Caring for your baby
The early days with your new baby can often feel overwhelming. In this section you will find lots of information to help support you to get to know your baby and grow in confidence as a new parent Our parent education and information padlet also has lots of helpful resources: https://padlet.com/chester_classes/caringforyourbaby
If you have any concerns about your baby’s wellbeing, it is best to get them checked out. If you see any of these symptoms in your baby, you should contact your midwife, GP or 111 right away:
- Your baby isn’t interested in feeding, or is having difficulty feeding
- Your baby is lethargic and it’s quite difficult to wake them
- Your baby has a temperature above 37.5C or below 36.5C
- Your baby is grunting, breathing very quickly or their breathing is laboured (you might see the skin pulling in around their ribs, their nostrils flaring or their stomach sucking in when they breathe)
- There are long pauses in your baby’s breathing when they’re awake or asleep
- Your baby has a high-pitched cry, a weak cry or you cannot settle them at all
- Your baby becomes jaundiced within 24 hours of birth
- Your baby’s jaundice becomes worse (jaundice can cause lethargy, yellowing of the eyes, reluctance to feed, fewer wet or dirty nappies, and pale or white stools)
- Your baby has not passed meconium (baby’s first poo which is very dark and tar-like) within 24 hours of birth
- Your baby has not had a wet nappy for 12 hours
- Your baby develops a rash all over their body
- Your baby’s soft spot on their head is sunken or bulging
You should call 999 or go to A&E if your baby has any of the following symptoms:
- Your baby is floppy and unresponsive
- You cannot wake your baby
- Your baby has a blue tinge to their lips or around their mouth
- Your baby has a pinprick rash which does not fade when a clear glass is pressed firmly against the skin
- Your baby feels abnormally cold to the touch
- Your baby’s skin is mottled or blue
- Your baby has a fit or convulsion
Skin to skin contact
Skin to skin contact helps your baby feel safe and secure.
When your baby is born we will encourage you to hold your baby in skin contact. Babies need lots of skin contact in the early days so we encourage you to keep your baby in skin contact as much as possible. Vest tops, low necked T-shirts, and cardiagans are useful clothes to wear in to make skin to skin contact easier.
WHY IS SKIN CONTACT SO IMPORTANT?
- It makes your baby feel safe and secure
- It regulates your baby’s heart rate and breathing, helping them to better adapt to life outside the womb
- It releases the hormone oxytocin which helps your baby’s brain to grow and develop.
- It keeps your baby warm
- It helps you and your baby feel calm and relaxed and to recover from the birth.
- It helps protect your baby from infection
- It encourages your baby to look for the breast and want to breastfeed.
- Your newborn baby needs to know you are close all the time. They will be used to hearing your voice and hearing your heartbeat and so skin contact helps your baby to feel safe.
To hold your baby safely, make sure their head is straight and their neck is upright so that they can breathe easily, and so that you can always see their face to check that they are ok.
After your baby is born, your midwife will check your baby to ensure they are well. They will consider if there are any risk factors present that could mean your baby may have an increased chance of becoming poorly. This includes assessing whether your baby has any risk factors for having an infection, low blood sugars or potential for withdrawal from specific maternal medications.
National guidelines are followed when considering risks factors. Depending on which risk factors are present it may be advised that your baby have regular observations, or it may be advised they have a 'septic screen'.
Observations on your baby would involve them staying with you and a member of staff coming to check their temperature, breathing rate, heart rate and wellbeing at regular intervals, this is usually done for 24 hours for risk factors for infection and 72 hours for those being monitored for withdrawal.
A ’septic screen’ involves your baby having a cannula, blood tests and antibiotics given intravenously through the cannula. Antibiotics are given 12 hourly for 36 hours until your baby’s blood test results are all back. If the bloods suggest an infection, then the paediatric doctors may suggest further investigations and a longer course of antibiotics, usually up to 7 days.
Babies who have a higher chance of developing low blood sugar will have this checked regularly.
We recognise that babies should stay with their parents whenever possible. If your baby requires observations or antibiotics, you will need to stay in hospital with your baby until they have completed their treatment. If your baby becomes unwell and requires care on the neonatal unit, there are beds next to each cot so that you can stay with them. Please follow the link for more information about our neonatal unit: https://padlet.com/chester_classes/NNU.
Following the birth of your baby you will be asked if you wish for your baby to have vitamin K in line with The Department of Health recommendation that all babies should receive vitamin K at birth.
Within 72 hours of giving birth, you will be offered a top-to-toe physical examination for your baby. This will include 4 specific screening tests to find out whether your baby has a suspected problem with their eyes, heart, hips or, in boys, their testes which would benefit from early investigation and possible treatment.
The screening tests are carried out again between 6 and 8 weeks of age as some conditions do not develop or become apparent until then.
Find out more: https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/eyes-heart-hips-and-testes-physical-examination
One to two babies in every 1,000 are born with permanent hearing loss in one or both ears. The newborn hearing screening is done soon after birth to help identify babies who have permanent hearing loss as early as possible.
Find out more: https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/hearing-loss
The newborn blood spot is done when you baby is about five days old and involves taking a small sample of your baby's blood to screen it for 9 rare but serious health conditions including:
- Sickle cell disease
- Cystic fibrosis
- Congenital hypothyroidism
- 6 inerited metabolic diseases
Find out more: https://www.gov.uk/government/publications/screening-tests-for-you-and-your-baby/blood-spot
Your midwife will let you know if your baby meets the criteria for a BCG vaccination or a Hepatitis B vaccination.
BCG - This vaccine protects against tuberculosis also known as TB. At the Countess of Chester we offer a targeted BCG vaccination programme. This means if the parents or grandparents of your baby were born in a country where the incidence of TB is high we would offer the BCG vaccination on the postnatal ward after birth.
Click here for more information about the BCG vaccination for babies: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1017772/UKHSA_12079_TB_BCG_and_your_baby_leaflet.pdf
Hepatitis B - Newborn babies start the Hepatitis B vaccination programme at birth, only if their mother or father is Hepatitis B positive. All other babies will be offered Hepatitis B vaccination as part of the routine schedule that start when your baby is 8 weeks old.
Click here for more information about the Hepatitis B vaccination for babies: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/736029/Protecting_your_baby_against_hepatitis_B_leaflet.pdf
Other vaccinations for your baby will be discussed at your 6-week GP check, or with your Health Visitor. Click here for the routine NHS vaccination schedule: https://www.nhs.uk/conditions/vaccinations/nhs-vaccinations-and-when-to-have-them/
Safe Sleep and SIDS
It is not yet understood why some babies die suddenly and for no apparent reason from what is known as sudden infant death syndrome (SIDS) or cot death.
We do know that placing a baby to sleep on their back reduces the risk and that exposing a baby to cigarette smoke or overheating a baby increases the risk.
SIDS is rare, so don't let worrying about it stop you enjoying your baby's first few months. Follow the advice below to reduce the risks as much as possible.
- Place your baby on their back to sleep, in a cot in the room with you.
- Keep your baby's head uncovered. Their blanket should be tucked in no higher than their shoulders.
- Place your baby in the 'feet to foot' position (with their feet at the end of the cot or pram).
- The safest place for your baby to sleep is on their back in a cot in a room with you for the first six months.
- Don't smoke during pregnancy or let anyone smoke in the same room as your baby.
- Don't share a bed with your baby if you've been drinking alcohol, if you take drugs, or if you are a smoker.
- Never sleep with your baby on a sofa or armchair.
- Place your baby on their back to sleep
- Don't let your baby get too hot.
All babies cry, crying is your baby's way of telling you they need comfort and care. Sometimes it's easy to work out what they want, and sometimes it's not.
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.
It’s okay to walk away if you have checked your baby is safe and the crying is getting to you. After a few minutes when you are feeling calm, go back and check on your baby.
Never, ever shake or hurt a baby. It can cause lasting brain damage and death
ICON has lots of helpful information to support you and your family to cope with crying: https://iconcope.org/parentsadvice/
The NHS website also has lots of tips to help soothe and comfort a crying baby: https://www.nhs.uk/conditions/baby/caring-for-a-newborn/soothing-a-crying-baby/
Jaundice is caused by rising levels of a natural chemical called bilirubin in the blood after birth. It causes a yellowing of the skin, whites of the eyes and the gums. It can also lead to babies being sleepy and reluctant to feed. Most babies will not be affected, but a small number require treatment. Most only need monitoring, some require light-treatment, a few require specialist support. If your baby has signs of jaundice contact your maternity department during the day or night. They will perform a bilirubin test.
Find out more about newborn jaundice: https://www.nhs.uk/conditions/jaundice-newborn/
When caring for your baby’s eyes good hand hygiene is important. You can clean your baby’s eyes with cooled boiled water using a clean cotton wool ball, wiping gently from the inside out. Only wipe the once with each cotton wool ball. You will need to use a separate cotton wool ball for each eye.
The small piece of umbilical cord that has been clamped will dry out, turn black and drop off normally between day five and fifteen. It then takes between seven to ten days for the belly button to heal completely. It is important to keep this area clean and dry to avoid infection. If it does get wet, dry it gently with a clean towel. You do not need to use any cleaning products or antiseptic powders. If it starts to smell, becomes red or swollen speak to your midwife, health visitor of GP for advice.
In the first few weeks of your baby’s life, you will change their nappy a lot!
It is important it is changed as soon as possible after peeing and pooing to avoid nappy rash and irritation. For the first month it is advisable that use cotton wool and water to clean the soiled skin, as babies have very delicate skin. You do not need to use barrier cream unless your baby has a nappy rash.
For more information and a video check out the NHS website: https://www.nhs.uk/conditions/baby/caring-for-a-newborn/how-to-change-your-babys-nappy/
It is a good idea to choose a time when your baby is relaxed to bath your baby for the first time; this will help it be more of an enjoyable experience for you and your baby. Make sure the room is warm and draft free. Get prepared first, you will need:
- a baby bath or clean washing up bowl filled with warm water
- two towels
- a clean nappy
- clean clothes
- cotton wool
It is important you get the water temperature right, use your elbow to test the temperature. It should feel neither hot nor cold.
You do not need to use any products in the water as babies have their own skin protector. If you wish to use soap, use and mild non-perfumed soap. Continue to use plain water for the first month. You baby will only need to be bathed once or twice a week initially.