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Information for parents after the birth

Introduction

Having a baby is an exciting and fulfilling part of life but it can be daunting for some women. The following information 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 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 or doctor.

Please use the alphabetical information list on the right or the category list below to navigate this section of the website and find the information you need. If you are unable to find what you need, please contact the Mater Mothers’ Hospitals Parent Education and Support Services on telephone 07 3163 8009.

Immediately after birth After the birth care—mother Safety
Breastfeeding Looking after your baby Support

Immediately after birth

Skin to skin contact

Immediately after the birth, your baby should be placed on your chest for uninterrupted skin to skin contact. If possible, this should continue up until your baby has had their first breastfeed.

Cuddling and lots of skin to skin contact encourages your baby to instinctively search for the breast and find the nipple using their sense of smell. They have a strong urge to do this, particularly in the first hour after birth.

Allowing uninterrupted skin to skin contact with your baby following birth will encourage licking, nuzzling, touching and sniffing and eventual feeding.

Skin to skin contact will also help to initiate breastfeeding in the first few days and enhance mother baby bonding. Skin to skin contact should not be disturbed until after the first breastfeed. If you or your baby are unwell or unable to have skin to skin contact immediately after birth, or you have an operative birth ask to have the opportunity for skin to skin as soon as you or your baby are able.

The beneficial effect of skin to skin contact immediately after birth will aid your baby to:

  • attach well on the breast
  • maintain their body temperature
  • have higher blood sugars
  • cry less
  • initially lose less weight
  • gain weight more quickly
  • breastfeed longer and more exclusively

The first breastfeed

The first step toward successful breastfeeding is early feeding and correct latching of your baby to your breast. Breastfeeding problems such as nipple damage can be avoided with correct latching. Please ask for guidance with latching from your midwife until you feel confident.

Medications for your baby

Your baby will be offered two injections at birth. They are Vitamin K and Hepatitis B medications and you will be asked to give your consent for these injections. Both these medications are described below, however, if you need more information, do not hesitate to ask your midwife.

Vitamin K

Vitamin K is a substance that is naturally present in the body. It plays an important part in helping the blood clot. At birth, a baby has very low stores of vitamin K and these are quickly used up over the first few days of life. Vitamin K deficiency bleeding (VKDB) is a rare condition that affects 1 in 10 000 babies, but if it occurs there may be serious consequences. Mater Mothers’ Hospitals recommend that vitamin K should be offered to all babies soon after birth, so that the levels of vitamin K are increased for the first few weeks of life to protect the baby against this disorder.

Vitamin K can be given as a single injection into the muscle at the top of the baby’s leg soon after birth. This method is more readily absorbed. It can also be given as a liquid medicine which is dropped into the baby’s mouth. This is usually given in three doses, the first soon after birth and then when the baby is a week old and then a month old. If you feel you do not want you baby to have vitamin K in any form, you will be given information about the signs associated with the development of VKDB so that you can call for advice at any time if you are worried.

Your midwife or obstetrician will be able to answer any questions you might have. It is important that you understand that although this is a recommendation, you have a choice as to whether or not your baby receives vitamin K and the method used to give it.

Hepatitis B

Hepatitis B is an infection caused by the hepatitis B virus which causes either acute (short-lived) or chronic (long-term) liver disease. Although babies infected with this virus usually have either no or very mild symptoms, more than 90% will go on to be chronically infected carriers of the virus. Carriers of the hepatitis B virus are not only able to pass the virus onto others, but also have a considerably increased risk of developing serious liver problems, including liver cancer, in adulthood.

Immunisation with the hepatitis B vaccine provides long-lasting protection in most cases. More than 95 per cent of babies can be protected by immunisation. This is part of a long-term prevention strategy to reduce illness and death from complications of the disease, and to eventually eradicate hepatitis B from Australia.

With your consent, your baby will be given a dose of the hepatitis B vaccine soon after birth. Your baby will then need three more doses of the hepatitis B vaccine to be fully immunised. These three doses are given two, four and six months of age in combination with other routine childhood immunisations, so your baby will not need to receive any extra needles. No further booster doses of the vaccine are necessary. The birth dose of hepatitis B vaccine is recommended by the National Health and Medical Research Council.

The hepatitis B vaccine for newborn babies is a very refined vaccine. It does not contain any preservatives or antibiotics. It is not a live vaccine and therefore cannot either cause disease or upset the liver. It is produced in yeast cells and is free of animal or human blood products. Therefore it is a very safe vaccine for newborn babies; there is no evidence that it interferes with breastfeeding in any way.

The hepatitis B vaccine is very well tolerated, even in newborn babies. The most common side effects are minor and disappear quickly and may include mild swelling and redness at the injection site. The hepatitis B vaccine does not increase the likelihood of a baby either developing a fever or having an allergic reaction.

Babies who have been fully immunised against hepatitis B do not require booster doses. There is good evidence to show that babies who complete a course of hepatitis B vaccinations probably have lifelong protection.

Does my baby still have the Hepatitis B injection if born prematurely?

Premature babies are more prone to infections and therefore they also need to be protected against hepatitis B. However babies born before 32 weeks may have a lower immune response to the hepatitis B vaccine than term babies. Nevertheless, there are several ways to ensure that these premature babies are fully protected. Your doctor will advise you on the most appropriate way to protect your baby.

Does my baby still have the Hepatitis B injection if having antibiotics as a precautionary measure?

Immunisation should only be postponed if a baby is very unwell or has a high fever. Antibiotics alone are not a valid reason to delay hepatitis B immunisation, even in newborn babies.

If my baby is too sick to receive the birth dose of hepatitis B, when can it be given?

The benefits of giving the birth dose can still be achieved if the hepatitis B vaccine is given within the first seven days of life. If this cannot be done because of sickness, your baby should commence the course of hepatitis B vaccines in combination with other childhood vaccines beginning at two months of age.

Where can I get more information?

For more information, please ask your doctor, midwife, community health nurse or local Public Health Unit. Alternatively, you can contact the National Immunisation Info line on: 1800 671 811 or visit www.ncirs.edu.au/assets/provider_resources/fact-sheets/hepatitis-B-fact-sheet.pdf

Breastfeeding

Breastfeeding works on supply and demand. Every time your baby feeds, your body starts to make the next feed. The more your baby feeds, the more milk you make. You do not have to wait a ‘set time’ for your breasts to fill up.

Prolactin, a hormone involved in breast milk production, has receptors in your breast that are stimulated in response to your baby feeding and the amount of receptors stimulated depends on how long, and often, your baby feeds at the breast. They are also responsible for long term milk production.

Learn more A guide to breastfeeding booklet.

Feeding cues

Look for and respond to early feeding cues which indicate that your baby is ready to feed. These include:

  • rapid eye movement
  • “clicking” or tongue sucking (“kissing” noise)
  • rooting—opening the mouth and searching to suck on contact
  • hand movements to the mouth and sucking on hands
  • moving other extremities
  • general increased alertness or activity
  • crying is a late sign of hunger—avoid waiting for this sign as a crying baby is difficult to latch.

Breastfeeding—the early days

Day one

Most babies are born with strong innate feeding instincts and will seek to feed soon after being born.

During your pregnancy and continuing through the first few days after your baby’s birth, your breasts produce milky fluid called colostrum. Colostrum is clear or yellowish in colour and is all your baby needs in the first few days. It is small in quantity, encouraging your baby to feed more frequently providing stimulation of your breasts which encourages your milk to ‘come in’ more quickly.

Colostrum is high in protein and full of antibodies, antioxidants and vitamins that will protect your baby form infections.

It is common for your baby to have a deep sleep following the first breastfeed. This is usually followed by increased wakefulness and readiness to feed. Your baby will also pass meconium (sticky black stool) and have one wet nappy.

Day two

On day two, it is normal for your baby to be more wakeful and want to feed more frequently, with no set routine, until your milk ‘comes in’ on day three or four.

Your baby receives approximately one teaspoon of colostrum per feed and should be allowed to finish feeding from the first breast before switching to the other breast.

By the second day, your baby’s stools are soft green/black and your baby should have two wet nappies.

Day three

By day three, you may notice your breasts beginning to feel fuller and slightly uncomfortable as your milk supply increases. To ease any discomfort, allow your baby to feed frequently. In fact, because breast milk is easily digested, your baby will feed at least 8-12 times in a 24 hour period.

These feeds may be clustered i.e. they may have several short feeds in a short time especially if they have previously had a long sleep.

Stools change to a greenish brown colour by day three and are less sticky. Your baby should have at least three wet nappies.

Days four to seven

As your first week of motherhood progresses, your breasts will continue to feel firmer and fuller as your milk supply increases to approximately 500-800 ml per day. Your baby will feed 8-12 times in a 24 hour period.

During this time it is important to allow your baby to finish the first breast before offering the second breast as the fat enriched hind milk will allow them to feel fuller for longer and more settled between feeds.

As your baby’s nutrition continues, stools (at least two to three per day) will change from lighter greenish brown to yellowish mustard in colour and can be watery or seedy. Your baby will have five to six wet nappies per day.

Learn more A guide to breastfeeding booklet

Baby led feeding

Breastfed babies feed according to hunger. Allow your baby to stay on the breast until they have had enough and fall asleep or come off the breast. You may notice that your baby may wish to suck more often in the early days until your milk comes in; usually on the third or fourth day. Allow your baby to feed as often as they wish.

Sucking time may vary from feed to feed. The most important thing to remember is to allow your baby to feed on the first breast until their rhythmic or nutritive sucking stops and they lose interest in the breast. Soften one side first before offering the second breast. This helps your baby to have the fat rich milk which comes at the end of the feed. This milk helps babies settle for longer periods and gain more weight.

Babies often cluster feed, i.e. if they have a longer break between feeds they then often have several feeds in close succession. Some babies may not display these feeding cues as distinctly, eg premature babies, small babies and babies who are sleepy due to jaundice (learn more about Jaundice and phototherapy).

Learn more A guide to breastfeeding booklet.

Positioning and attachment

The first step towards successful breastfeeding is early feeding and correct latching of your baby to your breast. Breastfeeding problems such as nipple damage can be avoided with correct latching. Please ask for support and guidance from your midwife until you feel confident.

Learn more A guide to breastfeeding booklet

Signs of good attachment and milk transfer

  • Comfortable breastfeeding—no pain
  • Your baby latches with a wide gape
  • Your baby’s chin is tucked well into the breast
  • Your baby’s cheeks look full during a feed.
  • Your baby settles into a long rhythmical sucking pattern after an initial few quick sucks.
  • You hear audible swallowing after every one to two sucks.
  • Your baby will come off the breast spontaneously when they have finished their feed.
  • Your breasts soften with feeds.
  • Your baby feeds at least 8-12 times in a 24 hour period.
  • Your baby is content and settles following feeds.

Expressing breast milk

There may be times when you need to express milk for your baby. This may be if you are going out, returning to work, if your baby is sick or unable to suck at the breast. The principle behind expressing breast milk is to aim to copy as closely as possible what occurs with normal breast feeding. A healthy full term baby would usually go to the breast within the first hour of life and feed frequently for the next few days until your milk ‘comes in’. Frequent and thorough removal of milk from the breasts is very important for milk production. Hand expressing or using an electric pump needs to commence as soon as possible after the birth of your baby.

Learn more A guide to breastfeeding booklet.

Storage of breast milk

After expressing breast milk, it is important to store the milk appropriately. The National Health and Medical Research Council (NHMRC) Guidelines for infant feeding provides the table below as a guide for storage of breast milk.

Breast milk Room temperature Refigerator Freezer

Freshly expressed into closed container

6–8 hours at less than 26C

If refrigeration is available store milk there

3–5 days at 4C

Store in back of refrigerator where it is coldest

For the hospitalised baby—2 days

2 weeks in freezer compartment inside a refrigerator

3 months in freezer section of refrigerator with separate door

6–12 months in deep freeze at -18C

Previously frozen and thawed in refrigerator but not warmed

4 hours or less i.e. next feeding

Store in refrigerator 24 hours—if milk has not been warmed

Do not refreeze

Thawed outside refrigerator in warm water

For completion of feeding

Hold for 4 hours or until next feeding

Do not refreeze

Baby has begun feeding

Only for completion of feeding then discard

Discard

Do not refreeze. Discard

Reference: NHMRC 2003, Guidelines for infant feeding.

Cleaning feeding equipment

For the health of your baby, it is important that feeding equipment is cleaned and cared for appropriately.

  • Rinse all equipment with cold water immediately after use
  • Wash thoroughly with detergent and warm water
  • Rinse all equipment with clean hot water so that no soap remains and allow to air dry completely
  • Store in an airtight container in the fridge for 24 hours. If not used in 24 hours repeat cleaning.
  • Alternatively use a domestic grade dishwasher with a hot water cycle and allow equipment to completely dry before storing in an airtight container

Note: It is important that equipment is dry before sealing bottles and storing.

Bottles/storage containers and other equipment may also be placed in the dishwasher for heat disinfection after general cleaning if the dishwasher has a final high temperature rinse program. Then follow cleaning feeding equipment steps as above.

If someone who lives in your home is unwell, general cleaning as well as boiling or steam disinfection is recommended.

Learn more A guide to breastfeeding booklet.

Disinfection by Boiling

To disinfect feeding equipment by boiling water, place all equipment into a large saucepan and cover with water making sure that all air bubbles are removed from the equipment.

Place a lid on the saucepan and bring water to the boil, keeping it boiling for 5 minutes.

Allow the equipment to cool in the saucepan until it is only hand hot before removing it. Leave the lid on while the water is cooling. Then follow cleaning feeding equipment steps as above.

Steam Disinfection

Units which use steam to disinfect are automatic and raise the temperature quickly to the range which kills germs. Follow manufacturers’ instructions carefully. Then follow cleaning feeding equipment steps as above.

Work and breastfeeding

Many women return to work while they are still breastfeeding. Following are some tips to help you manage your baby’s feeding during this time.

  • When you are not at work, breastfeed day and night as your baby requires. You can express after feeds when you are at home if you require more expressed milk for when you are at work.
  • Allow time before and after work for a relaxed feed. The more time baby spends sucking, the more satisfied baby will be and the better your milk supply.
  • While you are at work express milk for each feed you will miss. The number of feeds you need to express for will depend on the age and needs of your baby and how many hours you are at work.
  • If extra milk is required express when your supply is greatest. This is usually first thing in the morning so express after feeding baby and prior to leaving for work.
  • When you are on days off breastfeed your baby and express only if you require a stock of breast milk for work days.

Nutrition and breastfeeding

Healthy eating while breastfeeding is as important as it was during pregnancy. Your body still has a greater need for most nutrients. Some of the extra energy required for breastfeeding comes from your body fat stored during pregnancy. To meet your extra nutrient needs, it is important to eat a variety of nutritious foods.

Caffeine

Caffeine passes into your breast milk. This can make your baby irritable and unsettled, so try to limit caffeine—contained in drinks such as tea, coffee, cola, cocoa and guarana energy drinks. Limit your total intake of these food and drinks to less than three per day.

Alcohol

Breastfeeding mothers are advised not to drink alcohol as alcohol passes into your breast milk. If you do drink, limit the amount to 1–2 drinks and have them just after feeding. This will allow a lower alcohol level in your breast milk by the time of the next feed.

Vegetarian and Vegan eating

Vegetarian and Vegan mothers need to ensure they are getting all the necessary nutrients in their diet while breastfeeding so they should consult their doctor to have their vitamin B12 and iron status checked, and a nutritionist regarding their diet.

Fluid

When you are breastfeeding you require an increase in fluid intake to replace the fluid used in breast milk (~700mls/day). It is a good idea to have a drink every time your baby feeds and at other times during the day.

Avoiding certain foods during breastfeeding

Mothers may be told to avoid certain foods when breastfeeding, however, there is no evidence to support the claims that either colic or allergic reactions in infants are caused by the mothers food choices. Allergic reactions are rare in breast fed babies and only then should the mother’s diet be modified in consultation with her doctor, dietician and/or lactation consultant.

Returning to your pre-pregnancy weight

The greatest amount of weight loss occurs in the first three months after birth and then continues at a slow and steady rate until six months after birth. Breastfeeding your baby should help you return to your pre-pregnancy weight. Some of the weight you gain during pregnancy is used as fuel to make breast milk. Healthy eating and regular physical activity after you recover from the birth will assist in the prevention of weight retention after birth.

Dieting during breastfeeding

Breastfeeding helps mother’s lose weight and shape up after their baby is born. However, weight loss diets are not recommended during breastfeeding. Research indicates that a less than perfect diet will not effect a mothers milk supply or quality, however, if the mother is eating poorly she may feel tired and run down, and have a decreased resistance to infection.

  • Don’t skip meals.
  • Limit foods high in fat and sugar such as lollies, chocolate, soft drinks, cakes, sweet biscuits, chips and fatty take-away.
  • Use healthy cooking methods such as steam, boil, and grill or stir fry.
  • Trim fat from meats and avoid chicken skin.
  • Do some gentle exercise such as taking your baby for a walk—consult a physiotherapist or exercise physiologist.

Excess weight loss while breastfeeding

If you experience excess weight loss while breastfeeding it’s important that you do not stop breastfeeding. It is advised that you increase the amount of food you eat or consider the following:

  • Don’t skip meals.
  • Have three main meals and three between meal snacks.
  • Keep easy to prepare nutritious snacks on hand e.g. crackers and cheese, fresh fruit, yoghurt, nuts, seeds, dried fruit, canned beans, flavoured milk, fruit smoothies, breakfast cereals and milk.
  • Prepare a packed lunch or variety of snacks to have in a container beside you when baby feeds.
  • Prepare and freeze meals in advance when possible (or ask your friends/family to help).

Mastitis

Mastitis is a hot, red painful inflammation of the breast tissue usually caused by a blocked duct in the breast. To enable early identification of a blocked duct so that mastitis may be avoided, it is important to check your breasts regularly. Note any lumps, flushed areas or tender areas.

Quick treatment can prevent mastitis

It is extremely important to empty the sore, tender affected breast as much as possible. Feeding your baby is the best way to do this. Point the baby’s chin towards the flushed area for better drainage. You may need to use the ‘football’ or ‘rugby’ hold if the flushed area is on the side of your armpit.

If you cannot feed your baby, express the breast. This is not the time to wean.

Apply moist heat i.e. shower, washers to the affected area before you feed. Start feeding on the affected side for two feeds. Do not limit the sucking time on this breast. You may need to express the other breast for comfort. Gently massage the affected area with the heel of your hand while feeding or expressing.

Factors which can lead to Mastitis include:

  • Being overtired, skipping meals and not looking after yourself.
  • Sudden changes in feeding patterns such as the baby missing a feed or sleeping through the night.
  • Nipple damage (cracks, grazes) caused by poor attachment.
  • Poor attachment resulting in the breast not draining well.
  • Untreated engorgement.

Symptoms of mastitis can include:

  • Soreness, redness and a hot area on the breast.
  • Flu-like symptoms such as fever, tiredness, aching joints, backache.
  • ‘The shakes’
  • Nausea and vomiting.

If you develop these symptoms follow the five steps for blocked ducts in the prevention of mastitis section and get plenty of rest, eat healthy foods and accept any offers of help.

Seek medical advice if symptoms continue for 12–24 hours or if you have high temperatures or feel unwell. Your doctor may choose to start you on an antibiotic which treats mastitis and will not harm your baby. However, antibiotics may cause your baby to experience loose stools and additional care may be needed in the nappy area. All of the antibiotic tablets must be taken to prevent the mastitis returning. Do not stop part way through the course of antibiotics.

Breastfeeding support

Breastfeeding is an instinctive relationship and therefore is an individual experience for each family. While you are in hospital the midwives on each ward will assist and support you to establish breastfeeding. If you are having breastfeeding issues that cannot be resolved by your midwife, they will organise a referral to the Mater Mothers’ Hospitals Breastfeeding Support Service for you.

Mater Mothers’ Hospitals Breastfeeding Support Service is a service staffed by lactation consultants, located within the hospitals and designed for breastfeeding mothers. Learn more about Mater’s Breastfeeding Support Service.

If you are having breastfeeding concerns in your first few weeks at home, you can make an appointment to visit the service on 07 3163 2229. You may also wish to contact lactation consultants in private practice, the Australian Breastfeeding Association or your Child Health Nurse.

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

Medicines and Breastfeeding

All medicines taken by a breastfeeding mother will cross into the breast milk to some degree. However in most cases there is no need to stop breastfeeding. For the vast majority of medicines the amount transferred to the breast milk is very low (approximately 1%). There are strategies for reducing the amount the baby receives and usually other medication options to ensure that you are treated effectively and the baby is not affected. Exposure to the baby from medicines in breast milk is less than during pregnancy.

Talk to your pharmacist, doctor or lactation consultant about the medicines you are taking while breastfeeding. This includes medicines available on prescription, over the counter at pharmacy or chemist, from health food or grocery stores and naturopaths.

Like other medicines, complementary and alternative or herbal medicines change the way the body works and might cross into the breast milk to the baby. They may also interact with other medicines. Lifestyle or recreational drugs may accumulate in the breast milk with increased exposure to the baby. Ask your doctor, pharmacist or lactation consultant about what to do if you are taking any of these.

Formula feeding

At Mater Mothers’ Hospitals we respect your right to choose how you feed your baby and will support you with guidance and advice whatever your decision. If you choose to feed your baby using formula, the following information will help to ensure your baby’s health and safety. Learn more about formula feeding.

Equipment

To feed your baby using formula, you will require some equipment:

  • Formula—use cow’s milk based formula until 12 months of age. Only use soy-based or other special formulas for babies who cannot take dairy based products or because of specific medical, cultural or religious reasons.
  • Two to six large bottles.
  • Teats—shape variations offer no particular advantage unless your baby prefers that shape. However the teat shape best suited to a baby moving between bottle and breast is a long, straight teat.
  • A bottle brush for cleaning.
  • A container for storing clean equipment.

Cleaning feeding equipment

For the health of your baby, careful cleaning and safe storage of equipment should continue as long as bottles and teats are used.

  • Rinse equipment with cold water.
  • Wash thoroughly with detergent and warm water:
    • Bottles—use a bottle brush to ensure all milk residue is removed
    • Teats—force a little soapy water through the feeding hole to ensure it is not blocked.
  • Rinse thoroughly and allow to air dry.
  • Store in an airtight container.

Alternatively use a domestic grade dishwasher with a hot water cycle and allow equipment to completely dry before storing in an airtight container.

Preparing formula

The recommended and safest way of making formula is one bottle at a time in the bottle. This reduces the potential for contamination, the amount of equipment required and the possibility of mistakes when counting out the scoops of formula.

Formula is designed to remain at a constant strength. As your baby grows the amount of formula should increase NOT the strength. Never, for any reason, add any more scoops than specified in the package directions, unless specifically instructed by a qualified paediatric dietitian—this will only be necessary for babies with certain special health needs. Likewise, never dilute formula by adding more water than specified in the package directions.

Preparation steps:
  • Always wash hands and clean work surfaces before preparing formula.
  • To prepare the water, empty the kettle or electric jug, refill it with water and bring to the boil. Kettles or jugs without an automatic cut off should be turned off within 30 seconds of boiling. Allow the water to cool.
  • Pour the required amount of cooled boiled water into a clean feeding bottle.
  • Always use the scoop provided in the tin of formula.
  • Fill the scoop with formula powder and level off with the back of a clean knife. Do not pack the scoop.
  • Seal the bottle with a cap and disc and shake gently to mix the formula thoroughly.
Safety information
  • If not using immediately, store prepared formula in the fridge at the back where it is the coldest. Never store prepared formula in the fridge door.
  • Discard the contents of partially used bottles after one hour.
  • Discard any unused prepared formula after 24 hours.
  • Check the expiry date on formula containers and discard them if they are out of date.
  • Discard any open tins of formula after one month
  • The safest way to transport formula is to take the cooled boiled water and the powdered formula in separate containers and mix them when needed.
  • When it is necessary to transport prepared formula, it must be icy cold when leaving home and be carried in an insulated pack.
  • Microwaves are not recommended for warming infant formula as the milk heats unevenly and a ‘hot spot’ may burn your baby’s mouth.
  • Standing the bottle in warm to hot water is the safest way of heating formula. To ensure it heats evenly, swirl or shake the feed in its container.
  • Time taken to warm formula should not exceed 10 minutes.

Giving a formula feed to your baby

Feeding your baby with a bottle should be a special time for you both. Holding your baby close to you is important for parent infant contact and your baby’s development and should be a pleasurable experience. Your baby needs to be held cuddled and talked to when being fed.

  • Allow your baby to demand each feed
  • Test the flow of teat—the milk should drip steadily. The cap can be loosened slightly if the flow is too slow.
  • Test the formula temperature—sprinkle a small amount onto the inside of your wrist to ensure it is comfortably warm but not too hot.
  • Sit with your baby held close and hold the bottle so that milk fills the neck of the bottle and the neck of the teat.
  • Touch your baby’s lips with the teat, so that your baby’s mouth opens ready for sucking.
  • Stop briefly, half way through the feed to burp your baby. If the baby does not burp continue with the feed and try burping again at the end.
  • Let your baby decide when they have finished. The amount taken may vary from feed to feed.
  • A feed should take approximately 20 to 30 minutes and should not be too fast or too slow.
  • If your baby stops sucking or gets fussy after taking only part of the feed, but is well and gaining weight, take a break after about 30 minutes then offer the bottle again for five to 10 minutes.
  • If your baby is not gaining weight well, check with your doctor or child health nurse.
  • Never leave your baby alone with a bottle propped in his or her mouth. The milk can flow too quickly and your baby may choke.

How much will my baby need?

There are many individual variations in the amount of formula and the number of bottles consumed by your baby each 24 hours. Information on formula containers is a guide only and does not necessarily suit every baby. Plenty of wet nappies, consistent (but not excessive) weight gain and a thriving active baby indicate that all is well. If you have any concerns about how your baby is feeding please contact your doctor or child health nurse.

Constipation

Formula fed infants may be more prone to constipation. As there may be many reasons for your baby being constipated you need to discuss this situation with your doctor or child health nurse.

Learn more about formula feeding.

After the birth care—mother

The birth process is a special experience for every woman and will vary between individuals. It is important for a new mother to remember to understand the changes to her body after the birth of their baby and to know the signs of normal good health.

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. This is because oxytocin is released when you breastfeed which helps to contract your uterus.

Please note:

  • 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. Dry gently by patting with a clean towel.
  • Change sanitary pads at least every four hours—this can help reduce the risk of infection.
  • Lie down for approximately 20 to 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.

Learn more about recovering from 3rd or 4th degree perineal tears.

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 of your baby. 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 lean forward 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 tissue heals properly and is also a lifelong good habit.

Recommended toiletting position 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 required.

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. Following are the most commonly used forms of analgesia that may be prescribed for you.

  • 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.
  • 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.

Physiotherapy

You can start to do gentle pelvic floor “pulses” as soon as it is comfortable as they will help you to move more 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 correct 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 during baby care, adjusting the height of your bed or change table, or sitting or kneeling down if this is better for your back.

Postural Stretches

Try the following stretches while sitting 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”—your arms may be comfortable held behind the back of the chair.
  • 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 gradually after having a baby. Because the ligaments and support structures of your body are not back to “full strength” for up to a year after the birth of your baby, 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 Mothers’ Hospitals offer postnatal exercise, mother and baby and Pilate’s classes. For more information, or to book for these classes telephone 07 3163 8787.

Nutrition

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 per cent of women experience the ‘baby blues’ around three days after the birth. Baby blues can be caused by hormone changes, tiredness, pain, 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 to 20 per cent 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 or a variety of other community services. Please refer to the resources section 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 seven per cent 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.

Sex and contraception

Sexual relations can be resumed when you feel comfortable unless advised otherwise by your doctor or midwife.

Research has shown that if you are successfully breastfeeding you are unlikely to fall pregnant if all the following conditions are present:

  • You are fully breastfeeding successfully
  • Your periods have not returned (ignore bleeding in the first eight weeks)
  • Your baby is less than six months old

The Lactational Amenorrhoea Method (LAM) is the informed and conscious use of a naturally determined period of infertility. LAM means relying on the effects of full breastfeeding, without contraception, charting or abstinence. This is the method promoted by the Natural Fertility Services as best for both mother and baby in the first six months. 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 8768.

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 you resume intercourse. 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. Learn more about natural fertility services.

Looking after your baby

Rooming-in while in hospital

Rooming-in allows mothers and babies to remain together 24 hours a day and helps mothers bond with their babies and gain confidence in their care. 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. 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.

Nappy changing

Before changing your baby’s nappy, gather everything you need and place it all within easy reach so you will not be 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 your 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.

  • For baby 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 baby 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.

Please note: 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

Before bathing your baby for the first time, gather everything you need and place it all within easy reach. 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

After the birth of your baby, the umbilical cord which sustained your baby in your womb will be cut and a small stump will remain on your baby’s tummy until it drops off. 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.

The cord will feel cold and clammy initially, and then will become quite dry and brown in colour. Check at each nappy change—there should be no blood loss. 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.

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.

Weight

It is normal for your baby to lose some weight in the first few days after they are born, but they usually regain their birth weight by approximately two weeks of age.

If you wish to have your baby weighed after discharge from hospital 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 General Practitioner
  • Your midwife

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.

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 eg. 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. The most common time for a baby to be unsettled is in the late afternoon and early evening.

Babies usually cry for hunger or comfort so always try feeding or holding 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 37.5C. 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, General Practitioner or child health nurse if you are having problems.

Sleeping and settling

A newborn baby’s sleep cycle usually 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.

Many parents stop wrapping their baby after the first few weeks. If you are having difficulty getting your baby off to sleep or keeping her 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.

Used with Permission granted by Dr Jeanine Young, Safe Infant Sleeping Education Program, Queensland Health and SIDS and Kids, 2008.

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.

  • 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.
  • 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.

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.

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 the Queensland Health website or at SIDS and Kids.

Handling your baby

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

1. 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.

2. Picking your baby up

To encourage head control, pick 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.

3. 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.

4. 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

In Australia, all babies are given the Newborn Screening test, a simple and free blood test to search for rare but important disorders that affect babies. Early testing is important which is why this test is preferably performed when your baby is 48 to 72 hours old. Learn more about Your Babys' Newborn Screening Test.

Hearing test

The Healthy Hearing Program aims to identify babies born with hearing loss. It is free, available to all babies born at Mater Mothers’ Hospitals 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 person trained in the hearing screen will explain the procedure to you and answer any questions you may have.

Jaundice

Jaundice is rare in the newborn baby but very common in babies on day two or later. It happens because your baby’s own body needs to take over the processing of a yellow coloured waste product (called bilirubin) which is produced during the normal turnover of red blood cells. You may notice yellow colouring of the skin and sometimes the whites of the eyes, which usually begins to fade by the end of the first week. Occasionally jaundice is a sign of a more serious problem and needs tests or treatment. Your doctor or midwife will advise you if there are concerns. Learn more about jaundice and phototherapy.

Dressing your baby appropriately for the 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 to 26 degrees Celsius is appropriate.

Immunisations

Immunisations are free and commence at birth. The second set of immunisations is due at two months of age, and is available through your General Practitioner or child health clinic.

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. The personal health record is to be completed when immunisations have been given.

Speak to your doctor if you have any questions regarding immunisation.

When to seek medical attention for your baby

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

  • makes repetitive jerky movement
  • turns blue or very pale
  • has quick, difficult or grunting breathing
  • has a hoarse cough with noisy breathing or wheezing
  • feels unusually hot (fever), cold or floppy
  • is very difficult to wake or unusually drowsy or does not know you
  • develops red spots on the skin which do not lose colour briefly when they are pressed
  • vomits any green bile, or develops a swollen tummy.

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

  • Your baby develops any rash that is causing blisters, pus, weeping or bleeding.
  • 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 sleeping through feeds, 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 37.5C
  • Your baby becomes more jaundiced down to the level of the lower legs or feet.

Safety

Car restraint

From March 11, 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.

When purchasing or renting a child restraint, 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 greater 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.

Further information on child restraint laws may be located at Queensland Transport's website 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.

Support

Child Health Clinics

The Child Youth and Family Health Service offer a multidisciplinary service to assist parents in their parenting role and to enable children and families to reach their full potential. To find your local child health clinic go to www.health.qld.gov.au/cchs. It is essential to book ahead of time for your first appointment and allow approximately one hour. Please take with you your Personal Health Record Book and a change of clothes for your baby.

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.

Mater acknowledges consumer consultation in the development of this patient information.
Last modified 20/12/2016.
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