In a hospital ward that routinely achieves the incredible for some of the country’s poorliest babies, it can be the small moments that count.

The Neonatal Intensive Care Unit at Birmingham Women’s Hospital has no shortage of heart-rending stories in its 41 cots.

The unit, which opened in its present form in 2010, cares for about 950 babies a year and is frequently over-capacity.

Of the cots, 21 are ‘high dependency’, or the highest level of intensive care, including babies that need help breathing or have heart problems.

Behind the almost 7,000 admissions are myriad extraordinary stories of care, love and medical science. Some have gone on to influence international clinical practice. Other are simply remembered in small gestures, such as a former baby saying ‘hi’ to a nurse in the street.

Rhian Hughes

"It’s a very difficult job, a very emotional job and it’s hard to close the door at the end of the day and leave."

Rhian Hughes

Rhian Hughes, Clinical Education Lead, is among staff making the unit as festive as possible for babies transferred in from across the region and further afield.

“It’s a job you either love or hate,” Rhian said.

“It’s a very difficult job, a very emotional job and it’s hard to close the door at the end of the day and leave. You go home wondering what’s happening to a baby. It’s a job you can’t leave.

“It’s small moments that you wait for. What gets me always is when a dad cries.

“You can deal with crying hormonal mums, but when a dad cries it really gets me.

“Another moment is when a visitor comes in to the clinic and remembers you doing this or doing that. The baby might be a toddler but you recognise the parents. So many parents come back on birthdays and special days and remember what you did. It’s brilliant.”

To the families, Rhian and her team are nothing short of angels.

Every April for 20 years a bunch of flowers arrives at the clinic from parents whose baby passed away while at the unit, another of the small touches.

“I’m a mum and I remember the first time I heard my baby crying,” Rhian said.

“It was the best feeling in the whole wide world. To help mums through difficult births and difficult pregnancies so they can know that feeling too is priceless. For the babies that for one reason or another don’t make it, it’s about making that experience as positive as you can and allowing the parents to do the right thing in the right way and being flexible to their needs.”

“It’s a job where you go home and say I’m proud today" - Rhian Hughes

Among those who have expressed their gratitude in the most difficult circumstances was a teenage couple who lost their child but came back a week later to thank the clinic.

“They said how brilliant we had been and while you don’t do it for the thankyou, it’s lovely to know you have made that difference in what can be a traumatic time,” Rhian said.

“It’s a job where you go home and say I’m proud today. I’m proud to support and educate new staff into new jobs. I can’t see myself doing anything else.”

Mother and Baby statue at the Birmingham Womens Hospital
Mother and Baby statue at the Birmingham Womens Hospital

One of the most lasting examples of the work the unit does is when Rhian drops her eldest daughter off at primary school in the mornings. A schoolmate of her daughter was treated at the unit in 2014 and always says “hi” to Rhian, one of the nurses who cared for her.

It was only a chance conversation that led to the off-duty NHS worker and the girl’s mother realising the connection, since when they have become friends.

“There are births I can remember better than giving birth to my own daughters,” Rhian said.

“You remember the stories as if they were yesterday. There was a boy who was born on October 10 two years ago and I remember his delivery better than my own.

“I was invited to his Christening and his family have raised money for the unit.”

Christmas is as busy as any other day, with the difference being the families received donated presents and stockings with gifts.

Sharing the yuletide spirit fits with the newly-introduced concept of ’family integrated care’, giving parents the skills to look after their poorly babies.

Dr Gemma Holder

“Not only is our role to look after the babies but it’s to make families feel like families as well."

Gemma Holder

Dr Gemma Holder is a consultant neonatologist.

She said: “Not only is our role to look after the babies but it’s to make families feel like families as well.

“It’s incredibly important to remember that anything that happens over Christmas stays with you and if anything negative happens you’re going to be reminded of it every year.

“So anything at all that marks that time in a special way is important.

“The babies can be up and down and things can come out of the blue so it’s important to give the parents some positive memories.”

Whether at the school gates or as an infant heading home for the first time, the difference made by Dr Holder and her staff is not being forgotten.

The families

"The amount of hard work the doctors and nurses put in is totally underestimated as well as how passionate they are about their jobs" - mum Leah

Theo Parry, with mum Leah and dad David and big brother Oscar.

Theo Parry turns his head to look at the visitors arriving by his cot, his alertness showing his ongoing progress after arriving 11 weeks early.

His mother Leah was initially brought in to Birmingham Women’s Hospital as an inpatient after suffering medical complications during the pregnancy.

She was transferred to New Cross Hospital in Wolverhampton by ambulance as ‘high risk of delivery’ because there were no neonatal intensive care spaces available at the time. “It was a scary, emotional time,” Leah said.

“I had my other son Oscar at Birmingham Women’s Hospital and I feel comfortable and have great trust in them here. But New Cross were brilliant and they did everything they could, working alongside Birmingham Women’s Hospital, to get us back after Theo was born.”

Theo arrived by emergency caesarean section on November 20.

A week later mother and child were transferred back to the unit by the Neonatal Transport Service, which moves babies between neonatal units in the West Midlands.

Leah told how Theo had progressed. “You take every day as it comes,” she said. “It’s a bumpy road with some bad days and some great days. It’s an emotional rollercoaster.

“All of the staff here have been fantastic, both in caring for Theo and catering for my needs. The amount of hard work the doctors and nurses put in is totally underestimated as well as how passionate they are about their jobs.

Theo Parry with big brother Oscar

"They teach you how to look after your premature baby and are never off their feet making sure everyone is looked after.”

Nurses arranged for three -year-old Oscar to have pictures taken alongside his little brother, who is showing every sign of joining his family at their home in the near future.

Leah, 39, and husband David will spend Christmas with family at the unit, where visiting rules are relaxed for the day. “We hope that Theo will keep improving as he’s doing,” Leah said.

“He is making steady progress. It would be fantastic to eventually take him home but I’m in no rush. It will be when Theo is ready.”

Sebastian Luke entered the world around 15 weeks early, weighing 790 grams.

His parents Jenni and Jon have been ever-present at his side in the intensive care neonatal unit where their newborn arrived on November 12, before which she had been at a hospital in Worcester.

Jenni, together with husband Jon, who is self-employed, are living in family accommodation at the hospital and balancing work and family life with caring for their first child.

'The hospital give out beads of courage where parents can mark each milestone on a thread and it’s a nice way to mark things, good or bad.'

A week after the birth Sebastian was diagnosed with necrotising enterocolitis, a serious illness where the intestine becomes inflamed and starts to die. The infant needed four operations at Birmingham Children’s Hospital, three of them on his bowel and one to close a duct in his heart.

After a week Sebastian was transferred back to the unit, where the couple have spent five weeks living in family accommodation while caring for their child around the clock.

Father Christmas with baby Sebastian

While still on a ventilator, the tiny figure in the cot is recovering and his breathing has improved, though a long road remains before he can return to the family’s home in Worcester.

One of the highs so far was a visit from Father Christmas, arranged by the Noah’s Star charity, who stood over Sebastian’s carefully-regulated cot to give a festive message.

"Through it all, the staff, nurses and specialists have been amazing" - mum Jenni

“There are ups and downs, and even when very good things happen, it can all change in an instant,” Jenni said.

“One day you’re on top of the world and feeling great and the next day something happens and you feel awful again. How I feel is a reflection of how Sebastian feels and when people ask how I’m doing, it’s more a question of how he’s doing.

"It’s a long road ahead and you have to take things day to day.

“The hospital give out beads of courage where parents can mark each milestone on a thread and it’s a nice way to mark things, good or bad. I even put a bead in for the bad stuff. Through it all, the staff, nurses and specialists have been amazing.”

Dr Gemma Holder on ward

Sebastian’s parents have had sessions with a clinical psychologist who helps families in the neo-natal unit cope at what can be an incredibly stressful time.

Jenni, 30, is also able to stay in the hospital’s family accommodation, meaning she can deliver ‘expressed’ breast milk, which is delivered via a tube to Sebastian’s stomach, every two hours, and remain ever watchful at his side. Jon spends much of his time by his son but has to balance making ends meet in a self-employed role after his wife took maternity leave early.

Sebastian now weighs 1.3kg (around 2.14lb) and while there is a long road ahead, his family will remain at his side.