Friday, 10 May 2013

Guest Post: Your Newborn; the first few days.

There will be so many new things you will experience in the first couple of weeks, and questions you will no doubt be wondering the answers to. I have compiled a list below of some of the common subjects parents think about initially...

Midwives/ Health visitor
Your midwife will come and visit you at home once you are discharged from hospital. If you live in a busy town or city it is highly likely you will have more than one midwife and will see a different one each time. She will ask you questions when she visits and check your and your babies’ health to make sure everyone is happy with the way things are going. Don’t be afraid to bombard her with questions-it is much better to ask than struggle on when a simple answer could help make things easier for you. If you are having problems breast-feeding, she will be able to give you details of your local breast-feeding counsellor, who will come out and do a home visit.
She will also do your babies’ Guthrie (or heel prick) test on day 7. A few drops of blood are collected and sent away to test for a metabolic disorder called Phenylketonuria or PKU, as well as cystic fibrosis and screened for some other conditions too. You will be given a leaflet that explains them all in more detail. You will then be discharged from Midwife care around day 10, provided all is well with you and the baby.
Your local Health Visitor will then be given your details and will contact you within a couple of weeks to come and do a home visit. She will introduce herself and give you details of all the local baby clinics where you can go to get your baby weighed, and meet other mums.

Cord/ Tummy peg
This area needs to be wiped gently all around the remaining cord a few times a day as you do your baby’s nappy. Use a clean cotton pad and some cool boiled water to clean off any dry blood. Don’t use wet wipes, creams or any other antiseptic wipe in this area unless advised by your doctor.
The remaining cord generally falls off between days 7-10 and you will most likely just find it in your baby’s nappy as you go to change her. If your baby was overdue then the likelihood is that it may come off earlier, but if it still hasn’t fallen off by the time your Midwife wants to discharge you around day 10, she will probably give it a helping hand. Once it does fall off, your baby’s ‘tummy button’ as they are widely known, may be a bit weepy and gooey for a couple of days. Clean as directed above at every nappy change, ensuring that you give a really firm wipe now, as any remaining little bits that do not get cleaned off properly can make her tummy button red and sore and may cause an infection.

Fontanelle
This is the soft spot on the top of your baby’s’ head where her skull hasn’t yet fused together. Unbeknown to a lot of people there is also a smaller fontanelle towards the back of the baby’s head, which is much less noticeable and very hard to find. The main reason your baby is born with these two openings in the skull is to allow her head to mould and fit through the birth canal during labour-something that wouldn’t be possible with a totally fused skull. It also allows room for your baby’s brain to grow in the first year.
The Posterior fontanelle, at the back of her head, generally closes within 3 months of birth. The anterior fontanelle is on the top of her head and starts to close when babies are around 6 months, and is usually totally closed by the time they are 18 months. The fontanelle on the top of your baby’s head usually appears flat as part of the shape of her head-you may notice it ‘pulsing’ if your baby doesn’t have a lot of hair. This is totally normal and nothing to worry about. It may also bulge slightly when she cries. However, a fontanelle that bulges persistently should be looked at by a doctor, as it may indicate increased pressure inside the head. Equally, a significantly sunken fontanelle should also be seen by a doctor, as this generally indicates dehydration.

Sticky eyes
This is very common for babies in the first few weeks and is due to blocked tear ducts. You may find yellow/ white mucus in the inner corner of the eye and the lids may be stuck together when she has slept for a while. Clean each eye with cotton pads and cool boiled water-taking care to use a separate piece for each eye. Wipe from the inside corner (closest to the nose), outwards. You could also try squirting a bit of breast milk into her eye if you are breast feeding. It has amazing healing powers and will more often than not clear up a sticky eye. Squeeze a few drops into the affected eye before each feed over a couple of days. If the mucus is more of a green colour, and the eye looks particularly red, then see your GP as soon as possible, as it may mean your baby has an infection that needs treating with antibiotics.

Reflexes
There are some natural reflexes that your doctor will test for possibly at birth, but certainly at the 6-8 week post-natal check up:

*Rooting reflex - If you stroke a new-born baby’s’ cheek, they will immediately turn in that direction with her mouth open ready to suck. This helps them locate the breast or bottle and you can use this reflex to gain their attention and encourage feeding even if they are sleepy. It lasts for 3-4 months but may persist when they are sleeping.
*Sucking reflex - A new-born will suck when the roof of her mouth is touched, i.e. with the nipple or bottle teat. This reflex is present at birth and lasts 2-4 months when involuntary sucking takes over.
*Startle/ Moro reflex - If your baby is startled by a sudden or loud noise, or a feeling of falling, she will extend her legs, arms and fingers, arch her back, draw her head back and then draw the arms back with fists clenched into the chest. This moro reflex lasts 4-6 months.
*Walking or stepping reflex - This works best after the 4th day. Hold your baby upright on a table or flat surface, under her arms standing her up. She should lift one leg and then the other as if walking ‘steps’. This reflex is present from birth, and lasts for varying amounts of time, but usually disappears around 2 months and comes back much later when they are close to learning to walk.
*Palmar grasp reflex - When you touch the palm of your baby’s’ hand, her fingers will curl around and cling to your finger (or any other small object you place in her hand). You may also notice that she will curl her feet and toes when they are touched.
*Babinski’s/ Plantar reflex - When the sole of a new-borns’ foot is gently stroked from heel to toe, their toes will flare upwards and the foot turns in. This reflex lasts between 6 months and 2 years after which the toes curl down when the sole is touched.
*Tonic neck or fencing reflex - When placed on their back a baby will turn one way with opposite arms and legs extended and flexed-En garde!

1ST bath
Most babies cry the first few times they have a bath. Being lowered naked into water without any warning is a real shock to them and the majority will scream the entire time they are in the water. It is amazing how quickly they forget that they have just been floating around in water for the last 9 months. The more you bathe them though, the more they will get used to it, and after a few weeks it begins to become a very enjoyable experience for both of you. There are things that you can do to help your baby begin enjoying bath time as quickly as possible:

*Use a bath aid - Babies are like slippery little eels in the bath and are more likely to cry if they don’t feel supported and safe. A bath aid will help with this and give you more confidence, as you won’t be worrying about her slipping out of your hands and going under the water. It also gives you your hands free to splash water over her gently and wash her.
*Have everything ready before you start - nappies, clothes and a nice warm towel to wrap her in once you are ready to get her out.
*Talk to her and reassure her the whole time she is in the bath with a calm voice and a smile on your face as you splash little bits of water over her body. If she senses that you are anxious then she will be too. The sound of your calm voice will help her learn that bath time is a nice experience and not something to be scared of!

Baby blues
After the birth of a baby just over half of all new mums experience the ‘baby blues.’ In my experience it usually happens between days 3-7 post birth but can take up to 2 weeks to take effect. Many find that they are very emotional over a few days and seem to cry over the tiniest of things or even nothing at all! You may find it impossible to cheer up no matter how much you try and find this frustrating as you can’t understand the cause.
The baby blues are thought to be caused by the hormonal changes in your body after the birth of your baby. For many of us the baby blues tend to coincide with the time that your breast milk comes in. This is usually a stressful time anyway if you are breast feeding because your breasts will be feeling so painful and engorged that your baby will be possibly finding it more difficult to latch on. I distinctly remember my husband walking past the nursery on day 4 after our daughter was born. My milk had come in and latching on was proving very difficult for my baby on a breast that she had previously been used to being soft and accessible. He backtracked and came in immediately as soon as he saw both me and the baby in floods of frustrated tears! For me the baby blues only lasted a day or 2 with all 3 of my children which is the norm. If after a couple of weeks you are still feeling very overwhelmed and out of control then it is worth checking your feelings against the signs and symptoms of Post Natal Depression (PND)

by Lisa