Caring for your newborn

Caring for your newborn baby should be the most wonderful experience, but equally it can be filled with the overwhelming fear of responsibility for this tiny new bundle. In the UK, we are fortunate to have support from our incredible NHS midwives who are there to offer support and guidance to new parents in the early days and weeks following birth both within the hospital setting and out in the community. Once the Midwifery team discharge you from their care, they will ensure that the Health Visitors have been in contact with you, and it will then be they who continue to provide any support necessary until your baby is school age!

Our amazing Midwives at My Expert Midwife are here to support you throughout the Maternity journey from Trying To Conceive, Pregnancy, Labour & Birth, Postnatal Recovery, all the way through the transition to becoming a new parent. The Midwives have pulled together some top tips and areas of support that they feel will help to relieve some of the pressures of caring for your precious baby, however, these are only tips, you will get to know your baby better than anyone else and we are here to offer support in those moments where you just need another pair of hands, a gentle shoulder to lean on, or a bit of extra reassurance.

Feeding

Midwives will always support your choices whether that is to breastfeed, bottle feed or combination feed (a bit of both), but however you choose to feed and whether you choose to give breast milk or formula feed remember that your midwife will be there to support and offer safe advice; you will not be judged. A really important skill you will develop over the first few days with your new baby is identifying their hunger cues: rooting, tongue movements, rapid eye movements, head bobbing and sucking on their fists or fingers. Crying is a last resort hunger cue which can cause both you and baby unnecessary stress and upset so having the ability to recognise when your baby wants to feed is an easy way of reducing this. You will become tuned into your baby’s communication very quickly and probably without you even being aware of it – how incredible is that?!

Responsive Feeding is a really simple process where you follow your baby’s feeding cues letting them decide when they want to feed and for how long rather than the scheduled feeds of previous generations which often led to over-feeding, this is equally applicable whether breast or formula feeding. A well-baby will wake frequently for feeds and will take what they need rather than being overfed which can cause vomiting, gas, and general distress. Midwives will be able to identify a baby that is feeding well by their weight, the number of wet and dirty nappies, and your baby’s general appearance and behaviour, your midwife will be able to support you with understanding what is normal and when to be concerned. As a rough guide if bottle feeding allow them to take as much or as little feed as they choose don’t force them to finish a bottle. If breastfeeding a good guide is 8-12 feeds in 24 hours in the early weeks lasting between 5 and 40 mins each feed depending on how efficient a feeder they are. If you have been advised to stick to a strict feeding schedule perhaps because of jaundice or because of extreme weight loss for example, then you should always follow your own healthcare professional’s advice.

Midwives and Maternity Support Workers (MSWs) are experts when it comes to offering support with breastfeeding techniques and positioning to ensure your baby feeds well. They can also help with latch issues and offer advice if you’re experiencing any challenges so reach out to them, they’ll be more than happy to help.

If you have chosen to bottle-feed, midwives will be able to advise you on safe formula preparation, feeding schedules, and how to safely handle bottles including washing and sterilising. These are really important skills that can significantly reduce the risk of baby developing gastroenteritis, a potentially serious illness in a newborn.

Sleep

The Lullaby Trust’s advice on safe-sleeping practices have been adopted throughout the NHS and is the best resource to refer to ensure you are following the best guidance to reduce the risk of SIDS (Sudden Infant Death Syndrome). The main points are:

DO

• Place baby in the ‘feet to foot’ position, with their feet at the end of the cot.
• Always place your baby on their back to sleep (not on their front or side).
• Have your baby in the same room as you for the first 6 months.
• Use a firm, flat, waterproof mattress that is in good condition.
• The room temperature should be between 16 and 20°C.

DO NOT

• Use any cot bumpers, soft toys, pillows, and duvets in the cot.
• Sleep in the same bed as your baby if you or a partner smoke, drink or have taken drugs or medications that make you drowsy, are extremely tired, if your baby was born prematurely (before 37 weeks) or had a low birth weight (2.5kg or 5½ lbs or less)
• Sleep on a sofa or in an armchair with your baby as this increases the risk of suffocation.
• Smoke during pregnancy or while you are breastfeeding, and don’t let anyone smoke in the same room as your baby.
• Let your baby get too hot or too cold – keeping the room temperature around 16-20 degrees is ideal. You can check baby’s temperature by feeling their chest, tummy, or the back of their neck (your baby’s hands and feet will usually be cooler, which is normal).
• Blankets and bedding should be tucked around the base of the mattress to reduce the risk of baby kicking them over their heads and should come no higher than their armpits with arms left free.

Newborns sleep a lot, but they don’t sleep for long stretches, and this is a protective mechanism; baby’s need to feed regularly and so we want them to wake including during the night, although yes at the time it feels like torture just go with it and don’t be tempted to find “solutions” to get them to sleep through, it will pass!

Umbilical Cord Care

Midwives will show you how to care for your baby’s umbilical cord stump. It is important to keep it clean and dry using cooled boiled water and cotton wool until it naturally detaches; don’t be tempted to pull it. Don’t use any powder including talcum powder on it as it makes a perfect breeding ground for bacteria which in turn can lead to infection. It is normal for a cord to bleed a small amount and it might even smell a little bit odd as it starts to detach this is normal but if you suspect your baby has developed an infection at the cord site seek medical advice immediately. Signs of this can include baby being irritable, redness and or swelling around the site, puss oozing from the site, and an offensive smell but if you are ever concerned just reach out and ask your Midwife.

Nappy Changes

Midwives will be able to show you how to change your baby’s nappy and offer advice on keeping your baby clean and comfortable. They can also give advice on preventing and soothing nappy rash including using a baby specific nappy cream such as My Expert Midwife’s award winning No Harm Bum Balm There are many types of nappies available now including disposable and reusable (washable). Do your research and find what type suits you and your baby best. Whatever type of nappy you choose it is a good idea to give your baby plenty of nappy-free time to allow air to circulate around their gorgeous little bottoms which can reduce their risk of nappy rash.

 Bathing Your Newborn

We know that your newborn baby’s skin is approximately 30% thinner than yours making it more vulnerable to damage, so the Midwives at My Expert Midwife advise:

• Avoid bathing baby for at least 24 hours but the longer the better –a top and tail is more than enough in the first few weeks
• Test the temperature of the water before putting your baby into a bath – use a bath thermometer ideally (37-38 degrees C)
• Use only skincare products that have been designed specifically for baby’s skin – avoid any products with perfumes, essential oils, colourings, or chemical nasties
• Always moisturise them following a top and tail or a bath – babies’ skin needs extra hydration
• NEVER leave a baby in a bath unattended – drowning can occur in even an inch of water

Signs of an unwell baby and when to seek advice

Midwives will spend time discussing signs and symptoms of infection, dehydration, or pain in your baby. Trust your instinct and seek advice from your Midwife, GP, or local A&E if you have any concerns about your baby’s health. Symptoms to look out for that may indicate an unwell baby include (but are not limited to):

• Temperature above 38°C or below 36°C
• Changes to feeding patterns
• Sleeping more than usual
• Reduced urine output
• Pale, mottled, or blue skin, or they have a new rash
• Differences to their breathing (faster, slower, noisy with grunting or ‘tugging’ in at their chest)
• Bruising, swellings, or bleeding
• Bulging fontanelles
• Irritability
• Any new or excessive vomiting

Vaccinations

Before you are discharged from Midwifery services to the Health Visitors your Midwife will provide lots of information on vaccinations that are advised for your baby, ultimately it is your choice whether you accept or decline these vaccinations, however, it is important you are given all of the evidence to ensure you are s an informed choice, if you feel you don’t have enough information ask your Midwife they will be happy to provide what you need.  Baby’s vaccination schedule starts around 8 weeks and continues through to starting school and your Health Visitor will ensure you are kept up to date with latest evidence and information.

Postnatal Support

Following your birth, you will receive postnatal support from the team on the hospital wards and then midwives will conduct home visits to check in on both the baby and the mother, and/or invite you along to postnatal checks at your local GP surgery, this all depends on your local Maternity service. They will offer emotional support, help with any feeding concerns, check your blood loss, wound care, blood pressure, weigh baby, offer the Newborn Blood Spot Screening Test, and provide information on maternal mental health as a minimum, if you need any other support or advice ask them, they will happily oblige or signpost you as appropriate. Contact your team at any time you have any non-urgent concerns about you or baby and if you think you have an urgent problem call 111 or 999, or visit A&E.

Skin-to-skin contact and bonding with your baby.
Spending time with baby in skin-to-skin contact (baby naked against your or your partner’s bare chest) straight after birth is one of the most important things you can do:

• Calms you and your baby, regulates their temperature, breathing and heart rate
• Aids bonding.
• Initiates and supports breastfeeding.
• Kickstarts baby’s microbiome by transferring beneficial bacteria, fungi, and viruses from you to them

Continuing skin-to-skin contact at home is highly recommended by us and can be done anytime either of you need or want that extra close bonding time.

Remember, whether this is your first or you fifth baby it’s totally normal to have questions, and no question is a daft question so ask them. Midwives are there to offer you support, reach out they will want to help. Those early days and weeks with a newborn can seem so tough and yes, it is exhausting, but with the right help, advice and support you will navigate the rocky seas and get through it. The Midwives at My Expert Midwife have lots of useful information about all things Postnatal and Caring For Your Newborn on their website so head across for advice and don’t forget to visit us at our stand!

Written by Registered Midwife, Lesley Bland, My Expert Midwife