Category: Early Parenting

The first few days

Posted on by development

The first few days

The first few days of a babies life are at times spent in hospital where you baby has been born or sometimes you may be at home.

***Key Points***

Your baby is learning about the world and you are learning about your baby. Take time

Your baby is brand new, needs to be fed often and most of all needs to be reassured and feel safe enough to grow and develop in their new world.

***Key Points***

***Feeding***

Your baby will want to feed between every 2-4 hours usually in the first few days. It tiring, its exhausting but its temporary.

Your mature milk will come in on day 3 (ish) or around 72 hours after birth and your baby will then settle more between feeds. Don’t worry, this period will be short lived.

Baby’s can’t speak yet but they can give off little cues in their movements and cries.  It takes time to learn what your baby is trying to tell you.

It’s normal to feed anywhere between 6-12 times in a 24 hour period.

Wet and dirty nappies are a great indicator of how much milk your baby is getting

***Feeding***

***Bathing***

Bath your baby

Some babies love the sensation of being submerged in a warm, bit some don’t.  Ask the Midwife to help you if this is the first bath for you or your partner.

You don’t need to bath your newborn baby every day – you can wash your babie sface and bottom every other day.

When you are home establishing a nightly routine in time is a great way to create a bed time rhythm.

You don’t need any fancy soaps, oils or bath products. Warm water is great and gentle on your baby’s skin. You can use a vegetable based oil for your baby after their bath.

***Bathing***

***Hearing test***

Hearing tests

You will be offered a number of tests while in hospital. On day 1 or 2 after birth your baby will be offered a hearing test.

The newborn hearing test is a routine health check that will be offered to your baby soon after birth in private and public hospitals. The newborn hearing test is used to help detect any degree of hearing loss in babies. If your baby has hearing loss from birth (congenital hearing loss) it’s important to recognise this soon after birth. Early detection can mean you and a team of health professionals can provide support to enhance your child’s language, as well develop their social and emotional skills

The hearing test should ideally be performed before your baby leaves hospital after the birth.

The results of the test will be given to you immediately after the screen. Some babies will need to do a second test if the results of the first one are not clear.

***Hearing test***

***Screening test***

Screening test

All parents are offered the opportunity to have their baby screened for a number of rare disorders that are more easily treated if found early. The ‘newborn screening’ test is offered at around 48 hours of age. You might also hear it called the ‘heel prick’ test.

Newborn screening tests are free. The tests are not compulsory and a verbal or written agreement  is required from the parents of the child before the heel prick test is performed.

Most babies screened will not have any of the conditions but for the small number that do, there are enormous benefits to identifying these. Early treatment can improve their health and prevent severe disability or even death

A Midwife will perform the test by pricking your baby’s heel and putting a few drops of blood on a special filter paper.

Newborn screening helps to identify a range of conditions, including:

  • Phenylketonuria (PKU) —

A baby diagnosed with  Phenylketonuria cannot metabolise one of the building blocks of protein called phenylalanine. This then accumulates in the blood stream and causes brain damage. This is a rare inherited condition that can cause severe learning difficulties. Early treatment with a special diet can prevent the effects of this condition.

  • Congenital hypothyroidism (CHT) —

Hypothyroidism affects about 1 in 3,500 babies. It is caused by the thyroid gland not developing properly in pregnancy and therefore not producing sufficient thyroxine. Early treatment with daily thyroid hormone means your baby will grow and develop as expected.

  • Cystic Fibrosis 

Cystic fibrosis affects 1 in every 2,500 babies. Cystic fibrosis affects the mucus produced in the intestines and lungs and means this is is thicker than normal. This results in infections in the lungs and the intestines and can lead to difficulties with digesting food properly.

Approximately 95% of babies are with Cystic fibrosis are detected by the heal prick test. At times the test may also identify a group of babies who are healthy but a carrier of the disease. Babies with a positive test result will need a sweat test at about 6 weeks of age to determine whether the baby has CF or is only a healthy carrier. A healthy carrier is not affected by Cystic Fibrosis and will lead a healthy life.

  • Galactosaemia

An extremely rare disorder only affecting 1 in 40,000 babies. The disorder is caused by the accumulation of galactose (a type of sugar in milk) in the blood. Prompt treatment with special galactose-free milk will prevent serious illness. Without treatment, a baby may become very sick and die.

  • Other rare metabolic disorders 

The blood tested in the heel prick test can be tested for a range of other very rare metabolic disorders such as such as amino acid, organic acid and fatty acid oxidation defects. Collectively these disorders occur in 1 of every 4,000 babies and so are rare. These conditions are often treatable with specialised care and diets.

Physical health check

A Midwife will undertake a full heath check of your baby usually after 48 hours.

They will re-weigh your baby

Most babies will lose a percentage of their birth weight in the first 24-48 hours. This is normal as they are taking in small amounts of colostrum and metabolising brown fat for energy. This should be no greater than 10% of their birth weight.

Your baby will have a full examination to check the shape of their head, their eyes and ears, the roof of their mouth and tongue, their genitals, skin, hands and feet, spine and hips. In the rare event that any problems are found, the doctor or midwife might order further tests.

***Screening test***

***Vaccination***

Vaccination

The first vaccination is offered to you in hopsital.

This is your baby’s hepatitis B vaccinations which is given as an injection into the baby’s leg muscle.

The next vaccinationn is available at 6 weeks of age and your MCHN will discuss all the options with you during the first visit.

***Vaccination***

***Taking your baby home***

You will need a rear facing care capsule fitted to your car if travelling home by car.

You will need some nappies, clothing for your baby and a wrap or blanket to transfer your baby home.

See the Talkingbirth content page on safe baby products when setting up the nursery at home.

***Taking your baby home***

Childhood Immunisation

Posted on by development

Immunisation for your child

Immunisation is a safe and effective way to protect your baby or child from serious childhood illnesses.

***Key Points***

Large scale research tells very serious health risks of these infections or diseases which may also be life threatening are greater than the very small risks of immunisation.

Vaccination is an effective way to protect your baby against certain vaccine-preventable diseases.

***Key Points***

***How vaccines work***

Vaccines work by stimulating the body’s defence mechanism, called the immune system, to provide protection against infection and illness.

Immunisations harnesses the body’s own defence mechanism.

A baby’s immune system begins developing before birth. A mothers antibodies protect her newborn against many infections during and soon after birth while the baby’s immune system is developing and maturing. This response is shown to last around 4 months.

***How vaccines work***

***The National Immunisation Program***

The National Immunisations program  provides vaccines for your baby from birth.

Access to free National Immunisation Program vaccines requires a person to hold or be eligible for a Medicare card.

These include:

  • The hepatitis Avaccine is free for Aboriginal and Torres Strait Islander children living in high-risk areas (Queensland, Northern Territory, Western Australia and South Australia).

The first immunisation your baby will be offered is the Hepatitis B vaccine, usually offered in hospital prior to discharge.

The next schedule of vaccines are offered at 2 months of age (although your baby can have these from 6 weeks of age)

These include

Diptheria, Tetnus, Pertussis (whooping cough) Hepatitis B, Polio, Haemophilus Influenzae B

***The National Immunisation Program***

The full schedule and timings are available on the

https://www.health.gov.au/health-topics/immunisation/when-to-get-vaccinated/national-immunisation-program-schedule

***Where can I get my child immunised***

Your local council will run immunisation clinics. Speak to your MCHN about this option.

Your GP or paediatrician can provide immunisations.

***Where can I get my child immunised***

***Side effects of having a vaccine***

What are the side effects?

The side effects on having a vaccine can vary depending on the vaccine and each individual response.

Many children have some localised areas of redness, tenderness or swelling where the needle punctured the skin.

Your child may also experience mild fever, be unsettled or irritable. Encourage the to rest, drink plenty of fluids or breastfeed. You can give your child an appropriate dose of paracetamol if required.

Most side effects are short lasting and your child will recover within 12-24 hours. If you have any concerns please see your doctor.

***Side effects of having a vaccine***

***The Australian Immunisation Register***

The Australian immunisation register is where your vaccines are recorded.

This immunisation history statement shows all the immunisations your child has received.

It can be accesses here:

https://www.servicesaustralia.gov.au/australian-immunisation-register

You can obtain your child’s immunisation history statement

  • by calling the Australian Immunisation Register on 1800 653 809
  • through your Medicare online account on myGov

To receive the Family Tax Benefit Part A and the Child care subsidy your child needs to be up to date with their immunisation schedule or have a medical exemption if they are unable to be vaccinated.

***The Australian Immunisation Register***

Resources

You can call the National Immunisation Information Line on 1800 671 811 or visit the website.

Call the Australian Immunisation Register on 1800 653 809 or visit the website at Services Australia.

 

Child safety and baby products

Posted on by development

Child Safety and Baby Products

We know how exciting it is preparing for a baby to join your family but purchasing infant and nursery products can be very confusing.

***Key Points***

We know how exciting it is preparing for a baby to join your family but purchasing infant and nursery products can be very confusing.

Most manufacturers work to ensure their products are safe for your baby, not all will meet safety standards. It is often difficult for parents to choose products safely.

Be cautious of second hand or hand-me-down products- these can also pose safety issues

***Key Points***

“Tragically, since 2001, about two infant deaths in Australia per year have been associated with inclined sleep products such as rockers and bouncers marketed for sleep, while the death of around one child per year has been connected to other infant sleep products such as cots, inflatable beds and mattresses.

ACCC – Rickards

 

The Australian Competition and Consumer Commission (ACCC) is an independent Commonwealth statutory authority.

They are the federal government department that ensures that all Australians have access to information about products and services available.

Published in August 2022, parents and carers can get the latest, most reliable information on best practices to keep their baby safe and unsafe products

This is a dedicated website, where parents and carers can go for safety advice on how they can protect their baby when playing, moving, sleeping, soothing, bathing and changing.

Your First Steps

(www.babyproductsafety.gov.au)

Check the Government recall of products here to ensure the safety of any equipment you purchase

https://www.productsafety.gov.au/

Access the Kidsafe baby product guide here

Kidsafe

Kidsafe baby-product guide

Safe Sleep

Posted on by development

Safe Sleep

For all babies 0-12 months, research recommends six key steps to reduce the risk of sudden infant death (SIDS)

***Key Points***

  • Place your baby on their back to sleep
  • Keep your baby’s face a head uncovered
  • Keep baby smoke free before and after birth
  • Safe Sleep Environment
  • Sleep your baby, in a cot in your room for 6-12 monthsBreastfeed your baby

***Key Points***

1 Place your baby on their back to sleep

Placing baby on their back to sleep helps keep their airway clear and ensures their protective reflexes work. Sleeping on their back reduces the risk of suffocation, overheating and choking.

2. Keep your baby’s face a head uncovered

You may swaddle your baby but do not swaddle their head and do not place a hat or any head covering on your baby.

This allows their airway to remain clear which reduces the risk of suffocation.

Babies control their temperature through their face and head, so keeping baby’s face and head uncovered during sleep helps reduce the risk of overheating.

3. Keep baby smoke free before and after birth.

Smoking during pregnancy and around baby once they are born increases the risk of sudden infant death – this includes second-hand smoke. If you or your partner smoke, don’t smoke around baby and never smoke where baby sleeps.

Quitline on 13 78 48 have very helpful resources and there never is a better incentive than welcoming a new baby to your family to quit.

4. Safe Sleep Environment

The safest place for baby to sleep is in their own safe space, with a safe mattress, and safe bedding. Baby should always be placed on their back to sleep, with their feet at the bottom of the bassinet or cot.

Loose blankets, doonas, pillows cot bumpers, lambs wool coverings, soft toys like a teddy are not to be placed in your baby cot. Soft items in the cot are dangerous and increase the risk of suffocation and overheating.

5. Sleep your baby, in a cot in your room for 6-12 months

The safest place for baby to sleep is in their own safe space, in the same room as their parents or adult caregiver for the first 6-12 months

6. Breastfeed your baby

Breastfeeding has been shown to reduce the risk of sudden infant death.

 

Red Nose

NSW Department of Health

 

First few hours after birth

Posted on by development

The first few minutes after birth

Congratulations! your baby is in your arms!

It’s exciting, its overwhelming, you are exhausted and blown away!

***Key Points***

The first few hours after birth are highly significant for mother and baby and partners as your baby emerges from the womb to the world and you get to you know your baby

Don’t rush anything, friends and family will be excited to meet your baby but use this time to connect with your new baby.

Keep the room as warm, quiet, dimly lit and relaxed as possible to create a calm environment.

Keep your baby skin to skin

***Key Points***

***Meeting your baby***

Your baby may appear pale in the first minute/60 seconds after birth.

They will gradually become a skin coloured over the first few minutes although your baby’s hands and feet may remain pale or blue for some hours after birth.

Your baby may have vernix on their skin This is a greasy white substance that protects your baby’s skin in later pregnancy in a water environment. This is normal and healthy and will absorb in the hours after birth

Your baby has been listening to your voice during the third trimester of pregnancy and will recognise it when you speak to them after birth.

Your partner or support person’s voice may also be familiar if they have also been talking near your baby.

Skin to skin your baby will also be able to hear your heart beating as they did in the womb

We believe your baby’s vision is blurred at birth but they will be able to focus on your face from about 30 centimetres away. It is roughly the distance from your breast to your face.

In the newborn stage, babies are guided by smells, sound and touch.  If undisturbed, you may notice that your baby will start to use their hands to touch and explore and start bringing their hands to their mouth as they use scent to help guide them towards the breast.

Trying to keep the room as warm, quiet, dark and relaxed as possible will create a calm environment.   Family and friends will be very excited to meet your new baby but this time as a new family, spent getting to know each other is really important.  You will also probably want to know how much your baby weighs but ideally all these interruptions should wait until at least after your first feed.

***Meeting your baby***

***Apgar score***

One of the formal observations made after birth is called an Apgar score. It assesses your baby’s adjustment to life outside the womb.

The Apgar score is measured at 1 minute and 5 minutes after birth while the baby is on your chest. Sometimes it is measured again at 10 minutes after birth.

It records your baby’s

  • heart rate,
  • breathing,
  • colour,
  • muscle tone
  • reflexes

The maximum score is 10. A score of 7 or above usually means your baby is doing well. It is not an ability or intelligence test, and it doesn’t predict your baby’s health later in life, it is simply a measure of your baby’s wellbeing immediately after birth.

***Apgar score***

***Weighing and measurement***

In a hospital the Midwife will place two name bands on your baby.

Within the first few hours your baby will be weighed and the midwife will do a physical check.

They will check the baby’s length and head circumference.

***Weighing and measurement***

***Vitamin K***

The Midwife will discuss with you Vitamin K which is recommended by Paediatricians to be given to all newborn babies in the first hours after birth.

Vitamin K helps our blood to clot. Administering vitamin K soon after birth to babies prevents serious bleeding in infants.

This is more commonly given to your baby by an intramuscular injection, however it can be given as three oral doses. Talk to your Midwife about the options.

You should discuss the options and reason this is being suggested with your Midwife or doctor in pregnancy and they will ensure you have consented prior to this being administered to your baby.

***Vitamin K***

***The first feed***

Allowing your baby uninterrupted skin to skin time and letting them explore and find the breast themselves can often take upwards of an hour after birth.  This time is really important for your body to help regulate your baby and create a calm atmosphere.

Initiate your baby’s first breastfeed in the early hour/s after birth.

It can be a very strange sensation when your baby first feeds and their suction can sometimes be quite strong but it shouldn’t be painful in the way of sharp biting and pinching.

Make sure to ask your midwife for assistance if it doesn’t quite feel right.  Often, newborns may need a little support to work out how to latch properly so that it doesn’t cause you any pain.

***The first feed***

***What will my baby look like?***

In most cases your baby is in a state of quiet alertness when they are first born. They will open their eyes to suck and make eye contact. They are seeking connection.

Posture
You will notice their posture is often as if they are still in the womb. Elbows bent, knees flexed and arms and legs close to their body. It takes a few days to stretch out and relax their hips.

Head
A baby’s head is usually the first  part of the body to pass through the pelvis and birth canal and the shape can be affected by the process.

This can cause the skull bones of the baby’s head, which are not fused together to shift and overlap, called moulding.

This can make the shape of the head look elongated, stretched out, or even pointed at birth.

The skull bones will realign and reshape over the next hours and days

The heads of babies born by caesarean section or breech (buttocks or feet first) delivery usually don’t show much in the way of moulding.

Face
Your baby’s face may look quite puffy. Your baby’s features often change quite dramatically in the first hours and days after birth.

Eyes
Immediately at birth your baby will open their eyes, look around and make eye contact. They often have difficulty focusing more than approx. 30cm they may appear cross eyed. At times a bay’s eyes , the whites of their eyes may appear blood shot or red. This will resolve in a couple of days.

Genitalia
The genitalia (sexual organs) of both male and female infants may appear relatively large and swollen immediately at birth. This is due to the high maternal hormones which have transferred to the baby via the umbilical cord.

Due to the effects of the female hormones, some female babies will have a vaginal discharge of mucous or small amount of blood.

In male baby’s the scrotum may be swollen and red

All these features will subside in the first 24-48 hours.

Within the first 24 hours your baby will probably pass urine and their first poo, called meconium at least once. Meconium is a black and sticky consistency. You babies poo will change colour and consistency over the coming days as they ingest milk and this travels through their digestive track.

Skin and birthmarks

Some babies are born with a birth marks. Some areas of reddened birth marks will disappear in the first 12 months, others remain for life.

Speak to your MCHN if you are concerned or notice a change in size or nature of the birthmark.

Strawberry or capillary hemangiomas are raised red marks on a babies skin. They are caused by collections of widened blood vessels close to the skin surface. These may appear pale at birth, then become a brighter red colour and enlarged during the first months of life. Then, they usually shrink and disappear without treatment after the first 12 months of life. They are unlikely to be of concern, but should be examined by a MCHN who may refer you to your GP, dermatologist or paediatrician.

Rashes
Several harmless skin red areas or rashes and appear at birth or during the first few days. Tiny, flat, yellow or white spots on the nose and chin, called milia, are caused by the collection of secretions in skin glands and will disappear within the first few weeks.

Primitive Reflexes
Infants are born with a number of instinctual responses or reflexes. Most gradually disappear as the baby matures. These reflexes include the:

  • sucking reflex– a baby will instinctively suck on any object put in the mouth
  • grasp reflex, – a newborn will tightly close the fingers when pressure is applied to the inside of the infant’s hand by a finger or other object
  • Moro reflex, or startle response, which causes an infant to suddenly throw the arms out to the sides and then quickly bring them back toward the middle of the body whenever the baby has been startled by a loud noise, bright light, strong smell, sudden movement, or other stimulus

***What will my baby look like?***

Resources

Skin to skin – Cochran report

Skin to Skin – Unicef

MHMRC – flyer for parents on Vitamin K

RANZCOG – information regarding Vitamin K at birth

 

Skin to skin contact

Posted on by development

Skin to Skin contact immediately after birth

The first hour after birth is highly significant for new parents and for the baby who has just transitioned from the womb to life outside.

***Key Points***

Skin to skin contact at birth

  • regulates a baby’s heartbeat and
  • regulates their breathing rate
  • improve oxygen levels in your baby’s blood
  • help to maintain your baby’s body temperature
  • calms your baby, reduces stress and crying
  • helps to establish breastfeeding and makes successful breastfeeding at 6 weeks of age more likely
  • we know from premature babies, skin to skin contact increase weight gain and improves outcomes for baby’s born early.

***Key Points***

***Skin to skin***

Skin to skin

Your baby will be placed skin to skin on your chest immediately after a vaginal birth. A warm blanket will be placed over both you and your baby, to keep you both warm. This assists the production of oxytocin and prolactin being produced (essential for bonding and breastfeeding) and assists your baby to regulate their own temperature, heart-rate and breathing.

Your baby has spent months in an environment that is temperature controlled, if they become cold they need to use more energy and oxygen to keep their temperature stable.

They can smell you, hear your heartbeat and the familiar voice from the womb. They are warm and help firmly. Skin to skin is the best place for your baby immediately after birth…your baby will tell you that, and research supports it.

Skin to skin contact at birth

  • regulates a baby’s heartbeat and
  • regulates their breathing rate
  • improve oxygen levels in your baby’s blood
  • help to maintain your baby’s body temperature
  • calms your baby, reduces stress and crying
  • helps to establish breastfeeding and makes successful breastfeeding at 6 weeks of age more likely
  • we know from premature babies, skin to skin contact increase weight gain and imporoves outcomes for baby’s born early.

Following a Caesarean birth,  ask the Midwife with you to assist you to have your baby has skin-to-skin contact with you as early as possible. In theatre if possible or in recovery.

***Skin to skin***

***Warmth, quiet and calm***

At this time, the mother and baby’s needs are simple: warmth and a quiet, calm environment.

Babies have an innate instinct to seek the breast. Left unaided they will crawl to the breast and attach to the nipple. Swedish researchers in the 1980’s called this the breast crawl. Allow your baby to seek and explore as they initiate the first feed shortly after birth.

Prolonged skin to skin after birth allows you to get to know your baby and this attachment is critical for survival of your newborn baby.

This contact with the mother boosts the baby’s natural immune system. As babies emerge from the near sterile environment of the uterus they come in contact with the bacteria in the vagina and then skin of the mother, This kick starts the baby’s immune system and protects against disease in the future.

***Warmth, quiet and calm***

If birth doesn’t go to plan or there are complications and you are unable to hold your baby or do skin to skin immediately there are still many things you can do to ensure your breastfeeding journey isn’t interrupted.  Regularly hand expressing and/or using a pump with the guidance of your midwife will start to initiate your milk supply and still ensure your baby is getting precious colostrum.  Being close to your baby, touching them, holding them or being able to look at videos and smell clothing if you are separated from them will still help that magical cascade of hormones starting to work.

 

Your Recovery After birth

Posted on by development

The first 6 weeks – Your Recovery

What to expect in the first weeks home after birth

***Key Points***

You go through many physical changes as your body heals following birth as well as emotional changes in the early weeks after having a baby.

The first 6 weeks after birth are called the postpartum period.

Please visit the emotional health component of the Talkingbirth App for a comprehensive guide to emotional changes after birth.

***Key Points***

***Vaginal Blood loss***

Blood loss after birth is called lochia.

For the first few days this will be bright red in colour and like a heavy period.

The amount of blood loss will reduce over the coming weeks although it is normal to bleed anything up to 6 weeks after birth.

The colour will change from bright red to reddish brown to pink and watery.

If you have a sudden large increase in blood loss or pass a clot bigger than a 50c piece let your Midwife, Doctor or MCHN know.

***Vaginal Blood loss***

***Bowels and bladder***

Bowels and bladder

You may be reluctant to use your bowels after having a baby. Drink plenty of water and eat fibre rich foods to avoid straining. Do not ignore the urge to open your bowels or pass urine and take your time, so you feel you have completely emptied your bladder or bowel.

Ensure you have cleaned the area well after opening your bowels especially if you have had any stitches after birth.

***Bowels and bladder***

***Your uterus***

This amazing organ housed your baby for many months. It was the size of a pear before you became pregnant and grew to accomodate your baby. It will return to its pre-pregnancy size over the next approximately 6 weeks.

Immediately after birth your uterus will be around your belly button. It will slowly return to being below your pelvic bone. You might experience mild to moderate tightening’s as this happens, sometimes referred to as ‘afterbirth pains’. These are often mild after your first baby but become stringer as you have more children.

***Your uterus***

***Your perineum***

Your perineum

You may have experienced a small graze, a tear or an episiotomy during birth and your Midwife or doctor will have add stitches to the area to allow the area to heal. The stiches are absorbable so they will disappear and do not need to be removed. Keep the area clean especially after passing urine or opening your bowels.

In the early days

Rest – lie flat for at least 30 minutes twice each day. This will reduce tenderness and reduce swelling  and reduce the weight carried by the pelvic floor muscles and lower abdominal muscles.

Ice – If you have had a vaginal birth or attempted vaginal birth ice applied to your perineum will help reduce the swelling. Place inside a pad for 20-30 minutes every 2-3 hours

Compression – Firm supporting underwear will help support the perineum and the lower abdominal muscles.

Exercise – pelvic floor muscles can be commenced when you feel ready, usually within 1-2 days after birth.

Your perineum will feel tender for days or weeks after birth. Apply ice and you can take over the counter medications for pain. Rest as much as you can.

Remember your pelvic floor muscles. It is important to start to retrain these muscles as soon as you feel comfortable after birth

***Your perineum***

***Recovery after a caesarean section***

Recovery after caesarean section

After a Caesarean section you will have  surgical wound in the lower part of you tummy. It is normal as with any major surgery to have pain around the wound site.

It can help to support your wound with pillows when you move or are getting in and out of bed. Your physiotherapist will show the easiest way to get in and out of bed to minimise discomfort. It can help to support your wound by lying with pillows under your knees.

To assist with healing avoid lifting anything heavier than your baby in the first 4-6 weeks. Limit vigorous exercise and increase gentle walking and exercise slowly, being mindful of how your body feels.

Wear loose fitting underwear with a high waist to avoid discomfort on the wound

Sleep, rest and accept the offers of help.

***Recovery after a caesarean section***

Resources

Sleep in the early weeks

Posted on by development

Sleep and settling in the first 6 weeks

Sleep and settling concerns are common issues affecting families. We recognising the importance of sleep for a child’s long-term development and for the health and wellbeing of families.

***Key Points***

You will find information to guide you but no single strategy but rather a number of safe evidence-informed options that allow you to adopt an approach that suits your individual values, preferences, beliefs and parenting style.

We cover only the first 6 weeks after birth here but further information in the resources below.

***Key Points***

***Our approach***

There is a large amount of unregulated advice, information and approaches that it can be difficult to navigate what information is reliable.

Attachment or bonding with your baby is key to your baby’s development and sense of security.

It allows you to understand your baby’s cues.

We support a family centered approach and base our information here on the guide developed by the Department of Health evidence- informed sleep and settling model of care.

***Our approach***

***Newborns and sleep***

  • Newborns do often not know the difference between day and night.
  • Newborns generally sleep 12 to 16 hours in a 24-hour period
  • Newborns need regular feeding to grow and develop  so they usually sleep in short periods.
  • This means they will wake frequently during the night to be fed or changed.

You can help your baby to learn to sleep more at night by exposing them to light, being outdorrs in the natural light during the day and providing more stimulation by playing with them during the daylight hours.

At night create a quiet, dimly lit environment to encourage your baby differentiate between day and night rhythms.

***Newborns and sleep***

***Sleep cycles***

Sleep cycles

  • They do not have established sleep-wake rhythms like we do.
  • Newborns sleep in short bursts, known as sleep cycles which are usually around 20 to 50 minutes long.
  • It is normal for your newborn baby to wake between sleep cycles. As they become older they will learn to settle themselves back to sleep

***Sleep cycles***

***Crying***

Crying

  • Crying is the way babies communicate with you
  • They may cry when they are hungry, need their nappy changed or are tired and need to settle to sleep.
  • The early days and months of becoming a parent are a time when you are getting to know and understand your baby.
  • The average newborn cries and fusses almost three hours a day until around 3 to 6 months of age.
  • From approximately two weeks to three to four months of age, newborns go through a stage of increased crying, which will be at its worst at 6 to 8 weeks of age.
  • They cry at times without a known reason, as  long as your baby is growing, gaining weight and at other times happy then it unlikely a concern.

However if you are concerned call the MCHN line or speak to your MCHN about this.

***Crying***

Settling your baby to sleep

***Your baby’s tired signs***

When your baby is tired, they show signs or cues that they are tired. If you learn to recognise these signs, you can encourage your baby to go to sleep at the right time.

Babies from 0 to 3 months might start showing tired signs after 30 minutes of being awake.

These will include:

  • jerky movement
  • frowning
  • clenching of fists
  • yawning
  • staring
  • poor eye contact
  • fluttering of eyelids
  • rubbing eyes
  • sucking on fingers
  • back arching, grizzling and crying, which are late signs

***Your baby’s tired signs***

***A consistent approach***

Put your baby in their safe sleep space, such as a cot or bassinet when they are tired but awake

Use a consistent each time you settle your baby. Use a gentle and positive approach.

As part of a consistent approach your baby will usually benefit from cue to tell them it’s time to go to sleep. This may be swaddling, wrapping, dimly lit room or bath or massage.

A predictable routine before bed and settling to sleep will be calming for your baby and help prevent ongoing sleep issues.

***A consistent approach***

***Your baby’s sleep environment***

Your baby’s sleep environment

  • reducing stimulation around your baby – for example, sit in a quiet room with dim lighting.
  • swaddling or wrapping your baby (if they cannot yet roll over).
  • giving your baby a bath in the evening in preparation for sleep
  • giving your baby a gentle massage.
  • creating a pre-sleeping routine, like singing lullabies, reading a book or repeating the same phrase, ‘it’s time to seleep’

Try to have regular bed times, nap times and wake times to help your baby develop a rhythm to their day and night.

***Your baby’s sleep environment***

***Safe Sleep***

To sleep your baby safely

  • sleep your baby on their back
  • keep their head and face uncovered
  • ensure baby’s environment is smoke free
  • have a safe sleep environment
  • sleep baby in a safe cot in your room
  • breastfeed your baby

***Safe Sleep***

Resources

 

 

 

The MCHN service

Posted on by development

 Maternal and Child Health Nurse (MCHN) service

Taking your baby home brings much joy but also many challenges and the Maternal and Child Health service is available to offer information, guidance and support on issues about parenthood and child health and development.

***Key Points***

The Maternal and Child Health Service is a free service available to all Victorian families with children from birth to school age.

There are Maternal and Child Health Centres located in each local council area.

***Key Points***

***What is a MCHN***

The MCHN service is run by Maternal and Child Health Nurses (MCHN’s) who are registered nurses with extra qualifications in midwifery and maternal and child health.

They can offer support and guidance on such issues as

  • Breastfeeding
  • Child health and growth
  • Child development, communication, language and play
  • Safe sleeping
  • Starting solids, infant and child nutrition
  • Mental health support
  • Parenting skills
  • Oral health
  • Vision checks
  • Home safety for your child and injury prevention
  • Immunisations
  • Your family relationships
  • Family violence
  • Local groups and referral to support services.

Most Maternal and Child Health Centres run some additional sessions, such as sleep and setting sessions, breastfeeding support and guidance or mental health support groups. Ask your MACHn about other groups in your local area.

MCHN’s will commence new parent groups which gives you an opportunity to connect with other parents in your local area.

***What is a MCHN***

***Access to a MCHN***

How to access the MCHN service>?

After you have given birth to your baby, the hospital or midwife will contact the Maternal and Child Health Service in your local council.

A MCHN will call you a few days after you get home and arrange to visit you at home. You can contact them before this time if you have any concerns.

If you have not had contact with your local MCHN, e.g. if you have moved or your baby has been in hospital for a significant time, contact your local council for details of the nearest Maternal and Child Health Service. Call them to make an appointment.

Your place of birth will have given you a  My Health, Learning and Development Record (green book) remember to take it to each appointment so that your MCHN can record relevant information about your child’s health and development.

***Access to a MCHN***

***The Key Age and Stage Framework***

Key age and stage framework

There are certain times of development for your baby or infant that are known as key ages and stages, and visits to your MCHN are scheduled to correspond with these stages.

After the initial home visit – these are

  • 2 weeks
  • 4 weeks
  • 8 weeks
  • 4 months8 months
  • 12 months18 months
  • 2 years
  • 3-5years

During these visits your MCHN will ask you about your child’s

  • the health and development of your child
  • physical and emotional effects on the family
  • your own health and wellbeing
  • any concerns you may have.

You can of course make an appointment outside these times if you have any concerns.

***The Key Age and Stage Framework***

***MCHN 24 hour Help Line***

The Maternal and Child Health Line is a 24-hour telephone service (phone 13 22 29 in Victoria). Qualified MCHNs offer information, advice and referral to all families with young children.

An interpreter service is also available.

***MCHN 24 hour Help Line***

Resources

Call the 24 hour Maternal and Child Health Line: 13 22 29

Department of Education: Maternal and Child Health Services

The Royal Children’s Hospital: Mother and baby units

Download the Victorian Maternal and Child Health Services app.

 

Other states and territories in Australia have their own services for parents and babies:

ACT: Maternal and Child Health (MACH) Nursing Service

NSW Government: Maternal, child and family health

Queensland: Child Health Service

South Australia: CaFHS Centre Search

Tasmania: Child Health Centres

Northern Territory: Baby and child screening and assessment clinics

Western Australia: Child Health

 

 

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