Life after birth – becoming a family

During pregnancy, your baby’s brain is growing very quickly and you can help this growth by taking some time out to relax and talk to baby, to stroke your bump and maybe play music. Encourage other close family members to do the same.

New babies have a strong need to be close to their parents, as this helps them to feel secure and loved. When babies feel secure they release a hormone called oxytocin, which acts like a fertiliser for their growing brain, helping them to be happy babies and more confident children and adults.

Holding, smiling and talking to your baby also releases oxytocin in you, which helps you to feel calm and happy. We cannot spoil babies by giving them too much attention, when babies’ needs for love and comfort are met; they will be calmer and grow up to be more confident. Babies don’t benefit from lots of toys, looking at your face is the best way for babies to learn. Talking, listening and smiling triggers oxytocin and helps your baby’s brain to grow.

After your baby is born, hold him against your skin as soon as possible, and for as long as you want. Skin to skin contact reduces baby’s stress level by 75%. This will calm him and give you both the chance to rest, keep warm and get to know each other. If you want to breastfeed, this is a great time to start as your baby might move towards the breast and work out the best way to suckle for himself. Breastfeeding also releases lots of oxytocin in baby and mother, which will help you to feel close and connected. If you choose to bottle feed, giving the first feed in skin contact while holding your baby close and looking into his eyes will also help you bond.

Recognising potentially serious health conditions in women (NICE 2015)

Find out about your options

It’s important to plan contraception in advance. If you have your baby in hospital, you’ll probably discuss contraception with a midwife before you go home.

You’ll also be asked about contraception at your postnatal check, which happens 6 to 8 weeks after the birth. But you can discuss it at any time (including while you’re still pregnant) with a:

• health visitor
• midwife
• GP
• doctor or nurse at a contraception or sexual health clinic

Not all methods of contraception are safe for all women. You can discuss with your doctor or nurse which methods are suitable for you.

While coping with the physical changes in pregnancy, birth and beyond, your emotional wellbeing is important too. Many women feel anxious, unhappy, mentally distressed, depressed or even more severely mentally unwell during this time, which can be unexpected.

A ‘perinatal’ mental health problem is one that you experience any time from becoming pregnant up to a year after you give birth.

Having a baby is a big life event. It’s natural to experience a range of emotions during pregnancy and after giving birth. But if any difficult feelings start to have a big effect on your day-to-day life, you might be experiencing a perinatal mental health problem.

This may be new mental health problem, or an episode of a problem you’ve experienced in the past.

Becoming a new parent can be a very stressful experience. Finding ways to look after yourself that fit in with your responsibilities and needs can make a big difference to your mental health. Here are some ideas: building a support network, managing daily tasks and looking after yourself.

Or you can access support and services through voluntary organisations and charities.

It’s okay to walk away if you have checked the baby is safe and the crying is getting to you. After a few minutes when you are feeling calm, go back and check on the baby.

Never, ever shake or hurt a baby. It can cause lasting brain damage and death.

You’ve just had a baby and everyone is focused on your little one. But how about you?

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks.

• gently clean and dry the wound every day
• wear loose, comfortable clothes and cotton underwear
• take a painkiller if the wound is sore – for most women, it’s better to take paracetamol or ibuprofen (but not aspirin) while you’re breastfeeding

Non-dissolvable stitches or staples will usually be taken out by your midwife after 5 to 7 days.

The wound in your tummy will eventually form a scar.

This will usually be a horizontal scar about 10 to 20cm long, just below your bikini line.

Contact your midwife or a GP straight away if you have any of the following symptoms after a caesarean:

• severe pain
• leaking urine
• pain when passing urine
• heavy vaginal bleeding
• your wound becomes more red, painful and swollen
• a discharge of pus or foul-smelling fluid from your wound
• a cough or shortness of breath
• swelling or pain in your lower leg

These symptoms may be the sign of an infection or blood clot, which should be treated as soon as possible.

The sudden and unexpected death of a baby is usually referred to by professionals as ‘sudden unexpected death in infancy’ (SUDI) or ‘sudden unexpected death in childhood’ (SUDC), if the baby was over 12 months old. The death of a baby which is unexpected is also sometimes referred to as ‘sudden infant death’. While SIDS is rare, it can still happen and there are steps you can take to help reduce the risk for your baby.

While SIDS cannot be completely prevented, you can reduce the risks of it occurring considerably by following our safer sleep advice. For example:

• Sleep your baby on their back for all sleeps – day and night – as this can reduce the risk of SIDS by six times compared to sleeping them on their front.
• Share a room with your baby for the first six months – this can halve the risk of SIDS.
• Keep your baby smoke-free during pregnancy and after birth – this is one of the most protective things you can do for your baby. Around 60% of sudden infant deaths could be avoided if no baby was exposed to smoke during pregnancy or around the home.
• Never sleep on a sofa or armchair with your baby as this can increase the risk of SIDS by 50 times.
• Do not co-sleep with your baby if you or your partner has been drinking, is a smoker, has been taking drugs or is extremely tired; these factors can put babies at an extremely high risk of SIDS when co-sleeping. One study found that the risk of SIDS when co-sleeping is six times higher in smokers than in non-smokers.

The above is especially important for babies who were born premature or of low birth weight, as these babies are at a higher risk of SIDS.

Trust your instincts

It can be difficult to tell when a baby or toddler is seriously ill, but the main thing is to trust your instincts.

You know better than anyone else what your child is usually like, so you’ll know when something is seriously wrong.

Here’s a checklist of warning signs that might indicate your baby or toddler is seriously ill and requires medical help.

Temperature

• a high temperature, but cold feet and hands
• a high temperature that does not come down with paracetamol or ibuprofen (do not give paracetamol to a baby under 2 months and do not give ibuprofen to a baby under 3 months or under 5kg, unless prescribed by a doctor)
• a very high or low temperature
• your child feels hot or cold to touch, or is shivering
• your child is quiet and listless, even when their temperature is not high
• a high temperature in a baby less than 2 months old

Find out more about high temperature (fever) in children and what to do

Breathing

• rapid breathing or panting
• a throaty noise while breathing
• your child is finding it hard to get their breath and is sucking their stomach in under their ribs

Other signs

• blue, pale, blotchy, or ashen (grey) skin – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• your child is hard to wake up, or appears disoriented or confused
• your child is crying constantly and you cannot console or distract them, or the cry does not sound like their normal cry
• green vomit
• your child is not feeding normally and you’re worried
• nappies that are drier than usual – this is a sign of dehydration

Where to get help for a seriously ill child

If your child has any of signs of serious illness, get medical help as soon as possible:

• during the day from Monday to Friday – it’s best to call your GP surgery
• evenings and weekends – call NHS 111
• if your baby is under 6 months old it’s hard for a doctor or nurse to assess them over the phone – you can go to an urgent treatment centre or, if you’re very worried, take them to A&E

When to call an ambulance

Call 999 for an ambulance if your child:

• stops breathing
• will not wake up
• has a spotty, purple or red rash anywhere on their body that does not fade when you press a glass against it, as this could be a sign of sepsis – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
• is under 8 weeks old and you’re very worried about them
• has a febrile seizure (fit) for the first time, even if they seem to recover
• has a severe allergic reaction (anaphylaxis)
• may have been seriously injured by you or someone else

Trust your instincts. You know what’s different or worrying behaviour in your child.

It can be difficult to tell when your baby has an infection or if your baby is unwell as they can cause lots of different signs and symptoms. You know your baby best, so trust your instincts and, if you feel that something’s not quite right, contact your midwife, health visitor, GP or NHS 111. If you’re very worried, go to an emergency department.

• They are difficult to wake
• The appear floppy
• They are irritable and wont settle
• They have mottled or blotchy appearance
• They have difficulty breathing
• They have a rash, sores or blisters
• They have a temperature
• They have a high pitched or abnormal cry
• If they have had fewer than 2-3 wet nappies in 24 hours

What to tell your health professional

If you think your baby might have an infection, it’s important to tell your health professional anything they might need to know – even if they don’t ask. Being open will help them diagnose and treat your baby. Let them know anything during pregnancy or after birth that might be relevant, including the following.

If the person who gave birth:

• Had any illnesses during pregnancy, such as flu-like symptoms.
• Missed any routine vaccinations in pregnancy, such as COVID-19, RSV, influenza or pertussis vaccines.
• Had chicken pox seven days before or after baby’s birth.
• Has blisters or a rash on their breast/nipple (if breastfeeding).
• Has ever had a genital herpes infection, even if they don’t have symptoms at the moment.
• Had sexual contact with a new partner during pregnancy, particularly in the third trimester.
• Had symptoms of sexually transmitted disease during pregnancy.
• Travelled overseas during pregnancy.

If you or your baby:

• Have tested positive for Group B Strep.

If your baby has had contact with anyone who:

• Had chicken pox.
• Had an active cold sore.

Vitamin K is recommended for all newborn babies in the UK, to prevent a rare but potentially serious condition called vitamin K deficiency bleeding (VKDB). It is recommended that expectant parents read this information leaflet before their baby is born, so they are fully informed and have the time to make a decision prior to the birth.

The full information leaflet is available to read and download here.

Why do newborns need vitamin k?

Our bodies need vitamin K in order to form blood clots and to stop bleeding. We get enough vitamin K from the food we eat but also some vitamin K can be made by the bacteria that live in our gut. Babies are born with very low levels of vitamin K stored in their bodies as it does not easily transfer from the mother’s body and the bacteria that produce vitamin K are not yet present in the newborn’s intestines, so at birth they can be deficient.

What is vitamin K deficiency bleeding?

Vitamin K deficiency bleeding (VKDB) occurs when babies cannot stop bleeding because their blood does not have enough vitamin K to form a clot. The bleeding can occur anywhere on the inside or outside of the body. When the bleeding occurs inside the body, it can be difficult to notice and there may be minimal warning signs.

Is my baby at risk of vitamin K deficiency bleeding?

Babies are at risk of VKDB for up to a year after birth if they do not receive vitamin K. Some babies only experience mild bruising. However, VKBD can cause bleeding from the mouth, tummy button (umbilicus) or back passage. If not treated, babies can be at risk of bleeding in the brain, which can cause permanent brain damage or death.

About 1 in 2,000 babies are at risk of VKBD within a week of birth. About 1 in 11,000 are at risk of getting VKBD later than this and more than half of these babies have bleeding in the brain. The risk of VKBD in babies treated with vitamin K is reduced to very low levels of around 1 in 100,000, meaning that VKDB is almost completely prevented. This is why the treatment is recommended.

Unfortunately, some parents have been deciding not to give their baby vitamin K, after finding comments about a possible connection with cancer when looking for information on the internet. These comments stem from a single small study carried out over 30 years ago which suggested that children who received vitamin K might have an increased risk of blood cancer. However, many more studies around the world have been conducted since then and have found no evidence of any link.

How is vitamin K given and when?

Vitamin K is usually given as an injection into a leg muscle soon after birth. However, some babies may have vitamin K given in the form of mouth drops that the parents administer through multiple doses.

It is recommended that expectant parents read this information leaflet before their baby is born, so they are fully informed and have the time and space to make a decision.