Midwife Anneke is sharing with you an insight into what happens once you’ve had your baby and those early days and weeks at home and how to make that transition to new parents as magical as it should be.
ON THE WARD
Once your baby is born you’ll be transferred to the postnatal ward until you can be discharged home. On the ward you’ll be encouraged to have skin to skin time and your midwife will be on hand to support you in feeding your baby, showing you how to change the first nappy and dress your baby (if wanted) either in a babygrow or a swaddle blanket. After the first feed, mum will need to rest up for a few hours, so dads, this is when you will need to step in and care for your baby.
Skin to skin is wonderful for bonding with your new precious little one as well as calming baby, providing thermal and breathing regulation and breastfeeding success.
After a straightforward birth you could be back at home in as little as six hours but normally you may find you stay in hospital for 24 hours. If you have a cesarean it can be a few days or longer.
It’s important to know that postnatal wards don’t really cater for the dads and most of the time dads will only have an armchair to rest in, so if you are both comfortable with the idea, and don’t live too far away, we’d recommend that dad goes home, so he can rest up properly and come back early the next day refreshed.
Also, whilst it is common for babies to be extremely sleepy the first night after they are born, by the second night they can be more alert in terms of demanding feeding. So, although it is a good idea for dad to get some rest the first night, be conscious that mum may need more support by the second. This is particularly true if mum has had any complications in the birth, and it still may be difficult for mum to be mobile or lift your baby on her own.
All parents are offered a thorough newborn physical examination for their baby within 72 hours of giving birth. The purpose of the check is to make sure your baby’s eyes, heart, hips and genitalia are normal. It is usually carried out in hospital before you go home. Sometimes it’s done at a community clinic, GP surgery, children’s centre, or at home. Ideally both parents should be there when the examination is done.
The role of the midwife on the postnatal ward is to support you and your family to care for your baby; giving information, advice and doing physical checks of both mum and baby to ensure that they are healthy and well. Don’t be afraid to ask for their help when you feel you need it, no question is silly. If you are breastfeeding make sure you ask the midwife to support you with the positioning and attachment - your baby should breastfeed at least eight times in a 24 hours period – until you are happy to do it on your own.
Most hospitals will offer a demonstration of how to bathe your baby. It is a really good idea to go to this or ask the midwife if they can show you as it will help you gain confidence when you return home and have to take on the task yourself.
You’ll be given a red book to take home which is your child’s personal health record. Please make sure you go home with one!
Most UK hospitals will discharge you once:
· Mum and baby are medically well.
· Newborn physical examination and a hearing check has taken place.
· If breastfeeding, a midwife has seen a good latch and the mum is gaining confidence.
· Baby has passed urine and opened its bowels
· You show there is a car seat to take baby home in.
· You have any necessary medication from the pharmacy ready.
· All discharge and birth registration paperwork is complete. This can sometimes take a long time and even if you are told that you are ready it might be a good few hours later until you will actually be discharged – try and be patient as postnatal wards are very busy.
· In some hospitals you also have to have a member of staff accompany you off the ward with your baby.
AT HOME
It can feel completely overwhelming when you have given birth but just remember that you are doing what millions have done before you (and will after you) and instinct really does help.
Try to limit the number of visitors you have in the first few weeks as you try and settle in together as a new family unit. It is a very special time to snuggle down and relish in your beautiful baby and you will have enough to do with learning to care for your baby and need all the rest you can get in these early days.
At home you will be visited by a midwife and a health visitor whose role it is to keep an eye on you and your baby (see timeline on the right). A postnatal visit will involve the following:
Mum check
Chat about emotional and physical well being
Blood pressure check
Chat about breasts and breast feeding
Palpation of uterus
Check of Perineal tear or caesarean section wound if applicable
Check blood loss is normal
Chat about urinary and bowel function
Check legs for swelling.
Baby check
Check baby’s skin colour, eyes, muscle tone, fontanelles (soft areas on baby’s head)
Chat about baby’s feeding pattern and length of feeds and how much baby is taking if being bottle fed
Check baby tummy button is healing
Check baby bottom (looking at the condition of the skin)
Chat about wet and dirty nappies.
Listed below are the minimum numbers of times that the midwife will come and see you. Note if more support is needed they will see you up to six weeks postnatal.
Within 48 hours of giving birth: Head to toe check of mum and baby including how baby is feeding and the emotional wellbeing of mum.
Day 5: Head to toe check of mum and baby. New Born Blood Spot Screening Test (this is a blood screening test offered on the NHS to check for some blood disorders). Weigh baby.
Day 10-12: Head to toe check of mum and baby and weigh baby.
Between arrival home and midwife discharge: Health visitor visit to come give advice on newborn vaccination programme and check up for baby.
6-8 Weeks: Have an appointment with your GP/Obstetrician for a check up of baby and you. This has to be booked in advance.
8 Weeks: Book an appointment with your GP/children’s centre for baby’s first round of immunisations.
12 Weeks: Book an appointment with your GP/children’s centre for baby’s second round of immunisations.
16 weeks: Book an appointment with your GP/children’s centre for baby’s third round of immunisations.
Every month or as wished: Attend health clinic for baby’s weigh in and chat with health visitor (if needed). Your GP or health visitor can advise on your local one.
Things to do when you are home:
Register your baby’s birth in the town hall of the borough/area that they were born in (you have six weeks to do this).Register your baby with your GP (you need your baby’s birth certificate to do this).Apply for your baby’s passport (you can travel abroad with baby once they are over two weeks old and this will last until they are five years old).Book your six-week postnatal check with your GP/obstetrician.
This post was written by midwife, Anneke Brown. She started her Postnatal Support company, Komu, with her fellow mum and close friend after realising the lack of support out there for new parents after they’d taken their little one home from the ward. Together they have created a range of Digital Kits for new mums and dads to access from the comfort of their own home. The Kit contains more than eight hours of comprehensive video and audio content including practical tools and instructional advice and tips from a group of 19 Midwives and postnatal support experts with decades worth of experience between them.
There are 31 videos, 42 audios and four support documents teaching you all about:
· On the postnatal ward and those early days and weeks at home
· Baby's health and wellbeing
· Learning how to feed your baby; breast, bottle and weaning
· How to get your baby to sleep and safely
· Postnatal fitness, yoga and wellbeing
· Maternal mental health
· Navigating relationship challenges
· Preparing your dog to meet you newborn