospital. Close collaboration with our colleagues in the Paediatric Intensive Care Unit and the Heart Centre for Children is critical especially when treating babies with cardiac conditions who need joint care and expertise across teams.
Our close relationship with surgical teams has dramatically improved patient survival and enhanced the long-term developmental outcomes of critically ill neonates. Improvements include:
- The DAISy (Development After Infant Surgery) world-first study involved more than 780 babies and their families, surgeons and other healthcare professionals. Recommendations led to enrolment of all high-risk infants in multi-disciplinary clinics, early identification of issues and initiation of early intervention strategies.
- Working with respiratory specialists to look at why some babies stop, or have difficulty breathing, and the resultant impact on their nervous systems.
- With colleagues in the Heart Centre and other Australian facilities we are researching whether delayed cord-clamping in pre-term babies (less than 30 weeks gestation), affects blood circulation.
Almost half of the babies cared for in the Grace Centre each year are referred to our service before the end of your pregnancy. This section provides you with some information on what you can expect after your referral.
To help provide you with an overview of what the unit looks like, to introduce some of our staff and explain what you can expect we recommend you watch the Grace Parents video which can be found at the top of this page.
How are baby's referred to the Grace Centre?
If your baby requires surgery or support from The Children's Hospital after they are born your obstetrician will refer you to an appropriate surgeon or treating team at the hospital, they will arrange an appointment to meet you ideally prior to the baby's birth and possibly arrange some tests. Your obstetrician may also refer your care to a different hospital than your original planned delivery hospital closer to The Children's Hospital. This occurs as some baby's require transfer to the NICU as soon as possible after birth. Your obstetrician and team will discuss this with you in detail.
We work with your obstetricians and midwives prior to your baby's delivery notifying our team in the Grace Centre of your upcoming delivery and plans after birth. One of the teams we work closely with is the PEARLs team at Westmead (adult) Hospital.
The PEARLs team, your surgeons or treating team and Grace NICU develop a plan to identify how quickly after birth your baby will be transferred to the Grace Centre. This is dependent on a number of things including how much help your baby will need after they are born and how quickly they need to be treated by our team. Ideally you will get to cuddle your baby and have some photos taken prior to transfer, this may not be possible for all families. The team in birth unit and your midwife will talk to you more about the plan after birth. If you have birthed your baby at Westmead (adult) Hospital a team of doctors, nurses and your partner will accompany your baby over to the Grace Centre. Our unit is approximately a 20 minute walk from birth unit through internal hospital corridors.
What happens when we arrive in Grace?
Our team will meet your baby and determine what treatment they need. At this point some specialist teams such as heart doctors or surgeons may meet your baby and do some tests. If the baby's mum is still in birth unit we will take some photos and provide your partner with an update. We may also speak to the baby's mum on the phone. As soon as it is safe (this is determined by your midwives and team in birth unit) you will be bought over to the Grace Centre by wheelchair to spend time with your baby. In the next few days you will come over to the Grace Centre more and more as you recovery after the baby's birth.
Parent access in the Grace Centre
There are no visiting hours for parents in the Grace Centre they are welcome in the unit 24 hours a day, seven days a week. With the recent COVID pandemic there have been restrictions in place at the direction of the NSW Health Department. Currently siblings and other visitors (i.e. grandparents, aunts and uncles or family friends) are unable to visit the hospital. There are restrictions in place across the hospital to ensure we meet social distancing requirements. Both parents are welcome in the unit at all times. Each week we are evaluating the ongoing access restrictions and amending them as per the governments guidelines with our team.
When can I hold my baby?
We plan for this to happen as soon as possible. For some baby's if they are very unwell or having procedures we may need to wait a little while for your first cuddle - there are some other things you can do to make sure your baby knows you are there and can recognise your touch. A 'hand hug' also called (containment holding or hand swaddling) is a good option for baby's in the NICU. During a hand hug you place your hands at your baby's feet so they can push against you and place your other hand on their trunk or belly as this helps them feel secure, like they are back in your belly.
The other type of cuddle we recommend in the NICU is 'skin to skin' or 'kangaroo' cuddles. Kangaroo Care is a method of skin-to-skin contact to promote parent/infant bonding when baby is premature. A parent holds the infant on a bare breast or chest similar to a kangaroo carrying their young. Through contact with their parent’s skin, the babies are kept warm and experience a close connection to their parents. Kangaroo Care can also benefit older premature babies and full-term babies. Kangaroo Care has shown many benefits to baby and Parents, including promoting parent/infant bonding, helping the baby to maintain their temperature, supports breastfeeding, can help the baby gain weight and helps the baby get into a deeper sleep. The Grace Centre staff can help you to cuddle your baby just ask them!
You can find out more about skin to skin here: Skin to skin parent brochure
What do I need to bring?
We will provide everything you will need for your baby - nappies, wraps, dummy's (pacifiers), feeding and expressing equipment. When your baby is first in the unit they don't need to wear clothing as they sleep on a special heated bed. When they are getting closer to home we have clothes you can borrow or you can bring clothes in, if you bring clothes in we give them back to you to wash. You are welcome to bring in items that are special to you and your baby - family photos, a special toy or wrap.
Caring for your baby in the NICU
Caring for your baby in the NICU can be overwhelming. It is normal to feel concerned about how to manage wires and tubes, knowing when to touch your baby or how to offer comfort. You are the most important person to your baby. They recognise your voice and smell and you can offer them support and reassurance. The nurses in the Grace Centre will help you as you change your baby's nappy and learn to complete other aspects of their care. The following resource is useful in explaining some of what you can expect in the NICU: Caring for your baby in the neonatal unit parent fact sheet
Parking and accommodation
There is parking available at The Children's Hospital at Westmead with some families eligible for concessions you can find out more information here https://www.schn.health.nsw.gov.au/hospitals/sch/parking-concessions
If your family needs accommodation prior to the baby's delivery your midwife team will discuss this with you. After your baby is born there is accommodation at The Children's Hospital the cost and options available to you will be discussed by a member of our team.
Other useful resources
We recommend the following information sheets to family's in the NICU:
Our model of care
The Grace Centre’s vision is to Work with families to achieve the best for their child and every member of the Grace team is passionate about this responsibility and committed to achieving this. In Grace, our relationship with families starts from the moment their baby arrives. We work closely with the Pregnancy Support Network when the need for admission is detected during pregnancy.
Two units within the Centre provide different levels of care:
- 10 ventilator Neonatal Intensive Care Unit (NICU) beds for the most seriously ill babies; and
- 13 High-dependency Unit (HDU) beds for babies who don't need a mechanical ventilator, but whose complex conditions require close monitoring and observation.
Babies treated in NICU usually need:
- A surgical operation
- Support for their breathing via a ventilator due to prematurity, pneumonia, or surgery
- Diagnostic tests involving complex imaging with x-rays, ultrasounds, and other technological techniques.
- Special studies of body chemistry and cell biology
Our expert teams actively help strengthen the relationship between parents and baby. Despite being surrounded by monitors, leads and tubes parents play a vital role in providing care. As early as possible, parents are encouraged to be involved in their baby’s care, and our team will teach and resource you as required.
Our model of care is designed to support development by taking into account the potential implications of hospitalisation, delayed breast feeding, separation from mother, and repeated medical procedures.
Our NIDCAP certified professionals lead the developmental team to meet the needs of sick and premature infants and their families. They're available to discuss your baby’s development, explain behavioural cues and to assist participation in goal-setting for your newborn.
Being discharged from Grace is a happy, though sometimes stressful, time for families.
We work closely with families to ensure that they are well prepared and can confidently and comfortably care for their baby at home. This includes careful instruction on how to use specialist equipment and, if required, how to prepare and give medications.
Our Going Home booklet contains useful advice and suggestions, and includes helpful tips, tools and things to remember, like:
- having your infant car seat fitted by a qualified professional before discharge day
- settling your baby into a good sleeping routine may take some weeks
- always washing hands and making sure visitors do the same before holding your baby, and other ways to reduce the risk of infection
- avoiding large crowds for one to two months after discharge, especially during the cold/flu season
- information about Sudden Infant Death Syndrome (SIDS)
- what to do if baby gets sick
There’s information and descriptions about feeding and settling, communication, play and development, a list of useful contacts, as well as some important advice about ‘self-care’ for parents, including:
- take it one day at a time and try to plan for periods of sleep and rest
- use exercise to relieve stress and tension; even walking helps
- eat a balanced diet. Limit junk food. Drink plenty of water
- don’t try and do too much, avoid doing non-essential household jobs
Grace development clinic
With the increasing complexity of conditions being treated in the Grace Centre combined with improving survival rates, a demand for follow-up support and community care has emerged. Although the average length of stay for a baby admitted to the Grace Centre is 12 days; ongoing care and support continues long after discharge. Two thirds of babies treated in Grace return to the follow-up clinic.
The Grace Development Clinic is a specialist clinic—available by referral only—for babies after they leave the Grace Centre. This includes babies who have significant neurological problems, seizures, meningitis, lack of oxygen to the brain, brain haemorrhage, or who have cardiac disorders, undergone surgery, breathing abnormalities, or have metabolic disorders that may cause a risk to their development.
Because these babies have complex medical conditions, a developmental program is started during admission and the follow-up clinic team will make arrangements for support after discharge.
The Grace Development Clinic focuses on neuro-developmental assessments, early detection and referral to early intervention, and ongoing support designed to help these babies reach their developmental potential.
12 months and three years
Repeat Bayley Assessment and medical examination
For families who don’t live locally, our specialist team will make contact with the baby’s local NICU, GP and/or paediatrician and will link the family with community health services including Occupational Therapy, Physiotherapy, Speech Therapy, Early Intervention programs or other diagnostic services closer to home.
Acute Review clinic
Designed to facilitate early discharge from the Grace Centre, our nurses work closely with parents to help them transition smoothly to home and into the support of their local community services. Before your baby is discharged your initial clinic review will be arranged to provide ongoing support with weight management and feeding advice including linking with lactation and dietician services as required.
The Acute Review Clinic attend to blood work, ongoing review of wounds and clinical assessment for the period between discharge and your transition to community health services.
In recent years survival rate of babies in the Grace Centre has increased to over 97 per cent. Despite this, not enough is known about the long-term effects of serious illness, congenital heart disease and complex surgical interventions on young lives.
The Grace Research Unit is a lead academic and clinical neonatal research unit with a commitment to multi-disciplinary research.
The Centre successfully supports a Nursing clinical research program, Medical honours students, Registrar/Fellow college projects and Masters and PhD researchers.
Our researchers collaborate with colleagues in multiple departments within the Sydney Children’s Hospitals Network, nationally and internationally and present at national and international conferences. As a centre of excellence for neonatal research, we are committed to research that will further our knowledge and challenge clinical and educational practices to improve the way we treat and care for newborns.
With the ultimate aim of ensuring that babies go home as healthy as possible and with the best chance of a bright future, members of the Grace Research Unit are actively engaged with:
- Cerebral Palsy Research Institute (Chair). The Cerebral Palsy Research Institute has recently joined the Grace Centre Research Unit as part of the Discipline of Paediatrics and Child Health at the University of Sydney to further build capacity to improve the lives of young babies and their families.
- International Multidisciplinary Prevention and Cure Team for Cerebral Palsy (IMPACT for CP) Steering Committee
- Newborn and paediatric Emergency Transport Service (NETS) Research Committee
- Postgraduate Research Students’ Conference Organising Committee
- SCHN Research Advisory Committee
- Scientific Advisory Committee
- Early Career Researchers Committee
The 2018 Grace Research Report has more information about our published research, ongoing studies, student projects, grants and awards.
Building on success
We have an international reputation for providing leading-edge training to doctors from medical facilities around the world, and to nurses and allied health professionals passionate about pursuing this vital field of clinical care.
We are a NIDCAP training centre and in 2018 will establish our own NIDCAP training program inviting applications from health professionals across Australia.
We provide ongoing neonatal intensive care training for medical practitioners and nurses.
We have a wonderful team. The Grace Centre for Newborn Intensive Care is managed by a trinity of co-heads.
- Prof Nadia Badawi, AM – Neonatologist and Medical Director of Grace and Chair, Cerebral Palsy Alliance
- Ms Angela Casey – Nurse Manager
- Dr Robert Halliday – Neonatologist
They work together to lead a passionate, experienced and highly skilled multidisciplinary team which include:
Neonatologists are paediatricians specialising in saving the lives of critically ill newborns. Medical problems in premature and newborn babies can create challenges when vital organs are not developed adequately to function without intervention. Neonatologists evaluate and treat these medical problems.
Our nurses are specifically trained to care for neonates and premature babies with complex needs. They are experienced in interpreting the silent signals and gestures of critically ill infants and support parents in caring for their baby.
The neonatal nurses administer medications, perform complex procedures, work with sophisticated technology, and consult with a multidisciplinary healthcare team to co-ordinate all aspects of the baby’s care. Our nurses understand the fears and anxieties experienced by parents and provide emotional support and reassurance.
Allied health professionals
Providing essential service to our patients and their parents, our physiotherapists help with handling and positioning advice, respiratory care and assessment of musculoskeletal, neuromuscular or genetic conditions.
Speech therapists work closely with babies to develop pleasurable experiences around feeding and provide stimuli to help them learn to feed.
Occupational therapists help each baby to bond, explore their environment and engage in care activities such as a nappy change. They teach parents how to help their baby be comfortable, and provide development intervention when parents can’t be with their baby.
A lactation specialist is a certified nurses who advises, guides and helps with breastfeeding and expressing. They can provide support to help mothers successfully breastfeed while in hospital and continue when discharged home. Our lactation nurses work with new mothers on all aspects of feeding for each baby, which may include fluids and a nutrition through nasal or invenenous drip, or a gastric tube that carries milk into the baby’s stomach.
Our staff are trained and experienced in assisting families with a baby in intensive care. Focused on supporting the emotional wellbeing of parents, social workers can help with antenatal support, family relationship concerns and accessing support services in the community. Social workers advocate for families, and are there to provide grief and bereavement support to families in cases of the death of their newborn.
Coming from all professional disciplines, researchers bring together a broad range of expert knowledge, experience and care in this complex environment.
Their reasons are many and varied, but those inspired to support and fundraise for the Grace Centre are inspired by the common goal of improving each baby's and family's journey.
We welcome this opportunity to publicly recognise their contributions and share their remarkable generosity of spirit.
Pepper’s inspiration to support Grace was ignited 11 years ago by her daughter’s unexpected admission.
"A bed shortage at the time meant an agonising wait of several days before transfer, which was extremely tough. It was obvious that there was a need for more beds and for the many resources needed to ensure the survival of these precious little lives. I immediately resolved to do whatever I could to help."
Pepper’s personal message for families in Grace is: "You’re in the best possible place where the highly skilled people caring for your baby are the best of the best."
Lisa’s inspiration to support the Grace Centre is her precious little boy who needed intensive care during the first few months of his life.
Lisa says that being part of the Grace Gala Committee she sees first hand how vital equipment and expanded research is delivering improvements in care and better outcomes for babies and their families, now and into the future.
Lisa’s personal message for families in Grace is: "Enjoy every cuddle and moment with your precious baby. This may not have been the start you planned for you and your baby, but know you are in great hands at Grace."
Angela had heard about the Grace Centre at The Children’s Hospital at Westmead but it wasn’t until her daughter Amelia arrived in 2007 that her awareness of the skill and dedication of the Grace team was truly appreciated.
"Knowing Amelia was now in the best hands immediately helped us relax."
Angela’s personal message for families in Grace is: "It is perfectly natural to feel scared and unsure but know that you are in a wonderful place with the most knowledgeable experts caring for your precious bundle."
Megan is a close friend of Nadia Badawi and accepted an invitation to attend the Grace Gala. Seeing the wonderful work being achieved Megan says she felt duty bound to help fundraise for the purchase of life saving equipment.
"The Grace Gala Committee members share the common goal of making Grace a leader in newborn intensive care with state-of-the-art equipment and treatment modalities."
Megan’s personal message for families in Grace is: "Regardless of how desperate things may seem, be assured that each staff member will treat your precious baby as if they were a member of their own family. They are treated with dignity and the best of medical care."
The Grace family, particularly Megan’s late husband’s mother, Mrs B.A. Grace, are long-time supporters of the Grace Centre. When her husband died, Megan and her son toured Grace and saw first hand the wonderful work being done.
As a Grace Gala Committee member Megan says "It is a privilege to work with such a wonderful group of people all dedicated to helping raise money for Grace and for vital research."
Megan’s personal message for families in Grace is: "It’s a difficult time for any family with a baby needing urgent medical care, please take comfort in knowing that you are receiving the best care possible."
Fiona was approached by Rob White CEO of Cerebral Palsy Alliance to support the Grace Centre for Newborn Intensive Care in 2014.
Fiona says her fellow committee members are a constant source of inspiration. "They have experienced first hand the heart wrenching loss of a baby or have faced the challenges of caring for a very ill baby and it is my privilege to support them."
Fiona’s personal message for families is: "Know that you and your baby are cared for deeply and can feel safe and secure in this unique environment where every baby receives outstanding care. The professional support provided is magnificent and level of skill exceptional."
When Alicia’s son was born she didn’t want another family to endure the same heartache and was determined to make a difference. Today she attributes her inspiration to devote her tireless energy to supporting the Grace Centre to Lachlan and the care he received 14 years ago.
Alicia’s message for families who find themselves in Grace is: "Don’t be too hard on yourself. You are going through a very traumatic experience; there is no right way so just find your way of handling things. Take breaks when you can and be kind to each other. Ask lots of questions, no question is silly, and remember that the Grace staff are there to help."
Parent Advisory Council
Established in 2005, the Grace Centre for Newborn Care Parent Advisory Council offers a voice and advocacy role for families of babies treated on the unit. Recognising the important role that families play in our family-centred approach to care, membership to the Council offers them an opportunity to provide input, feedback and suggestions about existing policies, procedures and practices as well as views about new initiatives being considered for implementation in the unit.
Grace Centre staff or current members of the Council identify prospective members who undertake a recruitment process that addresses respect for diversity and differing opinions and the importance of confidentiality.
Membership is offered for a minimum of 12 months, although many representatives choose to continue on the Council for longer periods. New members serve a three month probationary period prior to membership being reviewed by the Council.
Members assist with the development of information and educational resources and can also volunteer to support our Grace Gala Ball including participation on the Gala Committee and helping raise awareness and support from corporate supporters.
Although communication is generally by email, the Council meets face-to-face quarterly, setting annual goals early in the calendar year, with extraordinary meetings conducted if required.
Like more information?
Contact Kerry Everson on (02) 9845 2715.