Life after birth – becoming a family

First feed, weight gain and nappies

Some babies feed immediately after birth and others take a little longer. Your midwife will support you with feeding your baby however you choose to feed. We encourage the first feed to be in skin to skin contact.

A children’s doctor (paediatrician), midwife or newborn (neonatal) nurse will check your baby is well, and will offer him or her a newborn physical examination within 72 hours of birth.

It’s normal for babies to lose some weight in the first few days after birth. Putting on weight steadily after this is a sign your baby is healthy and feeding well.

Tests and checks for your baby

You’ll be offered 2 screening tests for your baby:

• newborn hearing screening test
• blood spot (heel prick) test ( usually on day 5 )
• BCG vaccine for eligible babies between 2 and 4 weeks old

In the early days, the midwife will check your baby for signs of:

• jaundice
• infection of the umbilical cord or eyes
• thrush in the mouth

BCG Vaccine

Bacillus Calmette–Guérin (BCG) Vaccination for Babies

What is TB?

TB is an infection that usually affects the lungs. It can also affect other parts of the body such as the brain and the bones. With treatment it is possible to make a full recovery.

The BCG vaccine protects against Tuberculosis (TB).

In the UK, BCG is offered to babies who are more likely than the general population to come into contact with TB. The BCG vaccination is recommended for all babies from around 2 weeks of age up to 1 year old who:

• are born in areas of the UK where the rates of TB are high
• have a parent or grandparent who was born in a country where there’s a high rate of TB
• live with, or are close contacts of, someone with infectious TB

When will your baby be offered the BCG vaccine?

As parents you will be offered the BCG vaccine for your baby once the Newborn Bloodspot result is available and where possible before 28 days from baby’s birthday. You will be asked to give written consent (sign a form to give permission) for the vaccine to be given to your baby.

You baby’s BCG vaccination will be provided in an outpatient clinic, usually between 2 and 4 weeks of age. Details of the appointment will be sent out in the post.

If you have any questions about the vaccination, please discuss these with a midwife.

How is the vaccination given?

The vaccination is given by intradermal injection (an injection into the skin) and is administered by a midwife or a doctor.

Are there any side effects relating to the vaccination?

• Your baby may feel some discomfort which will be relieved by cuddling or feeding your baby.
• After the vaccine a blister or sore may appear at the injection site. If it does appear, it will heal gradually. It is advisable to leave the area uncovered to allow it to heal. It may leave a small scar.

What do I do if I declined BCG for my baby and I change my mind?

If you change your mind and decide that you would like your baby to have the BCG vaccine, please contact the Antenatal and Newborn Screening team on 01274 364295 between the hours of 9.30am and 4.30pm to arrange an appointment.

Please be aware we can only provide this vaccination before your baby has his / her 1st birthday.

2 weeks and beyond

You don’t need to give your baby a bath every day. You may prefer to wash their face, neck, hands and bottom carefully instead.

Most babies will regain their birthweight in the first 2 weeks. Around this time their care will move from a midwife to a health visitor.

The health visitor will check your baby’s growth and development at regular appointments, and record this in your baby’s red book.

Stitches

If you’ve had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry. If your stitches are sore or uncomfortable, tell your midwife.

Painkillers can help. If you’re breastfeeding, check with your pharmacist, midwife or GP before you buy over-the-counter painkillers.

Stitches usually dissolve by the time the cut or tear has healed, but sometimes they have to be taken out.

Going to the toilet

At first, the thought of peeing can be a bit frightening – because of the soreness. Drinking lots of water dilutes your urine, which may make it sting less.

You probably won’t have a poo for a few days after the birth, but it’s important not to let yourself get constipated.

Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you’ve had stitches, it’s very unlikely you’ll break them, or open up the cut or tear again.

It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain. Tell your midwife or GP if poo is leaking or you’re pooing when you don’t mean to.

Bladder control

After having a baby, it’s quite common to leak a bit of pee if you laugh, cough or move suddenly. Pelvic floor exercises can help with this but tell your GP at your postnatal check if they aren’t. They may refer you to a physiotherapist.

Piles

Piles are very common after birth but usually disappear within a few days. Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water. This should make pooing easier and less painful. Try not to push or strain – this will make the piles worse.

Bleeding after birth (lochia)

You’ll bleed from your vagina after the birth. It will be quite heavy at first, and you’ll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.

It isn’t a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection.

You may notice the bleeding is redder and heavier when you breastfeed. This happens because breastfeeding makes your womb contract. You may also feel cramps similar to period pains.

The bleeding will carry on for a few weeks. It will gradually turn a brownish colour and decrease until it finally stops.If you’re losing blood in large clots, tell your midwife. You may need some treatment.

Breasts

To begin with, your breasts will produce a yellowish liquid called colostrum for your baby. On the third or fourth day, they may feel tight and tender as they start to produce milk. Wearing a supportive nursing bra may help. Speak to your midwife if you’re very uncomfortable.

Tummy

After delivery, your tummy will probably still be a lot bigger than before pregnancy. This is partly because your muscles have stretched. If you eat a balanced diet and get some exercise, your shape should gradually return.

Breastfeeding helps because it makes your womb contract. You may feel quite painful period-like cramps while you’re feeding. You could also try these gentle postnatal tummy exercises.

Pelvic floor exercises

Your pelvic floor muscles surround and support all the organs in your pelvis – your womb, bowel and bladder.

If these muscles become weak, you can leak urine when you cough or sneeze. This is called stress incontinence. Exercising the pelvic floor muscles helps to prevent this.

You can start doing pelvic floor exercises before, during and after pregnancy.

It’s possible to become pregnant again very soon after the birth of a baby, even if you’re breastfeeding and even if your periods have not returned.

You usually release an egg (ovulate) about 2 weeks before your period starts, so it’s possible to get pregnant before you have a period.

There are various organisations, support services and health professionals who can support your mental health during pregnancy and after having a baby. These may include general health and pregnancy support services like:

• your GP
• antenatal care (with your midwife or obstetrician)
• your health visitor

There are also more specialist services to support you if you are at risk of becoming more unwell, or if you become more unwell. These include:

• perinatal mental health services
• community mental health teams (CMHTs) and crisis teams
• hospitals, and mother and baby units (MBUs)

Infant crying is normal and it will stop! Babies start to cry more frequently from around 2 weeks of age.

Comfort methods can sometimes soothe the baby and the crying will stop. Is the baby hungry, tired or in need of a nappy change? Comfort methods to try include:

• Talk calmly to your baby.
• Stroke them gently.
• Try placing your baby face down on your lap, or hold them against you and try stroking their back rhythmically.
• Hum or sing to your baby.
• Let them hear a repeating, constant and soothing sound.
• Classical music, including piano and guitar, can sometimes soothe some babies.
• Hold them close – skin to skin.
• Go outside with your baby and walk them in a pram or in a baby sling.
• The rocking motion can be very soothing for a baby.
• Try giving them a warm bath.