The Baby

Most babies will show an interest in latching on to the breast within the first hour after birth when they are in an alert state. After that, the baby should be encouraged to nurse every 2-3 hours. During the first 24 hours after birth the baby may be quite “sleepy” and one sleep of 4 or 5 hours is common. Babies should nurse 8-12 times in a 24 hour period. Nursing times vary from 5-60 minutes per feed.

Sometimes after being fed and changed, a baby may still be “fussy”. This may be caused by gas in the stomach and may be relieved by rubbing the baby’s back while supported over your shoulder, sitting or lying across your lap. Sometimes babies just want to be held.

The cord should be kept out of the diaper and the diaper folded down in front. The cord does not need any special care – just keep it dry. It is normal for the cord to smell as it decays. If the belly skin around the navel looks red or infected, you should contact your midwife. If the baby is bleeding from anywhere, you should contact your midwife.

At first a newborn’s stool is the colour and texture of tar. We recommend putting olive oil on the baby’s bottom. Within a few days, the baby’s stool changes to a very loose, mustard yellow. The frequency of bowel movements in a breast fed baby varies a great deal from many times a day to once every week. Both are normal if the baby is drinking only breastmilk. If the baby has not urinated or passed meconium within the first 24 hours, contact your midwife. The general rule of thumb is: 1 void on Day 1, 2 voids on Day 2, 3 on Day 3 and day 4, 4 voids or more. We recommend putting a tissue in the diapers to help you know if your baby has voided.

If a baby becomes at all jaundiced (yellow-looking skin or whites of eyes are yellow) especially within the first 24 hours of life, contact your midwife. Many babies will develop a mild-moderate degree of jaundice around the third day. This can be normal and will gradually disappear if the baby is feeding well. Call your midwife if your baby is jaundiced AND lethargic.

If the baby’s eyes look irritated or have a pussy discharge, contact your midwife. Most times it is a blocked tear duct, which is normal in infants up to 1 year of age. Clean it with warm water on a cotton ball as needed. Putting some expressed breast milk in the eye can also help keep it from getting to infected. To help clear tear duct massage inner corner of eye 4 times a day.
Leave the baby on his/her back to sleep. This is the safest position to prevent Sudden Infant Death Syndrome (SIDS). The current advice is to avoid a facedown position.

In general, the baby’s breathing will occasionally be irregular. Coughing, sneezing and crying help clear the baby’s lungs in the first few days. However, if the baby has a fever, or is gasping and grunting with each breath or breathing over 60 times a minute, contact your midwife.

Be careful in choosing commercial baby products. Mineral oils will absorb vitamins from the skin, vegetable oils will not. Some baby powders have Zinc Stearati, which with harm baby’s lungs. Cornstarch is a natural alternative. It is normal for baby’s skin to peel the first week or two.

The Mother

Nursing makes your uterus contract and you may have a gush of blood. Whenever you stand up, and blood that has collected in the back of the vagina will come out. If more than one pad is completely soaked in half an hour you should contact your midwife, and save the pads in case she wants to look at them.

You may choose to take your temperature in the week following birth. If above 38.0 C, this could indicate infection. Please contact your midwife. Your lochial discharge (bleeding) should smell like a period. If it smells foul, or if there is any pus in the discharge, you may have an infection and you should contact your midwife.

Your whole perineal area should be kept clean, even if you don’t have any tears. Many women find that soaking in a clean warm shallow (3-4” deep) sitz bath, once or twice a day, eases the discomfort of abrasions or stitches. A cold pack applied after birth will help ease the swelling. Always wipe from front to back. Try to keep your bowels loose. Spraying with lukewarm water from a squeeze bottle will minimize the stinging when you urinate, as well as cleansing the area. A herbal bath package is available through our office.

After birth, rest. Then gradually increase your active hours each day. Many women have found that if they don’t rest at first, they end up having to do it later.

Your breasts do not need to be washed more often than the rest of your body. It is much more important to wash your hands after going to the bathroom or before handling your breasts.

When your milk comes in, your breasts may feel uncomfortably full and hard. Sometimes a hot towel applied to the breasts will speed the let-down of milk. If you feel hard lumps or red-hot painful areas in your breasts warm compresses, massage, bed rest, and keeping the baby nursing are all beneficial. Page your midwife if you have red-hot painful areas or fever.

If you have any problems or questions around breastfeeding, or would like breastfeeding and mothering support please remember to call or attend your local La Leche League group. Local breastfeeding clinics are also available in conjunction with midwifery care to support breastfeeding.