Community midwifery

Postnatal care

Hi, my name is Charlotte and I’m a community midwife over at North Tees, I’m going to talk to you today about postnatal care.

Once you’ve had your baby and been discharged home from hospital, your community midwives resume your care. Community midwives work 365 days of the year and we will aim to come and visit you the day after you get home from hospital regardless of whether that’s a Saturday or Sunday or Christmas Day.

When you come home from hospital, we have three essential visits that we absolutely have to conduct, your initial day home, baby’s day five and baby’s day 10.

When we come and see you on your initial visit at home, we’re going to want to check you and baby over thoroughly. We’re going to want to do all your observations to ensure that you aren’t having any blood pressure or temperature problems. We’re going to ask about your blood loss. We’re going to inquire about any stitches, whether this is from a caesarean or from a perineal tear. We’re going to ask about your breasts, whether you are breastfeeding or bottle feeding. We want to know about your legs, whether you have any pain, swelling, or redness in your legs. And overall, we most importantly, we want to know about your emotional well-being.

When we check baby over, we want to ensure that they have a thorough top to toe check. We’re going to be looking at baby’s eyes and mouth to make sure that they’re clear. We want to look at baby’s skin, so we need to make sure that there’s no bruises or blemishes. It is quite normal for babies to develop rashes within their first few days as they’re getting used to wearing clothes and the natural dusts in the air. We’re going to look at baby’s cord to ensure that’s healing well. And we’re going to make sure that baby’s passing plenty of wet and dirty nappies.

When you come to your day five check, you will be invited back into the community midwife centre for an appointment there. This is because the day five check is quite important and we like to ensure that everything is done in a controlled environment as this helps us to avoid any repeats.

Baby will be weighed; we do expect babies to lose quite a bit of weight on their day five check. We have policies in place with certain amounts that baby can lose before we act upon it, so please don’t worry if your baby does lose some weight.

Your baby will then have a small heel prick taken and four spots of blood will be applied to a card. This heel prick is looking for lifelong but manageable conditions. We find things such as problems with baby’s thyroid. We can pick up sickle cell anaemia. We can pick up cystic fibrosis and we can pick up multiple different metabolic disorders. We are also currently involved in a trial for diabetes, but the midwives in the hospital will have spoken to you about this.

During your day five check, the midwives and the midwifery assistants will continue to inquire about your mental well-being and your physical wellbeing.

Round about day 10, baby will be weighed again. We would expect that most babies will start to gain weight at this point in time, although some of them will not reach their birth weight for a little bit longer.

The health visiting team will also be in touch around about day 10 to day 14 to take over your care once we look at discharging you.

Babies are quite prone to jaundice in the first few days after birth. This is because babies are born with too many red blood cells and they struggle to break them down so their bodies can turn a little bit yellow. This is quite normal, however, if you are concerned about your baby’s colour, if you feel that they are looking particularly yellow or they are particularly sleepy or not feeding well, please do not hesitate to contact your midwife’s office.

As I say, we can come and see you as often or as little as you would like us to, and we can also make contact over the telephone in the meantime. Midwives are experts in offering feeding support, whether that’s breastfeeding or bottle feeding, so, please don’t hesitate to shout up if you have any concerns at all.

When we come to visit you at home, we will ensure that your baby is set up to sleep safely. It is very important that babies are in a Moses basket or a Next to you crib rather than sleeping with you on the sofa or on the chair.

Babies should always be at the feet to the foot of the crib with no heavy blankets, bumpers, or teddy bears in the crib at all. Babies do not need a hat on when they are at home once they’re discharged from hospital, but we would recommend popping one on anytime you go outside.

Babies should have the blankets level with their nipples and tucked under their armpits and then tucked tightly down the sides of the crib so that they’re unable to wiggle downwards. If your baby is overheating, you can feel between their nipples and feel their chest and that is their core temperature.

Newborn babies are incapable of sweating, which is why it’s important not to swaddle babies so that you can control their temperature. If you are concerned about the temperature in your living room or bedroom, we tend to suggest that if you’re comfortable in just a short sleeve top, then baby will be comfortable in their vest and sleepsuit.