Posts Tagged ‘mother and baby’

How Soon Can I Go Home with My Baby? FAQ
I just want to go home
I hate the thought of being in hospital for long - how soon can I go home with my baby?
In most maternity units, there is a degree of flexibility as to how long you remain in hospital after
the birth If you wish to stay for as brief a period as possible, talk to your midwife about this. In
the past, postnatal stays tended to be longer - in 1997-98, the average stay in England was 2.2 days,
and was 5.5 days in 1981 Nowadays, the minimum length of time in hospital is about six hours and many
mothers just stay overnight to rest and gain some confidence. In some areas, you can move to a doctor’s
unit or birthing centre. To help make the transition home as smooth as possible plan your return,
making sure you have plenty of support in place.
How long you stay in hospital will largely depend on your type of delivery If you have a vaginal
delivery, you should be able to return home fairly soon, but a Caesarean may mean you need to stay in
for about three days Also, if your baby is born early, or is unwell, or struggling to feed or maintain
his temperature, then you will be advised to stay in hospital until your baby is ready When babies are
premature, mothers may have to leave them in the special care unit and visit regularly
Will I have any privacy in hospital? I don’t want to be on a ward.
There is usually an attempt to make maternity wards as cheerful as possible, although the reality is
they are often busy and lacking privacy. Your delivery room is likely to be a single room and may have
ensuite facilities. Postnatal ward facilities vary tremendously in different locations: there may be
single rooms, small rooms, or traditional Nightingale wards with a corridor of beds Each bed will have
curtains to pull around it for extra privacy, and bathroom facilities can vary.
Where will my baby sleep when we’re in the hospital?
Mothers and babies usually remain together for 24 hours a day You should only be separated from your
baby if there is a medical reason for this, for example your baby needs special care, and you should be
fully informed before agreeing to this. Your baby will usually sleep in a cot attached to the bed or
next to it This is recommended by the World Health Organization (WHO) and UNICEF who run a programme
called The Baby Friendly Initiative This works with healthcare systems to ensure a high standard of
care for mothers and babies, and many maternity units are guided by their advice.
My friend’s baby slept almost continuously for the first day or so. Is this normal?
The birth process is tiring for the baby as well as the mother and so it is not unusual for the first
24 hours to be fairly quiet, as your baby rests after the birth Babies are often very alert and ready
for a feed immediately after the birth, but then have a long sleep. Also, if you had drugs such as
pethidine or diamorphine, during labour: these can linger in the baby’s system and contribute to the
drowsiness. If your baby does sleep a lot at first, make the most of the opportunity to rest while
still offering regular feeds — your midwife will advise you. After the first 24 hours, you may still
find that your baby is feeding erratically, maybe every hour for five hours, and then having a
four-hour sleep. Rest assured there is no set pattern in the early days; your baby should feed when she
wants to and you shouldn’t expect any routine to emerge at this stage.
Will the hospital help me with the everyday care of my baby if I’m having problems?
While -you are in hospital there will be midwives and maternity support workers to help you They have
plenty of advice and information to offer so don’t be afraid to ask about anything that is worrying
you, such as specific questions about your baby, or any aspects of baby care (see below). However do
bear in mind that maternity units tend to be extremely
busy and this, coupled with the fact that presently there is a shortage of midwives nationwide, means
you may have to be patient and prepared to wait a while at times before someone is free to help you
Before you go home you will also be given contact numbers in case you need help or advice in between
your postnatal checks.
Once you are home, your community midwife and your health visitor will be available to offer advice and
support They will also be able to give you details of local mother and baby groups, and postnatal
drop-in clinics, all of which offer support and information for new mums and their families and give
you the chance to meet other mums.
Do we need a car seat straight away or can I hold my baby in the car?
If you intend to take your baby home in the car, it is a legal requirement for them to travel in a car
seat appropriate for their age. Indeed, it is illegal for children to travel in a car without a
correctly fitting and fitted car or booster seat until they are over
Getting advice in hospital
Although the arrival of your baby is a time of incredible excitement, it can also seem overwhelming and
you may feel daunted by the enormous task of looking after and meeting the needs of this tiny new baby.
One of the benefits of your stay in hospital, as well as recovering from the birth, is to help you feel
confident in the care of your baby, There are several aspects of baby care and feeding that the
hospital midwives can help with.
* Staff can help you to establish breastfeeding by
guiding you on technique. Some hospitals have a    BATHING HELP: dedicated breastfeeding counsellor on
site.
* The midwives can help you with everyday care by
demonstrating topping and tailing, bathing techniques,
changing a nappy, and dressing and undressing.
Small babies and children need the protection that baby seats and child seats are designed to provide.
So, yes, you do need to get your car seat ready before the birth to take your baby home from the
hospital.
I’m going to be on my own when I go home and I’m worried I won’t manage.
It’s only natural to feel anxious about your new responsibilities when you arrive home with your baby
Being a single parent is increasingly common so don’t be afraid to ask for help. Your midwife and
health visitor will visit you to help with any baby-care problems and you will be given contact
telephone numbers before your discharge from hospital in case you experience problems or need advice in
between postnatal visits and checks
When you are on your own, it’s a good idea to arrange for a group of reliable friends or family members
who are willing to assist you with babysitting, morale boosting, and provide general all-round back-up
in the early days. Over time you
can establish a network of other single parents in your area with whom you can share your problems and
solutions. Also, ask your midwife or health visitor for contact details of local postnatal groups and
organizations that support single parents.
My mum is coming to stay with me but I don’t want her to take over. How should I approach this?
Overbearing mothers and mothers-in-law can be a problem, however well-intentioned they are. You will
find it’s not just mothers who insist on issuing lots of advice and information, but friends and other
relatives can be just as vocal Although this advice is often useful, some of it may be old-fashioned or
simply conflict with -your own ideas on how to care for your baby
Even though -you may be feeling vulnerable after the birth, practise being clear and assertive about
the way in which you want to do things and make sure that people understand and respect your views and
that your partner supports you in this too. It may help to pass on leaflets or books that you have read
so your mother can see how things have changed since she brought up her children, and what advice you
are following. You could suggest other ways in which she could help, such as shopping, cooking, and
cleaning, so that you are left with the care of your baby Most mums just want to help in some way, so
it’s up to you to channel her enthusiasm
Will I get any sleep at all in the early days?
You will get sleep but whether it is of the same quantity and quality that you are used to is
questionable. Although young babies need a lot more sleep than adults, approximately 16 hours each day,
they do not take all of this sleep in one long stretch as they need to wake up for frequent small feeds
Up to the age of three months, babies have ‘’sleep—wake” cycles throughout the day with longer spells
of sleep at night
The length of these cycles varies from baby to
baby, but on average your baby will sleep about two hours at a time in the day, and four to six hours
at night. All babies wake up a number of times throughout the night. The length of time your baby
sleeps for during the night may also be affected by how she is fed. Several studies suggest that
breastfed babies take longer than formula-fed babies to develop a pattern of sleeping through the
night. This is because breast milk is easier to digest than formula milk, so babies get hungry more
quickly and wake more often in the night Most babies are physically capable of sleeping through the
night from the age of six months.
Should my baby be in her own room or in with us and, if so, for how long?
In the early days, when your baby is fed frequently, often every two to three hours, you may find it
more convenient to have her closer to you. UNICEF recommends that babies share their mother’s room for
the first six months of life as this helps to sustain breastfeeding and is also thought to help protect
babies against cot death (see p.276).
As -your baby grows and develops, her needs and sleeping patterns will change One of the main changes
is that your baby will start to sleep longer between feeds at night and often this is the stage that
many parents decide is a good time to move their baby into their own room. You may also find that, if
your baby is a light sleeper, she may sleep better in her own room as she is less likely to be
disturbed by you and your partner
I’m a really deep sleeper and I’m worried that I won’t hear my baby crying. Is this likely?
This is a common worry for many new parents,
but you should rest assured that it is highly unlikely you will sleep through your baby crying Many new
parents find that they do not sleep as deeply following the birth of their baby, which may be partly an
unconscious worry about sleeping too deeply and not attending to their baby’s needs Having your baby
sleep in the same room as you to begin with and using a baby monitor later if your baby moves into her
own room will help you to feel confident about hearing your baby at night It’s a good idea to try to
catch up on some sleep during the day-time and take a nap while your baby is sleeping, as this will
mean that you are not totally exhausted when you go to bed at night. You should also learn to trust the
greatest prompt of all, your natural inbuilt maternal instincts!
Who can I turn to if I have problems with breastfeeding?
Although breastfeeding comes naturally to some mums, for many others it can prove surprisingly
difficult. Initially you will have midwives and maternity care assistants on hand in the hospital to
assist you with breastfeeding. Once you return home, your community midwife and health visitor can
continue to advise you, but obviously they will not be available 24 hours a day If you continue to have
problems with breastfeeding, there are many helplines and local support groups available for which your
hospital, doctor’s surgery, and health centre should have contact details. Also, there are plenty of
Internet sites that have forums, which are useful for discussing problems and comparing experiences.
Some midwives and health visitors run local drop-in breastfeeding sessions, and some breastfeeding
groups meet informally in cafes, so enquire whether there are any of these groups locally The National
Childbirth Trust (NCT) (see p 310) also has a national network of trained breastfeeding counsellors and
a helpline for you to call.

Leaving hospital

Each hospital varies, but generally, before being discharged from the hospital, several checks take
place. *You will be examined by a midwife or doctor to check that your uterus is starting to return to
its pre-pregnancy size.
* If you had stitches, these will be checked to see if they are healing properly.
*Your baby will undergo various newborn checks (see p.220) and will need to be signed off by a
paediatrician.
* If you need to take any medication home, this will be dispensed and you will be told how to arrange
your postnatal check.

First days at home
Regardless of whether or not this is your first baby, on your return home you are likely to be both
physically and mentally exhausted. If this is your first baby, although the transition to motherhood is
exciting, it can be daunting and, once home, you may be surprised at how big an adjustment this is.
While some families want to share their joy with family and friends as soon as possible, others decide
to have some quiet time together at first to get to know the new arrival and get used to their new
roles Try to put worries about housework and clearing up to the back of your mind – these will keep
Hormonal changes may mean that you feel quite low and weepy about three days after the birth, known as
the ”baby blues” (see p.281). Getting as much rest as possible will help you to recuperate and begin
to feel normal once more.
I don’t want to go home too soon - can I stay in hospital if I want to?
When you leave hospital is something that you will agree with the hospital midwives and doctors, and it
will be dependent on your particular needs and circumstances. Although you obviously can’t remain in
hospital indefinitely, generally you won’t be transferred home until you feel ready to return The
midwife will ensure that you are confident feeding -your baby, whether this be breastfeeding or
bottlefeeding and that you are confident providing everyday care for your baby, which is good
preparation for returning home.
When you go home, your care will be transferred back to the community midwife, so you will continue to
receive support, information, and advice as necessary Also, planning in advance support for when you
return home may help you to feel more confident about leaving the hospital As well as support from your
partner, try to enlist the help of family, friends, and close neighbours to help you cope in the first
few weeks after the birth.

BEING TOGETHER:
We had so many visitors in hospital last time it was exhausting. Can I stop this?
Many people seem to believe that if you are in hospital then they can visit whenever they want to,
whereas most people, even close family. wouldn’t just turn up on your doorstep unannounced if you were
at home with your baby If you know in advance how you will feel then you really need to be assertive
this time and let people know your wishes It is possible to do this in a diplomatic way without
offending people by simply telling friends and maybe family too that you would prefer to have some
quiet time with your partner and children during the first few days to recuperate and get to know your
new baby. Most people will understand this sentiment and will be more than happy to wait for a few days
until you are feeling ready to see them.
If you are discharged fairly early from hospital
it may be easier to control the flow of visitors as you will be able to dictate visiting on your own
terms. You can then take the time that you need to settle down to a new family life.

Keeping active in pregnancy
I regularly go to the gym. I’ve just found out I’m pregnant -can I still go?
Many forms of exercise are safe during pregnancy Regular exercise keeps you fit and healthy, so if you currently exercise then it’s fine to carry on as before Although you can continue to take part in most activities during the first trimester of your pregnancy, you may need to stop more vigorous exercise as your pregnancy continues Do tell your fitness instructor that you are pregnant, so they can tailor your programme accordingly — pregnancy is not the time to break records or go for personal best! Ideal exercise gets your heart pumping, keeps you supple, manages weight gain, and prepares your muscles for the hard work of labour and delivery without causing undue physical stress for you or your baby.
Benefits of exercise
why you should aim to stay fit in pregnancy
There is no doubt that exercising during pregnancy offers numerous benefits to both mother and baby.
* Regular exercise increases flexibility and suppleness, which will benefit you in labour, * Aerobic exercise, such as swimming, increases stamina, improving blood circulation and preparing you for labour. * Exercise releases endorphins, the body’s natural painkillers, helping you to relax and lifting your mood
•    Exercise keeps backache at bay.
•    An exercise regime will help you to recover more quickly after the birth
Being active during your pregnancy can also reduce the physical discomforts of backache, constipation, fatigue, and swelling, as well as improve your mood and even help you to sleep more soundly. The Royal College of Obstetricians and Gynaecologists (RCOG) states that weight-bearing exercise in pregnancy can reduce the length of labour and may decrease delivery complications. So continue if you can.
Other forms of exercise recommended in pregnancy include swimming, walking, aquanatal classes, yoga, and pilates, as these are not high impact so are less likely to injure your joints.
What’s the best type of exercise during the third trimester?
Swimming is an excellent form of exercise and can be maintained safely throughout pregnancy
It improves circulation, increases muscle tone and strength, builds endurance, and is favoured in late pregnancy as it makes you feel almost weightless. Many women find aquanatal classes enjoyable
exercising while standing in water is gentle on the joints and helps reduce swelling in the legs, common in late pregnancy Aquanatal classes may be run either by a local midwife or by an exercise teacher trained to teach pregnant women.
Walking is a good form of exercise for this later stage of pregnancy as it keeps you fit without jarring your knees and ankles. Take some water to drink to avoid dehydration Yoga and pilates are good if you can find a registered practitioner experienced in dealing with pregnant women. Yoga teaches breathing and relaxation techniques that can help with the demands of labour and birth. Many pilates exercises are done in a ”hands and knees” position, which is ideal for pregnancy as it takes stress off the back and pelvis and, towards the end of pregnancy, can help to position your baby ready for delivery.

I’ve had a previous miscarriage - should I avoid all kinds of exercise?
Many doctors feel that it is best to avoid all but the gentlest forms of exercise in the first 12-16 weeks of pregnancy if you have had two or more miscarriages, or have had vaginal bleeding during this pregnancy
I’m not terribly fit, but would like to start an exercise regime - any advice?
If you are unused to exercise, then moderate activities, such as walking and swimming, would probably be best for you and beneficial for your baby, whereas starting a new competitive sport or vigorous exercise programme would not be ideal Your body is already undergoing huge changes with your heart, lungs, kidneys, and virtually every other major body organ beginning to work much harder. Also, the pregnancy hormones progesterone and relaxin are softening the muscles and ligaments, so soft tissue injuries, back injuries, and abdominal strain become more likely, especially if you haven’t exercised much before. Contact sports, vigorous team sports, and activities like diving and gymnastics carry the further risk of direct injury to your abdomen and uterus - especially as your uterus grows and rises out of your pelvis.
Is it safe to go jogging when you’re pregnant?
Exercise is recommended in pregnancy to improve your circulation and energy levels, boost the immune system, and increase your stamina for labour. Although low-impact activities, such as walking, swimming, and gentle toning and stretching, are ideal, if you are used to jogging and your pregnancy is straightforward, it is fine to continue in pregnancy. However, it is not advisable to take up jogging for the first time now, particularly as there is a risk of falling and hurting your abdomen, and you should avoid jogging if you have a high-risk or multiple pregnancy Other sports and exercises to avoid include gymnastics, horse riding, skiing, and squash.

When should I start doing pelvic floor exercises?
Pelvic floor exercises (see above) can be started at any stage of your pregnancy, but the earlier you start them the better These exercises strengthen the pelvic floor, which is the network of muscles that support the bladder, womb, and bowel. Strengthening these muscles helps to reduce the risk of leaking urine while coughing or sneezing, known as stress incontinence It is important that you know how to do these exercises and practise them regularly throughout your pregnancy
As well as practising the exercises shown above, another way to exercise your pelvic floor muscles is by inserting a finger into your vagina and tightening the muscles around it.

I’m very desk-bound in my job - is it dangerous to sit for long periods of time?
During pregnancy, your circulation slows down and if you sit for long periods of time with the lower leg vertical, it can make it hard for blood to travel upwards. Although this may increase the risk of a blood clot, known as deep vein thrombosis (DVT), sitting for long periods in itself is unlikely to cause a clot Your degree of risk also depends on your level of activity at other times. Exercise is the best way to minimize the risk of a blood clot and taking a brisk daily walk is ideal as it exercises your legs. There are also simple measures you can take while at work to reduce the risk of developing a clot. Try ankle movements every hour, get up and walk around every 3-4 hours, take the stairs rather than the lift, and walk over to see a colleague rather than email.
If you are especially concerned, talk to your midwife or doctor about wearing special stockings that are designed to improve circulation However, it is important that you get the right size, as stockings that are too tight can add to the problem.

I’ve been getting lower back pain - could it be due to bad posture? I’m eight months pregnant.
In a recent review of current research, more than two thirds of pregnant women reported back pain. This pain increased with advancing pregnancy interfering with work, daily activities, and sleep. Lower back pain is caused by the forward pull of the growing abdomen, so as your baby increases in size and gestation, the strain on your back is greater So although bad posture may not be the sole cause adopting a good posture is important to reduce the strain Gentle exercise also helps to reduce the pain, and water aerobics is particularly beneficial.
Some women use a Transcutaneous Electrical Nerve Stimulation (TENS) machine in late pregnancy (see p.175), which helps to block the pain nerve impulses to the brain and stimulates the release of natural painkillers called endorphins. Other tips for lower back pain include a warm hand massage using a base oil a warm deep bath, and using cushions to support you when relaxing and in bed
I’m seven months’ pregnant now and quite big. Should I adapt my swimming style?
You may find that as you get very large towards the end of pregnancy, you need to alternate your swimming style to find the one that is most comfortable for you. Apart from this, a low-impact activity like swimming is ideal as the water provides resistance, there is a low risk of injury and the mass of water relieves pressure on the abdomen and helps to ease lower back pain.
My midwife is running aquanatal classes at our local pool - are they safe?
Yes, low-impact activities such as aquanatal classes are fine in pregnancy. You are fortunate to have this facility as not all areas are able to provide classes. The trainer or midwife conducting the sessions
should be able to advise you about the range of movement recommended to minimize any risk.

We love going clubbing; will the loud music be OK for my baby?
There is evidence to suggest that babies can hear
in the womb from about 16-20 weeks. However, your baby is protected by the amniotic fluid surrounding him, so most noises do not affect him. The ears of a fetus are often full of a protective greasy coating produced by the skin, known as vernix, so external loud noises would be muffled by the time they reach your baby. Your baby is most likely to respond to your reaction to loud music rather than the music itself
There is a study that suggests that constant or regular exposure to noise can increase the risk of a small-for-dates baby, meaning your baby’s growth is smaller than expected for his gestation. However, it is more likely that it is the environment and its effect on the mother that contributes to the baby’s weight rather than the actual noise. Too much clubbing may mean you are getting too little rest and you may be drinking more alcohol than you should. You should
probably consider whether you are getting enough quality rest and ensure that you are reducing or stopping your alcohol intake, as this is more harmful to your baby than loud music.
We like walking, but should I cut down on the number of miles now that I’m pregnant?
Walking is ideal in pregnancy as it is low-impact exercise and can be maintained throughout your pregnancy If you plan to continue lengthy walks and like to walk briskly, try combining this with a slower, more leisurely pace. It’s important to control your body temperature so that you don’t overheat and feel uncomfortable To do this, drink plenty of water to avoid dehydration and wear layers that you can take on and off as required. As your tummy grows, you may find hill climbing causes physical instability, as may trekking over uneven terrain, so stick to more level paths. If you find yourself getting breathless, take frequent breaks.

Antenatal yoga
Practising yoga in pregnancy is hugely beneficial. As well as strengthening and toning muscles, which will help you in labour and birth, yoga aims to bring about a greater awareness of your breathing rhythms, providing a perfect relaxation tool in pregnancy and preparing you to breathe through the contractions. Find an accredited teacher experienced in teaching pregnant women or attend an antenatal class.

Exercise in late pregnancy
adapting your routine to suit your changing needs
Towards the end of pregnancy, you will inevitably slow down, but you may not want to stop altogether! There are sensible ways to modify your exercise regime to ensure you stay safe and fit. * In later pregnancy, avoid exercises that involve sudden movement, such as tennis, as your balance is less steady now. * Swimming is perfect in late pregnancy and aids relaxation.You may need to modify your stroke and enjoy more floating. * Reduce the intensity and length of your workout to avoid exhaustion.

Pelvic floor exercises Strengthening the muscles that support pelvic organs
Learning how to exercise your pelvic floor muscles is vital in pregnancy to help you avoid stress incontinence (leaking urine). This discreet exercise can be practised any time. Pelvic floor exercises involve squeezing your buttocks in and pulling in your tummy muscles, then holding for 5 seconds and releasing. Repeat this 5-6 times several times a day. You could imagine your pelvic floor going up like a lift, contracting your muscles a little more at each floor.

Safe exercise
Taking care in pregancy
Although exercise is highly recommended during pregnancy, this is a time when you may have to moderate your usual programme, especially as you get bigger, and avoid types of exercise or situations that may put you or your baby at risk.
What safety precautions should I take? If you are taking up exercise during pregnancy, be sensible about which type of exercise you choose. Avoid any type of exercise that is too strenuous and opt for low-impact activities, such as walking and swimming. Always do warm-up stretches before exercising and build up your stamina and fitness gradually. This is especially important as hormones in pregnancy relax joints and ligaments
in preparation for labour (see opposite), which means that you are more susceptible to injury. Avoid exercising in very hot conditions as this may be harmful to the baby; in hot months, exercise early in the morning or indoors Also, avoid exercising near traffic as you are more likely to be affected by pollution while exercising. Your centre of gravity changes in pregnancy, so avoid high-impact, fast-moving sports, such as tennis.
Should I stop exercising at any time?You should stop exercising straight away if you feel dizzy or short of breath; if you feel that you are overheating; if you are experiencing pain in your back or pelvis; or if you feel exhausted.