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After the birth of your baby

Congratulations on the birth of your baby!

While having a baby is a normal life event that is both exciting and fulfilling, at Mater Mother’s Hospital, we understand that after the birth of your new baby you may feel a range of different emotions. This brochure aims to ease some of your concerns, assist you in coping with the changes in your body and prepare you for your new role as a parent. It provides information relevant to your stay in addition to the things to expect when you go home. It is, however, only a guide as each woman and their family may require different information and care depending on their circumstances. If you have any questions, please ask your midwife, nurse and/or your doctor.

We encourage you to read this brochure as soon after the birth as possible and review the information daily.

Education

During your stay, midwives and nurses will provide education and information to enable you to confidently care for yourself and your baby. There are also a range of talks available for you to attend—your midwife or nurse can direct you as to the time and venue. We recommend that you attend as many as you can.

Educational programs are available on Channel 13. Please refer to the leaflet at the back of the bedside guide for program times and details.

Visitors

Visiting hours are from 10 am to 1 pm and 3 pm to 8 pm. Although this is an exciting time for you, your family and friends, you are encouraged to limit your visitors and telephone calls so that you have an opportunity to rest and to learn how to care for yourself and your baby.

Visitors should wash their hands before cuddling your baby. For the comfort and safety of yourself, and other patients, please ask your family and friends NOT to visit if they:

  • are sick
  • have an infectious illness
  • have recently had contact with infectious diseases (e.g. chicken pox, colds or flu).

Children must be supervised at all times. Noise levels should be kept to minimum for the comfort of other patients who may be unwell. There is a patient lounge located on each floor that you may use during visiting hours.

Rest period

We encourage mothers and their newborns to rest between the hours of 1 pm and 3 pm every day. Visitors will not be admitted to the wards during this time except for your partner or support person. Telephone calls will be diverted to the midwife’s staff base and we recommend that mobile phones are switched off.

Feeding your baby

You will have been provided with the Mater Mothers’ Hospitals’ booklet, A guide to breastfeeding, which contains detailed information to help you breastfeed your baby. In addition information, assistance and support with breastfeeding are available from the midwife or nurse caring for you and your baby. Breastfeeding talks are held every day of the week, except Sundays, at 10.30 am. Please ask your midwife or nurse for direction as to the location of these sessions. It is recommended that you attend a session as early as possible during your stay.

Mater Mothers’ Hospitals’ Breastfeeding Support Service, a service designed for breastfeeding mothers and staffed by lactation consultants, is located within the hospital. If you are having complex breastfeeding issues that cannot be solved by the midwife caring for you, they will organise a referral for you. If you are having concerns in your first few weeks at home, you can make an appointment to visit the centre on 07 3163 8847. You may also contact lactation consultants in private practice, the Australian Breastfeeding Association or your Child Health Nurse—please refer to the resource section of this document.

At Mater Mother’s Hospital we respect your right to choose how you feed your baby and will support you with guidance and advice whatever your decision.

Mother’s care

Normal vaginal blood loss

  • For the first two to three days after the birth, your blood loss may be like a heavy period. Over the next week the amount will gradually lessen and the colour will change from red to brownish/pink. Spotting can continue for four to six weeks after the birth and a small number of women may have a scant loss up to twelve weeks.
  • It is normal to experience period like cramps and slightly heavier blood loss during breastfeeding in the first few days.
  • If you pass any clots you need to keep these and show your midwife or doctor.
  • If you have a sudden increase in blood loss once you are home you need to see your doctor as soon as possible.
  • Do not go swimming until your bleeding has stopped.
  • Do not use tampons until after your six week check.

Perineal care

The perineum is the area of skin and muscle between the vagina and anus. At the very end of your labour these skin and muscle layers thin and stretch to allow your baby to be born. If you have had some form of perineal or vaginal tearing, or an episiotomy (a cut made into your perineum to enlarge your vaginal opening), the following recommendations will assist you to heal and become comfortable.

  • Use ice regularly, leaving on for 10 minutes at a time, and reapplying each hour as necessary for the first few days, or while it still feels helpful. Ice should be wrapped in a thin piece of dampened cloth and then placed on the perineum, or ice packs can be placed in the inside lining of a sanitary pad.
  • Keep the perineum clean by showering each day.
  • Change sanitary pads at least every four hours—this can help reduce the risk of infection.
  • Lie down for approximately 20–40 minutes in each hour for the first 24 hours, if you can, as this reduces any swelling and assists healing. Lying on your side is often more comfortable than on your back if you have any low back ache.
  • Resist sitting with crossed legs, or any sitting position that allows your labia to gape open, if you have a tear or stitches. This assists to reduce strain on your perineum or stitches.
  • Practice several very gentle pelvic floor “pulses” each hour without trying to “hold”. This helps to reduce swelling and promotes healing.
  • Move smoothly and carefully, avoiding any straining, holding your breath or lifting anything heavy—especially toddlers!
  • Be careful to draw in the pelvic floor before you go to move, lift, cough or sneeze—this will protect the perineum.
  • If you have stitches, they are dissolvable and will fall out between one to three weeks after the birth. You may find some stitches on your toilet paper or in the shower.

If you have had a third or fourth degree tear, you will be given Mater Mother’s Hospitals’ booklet, Recovering from third or fourth degree perineal tears—information for women and carers, which outlines recommendations for care in these situations.

Involution

  • By the end of the first week your uterus is nearly as small as it was before you became pregnant and has usually returned to its pre-pregnancy size by six weeks.
  • It is important to remember that your abdominal muscles have stretched to allow your baby to grow and may take several months to recover.

Bladder

  • You need to try to pass urine every three to four hours. Passing urine may be difficult after the birth because you may not be able to feel what you are doing.
  • If you have stitches or grazes, passing urine may sting so try doing this in the shower, leaning forward on the toilet or tipping warm water over your perineum as you sit on the toilet. Drinking water dilutes your urine which may also help.
  • Please tell your midwife, nurse, physiotherapist or doctor, before you leave hospital, if you:
    • are having problems passing urine
    • have little or no sensation when passing urine
    • have little or no control over the flow of urine
    • have problems controlling your bladder if you laugh, cough, or move suddenly.

Bowels

  • It is normal not to open your bowels for a few days after the birth; however your bowel motions need to remain soft and easy to pass as this allows stretched muscles and a stitched perineum to heal quickly and well. It is important to eat fresh fruit, brown bread and wholegrain cereals and to drink plenty of water.
  • When you go to the toilet use the lean forward position and use a clean pad to gently support your stitches. Do not strain—just relax and take your time. This remains important for at least six weeks after the birth while the affected tissues heal properly and is also a lifelong good habit.
  • Note: See the diagram included for the correct “lean forward” position. Remember to keep the curve in your back as you lean forward from the hips. Lean through your forearms onto your thighs. Come up onto the balls of your feet if comfortable. Allow your abdomen to relax forward and do NOT hold your breath or strain. A small footstool may enhance the position.
  • If constipation is a long-term problem for you, please discuss this with your doctor—a consultation with a dietician may be indicated.
  • Try not to strain as this may worsen any haemorrhoids you may have. There are ointments available from the pharmacy to aid in lessening the discomfort from haemorrhoids.

Pain management

You may require regular pain relief after the birth of your baby and the following are the most commonly used forms of analgesia that may be prescribed for you:

  1. Paracetamol with or without codeine: paracetamol is very effective for pain relief and lowering fever if given regularly. It is used to treat mild to moderate pain. Codeine is used for moderate to severe pain. Do not take more than eight tablets containing paracetamol in any 24 hour period as this can affect liver function. A side effect of codeine is constipation—please tell your midwife or doctor if you are concerned about constipation
  2. Anti-inflammatory tablets: diclofenac/Voltaren or ibuprofen/Nurofen may be required and are considered safe to take while breastfeeding. However they should not be used if you have asthma, high blood pressure, ulcerative colitis, Crohn’s disease or disorders of blood coagulation or if you are already taking the following medications—lithium, digoxin, antihypertensives, diuretics or anticoagulants. Please inform your midwife or doctor if you have any of these health issues.

After a caesarean birth please refer to Mater Mother’s Hospitals’ booklet, Caesarean birth information for women and carers.

If you have any concerns regarding your pain relief, safety of any medication or how the medication is affecting you, please speak to your doctor, pharmacist or Mater’s National Prescribing Service Medicines Line on 1300 888 763.

Physiotherapy

  • You can start to do gentle pelvic floor “pulses” as soon as it is comfortable as they will help you to move easily and recover quickly.
  • It is important that the muscles which form the deep muscular “corset” of your body (the pelvic floor and deep transverse abdominal muscles) start to work again as quickly as possible, because they support and protect your uterus, bladder, bowel, spine and pelvic joints and will help you avoid pain in the perineum, tummy and back.
  • After having a baby, you should always get in and out of bed on your side, as this reduces the strain on your perineum, back and tummy. If you have pain as you move be extra careful to get in and out of bed the right way.
    • Lie on your back with both knees bent up.
    • Roll over on your side without twisting too much.
    • With your upper arm well in front of you, push your upper body forward and up, as you allow your legs to go down at the same time.
    • Remember to keep breathing, keep your knees bent and come forward in one smooth action.
    • If you are able to gently draw in the pelvic floor before and as you get up, this may feel more comfortable
  • Always try to sit up tall (using good chair support when possible)—avoid sitting on the edge of the bed where your back has no support.
  • Make sure you keep your back straight, especially when caring for your baby i.e. adjust the height of your bed or change table, or sit or kneel down as this is better for your back.

Postural Stretches

Sit up well supported in a chair

  • Take a deep breath in and lift your chest as you breathe in. As you let go of your breath, release tension and let your shoulders go back and down.
  • “Roll” your shoulders forward, up, down and back.
  • With your hands on your shoulders, draw as large a circle as you can with your elbows. Slowly repeat three times in each direction.
  • Sit with the crown of your head as tall as can be. Tuck your chin under to create a “double chin”. Hold, then release.
  • Stretch shoulders and spine backwards using the chair as a “pivot”—place your arms behind the back of the chair, to assist with the stretch.
  • Sit tall, facing forwards. Slowly tilt your head over to one side, keeping your shoulders down. Pause, and then come up. Repeat to the other side.

Activity

  • When you go home, continue to do your Home Exercise Program that you started in hospital—postural stretches and gentle strengthening
  • Ensure that you move carefully and smoothly, drawing in the pelvic floor before and during movements, especially more strenuous activities such as lifting, pushing, coughing etc.
  • Return to all activities at home gradually, starting with short sessions only—as your muscles recover and get stronger, you will feel able to gradually increase your activities.
  • If the activity hurts or strains your tummy or perineum or you are holding your breath, stop what you are doing—this is not good for you.
  • It is very important to return to a general fitness program after having a baby. Because the ligaments and support structures of your body are not back to “full strength” for up to a year postnatally, it is important to choose from the many safe sports and exercise programs available, while avoiding a few “risky” activities.
  • Walking, swimming, aquarobics, Pilates and Fitball based programs, gym stations with light/medium weights, cross-training and cycling are all great.
  • If high impact is involved, try to avoid the activity. Even if you have strong muscles, your supporting ligaments may not cope with the sudden strain of high impact aerobics classes or jogging. Try social rather than competitive team sports.
  • A physiotherapist can help you make a good recovery and if further treatment is required an outpatient appointment can be arranged before you go home.
  • To assist your physical recovery the experienced physiotherapists at Mater Mother’s Hospital offer the following classes:
    • Firstly—physio postnatal review class
    • Secondly—mother-baby exercise class. Bring your baby. The first four classes are free.
    • Thirdly—Pilates back in balance postnatal class

It is recommended that you attend these classes in sequence. For more information, or to book for these classes phone 07 3163 8787

Diet

  • It is important to eat healthily after the birth of your baby, just as it was when you were pregnant. Your body needs food from all five food groups to help it recover from the birth.
  • When you are breastfeeding, eating “everything in moderation” is the general rule. Breastfeeding mothers often have large appetites and you need to satisfy your appetite with healthy food choices.
  • Thirst is also increased when breastfeeding but drink to thirst only. Thirst is satisfied best by water and not by soft drinks or juice. It can be useful to have a drink ready when you are feeding.

Postnatal feelings

  • Approximately 80% of women experience the baby blues around three days after the birth. Baby blues can be caused by hormone changes; tiredness; pain from stitches; a wound or full breasts or even feeling flat after all the excitement of the birth. You may feel anxious about small things and become very weepy.
  • Your partner can be most helpful by being supportive, listening to you and caring for your baby while you get some rest.
  • Some new parents find it difficult to bond with their new baby. You should not feel guilty if you don’t instantly bond or do not feel how you expected to. Your feelings will change and grow over time.
  • About 10–20% of women can go on to develop postnatal depression (PND) which may include one or more of the following signs or symptoms:
    • persistent low mood
    • extreme anxiety, confusion and panic
    • difficulties in sleeping or excessive sleeping
    • not eating or overeating
    • inability to enjoy anything or cope with routine tasks
    • inability to think clearly or make decisions
    • feelings of wanting to harm baby or self
    • wanting to run away
  • Postnatal depression is a treatable condition and it is most important to get help early. You can seek help through your midwife, GP, child health nurse, Belmont Private Hospital or Ellen Barron Family Centre. Please refer to the resources section at the end of this brochure for contact details.
  • It is also important to seek help if you found your childbirth experience stressful, disappointing or traumatic so please ask your midwife or doctor if you have any questions, regarding the birth of your baby. Approximately 7% of women develop post traumatic stress disorder (PTSD) due to the severity of distress they feel. Symptoms may include flashbacks, being on guard, nightmares, avoidance, depression and anxiety. For information about birth trauma contact the Birth Trauma Support Group or Birthtalk. See resources section at the end of this booklet for contact details.

Sex and contraception

  • Sexual relations can be resumed when you feel comfortable unless advised otherwise by your doctor or midwife.
  • Be aware that breastfeeding is not a method of family planning and it is still possible to become pregnant while breastfeeding.
  • Lactational Amenorrhea Method (LAM) is an effective natural method of family planning that research has shown to be more than 98% effective if certain situations exist (i.e. if you are fully breastfeeding, if you have not yet had a period, and your baby is less than six months old). A trained natural fertility consultant can advise you with this method of family planning.
  • There are other options for family planning which you can discuss with your doctor or a natural fertility consultant. If you would like assistance please contact the Natural Fertility Services at Mater Mother’s Hospital on 07 3163 8437.
  • If you have chosen not to breastfeed, are partially breastfeeding or are expressing for a premature or sick baby, ovulation may occur before the return of your period and therefore it is possible that pregnancy could occur anytime after your baby is three weeks old. Your first period may start as early as one month after birth or up to 12 weeks.
  • The longer it takes for your period to return, the more likely it is that you will ovulate before it does and so pregnancy could occur before having a period.

When to seek medical attention

It is important to seek medical attention as soon as possible if:

  • you have increased blood loss, with or without clots
  • your blood loss starts to smell
  • you experience high temperatures
  • you have increasing pain
  • you find a red, hard, hot area on your breast that does not clear with breastfeeding, with or without flu-like symptoms such as aches and pains and shivers
  • you have difficulty passing urine or a bowel motion
  • you have increased tenderness or swelling of the perineum
  • your abdominal wound is oozing fluid, or the skin is red or hot to touch (caesarean sections)
  • you have symptoms of postnatal depression.

If you are concerned in anyway about yourself or your baby you should seek medical attention.

Baby’s care

Rooming in

Mater Mother’s Hospital practices rooming-in—that is, allowing mothers and babies to remain together 24 hours a day. Rooming-in helps mothers bond with their babies and gain confidence in their care and research shows that mothers and babies who room-in get more sleep. A mother who is rooming in is able to attend to her baby when feeding cues are displayed, helping her establish a good milk flow by promoting milk let-down. This means you are less likely to have hard sore breasts, your milk supply will become established, and breastfeeding will get off to a good start. You also make antibodies from your own body and environment that you pass on to your baby through your breast milk. This means your baby is at less risk of infection in the first few days when they are in close contact with you.

Nappy changing

  • Gather everything you need and place it all within easy reach before you commence a nappy change so that you are not tempted to leave your baby unattended on a change table, for whatever reason.
  • The height of the change table or any surface used for changing or bathing your baby should be just under the level of your bent elbow, so that your back stays straight. Always keep one hand on your baby, especially as they get older and more “wriggly”. At this point you could consider changing baby on a lower surface or a change mat on the floor.
  • Encourage eye contact with your baby during nappy changing and with the nappy off, stroke across the chest and legs to encourage kicking and relaxation. You could use a little oil for this but that is optional.
  • For girls—wipe from front to back, wiping away any bowel motion or urine from their skin, leaving any protective mucous in the vagina. Baby girls can also have a small loss of blood from the vagina in the first week, like a small period. This usually only lasts a few days and there is only a very small amount of blood.
  • For boys—clean all around the folds of skin but leave the foreskin in place. If the foreskin is pulled back too early, scarring of the head of the penis may occur. The foreskin may take many years to roll down naturally. Boys can spray urine everywhere, so be very prompt when replacing the nappy.
  • NB: Some babies, both boys and girls can also have swollen breasts that feel quite lumpy and hard which may even ooze milk. Swollen breasts and vaginal blood loss in babies result from the hormones passing from the mother to the baby before birth. They are of no concern and usually resolve quickly.

Normal infant urine and bowel habits

Urine

  • You could expect that your baby will have one wet nappy on the first day, two on day two and three on day three, and so on until breastfeeding is established. Then you would expect approximately six to eight wet nappies per day, with the urine a pale yellow in colour.
  • If using disposable nappies it can sometimes be difficult to tell if the nappy is wet—feel the front and bottom of the nappy to check the crystals inside the nappy—if wet, they should feel full.

Bowels

  • Your baby’s first bowel motions, called meconium, are black/dark green in colour and should occur within 24 hours of birth. After a few days of feeding the bowel motions change colour to brown/green and then to a yellowish mustard colour which is loose with small curds in it like cottage cheese.
  • Your breast milk contains natural laxatives which prevent constipation. In the early days babies may have a bowel motion with every feed but this will slow down. The normal range of bowel motions is eight per day to one per week. If you have any concerns contact your midwife, doctor or child health nurse.
  • Formula fed babies are more prone to constipation. If this is a problem please seek assistance from your midwife, child health nurse or doctor.

Bathing

  • Gather everything you need and place it all within easy reach before you start bathing your baby. Never leave a baby alone in the bath.
  • The temperature of the bath should be warm but not too hot. You can place your elbow or wrist in the water to check the temperature—if it is comfortable then it should be suitable.
  • Babies may only need to be bathed every second day in cooler weather but in warmer months a daily bath is recommended.

Cord care

  • The cord will feel cold and clammy initially, then will become quite dry and brown in colour.
  • Check at each nappy change—there should be no blood loss.
  • When bathing your baby wash the cord with water and dry gently when drying your baby.
  • There are no nerve endings in the cord so you will not hurt your baby when cleaning the cord.
  • The cord stump will usually drop off within seven to ten days. When it is close to dropping off, you may notice old blood around the base of the cord. It is normal for the cord to smell at this stage. Just clean as previously described.
  • If the skin around the cord becomes red or hot to touch, looks inflamed, is offensive to smell or is noticeably draining pus, show your midwife, nurse, doctor or child health nurse as soon as possible.

Weight

  • It is normal for your baby to lose some weight in the first few days, but they usually regain their birth weight by approximately two weeks of age. In hospital your baby will be weighed at birth, on day three and on discharge.
  • If you wish to have your baby weighed after discharge there are several options:
    • Child Health Clinic—by making an appointment or some clinics have a drop in area for self weighing
    • pharmacies—some offer a baby weighing and advice service conducted by qualified Child Health Nurses
    • your GP.

Normal infant behaviour

There is a wide range of normal behaviour for babies in the first few months of life.

  • They are born knowing how to suck and learn in the first few days how to coordinate their sucking and breathing.
  • They have irregular sleeping and feeding times in the first three months.
  • Sneezing is a way babies have of clearing their nose and most babies sneeze several times a day.
  • Hiccoughing is normal behaviour, it will not harm your baby and no treatment is required.
  • Newborn babies can use all their senses:
    • They will look at people and things, particularly at people’s faces if they are close.
    • They will enjoy gentle touch and the sound of a soothing voice.
    • They will react to bright light and noise.
    • They will grasp your finger with hands or feet and they will make stepping movements if they are held upright on a firm surface.
  • All these automatic responses, except sucking, are lost within a few months and your baby will make controlled movements instead.

Crying

  • Babies cry to gain our attention and at times there may be no obvious reason. They may cry because they are hungry, have wind or pain, feel hot, cold or uncomfortable, feel tired and unable to sleep or feel lonely and want company. When you respond to your baby they learn to trust your ability to comfort them.
  • When babies cry it can be mild fussing or intense crying and screaming. Crying can stop as quickly as it started or last for hours at a time.
  • The most common time for a baby to be unsettled is in the late afternoon and early evening.
  • It is normal for babies to have at least one unsettled period each day therefore it is important that you have some strategies to cope with these periods of crying e.g. holding your baby close, talking to them in a soft, soothing voice, singing, swaying, rocking, wrapping, using a sling or a pouch, use of music or noise, a warm bath or a walk in the pram.
  • Babies usually cry for hunger or comfort so always try feeding or holding your baby skin to skin first.
  • If your baby’s cry sounds different or unusual it may be the first sign of illness particularly if your baby is not feeding well, won’t be comforted or has a temperature above 37.5º C. If you think your baby is ill take them to your doctor immediately or to the nearest emergency department.
  • Never shake or toss your baby as this can cause bleeding and damage to the brain. If you become upset or distressed some helpful hints include: put your baby down safely in a cot or pram; walk away and take deep breaths to calm your self; make your self a cup of tea; ring a friend or ask someone to help you. Talk to your midwife, GP or child health nurse if you are having problems.

Sleeping and settling

  • A newborn baby’s sleep cycles lasts about 20 to 40 minutes with broken sleep anywhere from two to six hours.
  • During “light sleep” babies will sometimes move and make noises. Their breathing pattern is irregular and they can be woken easily at this time.
  • During “deep sleep” they are very still and will not move when touched.
  • Settling Your Baby. A Survival Guide for Parents Birth to Twelve Months is a useful publication and is available for purchase—please ask your midwife, nurse or ward receptionist.
  • Many parents stop wrapping their baby after the first few weeks. If you are having difficulty getting your baby off to sleep or keeping them asleep, it may be worth another try. If you choose to wrap your baby, make sure baby’s head is not covered and wrap baby firmly but not too tightly. Wraps should be of lightweight cotton or muslin material and ensure your baby is not overdressed under the wrap.

Safe sleeping

To provide a safe sleeping environment for your baby, the following guidelines are recommended:

  • Sleep baby on the back, from birth—never on tummy or side.
  • Sleep baby with their face and head uncovered.
  • Avoid exposing babies to cigarette smoke, before and after birth.
  • Put baby’s feet at the bottom of the cot.
  • Use a cot that meets Australian Standards.
  • Fit the cot with a firm, clean mattress that fits snugly in the cot, and do not use additional mattresses or extra padding in travel cots.
  • Tuck in bedclothes securely so bedding is not loose.
  • Remove quilts, doonas, bumpers, pillows and toys from the cot.
  • Read the SIDS and Kids brochure.
  • Make sure that everybody who cares for your baby uses the safe sleeping recommendations to put your baby to sleep.

Physiotherapists also recommend the following for your baby’s wellbeing and development while sleeping safely:

  • Keep the room well ventilated
  • Do NOT bend the mattress to prop your baby up
  • Ensure your baby sleeps with head turned to left and right for equal time, to prevent flattening and asymmetrical moulding of the skull. As your baby grows and starts to focus on particular objects, active stimulation can be used to encourage change of head position. Another way to achieve this is to sleep your baby at different ends of the cot.

Co-sleeping with your baby has been shown to be beneficial by being associated with longer and more restful maternal and infant sleep and more successful breastfeeding. Bed sharing (mother awake) and co-sleeping also needs to be safe and certain conditions need to be met both in hospital and at home:

  • Your midwife or nurse will explain Mater Mother’s Hospitals bed sharing and co-sleeping policy.
  • In hospital, if you are very tired and think you may fall asleep with your baby in bed with you, it is important that you ring for assistance so that a midwife or nurse can check on you and assist you to put your baby in their cot when you wish to sleep.
  • It is important that your baby should not overheat so do not wrap if bed sharing or co-sleeping
  • Co-sleeping is not recommended if either parent is a smoker, under the influence of alcohol or illicit drugs, or is obese.
  • It is considered dangerous to let a baby sleep in a bean bag, waterbed, sofa, sagging mattress, unattended on an adult bed, or with other children or pets
  • Co-sleeping is also sleeping with your baby in a cot at arms reach beside the bed, so baby can hear your breathing and smell you.

For more information on safe sleeping, bed sharing and co-sleeping refer to the Child Health Information Factsheet entitled Safe sleeping for babies: reducing the risk of sudden infant death. Other information is also available at www.health.qld.gov.au/ ph/documents/childhealth/29567.pdf or at www.sidsandkids.org

Handling your baby

The following are suggestions for holding and handling your baby in ways that are helpful for your baby’s wellbeing and development. “Baby handling” information sessions are available while you are an inpatient—please ask your midwife, nurse or physiotherapist for details.

Tummy time (prone)

Although babies should not sleep on their tummy, it is important that all babies spend time each day in this position to encourage their physical development. Babies need to develop head control and enjoy being on their tummy in preparation for rolling and crawling. This can be commenced from birth. When your baby is awake you can try:

  • Prone over your arm or on your knee
  • Prone on your chest or on your bed—you can sit on the floor and talk to your baby.
  • Remember—back to sleep, tummy to play and sit up to watch the world.

Picking your baby up

To encourage head control, pick your baby up through side lying. Place one hand on your baby’s chest and use the other hand to roll your baby onto their side. Support the chest and back as you lift through side lying. Put your baby down onto their side in the same way and then roll your baby onto their back.

Carrying your baby

 

Apart from cradling your baby in your arms, you might like to try these other ways of carrying your baby:

 

  • lying prone over your arm, with your baby’s head close to your elbow and facing outwards—this is a great way to calm an unsettled baby
  • high over your shoulder with both arms forward—good for burping (see above).

Equipment

  • If using a baby sling, choose one that provides good, even shoulder support. If the weight of the sling is supported onto your hips this will help you to maintain a good posture. Keep baby’s weight close to your body.
  • Please avoid the use of Baby Walkers and Jolly Jumpers, as these can affect your baby’s development. For further information please see a paediatric physiotherapist.

Newborn screening test

You would have been provided with the Mater Mothers’ Hospitals brochure, Your baby’s Newborn Screening Test—Information for parents on admission to the postnatal unit. This provides the most current information regarding this test which is offered to all new parents for their baby. If you have any further questions after reading this brochure please ask your midwife or doctor. This test is performed 48–72 hours after birth.

Hearing test

The healthy hearing program aims to identify babies born with a permanent hearing loss. It is free, available to all babies born at Mater Mothers’ Hospital and performed as soon as possible after birth. If this test is not done before you and your baby leave hospital, your baby can have the screen as an outpatient. The nurse or a person trained in the hearing screen will explain the procedure to you and answer any questions you may have.

Jaundice

Jaundice in the newborn baby is common and occurs in approximately 60% of babies. It is normal and most babies experience some degree of jaundice as their body processes waste products of the extra red blood cells required by your baby in utero. It is noticed as a yellow colouring of the skin and whites of the eyes and usually begins to fade by the end of the first week after birth without any problems. If your baby is jaundiced please ask your midwife or nurse for the Mater Mothers’ Hospitals’ brochure, Jaundice and Phototherapy, Information for parents.

Dressing your baby for climate

Dress your baby in similar weight clothes to yourself. The general rule is what you are wearing plus one layer which is usually a light wrap. Caps and bonnets should not be worn inside the house once you are home from hospital as babies need to lose excess heat from their heads and faces. If you have air conditioning make sure the room does not become too cold—a room temperature of about 24–26 degrees is appropriate.

When to seek medical attention for your baby

The following are urgent problems. You need to take your baby to the emergency department of the nearest hospital or dial 000 for an ambulance if your baby:

  • makes jerky movements
  • turns blue or very pale
  • has quick, difficult or grunting breathing
  • is very difficult to wake, unusually drowsy or does not know you
  • has any skin rashes, especially red spots which do not fade and lose colour when they are pressed.

Other problems that could be serious and require your baby to be seen by a GP, or an Emergency Department if out of hours, include:

  • Your baby has a hoarse cough with noisy breathing, wheezing or cannot breath through their nose.
  • Your baby feels unusually hot (fever), cold or floppy.
  • Your baby cries in an unusual way or for an unusually long time or seems to be in pain.
  • You notice any bleeding from the nose or any bruising.
  • Your baby keeps refusing feeds or continues to vomit up feeds.
  • You observe any sticky eyes or conjunctivitis.
  • Your baby has very liquid bowel motions which are green brown in colour—this could be diarrhoea.
  • Temperature above 37.5º C
  • Your baby becomes more jaundiced.

Safety

Car restraint

  • From 11 March 2010, new child restraint laws will be introduced to ensure that all children up to seven years of age are secured in an approved child restraint that is installed according to the manufacturers’ instructions.
    • Birth to six months (less than 8 kilograms) rearward facing baby capsule or infant restraint
    • Six months to one year (8 to 12 kilograms) rearward or forward facing infant restraint
    • Six months to four years (8 to 18 kilograms) forward facing restraint with built in harness
    • Four to seven years (14 to 26 kilograms) booster seat with H-harness or a booster seat with a secured adult seatbelt
  • Look for a label or sticker that states the child restraint complies with the Australian Standard.
  • If you have a second-hand restraint, you need to be assured of its history and that it has not been in an accident. If you do not have this information, the manufacture’s fitting instructions, or the restraint is more than 10 years old you should not use it.
  • If you are unsure about the fitting of a child restraint, you can contact the Child Restraint Fitting and Checking Service on 07 3854 1829.
  • Restraints and strollers should have a five point harness system.
  • Never leave your baby unattended in a car.
  • For further information on child restraint laws may be located at http://www.tmr.qld.gov.au/Safety/Driver-guide/Child-restraints.aspx or telephone 13 23 80

Safety in the home

  • Be aware of issues in your home and start thinking about when your baby will be crawling and walking.
  • Never leave your baby unattended on a high surface or in the bath.
  • Always check the temperature of the bath.
  • Do not handle hot drinks or food when holding your baby.
  • Make sure all your baby furniture meets the Australian standards.
  • Remove bibs before putting your baby to bed.
  • At the table, use placemats instead of table cloths.
  • Place caps on the electricity sockets.
  • Adjust dangling cords on blinds or curtains so they are not accessible and position your baby’s cot away from the window as the cords may cause strangulation.
  • Put away items which are small enough to put into a baby’s mouth.
  • Lock up dangerous liquids and poisons.
  • Remove ribbons and ties from your baby’s clothes as they can cause strangulation.
  • You may also want to visit Kidsafe Qld at Herston.

Child Health Clinics

  • Prior to discharge your midwife or nurse will offer you a referral to the Child Health Service and provide details of the location of your nearest Child Health Clinic. Following your request for referral, you should receive a telephone call from the nominated Child Health Clinic within one week of the referral. If you have not heard from the Clinic by the end of that week, you are advised to call the Clinic to make an appointment. You may also find this information on the QHealth website: www.health.qld.gov.au/cchs.
  • Child health clinics can offer information and support on issues relating to both you and your baby including individual consultations; nutrition and breastfeeding support; growth and development; health information and advice, and a range of parenting groups.
  • Take your baby’s personal health record book to each appointment.

Immunisations

  • The most important benefit of immunising your baby is to significantly reduce the risk of serious side effects of a number of diseases and, in most cases, contracting the disease.
  • Your baby’s health record book contains a brochure on immunisation. You are advised to read this and have a good understanding of the immunisations and the associated risks and comfort measures for your baby following immunisation.
  • peak to your doctor if you have any questions regarding immunisation.
  • Immunisations commence at two months of age, are free and are available through your GP or child health clinic.
  • The personal health record is to be completed when immunisations have been given.

Planning for going home

Having a baby is a normal life event and going home without delay is preferred by most women. Mater Mother’s Hospital offers a home visiting service to women within certain geographical boundaries. The whole family benefits from postnatal care in the home as it helps family bonding and the adjustment to parenthood.

Mater’s Home Care Program

This program is available to mothers who leave hospital early and provides the support and education that you need in the first week of your baby’s life. The midwives who visit you will be able to see how well you and your baby are doing at home and talk to you about your personal and family concerns in a less formal, more relaxed and private setting. A decision about whether to take part in the home care program can be made at any time during your pregnancy or after giving birth. If you wish to take part in this service please discuss your options with your midwife.

Discharge time

The discharge time from Mater Mothers’ Hospital is strictly 10 am each day. Please ensure that you have pre-arranged for someone to be available to pick you up at 10 am on the anticipated day of discharge, that your baby safety restraint has been fitted securely and that you are familiar with it’s use.

Family adaptation to your new baby

  • Going home from hospital can be very exciting but you may also feel nervous without the hospital staff on call to help you.
  • The more your partner shares your baby’s care the more you will both enjoy your baby.
  • Discuss with your partner the sharing of household chores.
  • You will need lots of help when you get home so take advantage of family and friends’ offers to help.
  • Avoid having a lot of visitors in the first week.
  • Taking some time to spend with your partner is important at this time. You may feel so tired in the early weeks that it is easy to let things slide.
  • If you already have children you may witness some sibling rivalry. Some strategies that may help at this time include:
    • Involving your older child in your baby’s cares, bathing, nappy changing etc.
    • Spend special time each day with your older child or children.
    • Organise your toddler with a game, food or drink prior to feeding your new baby.

Follow up care after discharge

  • GP check for baby at five to ten days
  • GP check for mother and baby at six weeks
  • Child Health Clinic—you will be offered a referral to your local clinic
  • immunisations at two months
  • physiotherapy review four to six weeks—optional

Resources and contact numbers

In addition to the information numbers listed in the Personal Health Record Book and the Child Information Booklet the following information may be helpful:

  • Australian Breastfeeding Association www.breastfeeding.asn.au 1800 686 2 686
  • Australian Psychological Society 1800 333 497
  • Belmont Private Hospital (Mother-Baby Unit) 07 3398 0238
  • Birthtalk Support and Education Group www.birthtalk.org or 0403 012 209
  • ABA Breastfeeding Helpline (24 hours) 07 3844 8977/07 3844 8166
  • Caesarean Awareness Network Australia 
  • Childbirth Connection www.childbirthconnection.org
  • Child Health: 13 HEALTH (43 25 84) and ask for the Child Health Nurse
  • Domestic Violence Helpline 1800 811 811
  • Ellen Barron Family Centre 07 3139 6500
  • (Child Health for complex child and parenting needs)
    Ethnic Communities Council of Queensland 07 3844 9166
  • Health Advice for the whole family 13 43 25 84 (13HEALTH)
  • (24 hours a day 7 days a week)
    Kidsafe Qld 07 3854 1829
  • Maternity Coalition www.maternitychoices.org.au
  • Multiple Birth Association www.amba.org.au 1300 886 499
  • National Continence Helpline 1800 33 00 66
  • National Prescribing Service Medicines Line 1300 888 763
  • Playgroups Queensland 07 3855 9600/1800 171 882
  • QIRCH (Queensland Integrated Refugee Community Health Clinic) 07 3391 6677
  • St Johns Ambulance first aid courses 07 3253 0500
  • SIDS & KIDS www.sidsandkids.org 1300 308 307
  • Qld Ambulance capsule hire and fitting 1300 369 003
  • Quit line 131 848

Mater Services

  • Accident and Emergency—Adult 07 3163 8484
  • Accident and Emergency—Children’s 07 3163 2400
  • Accident and Emergency—Private Adult and Children’s 07 3163 1000
  • Fertility Clinic—Family Planning 07 3163 8437
  • Physiotherapist 07 3163 8787
  • Breastfeeding Support Service 07 3163 2229
  • Psychology and Counselling/Audiology and Speech Pathology/Nutrition and Dietetics/Physiotherapy/Occupational therapy/Home-based therapies 07 3010 5744

Additional resources

For video resources on this topic in languages other than English, visit the Raising Children Network website.*

*Please note that Mater cannot guarantee the accuracy or appropriateness of information provided on third party websites.

Acknowledgments and references

Staff of Mater Mothers’ Hospital, Mater Mothers’ Private Hospital and Mater Private Hospital Redland

Mater consumer representatives

Maternity Coalition

Birthtalk: Support, Education and Celebration of Birth

Understanding NICE guidance—information for pregnant women, their partners and the public (2004) National Institute of Clinical Excellence

Contact details

Mater Mothers’ Private Redland
Weippin Street, Cleveland Qld 4163
Telephone: 07 3163 7444

© 2013 Mater Misericordiae Health Services Brisbane Limited. ACN 096 708 922.

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-430166
Last modified 15/11/2017.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 08/4/2014
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