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Workplace support for parents with premature or sick babies

There are over 95,000 premature or sick babies born each year in the UK.

When a baby is born prematurely, or with health needs, it can be a difficult time for parents, and work may be the last thing they want to think about. This guidance provides important information for employees and employers in relation to preterm births or full-term births where the baby is sick. It sets out best practice guidance for managing employees in these difficult circumstances.


Pregnant employees and new mothers are entitled to 52 weeks of maternity leave, normally the earliest maternity leave can start is 11 weeks before the expected week of childbirth. However, leave will start the day after the birth if the baby is born early.

If an employed mother is off work for a pregnancy-related illness in the 4 weeks before the week that the baby is due, her maternity leave and pay will start automatically - regardless of what has previously been agreed in respect of start dates, and even if the employee has only been off work for a short period of time.

Even when a baby has been born prematurely, or is sick, the mother must notify her employer as soon as reasonably practicable that she has given birth, and provide the date that the baby was born.

What does premature birth mean?

The NHS defines premature babies as those born before 37 weeks gestation. There are 3 sub-categories of premature babies:

  1. Extremely preterm (before 28 weeks)
  2. Very preterm (before 32 weeks)
  3. Moderate to late preterm (32-37 weeks)

Some babies will be born full-term (37 weeks+) but sick. These babies may have an infection, need treatment for jaundice, or have been born with a condition which makes them sick or means that they require urgent and / or significant medical attention.

Specialist care is provided for premature or sick babies usually in a specialist new-born (neonatal) unit. Babies may be transferred to a different or specialist hospital if the treatment or specialist care they require is not available in the area where they were born.

Employee responsibilities - evidence of pregnancy and birth

MAT B1 Form

The MAT B1 certificate enables a pregnant women and new mothers to claim Statutory Maternity Pay from her employer or Maternity Allowance from the Department for Work and Pensions (DWP). It will normally be given to the mother around the time of her 20 week scan and it confirms the pregnancy; expected week of birth; or the actual date of the birth if completed after the birth.

Doctors and registered midwives must issue the MAT B1 form not more than 20 weeks before the expected week of birth. The form must be signed by a doctor or midwife, and handed to the mother's employer / DWP as soon as possible.

Payment of Statutory Maternity Pay or Maternity Allowance cannot normally start until the mother has given her employer / DWP certain information - which will usually be set out in the MAT B1 form.

For further information on the MAT B1 form click here

Supporting the parents following the birth

Sometimes the mother is unable to obtain and complete the MAT B1 form before the birth, for example if the baby is born prematurely or the mother and /or the baby is sick. This may mean a delay in getting the form signed and sending it to the employer / DWP. Therefore the mother will not receive Statutory Maternity Pay / Maternity Allowance until the form can be provided. Both parents can have significant extra expenses at this time, for example travel and parking costs connected to hospital visits and care costs for other children they have and who they are unable to care for themselves whilst their baby is in the neonatal unit. Employers should bear in mind that this is a very stressful time and consider helping their employee to meet these unexpected costs by providing a loan, advance of salary, or giving the employee access to any in-company schemes such as workers or benevolent funds, etc.

The parents may be unaware, or have forgotten, that the mother's entitlement to Statutory Maternity Pay or Maternity Allowance is based on the mother providing the MAT B1 form and employers should consider whether it would be appropriate, and helpful, to remind them. Employers should bear in mind that this is a very stressful time for parents and any communications regarding this or other matters should be approached sensitively and compassionately.

Communicating with the employee is important but it should be done with care. While congratulations may not seem appropriate, and each birth will be different, it's still important to acknowledge the birth of the baby. This acknowledgment may be in the form of a card to let the parents know their employer and colleagues are thinking about them at this time. Parents can often feel excluded because even once their baby is home no one talks about their child. Employers should ask parents if they are happy to be contacted and the best way to do this, eg by email, text or phone.

Employers should ask the parents what they would like them to tell their colleagues about the situation. Good support for parents can make a big difference and offers of support from colleagues could include: lifts to and from the hospital; home cooked food; or even help with additional childcare. Even a simple text or email showing support can mean a lot.

Fathers and partners of the mother may also need their employer to be flexible regarding them taking time off as they will want to support their partner as well as be with the baby at this difficult time. Employers may want to remind fathers and partners who are eligible for Paternity Leave and Pay that they can take this leave within 8 weeks of the actual date of birth or within 8 weeks of the date that the baby was due to be born if they prefer (as some fathers may prefer to take Paternity Leave after the baby is home).

Employers could consider ways in which they could help such as reminding their employee about their statutory entitlement to take: parental leave; paternity leave; special leave; or accepting a shorter notification period for shared parental leave.

The death of a premature or sick baby

Sadly, not all premature or sick babies survive and grief impacts on the emotional, spiritual and psychological well-being of the parents. Grief doesn't have predicted stages or phases and everyone reacts differently to bereavement, and this should be understood and respected by both employers and colleagues.

It is important to remember that the mother will still be entitled to take up to 52 weeks of Maternity Leave if she wishes, and up to 39 weeks of Statutory Maternity Pay (if she is eligible for pay). Where a baby is stillborn after 24 weeks of pregnancy, or if the baby is born alive but dies after birth, the mother still qualifies for her maternity rights. The woman's partner will be able to receive any paternity leave and pay they qualify for if their baby is stillborn after 24 weeks or is born alive but dies after birth.

For advice regarding Shared Parental Leave, see the section, Death of the child before or during birth, or within the first year, in the Acas guide, pdf icon Shared Parental Leave: a good practice guide for employers and employees [538kb].

Bereavement can be challenging to manage, however a compassionate and supportive approach can demonstrate that the organisation understands that the employee has been through an incredibly difficult time and will continue to deal with the loss.

pdf icon Managing bereavement in the workplace - a good practice guide [318kb]

This guidance aims to help employers manage this difficult situation through appropriate and sensitive discussions with their employee, both in the immediate aftermath of bereavement and in the long term.

Returning to work

Returning to work can be a difficult time as many babies born early or sick may have been in hospital for a while and parents may be worried or anxious about leaving them. This particularly applies if they have ongoing health or developmental issues which require frequent hospital appointments or make it difficult to find suitable childcare. Employers should recognise that the plans the parents had made prior to the birth with regard to returning to work may now have changed.

Employers should try to balance the needs of the business with understanding the pressures facing parents.

Employers can support employees by offering contractual benefits or allowing extended leave, this may be through:

Before returning to work the employee may wish to make a formal request for flexible working. There are many forms of flexible working, such as flexitime, part-time working or homeworking and employers must have sound business reasons, eg cost, for rejecting a statutory request for flexible working.

If a request is granted it would mean a permanent change to the employee's contract. However, employers could agree to an informal flexible working arrangement which could help employees settle back into work. An informal arrangement is whatever the employer and the employee agree between them but employers and parents may find it helpful to describe / record the new working pattern and the date it will start, and also how long this temporary change will last (or when it will be reviewed).

Shared parental leave and pay can help parents who wish to take time off later on as it enables eligible parents to take leave in up to 3 blocks - returning to work between periods of leave if they wish. If the parents are eligible for Shared Parental Leave and/or Pay the mother will need to end her maternity entitlement early, or commit to ending it, in order to create leave and pay which can be shared with the father/partner or taken more flexibly.

Good communications is the key to a successful return to work. A good working relationship between the employee and their line manager is `important. Managers could check on how the employee is managing after returning to work by holding regular review meetings.

Additional appointments following discharge from hospital

Following their discharge from hospital, premature and sick babies may need to be monitored and may require follow up appointments with the hospital, another specialist or their GP.