Postnatal Care (after the baby is born)

• Obstetrics Introduction
• Schedule of Visits and Pregnancy Calendar
• Tests Done in Early Pregnancy
• Ultrasound
• Vaccinations In Pregnancy
• Helpful Information
• Labour
• Lower Segment Caesarean Section
• Postnatal Care

General Information

If you are planning to breast feed your baby we encourage you to give your baby the first feed as soon as possible after birth. The midwives will support you in this. Once everything is settled after the birth, you will be offered refreshment and a shower.

After the birth

The baby’s natural instinct to feed is strongest in the hour after birth. Having skin to skin contact with your baby immediately after birth encourages successful breast feeding. The midwife will help you put the baby to the breast as soon as you are comfortable.

Midwives are there to help you with feeding (however you choose to feed), and to provide you with information available to you in the antenatal classes and postnatal wards.

Breast feeding

How you feed your baby is an important health decision. There are many factors that can affect your decision but the choice in the end is yours. During the pregnancy, take the time to find out about how to feed your baby. Discuss any questions or concerns with the midwife or the doctor.

Advantages of breast feeding

• Your milk will give the baby all the food, minerals, vitamins and water he or she will need.
• Human milk is easier for baby to digest.
• It helps prevent many serious problems such as: allergies, eczema, asthma, obesity, heart disease, some forms of cancer, juvenile diabetes.
• Human milk protects a baby against human infections, eg. coughs, colds and sore throat. Many other infections are rare in breast fed babies such as gastroenteritis (very bad diarrhoea) and meningitis (infection of the covering or the brain).
• Human milk provides major benefits to premature babies. It helps prevent serious bowel problems and improves the baby’s ability to fight infections. It is important to start expressing milk on the day the baby is born.
• Women who breast feed are less likely to get breast cancer, ovarian cancer, osteoporosis, and their periods return later.
• Breast feeding is cheaper and more convenient (once you are organized)

Two or three days after birth most women will notice an increase in the amount of milk in their breasts. The milk also changes consistency and colour. To maintain milk production you will need to breast feed your baby frequently.

A midwife will thoroughly examine the baby, the first “physical”. Your baby is weighed and measured, the temperature taken and the baby is dressed and wrapped. At this stage you will be asked about the baby receiving Vitamin K.

If you need to talk about breast feeding worries or need help with breast feeding problems, you can contact:

• an Early Childhood Nurse or a Community Nurse through your local Community Centre
• Telephone your local Early Childhood Community Health Centre:

Parramatta	9635 9496
Wentworthville	9631 8258
The Hills District	8853 4500
Fairfield/Liverpool	1800 455 511
Blacktown	8670 3300

During pregnancy you can contact the lactation consultant at the Maternity Unit.

OTHER RESOURCES

Australian Breastfeeding Association	1800 686 268
Karitane	1300 227 464
Tresillian	02 9787 0855

Acknowledgement: “Breastfeeding Advice” Western Sydney Area Health Service

Vitamin K

Haemorrhagic Disease of the Newborn (HDN) is a rare but serious bleeding disease in newborn infants. Medical experts agree that this disease can be prevented by giving the baby an injection of Vitamin K soon after birth.

Without Vitamin K, approximately 14 babies could die each year from this disease in New South Wales. Since the 1970s, Vitamin K has been given to all babies after birth and the disease has almost disappeared. It is recommended that newborn infants receive Vitamin K. Please discuss this with your obstetrician.

Hepatitis B

Hepatitis B is a virus that affects the liver and can cause fever, nausea, tiredness, dark urine and yellow skin (jaundice). It is usually spread through the blood of an infected person, through sexual contact, or from a mother to her baby at birth. Most children who catch this virus become “carriers” of the Hepatitis B virus can spread it to other people. Carriers are at risk of liver disease.

As a precaution against the spread of Hepatitis B it is recommended that all babies be immunised. Hepatitis B immunisation involves a series of 4 injections and all babies are offered the first injection while you are in the postnatal ward. The subsequent injections will be given by your local doctor.

Postnatal care

Yourself:

Following the birth, you will experience vaginal bleeding for 2-3 weeks. This changes from bright red to brown and then stops. The amount of bleeding varies. To ensure the optimum hygiene, it is recommended that after you visit the toilet, you wipe up any blood loss yourself. You should have at least one shower per day and several washes (or flush with a plastic squeeze bottle of warm water).

Baby’s care:

Each day while in hospital the midwives will check the baby for general wellbeing. They will help with advice on feeding and caring for the baby yourself, and any treatments that may be required.

The Newborn Screening Test

This test is recommended by the NSW Department of Health for all newborn babies. It screens for several rare medical disorders which can be easily treated at this stage. It is usually performed 48 hours after birth and involves a prick of the baby’s heel to collect a small blood sample. Consult a midwife for more information.

Hearing screening

All babies in New South Wales are given a hearing test in the first few days after birth. It is simple and non-invasive.

Going Home

Most women are well enough to go home after 24-48 hours but most tend to stay for 4-5 days. This obviously depends upon the wellbeing of both mother and baby.

Advice:

Once home, you will find that everyone has advice for the new mother – it can become very confusing when you get different information from several people. Listen to the advice, but you must decide what is right for you and your baby, and trust your own instincts. If you are unsure or worried, contact the nearest Early Childhood Centre.

Visitors:

Although it is wonderful to see friends and relatives, visitors can be exhausting. If you feel tired, say so!

Tiredness:

This is a completely normal state for new mothers. It is to be expected that when you are “on call” 24 hours a day. Try to rest during the day when baby sleeps.

Remember: Sleep is more important than housework. Keep the housework to a minimum in the first few weeks and if those visitors keep coming, ask them to do some simple tasks for you such as getting in the washing or perhaps some shopping.

Exercise

You should do your pelvic floor exercises regularly. They can be incorporated into the daily chores. Try to space time for those extra exercises which will help you to get back in shape.

Diet

Follow the same diet you were on during pregnancy.

Alcohol

No safe level of alcohol consumption has been found for breast feeding mothers. Alcohol passes through the breast milk and may affect the baby. We suggest NO intake of alcohol.

Caffeine

Caffeine is found in tea, coffee, chocolate and some soft drinks (eg. Coca Cola). Drinking more than a few glasses each day may cause the baby to become irritable as the caffeine passes through the breast milk.

Postnatal check

You should have a postnatal check 6 weeks after the birth. An appointment should be made with your obstetrician and a Pap smear will be offered at this visit. If you have concerns about the baby, contact the Early Childhood Centre, or perhaps make an appointment with the Paediatrician who saw your baby in hospital.

Sex and Contraception

You can resume sexual intercourse when you feel comfortable to do so. Initially, intercourse may be uncomfortable, so your partner should be aware that gentleness is essential and a lubricant may be necessary. Your sexual feelings are often reduced for a while after birth. This is due to physical and emotional changes that go with a new baby.

The different methods of contraception will be discussed at your postnatal visit.

Baby Blues and Postnatal Depression

What is “baby blues”?

Baby blues is a time period when you can experience mood swings after the baby is born. Up to 70% of women experience baby blues which last from a few days to a couple of weeks.

What causes baby blues?

The condition may be caused by the sudden change in hormone levels which happens around the time of the baby’s birth. There can also be other contributing factors. After all the anticipation and apprehension you may have felt before the birth of the baby, combined with the physical exertion of the birth itself, you may feel unprepared for the sheer weariness which overcomes you after the event. You will probably need a lot of rest to get your strength back.

How will you feel when you get the baby blues?

You could feel emotional and burst into tears for no particular reason. Some mothers feel very tense and anxious. They may worry about minor problems and often have trouble sleeping. Others may feel generally unwell and excessively tired.

What is the difference between baby blues and postnatal depression?

Whilst baby blues occurs during the first week or so after giving birth and lasts for a short time, postnatal depression is a condition which can last a few weeks to several months after birth. It affects 20% of mothers. Onset can be any time in the first year after birth. Isolated from social networks, and significant life events such as a death in the family or moving house are strongly linked to postnatal depression.