You will be starting a new way of life. This is a description for first time mums - and a reminder for subsequent mums - covering various tests and procedures for mums and their newborns.

As a new parent it can feel lonely, but a community midwife will visit you at home for about the first ten days after the birth, to make sure that your new baby - and you - are feeling fine. At this point your health visitor takes over, offering her experience with information and advice, giving you reassurance throughout your babies development. These health professionals are there to support you at this time, so please ask them about any worry you may have, however small.

Immediately after the birth

You may notice the bones of your babies skull have not grown together. There are two soft spots called fontanelles which allow the baby's head to grow.

You may notice the baby's skin has spots, patches or is discoloured or peeling. It could also be covered in vernix, the creamy white substance which coated his skin whilst he was growing inside you.

The head may be a bit pointed - due to the narrow path he had to travel - or may show forceps marks on each side of the head. If delivery was with a ventouse or suction cap there may be a raised area called a caput where it was used. All of these things should fade away after a few days.

The umbilical cord will still be attached to the babies tummy as a blue / white stump. It will shrivel and fall off after about a week.

Genitals may appear a little strange at first - this is usually due to parental hormones and things tend to settle down gradually.

Your baby may have a thick head of hair - or none whatsoever. Both are normal.

Birthmarks

Birthmarks may be present:

• Dark or pale brown marks. These occur in 10 percent of babies, and whilst they may not fade they are harmless and need no treatment.
• Blue-black patches. Called Mongolian blue spots, they appear over the base of the spine - are common in dark-skinned babies and lessen over the initial years.
• Stork Bites - These are small, flat pink areas on the nape of the neck and eyelids, disappearing within a couple of weeks.
• Strawberry birthmarks. Bright red marks with clear edges - may actually grow in the first six months then gradually become smaller, usually gone by six years. Needs treatment only if near eyes or if they might cause discomfort.
• Port wine stains. Deep purple marks often on the face, which are permanent. Harmless, but can be upsetting. Laser therapy can produce excellent cosmetic results these days.

Jaundice

Jaundice is not uncommon, giving a yellow tinge on the skin. This is because of the immature liver. Can be treated with phototherapy (light treatment) if the midwife feels it is a problem. The baby may be more interested in sleep than food - but wake him to feed him, which can help. If jaundice begins in the first 24 hours, this should be investigated by a paediatrician. If your baby remains jaundiced after 2 weeks, or develops jaundice symptoms (dark urine, pale poo, yellow skin and whites of eyes) consult your doctor.

Baby Checkups

Not only will your baby be weighed and checked at birth by a midwife, within 24 hours there will be a full check-up. The doctor will:

• examine skin and fontanelles of new baby
• examine baby's eyes, ears, nose, mouth and neck
• listen to baby's heart and breathing
• check internal organs (by feeling tummy)
• check spine
• check genitals
• Examine hips (some babies have dislocation of hips)

Mother Checkups

Your midwife will check you too, in the first few days:

• How you are feeling, physically and emotionally
• Temperature and pulse (for infection)
• blood pressure
• breasts - are you breastfeeding? Any problems with your breasts?
• tummy - to check your uterus is returning to normal size. Many women feel afterpains which are rather like period pains, caused by contractions of the uterus as it shrinks. This can be worse as you breastfeed or with subsequent children. It is a good sign that all is well.
• your pad - to make sure your loss is normal
• your legs - checking for a blood clot

Sweat

You may sweat more than usual - and need to visit the loo more often - as your body gets rid of extra fluid it was carrying. The good news is your face and extremities should begin to look less puffy too.

Your baby will be given an NHS number at the hospital, immediately after birth.

Getting to know each other

It is good practice to have some quiet time to hold and cuddle your newborn. This should be skin to skin, to calm the baby, giving a warm, safe environment. This is possible even after a Caesarian. Look out for the reflex to grab your finger - which fades after a while. You can start breastfeeding straight away. You may be encouraged to give a "one-off" breastfeed, giving the benefits of colostrum (first milk) to the baby. Colostrum contains antibodies important to health, so this is a good idea even if you intent to formula feed.

Vitamin K and HDN

Vitamin K is given to newborns to prevent a rare but serious bleeding disorder - HDN (haemorrhagic disease of the newborn). 1 in 5,000 get this, 1 in 10,000 dies from it.

Guthrie Test

The midwife will prick the babies heel during the first week for a small blood sample, to test for an enzyme deficiency (phenylketonuria) and for thyroid deficiency. Depending on where you are in the country, cystic fibrosis (a condition affecting the lungs and digestive system) and blood disorders (sickle cell anaemia and thalassaemia) may be tested for, via further blood samples. If you hear nothing - everything is fine. The midwife can tell you the results if you wish to know.

First nappy

The first poo will be sticky and green-black. It is called meconium and is what remains of the amniotic fluid that your baby swallowed. A normal service will begin within a few days.

Baby Eyes

Babies can focus at about a yards distance initially, perfect for looking at your face, although they may squint a bit as they get used to focusing.

APGAR

The baby is scored at one minute and five minutes on:

• Appearance - colour
• Pulse
• Grimace - response
• Activity - muscle tone
• Respiration - breathing

Each feature is scored 0-2 giving a maximum of 10 per test. Babies often do better on the second test.

• 7+ score - Baby should do well
• 0-6 at one minute - may need help clearing airways
• 0-6 at five minutes may need special care

Blue Mother

It is quite usual for the new mother to feel weepy and depressed for a few days after birth. This is called third day blues or baby blues and is partly caused by hormone levels changing. It will soon pass.

These are some of the things now on your regular agenda:

• Feeding
• Nappy changing
• Bathing
• Sleep problems
• Looking for development "milestones"

If you would like to share your own thoughts please send your story to: contributions@forparentsbyparents.co.uk

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