Early Days

If you have stitches there is usually some swelling for a day or two after the birth and this can have a pulling sensation. You should soak in a bath as often as you can and within 3-4 days after deliver they will be much less sore.

Bleeding should lessen considerable within the first three days after delivery and slowly become darker in colour before fading to light. After you go home you may experience episodes of bright red bleeding when you exert yourself or when you breast feed your baby. As long as bleeding is not excessively heavy you should not be concerned. You may pass some clots of blood which collected inside the uterus before being expelled and they are not very significant. Sometime a painful contraction of the uterus is followed by a blood clot or a gush of red blood.

It is not unusual to get baby blues around the third day after delivery. You may be very weepy for no reason and often if you have not slept enough. These weepy feelings usually go away after a few days but if they don’t you may be at risk of post natal depression so please talk to your GP. The most important thing about post natal depression is to recognise that you might have it. Denial can cause terrible problems for you and your family and might delay correct treatment. The causes of post natal depression are many and varied but a cure is available to everyone.

These are cramp like pains caused by the uterus contracting back to normal size after the birth of your baby. After a first baby the pains are usually mild like period pains but after subsequent babies the after-pains can be more severe. Pain killers will help.

Your new born baby will be given a routine examination by the paediatrician prior to discharge. The purpose is to establish if your baby is healthy and normal internally and externally. The external points include their skin facial structure eyes limbs and hips. The internal points are the heart lungs abdomen and brain. It is very reassuring when this examination confirms that your baby is healthy, if any problem is identified it can be dealt with quickly.

Vitamin K will be given to your baby soon after birth. This is a substance which is necessary for normal blood clotting. If levels are too low the baby is prone to develop the bleeding condition ‘haemorrhagic disease of the new born’. It is given by injection to all babies within 24 hours of birth.

At birth a clamp is placed on your baby’s umbilical cord close to where it enters the tummy and the remainder piece of cord is cut off. This remaining stump quickly involutes (shrivels) and the clamp is removed on the second or third day. The remaining piece of cord continues to shrivel and it usually separates away completely by the end of the first week. The midwife will show you how to care for the cord by cleaning it with cotton wool and water.

The heel prick test is performed on all new born babies. It is a screening test to detect rare serious disorders all of which can be treated successfully if picked up quickly after birth. The 2 most common ones are hypothyroidism (1in 3000) and phenylketonuria (PKU) (1in 7000). The process involves taking a blood sample from your baby’s heel. The timing of the sample is critical. The sample is obtained on day 4 if bottle feeding and on day 5 is breastfeeding.

A small amount of blood is obtained from your baby’s heel and the blood is absorbed on to a specially designed card which is sent to the central screening laboratory. If any abnormality is detected you will be contacted immediately by the hospital or your GP.

Jaundice is a yellow discolouration of the skin and is commonly seen in new born babies. It is due to a substance called bilirubin which is formed from the natural break down of red blood cells. This bilirubin is handled and disposed of by the liver. In new born babies the liver is sluggish and the bilirubin collects in the blood. In most cases the jaundice is harmless and settles in a few days. However, on rare occasions excessively high levels can cause deafness and a variety of other problems. If there is a suspicion of jaundice a sample of blood will be taken to check the level. If the level is high your baby will be treated by phototherapy which helps to eliminate the jaundice from the body. This is a simple safe technique. A special ultraviolet lamp is place over your baby who is only wearing a nappy. The treatment usually takes 24 – 48 hours.

Sticky eyes or conjunctivitis is very common in the first few days after birth. A new born baby produces very few tears. In the absence of tears the eye is very prone to infection because tears have irrigation and antiseptic properties. The infection is usually mild and treated by cleaning with cotton wool and water. If the infection is severe or persistent the doctor will prescribe opical eye drops or ointment.

Sometimes the eye infection is due to a blocked tear duck. While this is not a serious problem, it means that the eye will remain sticky on and off over a period of a few weeks until the duct opens up. You should continue to clean the eye with cotton wool and water.

Thrush is a white coating on the baby’s tongue and the inside of the cheeks.

It is not serious or painful and should not interfere with feeding. It should not be confused with the white discolouration on the tongue which is simply due to the fat in the milk. Thrush can easily be treated with a preparation from the chemist. Thrush can also cause a nappy rash. This rash is dull red in appearance with small broken areas of skin; again treatment is easy and can be obtained from the chemist.

Pelvic floor exercises are essential. The pelvic floor muscles stretch and weaken as the baby grows during pregnancy. This can put women at risk of incontinence during pregnancy, as well as incontinence and prolapse problems later in life. Exercising these muscles as soon as possible after the birth will help to reduce swelling and pain and assist in the overall recovery of the pelvic floor.

The physiotherapist can help mothers to develop a plan to get back into shape, and provide information on general exercises, good postural habits and specific exercises to strengthen back and abdominal muscles following the birth.

Most mothers go home 2 or 3 days after the birth but if you had a caesarean section you may need to stay a few days longer. It is important that you feel confident about your baby.

Before you leave the hospital your baby will be weighed. Don’t worry about a little weight loss this is normal and due to your baby getting rid of excess water. Up to 10% of the baby’s body weight can be lost. After 4 days the weight loss stops and by days 7-10 birth weight will be regained. After the first 10 days there should be a steady weight gain of 180g (6ozs) per week.

Before you go home the baby’s umbilical cord will be checked to ensure it is shrinking.

You should use a suitable correctly fitted car seat to take your baby home and do not place the baby in the front seat if your car has an air bag fitted on the passengers side.

The first few days at home with your new baby especially if it is your first baby are tinged with a mixture of excitement and anxiety Looking after a baby is hard enough, but most new parents also have to think about household chores, or seeing friends and family – all the things they did before. You may also have older children who will need your attention and understanding as they come to terms with the new baby.

In the first few weeks, try to cut down everything to a minimum of just looking after your baby, while someone else shops for food, cooks and washes. If you stock up the cupboards or freezer when you’re pregnant, you’ll be thankful later.

Decide what is important to you, and try to ignore the rest. You may feel better if you make a list of things to tackle when life has settled down again – although this could be some time.

• Decide on your priorities – write them down and keep the list where you can see it
• Set yourself realistic goals – they may be very limited at first
• Keep a store of nappies and change of clothes in each room where your baby is during the day and night
• Accept offers of help from visitors. Let them wash up or do the ironing. You don’t have to let them cuddle your baby while you do the chores
• Putting your baby into a baby sling tied onto your front can help. Make sure you choose one that gives you and baby good support

Most parents say they never could believe how exhausting a tiny new baby can be. Going without sleep or having your sleep disrupted can be physically and emotionally draining. And sometimes, it might feel like your baby just doesn’t want to sleep, despite everything you try. This can be particularly stressful if you are returning to work, and for partners who are working and trying to avoid having disturbed sleep.

It is important to keep in mind that your baby’s period of sleep disruption – however difficult and tiring – won’t last forever. If you have disturbed nights, getting through the day can feel like a hard slog. You could try the following:

• If you can, sleep during the day, when your baby does
• Don’t worry about non-essential jobs around the house, and accept help from family and friends when it’s offered – or just ask them
• Take extra care of yourself in the daytime with nourishing food, gentle exercise and as much rest as possible
• If you are finding it difficult to sleep when your baby sleeps even though you feel exhausted, talk to your GP, as it could be an indication of postnatal depression

The early days are hard for partners too. Although they can provide essential support by cuddling baby, providing food, cleaning up and keeping visitors under control, they may feel overwhelmed by the changes, sidelined and left out sometimes.

Becoming a parent can put a strain on relationships, regardless of what they were like before. This can be your relationship with your partner, friends or family members. But there are ways to work through difficult times and stay close to your loved ones.

Keep talking to each other about how you’re feeling and this will help to understand each other better.

All babies have the same pattern of activity:

• Sleeping
• Gradually waking up
• Crying for a feed
• Being alert and playful
• Followed by a further period of sleep

The problem is that individual babies spend different amounts of time at each of these activities.

When your baby is crying more than sleeping parents quickly become worried drained and exhausted. The important issue is whether the baby is well or ill.

If your baby is feeding and keeping the milk down this is reassuring.

The nature of the cry is helpful.

Healthy babies have a loud vigorous cry; sick babies have a lower pitched whimper.

Healthy babies have a pink colour sick babies have a poor greyish colour.

Trust your instincts, if your baby is out of sorts and different to previously call your doctor.

(Getting your baby to sleep, see section Caring for Your Baby)

During the first week you will quickly get to know your baby, all babies have their own likes and dislikes – personality starts on day 1.

A baby will prefer to be held in a certain way, fed a certain way, played with at certain times and left to settle at other times.

Babies will quickly grasp the feeding routine and hopefully the difference between day and night.

Your new born baby has a vast array of non-verbal skills which will be used to constantly communicate with you. For example the way baby looks at you and certain body movements.

Within days your baby will recognise your face and voice and when you make faces will try to copy you.

Your baby will make little noises to attract your attention and will stare intently at you.

You will probably be able to detect a smile from three weeks onwards.