Maternity Leaflet: Community Postnatal Care

Community Postnatal Care: Whether your baby is born at home, in the Abbey Birth Centre or on the Labour ward, you can expect a visit at home by a midwife on your first day at home following the birth (this would be your first day following discharge if you have had your baby in hospital).

Leaflet Details

Patient Information

What to expect in the days and weeks following the birth of your baby

Whether your baby is born at home, in the Abbey Birth Centre or on the Labour ward, you can expect a visit at home by a midwife on your first day at home following the birth (this would be your first day following discharge if you have had your baby in hospital).

This first visit is to check on wellbeing of both mum and baby and to carry out postnatal checks. The midwife will discuss topics with you such as infant feeding, registering the birth, registering with the GP, sex and contraception, exercise, safe sleeping, and care of the newborn (nappy changes, cord care, eye care) etc.

Schedule of routine postnatal care

There is a routine pathway of care provided during the postnatal period.

• First day at home following the birth - Home visit.
   
• Day 3 - Phone call if baby well. Postnatal appointment for vulnerable babies who need to be weighed.
   
• Day 5 - Postnatal appointment to check baby’s weight and carry out Newborn Bloodspot Screening
   
• Day 10 - Discharge appointment in postnatal clinic.

If you or your midwife think additional support is required, they can put a plan in place for additional appointments, which can be for an enhanced period of up to 28 days.

Our feeding and nurturing Padlet offers a host of information on how to establish safe and effective feeding including self-help tips, videos and drop in community feeding support running throughout the week. Feeding and Nurturing Ashford and St Peter’s Hospital:

Weight loss

It is normal for babies to lose weight in the first few days following birth. This will be monitored on day 3 and day 5 for vulnerable babies and day 5 for well babies. Weight gain after this is usually a sign that your baby is well, and feeding is going well.

Your midwife or maternity support worker will be able to provide you with support and advice around infant feeding and provide details of feeding support groups if needed.

Your baby’s weight will be documented in your baby’s health record (red book).

Jaundice

Jaundice in newborn babies is common. It causes yellowing of the skin and the whites of the eyes.

Yellowing of the skin can be more difficult to see in brown or black skin. It may be easier to see on palms of hands or soles of feet.

Although it is common it is important that it is monitored closely to ensure that your baby does not become unwell and requires treatment. Your midwives and maternity support worker may use a small machine to check jaundice levels or may need to take a blood test from your baby’s foot to check level are within normal ranges.

If your baby becomes reluctant to feed and more sleepy, it is important that you contact the Call a Midwife Line immediately.

Safe Sleeping

The following advice is recommended to reduce the risk of Sudden infant death syndrome (SIDS).

• Place your baby on their back to sleep, in a cot, in the same room as you, for the first 6 months.
   
• Keep your baby’s head uncovered - their blanket should be tucked in no higher than their shoulders.
   
• If wearing your baby in a sling or carrier do not cover their head with the sling material or with a muslin.
   
• Place your baby in the feet to foot position with their feet at the end of the cot or Moses basket.
   
• Do not let your baby get too hot or cold.
   
• Do not share a bed with your baby.
   
• Never sleep with your baby on a sofa or armchair.
   
• Do not smoke during pregnancy or breastfeeding, and do not let anyone smoke in the same room as your baby.

Infection

Whether you have had a vaginal delivery or a caesarean section, it is important that you monitor for signs of infection.

You should ensure that you change maternity pads regularly, ensuring you wash hands thoroughly before and after to minimise risk.

It is important that you look after yourself in the postnatal period ensuring good fluid intake, varied diet and pelvic floor exercises which can all aid healing.

Signs of infection may include:

• High temperature
   
• Increase in vaginal bleeding and or passing clots
   
• Abdominal pain
   
• Smelly discharge from the vagina

If you have had a caesarean section, you are at greater risk of infection if you are diabetic, overweight, or smoke.

Signs of wound infection:

• Redness or swelling around wound
   
• Pain at wound site
   
• High temperature
   
• Fluid or bleeding from wound
   

Mastitis

You are at risk of mastitis or breast infection if milk ducts become blocked with milk.

Signs of mastitis:

• Red, swollen area of breast which is hot to touch
   
• Hard lump on breast
   
• Pain in the breast
   
• Fluid leaking from nipples
   
• High temperature
   
• Flu like symptoms.

If you suspect you have mastitis or blocked milk ducts it is important that you continue to breast feed in order to drain the blocked duct. You may need antibiotics, so it is recommended you are seen by a doctor for review. Paracetamol can be taken to manage fever. You may find it helpful to massage the swollen area and place a cold compress on the area.

Transfer to the health visitor

When the midwife is satisfied that mum and baby are fit for discharge, you will be transferred to the care of the health visitor. This will normally be once baby is over birth weight and feeding is going well and when mum is well and has no concerns.

The health visitor will have likely made contact with you at this stage and arranged to visit you at home or may have met with you prior to the birth.

The health visitor’s role is to provide support and advice to families from birth to 5 years. You will normally be seen at 10 days, 6 weeks, 9-12 months, and 2 years. They run regular weighing and support clinics locally and will provide you with information of these at your first meeting.