What no one prepares you for when bringing your newborn home

Every pregnant woman looks forward to the pregnancy glow, followed by the fairytale of bringing your baby home. Bringing your newborn home is probably the Best Feeling in the world. Whilst this is followed by all the excitement after the 9 month wait, there are many questions that may require answers, guidance and you may quite often need a helping hand.

The first 24-48 hours after the birth is generally spent in the hospital or place of birth, with nursing assistance and guidance. You would generally follow the routine of the   hospital. When bringing your baby home for the first time a cascade of overwhelming emotions may unfold, as mums feel a load of responsibility juggling between their newborn, their family, their daily routine and often neglecting their own needs.

Day 1 to 2 of been home

Settle in and get enough rest and sleep. Remember that you deserve to be spoilt after a long 9month journey so don’t feel guilty about sitting for long periods of time or sleeping during the day. Try and delegate responsibilities, get the extended family to help for the first week, get a helper if possible. Try and ignore the household chores. Frozen, pre-cooked meals done during the last trimester would be exceptionally helpful during this time.

Your breast might become hard and full as your milk flows in when you get home. Stitches on the tear, episiotomy site or ceasar site may pull and feel tender. Your baby may also have a tinge of yellow on the skin colour and eyes.

What to do:

• Your breasts might become hard and full- an electronic breastpump may be exceptionally handy, this might be the time to express excess milk and freeze it for a time that you might need it at a later stage. Cold icepacks and cold cabbage leaves should be placed on the breast immediately after expressing to relieve the engorged breast. Be careful not continue with the cabbage leaves when the lumps are no longer there, as this might decrease milk supply in long term use. Consult with a lactation consultant if there are any concerns. Lactation consultants can assist in the comfort of your own home.
• Stitches on the cut or episiotomy site may pull and feel tender- salt water sitz baths will serve as an antiseptic. Use a spray bottle with salt water each time that you use the restroom. This needs to continue until the stitches have dissolved and healed.
• Caeser sites- the Obstetrician will advise when the dressing on the caeser site will need changing. Once this is removed it is important to keep the area dry and clean. Cleaning with salt water two to three times daily and patting the area dry after cleaning.
• Baby may also have a tinge of yellow on the skin colour. 10minutes of sunlight after a feed is great in controlling mild jaundice, however in the event that the jaundice level increases phototherapy may be needed. Phototherapy can be done in the comfort of your own home if the jaundice levels are not too high. If your baby looks yellow it is always best to consult with your pediatrician, midwife or care giver.
• Feeds- As mundane as this may sound, it is important to feed your baby every 3 hours. There may be times after birth that the baby may sleep for long periods of time, and the common thought of waiting for your baby to wake for feeds, or waiting for them to wake up when they are hungry, does not always apply. The baby may have been routinely sucking in utero, however breastfeeding is a new experience for both the mum and the baby. Some babies wake up and latch without any difficulty, whilst other babies may need to be stimulated to wake up and feed. If your newborn sleeps for 4 hours or longer, it is vital that the baby be woken up and stimulated in order to feed. Breastfeeding is always the best unless limited by a medical condition.

Day 3-5 of been home

You may become tearful and feel emotionally drained. A lack of sleep may exacerbate this feeling, so it is vital to nap during the day.  Babies can be irritable, or cry especially toward the evening whilst other babies may not wake up as often for feeds.

What to do:

• Increase your fluid intake, continue your supplements and ensure that you are getting a balanced diet.
• Try sitting outside for some fresh air and sunlight.
• Have a nice hot bath, soft music and a cold drink after the baby has had a good feed. You deserve a take time out!
• Ensure that you have sufficient rest and sleep. Try sleeping when baby sleeps during the day.
• Kangaroo care or skin to skin will help keep babies calm, regulate temperature and promote bonding. Both the dad and mum can practice skin to skin contact.
• Babies tend to loose 200g within the first 3 days after birth. They therefore need to feed regularly to maintain weight gain.
• If babies are irritable assess if the baby has been feeding every 3 to 4 hours. A baby that has been sleeping for long periods or not feeding every 3 hours may have difficulty in regulating their sugar and may have difficulty in feeding. Smaller babies may need to feed more often, especially if breastfed and this is easily digested and softer on the baby’s tummy. Burp your baby after feeds.
• When placing your baby down, always put baby on their side or at a 30 -40% angle, and never on the baby’s tummy.
• Before feeds ensure that the baby has a dry nappy, and check again after the baby has fed.
• Clean the cord with each nappy change. The cord will be dry and almost ready to fall off.
• Baby baths and a baby massage may sooth an irritable baby.
• Avoid tapping baby harshly, but gentle rocking to calm a crying baby.

Day 5-10 of been home

You may start feeling a little better. If feelings of tearfulness tend to get worst over the next week, please consult with your health care provider.

Your nipples may crack, or bleed even when latching is perfect- nipple care starts during the last trimester of the pregnancy. Applying oils or nipple cream prenatally and postnatally after each feed will assist with healing.

Start practicing the kegal exercises to train your bladder and strengthen the pelvic muscles.

If there are haemorroids-prescribed ointments from your obstetrician can be used, ice packs, witchhazel on the pad can ease the discomfort. A high fiber diet, increased fluid intake and a balanced diet will assist is keeping the stool soft.

A full body massage might works wonders! If this is possible, you may contact a postnatal doula or masseuse for a postnatal home massage. Your postnatal bleeding would have decreased substantially. Overall pain would have decreased.

What to look out for and seek medical advice on:

If there is excessive bleeding, or clots

If the discharge is offensive in smell

If the caeser site, episiotomy, or tear seems to ooze with discharge.

If there is a spike in temperature, fever or an increased pain.

If  there is an increased amount in tearfulness, anxiety, anger, feeling of inability to cope, difficulty in sleeping or depression.

Once the 10 days have passed, you are likely to be more relaxed and fall into your own routine. Allow 4 -6 weeks for your body to heal. Avoid strenuous activity, eat a balanced diet, drink lots of fluids and rest as much as you can. Your baby will change on a daily basis and will even start making eye contact with you. Take time out to enjoy those precious moments. Laugh allot, smile often and enjoy those moments. 

Ruwaida Moola has been practising midwifery since 1999, working in various hospitals and clinics. She currently practices midwifery with Genesis as her main birthing clinic. She has practising rights at Garden City Clinic, Oxford Rd Day Clinic, Brenthurst Clinic and Parklane Hospital and utilizes these hospitals as the emergency back-up hospitals.

She works closely with Obstetricians, Doulas, Chiropractors, Homeopaths, Herbalists, Reflexologists, Acupuncturists, Psychologists, and Paediatricians and believes in a multi-disciplinary approach. I also practice as a senior fertility sister at the BioART Fertility Clinic. She is a Registered Nurse and Fertility Nursing Sister, Nurse Educator and Advanced Midwife.

Find Ruwaida at www.miraclebirths.co.za.

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