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Aileen Keigher, Midwife
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Midwife & School Nurse, RGN/ RM
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Newborn baby care

Coming home from hospital

In the past, new mothers spent around 10 days in a hospital recovering from the birth and getting help with the baby. Today both new parents and hospitals can be over eager to discharge newborn babies.
In Short
Try to get as much help as you can from midwives and healthcare professionals in the maternity hospital to help you with breastfeeding your baby. It can be harder to get support when you are home alone. You should be provided with contact details of where to get help should you need this when you are at home.

Whether you had a vaginal birth or a caesarian delivery, be kind and gentle with yourself and give yourself time to recover physically and emotionally.

Get as much practical support as you can to help with household chores and looking after other children so that you can concentrate on getting to know your new baby and all the care he needs.

When can I come home?

All being well it may be possible to go home a few hours after the birth. If there are any concerns you may stay a day or two. If you’ve had a caesarean, provided your baby is well, you will generally be discharged after around three days.

You will be given your handheld notes to hand over to your community midwife when she does a home visit. You may be given a copy of the letter with details of your baby’s birth for your family doctor (although this may be sent directly to your doctor). You will be provided with instructions on how to register your baby’s birth, which you are legally required to do before they are six weeks old.

Before you and your baby can be discharged:

  • A hospital paediatrician or specially trained midwife check out your baby for any signs of infection, developmental problems or ill health. If all is okay, he will be formally discharged.
  • An obstetrician or midwife will assess you. She will ask if you’ve had a wee, check your womb is returning to its pre-pregnancy size by feeling your tummy, examine your stitches (if you have any) and take your temperature and blood pressure. If all is okay, you will be formally discharged.
  • Your baby will have a routine hearing screening test to rule out hearing impairment. In some areas, it will be done by a healthcare assistant or health visitor within a few weeks of you coming home.
  • You will be offered vitamin K for your baby to help his blood clot properly to prevent bleeding into the brain. If you consent, your baby will receive an injection or oral dose of vitamin K; if you have it orally then you need to take two more vials of vitamin K home with you. One to be given at one week, the second to be given at one month after birth.
  • If you are breastfeeding make sure that you have had support and had a couple of latching on attempts and feeds before you leave. Help now can really help you to establish breastfeeding and avoid a poor latch and of pain and discomfort for you and poor feeds for your baby. Make sure you have contact details of where you can get help with breastfeeding when you go home.

Bringing your baby home from hospital

Unless you can push your baby home in a pram or carry him in the baby sling on the bus, you will need a car seat for your baby suitable for a newborn. Before your baby is born, have a few goes at practising attaching the car seat. Prepare for a slow and momentous drive home as (especially for dads) this is often when it sinks in that you are utterly responsible for the care of your new baby. Most new mums cannot wait to get home from the busy postnatal ward. Make sure that you have planned and got support lined up from your partner and family as the first days at home can be a tough transition.

Will I get help from the community midwife?

Depending on your hospital trust and whether or not this is your first baby, you should receive some visits from your community midwife/support worker during the first 10 days. You may also are asked to attend a postnatal clinic but do let your midwife know if you are unable to do this. She will check that your baby is doing well, offer support with feeding and make sure you are recovering from the birth. She will weigh your baby at least twice during this period (more if the baby has lost a significant amount of weight) confirm your baby is regaining her birth weight (most babies lose a bit of weight in the first days after the birth). Write down any questions you want to ask before she comes just in case you forget something. Your midwife can help you with:

  • Latching on properly and establishing breastfeeding.
  • Bottle and formula feeding advice, if you choose to bottle feed.
  • Everyday care and safety advice such as cord care, bathing and cleaning your baby, nappies, and poo questions, sleeping and SIDS advice.
  • Your own feelings and needs after the birth so let them know if you are feeling particularly low.

When you and your midwife are happy, you will then be discharged her care and passed over to your community health visitor.

Recovering from a C-section

It can be a shock to try and sit up after you’ve had a caesarean as the muscles you use to sit up have been cut to deliver your baby. However, it’s important (and you will be encouraged) to get up and about as soon as you can after the birth, but it’s normal to feel a little shaky the first time you wee, poo or have a shower. At first, you will need to gently support your scar when you do go to the loo or feel a sneeze coming on as it will hurt.

Once the dressing has been removed (usually in the shower), you will need to keep the scar clean and dry (after showers) and look out for redness, puss or signs of infection. Depending on the kind of stitches or staples your surgeon used they may need to be removed after about a week; your midwife can do this when you are back at home.

A caesarean section is major abdominal surgery so be gentle with yourself after the birth. Rest as much as you can. No heavy lifting or hoovering and don’t go up and down stairs too much. Check your car insurance as you may not be able to drive for a few weeks.

Postnatal pilates and yoga can help rebuilding your core muscle strength, which is particularly helpful after a caesarean. It’s a good idea to check with your doctor before you start exercising and wait until after your 6-8 week check up.

How will I cope at home in the early days?

These first few days and weeks with your baby are all about bonding, getting to know your baby and learning to be a parent.

The early weeks after having a baby can be overwhelming and prepare to feel exhausted a lot of the time. Don’t be in a rush to get back to normal too quickly as this is a special time for you to adjust to being a new family. Your body has been through a life-changing experience – they don’t call it ‘labour’ for nothing! We would recommend that you keep things simple, stay in your nightclothes if this helps you, ask family and friends to take over domestic chores. You will quickly exhaust yourself if have to look after lots of guests and get out and about. Try to keep visitors to a minimum and accept all offers of help. Try also not to pass your baby around for all visitors to hold as this can be very unsettling so try to keep this to close family members only while your baby is getting used to the world.

Stocking up on freezer meals or asking family and friends to bring food can help ensure you are fed in those early weeks. Getting and/or having a stock of clean clothes before the baby was born should now leave you time to:

  • Recover from the birth, both physically and emotionally
  • Establish breastfeeding
  • Get to know your baby with lots of skin-to-skin contact and cuddles, which will help you bond and relax.
  • Catch up on rest and sleep and enjoy your baby.

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I am feeling overwhelmed is this normal?

The baby blues are a very common phenomenon where new mums feel overwhelmed, tearful and sad. This tends to happen around three to four days after your baby is born and coincides with a huge drop in progesterone levels in your body (much bigger than that observed around pre-menstrual syndrome to give you an idea of the hormonal change you are experiencing).

You will also be tired and still not recovered from the birth so be kind to yourself at this time. Speak to your midwife or health visitor if you start to feel depressed. These feelings are very common in the tough first weeks with your baby. If you think that your depression is more than baby blues, talk to your health visitor or family doctor about postnatal depression. Around 1in 10 women go on to experience postnatal depression and they are there to give you the help you need.

Testing your baby for serious illness – Heel prick test

About five days after the birth, your midwife will do a heel prick test to test for up to nine serious but rare illnesses, many of which can be improved if treated early. A little spot of blood is taken from your baby’s foot and taken away for analysis. The test includes screening for:

  • phenylketonuria (PKU)
  • cystic fibrosis
  • sickle cell disease
  • congenital hypothyroidism
  • thyroid hormone deficiency.
  • medium-chain acyl-CoA dehydrogenase deficiency (MCADD) tested in some

If any of the tests come back positive, you will be contacted by your doctor.

If you are based in the USA, your baby will be screened for a greater number of rare illnesses, up to 77 conditions and rare diseases. This depends on which State you live in.

DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.