Your complete newborn survival guide

Congratulations – your baby is here at last! Now what on earth are you supposed to do with him? Read on for the complete lowdown on getting through the newborn period and loving life with your new baby from day one

Throughout your pregnancy, you’ve been focusing on one thing – the moment you’ll finally meet your baby. But far from ending with the birth, the adventure that is motherhood is only just beginning. First, though, you have to get through the exhausting, overwhelming early weeks with your newborn.

When you’re full of the joys of pregnancy, it’s hard to imagine exactly what’s in store after the birth. Okay, you know it’s going to be hard work, but getting your head around the reality of being responsible for a tiny, helpless human being 24 hours a day is no mean feat. Once your baby’s here, though, it’s a different story.

And far from floating along on cloud nine, you’re so tired you can barely remember your name, have aches and pains in places you never knew you had, and are in a permanent state of panic about your fragile, defenceless newborn baby.

Well, guess what? You’re not alone. It’s perfectly normal to feel as if you’re floundering hopelessly at first, and even pining for your old life.


What happens next?

Your baby is in your arms, but there’s still lots to do before you can go home and get on with being a family. Here’s what to expect in the hours after the birth

Hour 1

Apgar tests

Your baby’s Apgar tests are done at birth, five minutes and 10 minutes. He’ll be given a score out of 10 based on his colour, muscle tone, heart rate, breathing and response to stimulation, but there’s usually only serious cause for concern if he consistently scores less than five. Midwives can generally perform Apgars by sight, so they won’t interfere with your first cuddles.

Delivering the placenta

‘If you’ve had a completely natural labour and delivery, it’s possible to have a natural third stage, where you wait for your uterus to expel the placenta by itself,’ explains Debby Gould, head of midwifery at University College of London Hospital.

‘But if you’ve had any intervention, you’re at greater risk of haemorrhaging, so a managed third stage is advised. You’ll be given an injection that makes your uterus contract and your placenta detach – this minimises blood loss, but may cause nausea and leg pains.’

Initiating feeding

Planning to breastfeed? Try to get started within minutes of the birth, when your baby’s sucking reflex is strongest. Your midwife will show you what to do, but you can get more in-depth help later on the postnatal ward – many hospitals have specialist feeding advisors or peer supporters.

Vitamin K injection

Some newborns have a vitamin K deficiency, which can cause life-threatening bleeding. As a preventative, all babies are given vitamin K, usually by a single injection. However, these injections were once linked to cancer – although this has been refuted – so you may prefer your baby to have it orally, which requires repeat doses at seven and 28 days old.

Hour 2

Baby checks

‘Soon after the birth, the midwife will do a head-to-toe check of your baby, looking for abnormalities like missing digits and signs of illness such as a high temperature,’ says Debby. He’ll also be weighed.

Mummy checks

You’ll be checked over, too – you’ll have your blood pressure, pulse and temperature taken, and the midwife will assess whether your blood loss is normal.

Later on, a midwife will talk to you in depth to pick up signs of postnatal complications such as pre-eclampsia, deep vein thrombosis (DVT – life-threatening blood clots in the legs), and uterine infection.

Stitches

‘If you have an episiotomy or tear, you’ll be examined to assess the wound,’ says Debby. Most tears and episiotomies can be sutured by the midwife with a local anaesthetic injection, but more severe wounds will be repaired in theatre by an obstetrician, with spinal anaesthesia.

Hour 3

Bleeding

Whether you deliver vaginally or by caesarean, you’ll bleed quite heavily afterwards. ‘It’s normal to need two maternity pads, one on top of the other, at first,’ says Debby, ‘but after a few hours, your bleeding should diminish until it’s like a heavy period. If the blood is running down your legs, contains clots bigger than a 10p or smells offensive, tell a midwife.’

Hour 4

Getting clean

Before you move to the postnatal ward, you’ll be encouraged to have a shower (although if you’ve had an epidural, you’ll have to wait until the numbness wears off, which could be the next day).

You’ll also need to have a pee to make sure your bladder is functioning. ‘This can be painful, especially if you have stitches, but it’s important to keep drinking – if your urine is concentrated, it will sting more, and could lead to a urinary infection,’ says Debby.

Hour 5

Pain relief

If you’re uncomfortable, you’ll be offered pain relief. There are plenty of options, from paracetamol for general soreness to morphine after a caesarean.

Hour 6

Early discharge

If you had an uncomplicated delivery and your baby is feeding well, you may be able to go home now. Postnatal wards tend to be pretty hectic, so home is often the best place to recover from labour and bond with your baby.

Hour 8

Caring for your baby

From the word go, you’ll be responsible for looking after your baby. ‘A midwife, maternity care assistant or nursery nurse will show you how to change nappies and care for the cord stump, and you may be shown how to bathe him, although this might wait until your community midwife visits you at home,’ says Debby.

Hour 10

Visiting times

Visiting hours operate on postnatal wards, so your other half will be sent home for the night. It’s normal to feel a bit overwhelmed and lonely, so have cash for the phone handy so you can call someone for moral support.

Hour 12

Back on your feet

If you have a caesarean, you’ll have a catheter to empty your bladder. This will probably be removed after about 12 hours, and you’ll be encouraged to start moving around – DVT is more common after c-sections, because you’re less mobile. You’ll also need to wear compression stockings and/or have anti-clotting injections.

Hour 18

Newborn check

Within 72 hours of birth, your newborn will have a thorough examination by a specialist midwife, paediatrician or neonatal nurse to look for problems such as heart murmurs, hip defects and talipes (club foot). It also takes into account family health issues or complications in pregnancy or labour which might have affected him.

Hour 20

Hearing screening

All newborns are screened for hearing defects, usually before leaving hospital. A tiny earpiece is placed in his ears to test their response to sound. The test is painless – most babies don’t even wake up.

Hour 24

Home time

The average hospital stay after giving birth is one night, or three after a c-section. Going home with your newborn can be nerve-wracking, but you’ll be given contact numbers for emergencies, and a midwife will visit you the following day. And, nerves aside, nothing beats crossing the threshold of your home as a family.

 
Should I worry about…?

So much for peachy skin and downy hair – newborns are often far from perfect to look at. But many of those new baby niggles are completely normal and very common. We asked health visitor Gloria Martin to put your mind at rest

Sticky eyes

‘Babies’ tear ducts are prone to blockages because they’re so tiny,’ says Gloria. ‘Bathing the eyes with cooled boiled water usually sorts the problem, but if you think your baby may have conjunctivitis – for example, if his eyes don’t improve after a couple of days, or if the whites look red, see your health visitor.’

Yucky cord stump

Your newborn’s cord stump may look and smell unpleasant, and even bleed slightly. ‘Until the stump has fallen off, leave it well alone,’ Gloria advises. ‘Once the stump is off, keep the area clean by bathing it with cooled boiled water, making sure you dry it thoroughly. If you’re concerned, for example if it becomes very weepy, smelly, red or swollen, seek advice.’

White spots

‘Milk spots (milia) are white spots around the eyes and upper cheeks, caused by your baby’s immature glands. They may come and go over the early weeks, but are very common and no cause for concern,’ says Gloria.

Baby acne

Some babies have red spots which can spread to the chest, neck and upper back. ‘These are usually hormonal and are sometimes known as “baby acne”,’ Gloria says. They tend to clear around six to eight weeks and rarely need treatment.

Black poo

The contents of your newborn’s nappies can be pretty alarming – a thick, tar-like substance that sticks like glue. This is meconium – the waste that collected in his digestive system while he was in the womb. ‘Most babies finish passing meconium by three to five days old,’ Gloria says.

Sore bottom

Nappy rash is irritation caused by your baby’s skin being in contact with wee and poo. One mistake many new mums make is using nappy cream at every change. ‘Disposable nappies wick moisture away, and barrier cream stops this happening, which can actually cause nappy rash,’ Gloria says.

To prevent nappy rash, clean your baby’s nappy area with cooled boiled water and dry him thoroughly at every change, and give him nappy-free time so his skin can breathe. If he looks sore, try a cream designed for nappy rash, and see health visitor if you’re concerned.

Yellow skin

Jaundice (yellowing of the skin and eyes) occurs when your baby’s liver is unable to process bilirubin, a substance produced by his body after birth. All babies produce bilirubin, but some babies have difficulty coping with it – over half of newborns have some jaundice. ‘Jaundiced babies may not feed very well.

‘If it’s severe your baby might need phototherapy (light therapy) to break down the bilirubin,’ explains Gloria. But usually, jaundice clears by itself, although in breastfed babies, it can last around six weeks. Sunlight may help, so try laying your little one near the window in a warm room.

Blotchy mouth

White patches in your baby’s mouth can be a sign of oral thrush. They can be sore and cause feeding problems, but many babies seem unaffected and it may clear by itself.

‘It may be a problem if you’re breastfeeding as the thrush can get onto your nipples, so you end up passing it between you,’ Gloria says. ‘If you think your baby has thrush, see your health visitor, as it can be treated with antifungal medication.’

Squishy head

Every baby has a fontanelle just above the forehead. ‘This gap between the bones allows a certain amount of movement during delivery,’ says Gloria.

Avoid putting pressure on his fontanelle, but don’t panic if you bump it. Fontanelles close gradually and are usually gone by the age of two.  
 

Blistered lips

‘Nursing blisters on your baby’s lips are caused by the suction when he feeds, and are very common,’ says Gloria. ‘They don’t hurt or interfere with feeding in any way.’ In fact, they’re thought to be a sign that your baby is feeding well.

And don’t forget about yourself…

‘Take advantage of the times when your baby is resting to put your own feet up. This way, you’ll be better prepared to rise to the challenge of his demands.’
Andrea Grace, M&B sleep expert (andreagrace.co.uk)

‘Pace yourself. Even though I had an easy delivery, walking to the shops five days after giving birth left me so exhausted my husband had to come and fetch me in the car.’

Helen Reader, mum to Isabelle, 12 weeks

‘Walking with your baby every day is such a good idea. It’s healthy exercise, you both get lots of fresh air, and getting out of the house will help you avoid developing postnatal depression.’

Caroline Deacon, author of Babycalming (Thorsons, £8.99)

‘Once breastfeeding is established, try expressing once a day so your partner can do the last feed of the evening and let you have an early night.’

Sam Dickens, mum to Ben, two, and Poppy, six months

‘If you have an episiotomy, much relief can be obtained by placing ice packs against the area and using an inflated rubber ring to sit on. Regular bathing in warm water will also relieve the discomfort, but avoid highly perfumed soaps and oils, which can irritate the wound.’

Lesley Regan, professor of obstetrics and gynaecology and author of Your pregnancy week by week (Dorling Kindersley)

‘Breastfeeding makes you incredibly thirsty, literally as soon as you latch your baby on, so have a drink handy. Sports bottles are great because they won’t spill if you knock them over.’

Rebecca Daley, mum to Tara, 11 months



Make your baby feel secure

After the security of his mother’s womb, a new baby can feel very exposed to the strange new world around him. Making your baby feel as secure as possible in those first few months is vitally important.

Because Pampers understand this, it has created New Baby with ‘Secure Me Fit’ tabs. These unique stretchy fasteners allow you to overlap the tabs, giving a more snug, secure fit on even the smallest tummies.

Choose the best absorbing nappy

Whether you choose to breast or bottle feed your newborn, his poo will be soft and runny for the first few months. Pampers New Baby is the only nappy with Totalcare™ Technology; a soft-weave net and absorbent dual core that is designed to absorb and contain soft, runny poo and wee. The nappy also has not just one, but two sets of leg cuffs to ensure the content is contained within the core.

Protect your newborn’s skin

A newborn’s skin is delicate, so keeping it clean and healthy is important, especially near the nappy area, which can be particularly sensitive. Pampers Sensitive Wipes, winner of the 2007 Baby Product of the Year award, are water-based, unscented and skin pH-neutral.

They contain no alcohol or perfume and gently counterbalance the effect of wee and poo, which can cause skin irritation. Pampers Sensitive Wipes are clinically tested and proven not to have the tendency to irritate skin.

For his next stage of development

As your baby begins to move around and wriggle more he needs a nappy that stays securely in place.  The 2008 Product of the Year baby category award winner, Pampers Active Fit with Non Stop Grips, provides the strongest ever grip for an unbeatable non-stop fit that stays in place even when your baby doesn’t! To celebrate this win, Pampers’ best nappy now gives you even better value, with a standard carry pack of Pampers Active Fit including an extra two nappies.

Diary of a new mum

Beth Gibbons, 33 and her partner Daniel Atkins, 30, live in Bedfordshire.

Beth gave birth to their son Jonah Henry on 14 December 2007. Here’s how she found the first few weeks…
 
Day 1 Jonah finally made an appearance at 12.24pm – all 6lb 2oz of him. I’d planned a homebirth with nothing but hypnobirthing to ease the pain but ended up being taken to hospital in an ambulance, having an epidural and delivering by ventouse!

The rest of the day flew by as Daniel and I took it in turns to give him cuddles, grinning at each other in disbelief. I decided I’d get more sleep in my own bed so we asked to be discharged.

It was good to be back at home - a family at last. I have to keep looking over at Jonah purring away in his crib to believe I’m a mum!

Day 2 Thankfully, Jonah slept right through and we were still in our jammies when the midwife arrived at 2pm. My muscles ache and with every cough or sneeze I feel like I’m going to split my stitches. Daniel is already a dab hand at changing nappies and keeps reporting every bowel movement (still a delightful treacly-black colour). In fact, all I’ve really done today is feed, cuddle and stare at Jonah.

Day 3 Last night I plonked Jonah in his crib around10pm, but he just lay there completely alert as if no one had told him it was night time. Then the crying began. I fed him, winded him, changed him but nothing would stop the wailing. In the end I gave up and fell asleep with him on my chest.

I know some baby experts think this is a no-no. I was so anxious about smothering him in my sleep I kept having nightmares and woke up screaming ‘Where’s the baby?!’. Bleary-eyed today and we’ve had so many visitors I’m surprised the kettle hasn’t blown up.

Day 4 Jonah’s skin was so yellow this morning he looked like a character from The Simpsons. We rushed him back to hospital and were told he’d have to be admitted right away as the levels of bilirubin in his blood are dangerously high. I was feeling really hormonal anyway, but watching him scream as they inserted a canula into his tiny hand was too much to bear and I bawled. He’s in the neonatal intensive care unit now under a special light box. Daniel and I haven’t left his side.

Day 5 Neither of us slept a wink, but at least Jonah’s jaundice is a bit better. He’s being taken up to the maternity ward for more phototherapy and further tests. I’m so tearful, the slightest thing sets me off. One midwife implied I wasn’t breastfeeding properly and I burst into tears. Daniel and I have been snapping at each other all day, too. None of this is how I envisaged my first week of motherhood to be.

Day 6 Last night was my first alone with Jonah and I lay awake feeling terrified as I watched him sleep fitfully beneath the blue glow of the lightbox. I soon got the hang of it, though, feeding him every couple of hours and rocking him back to sleep. In fact I felt pretty proud of myself when Daniel arrived this morning and Jonah was still breathing! He’s now a healthy shade of pink, too, so we should be able to go home tomorrow.

Day 7 Jonah is a great feeder – he’s already gained half a pound! Stitches still painful, but warm baths help ease the pain.

Week 2 I felt really vulnerable the first time we ventured out the house. It felt so weird being out without my bump. Had a family get-together at Mum’s. A bit awkward getting my boobs out in front of my brothers to feed Jonah, but soon got over it. All that breastfeeding left me ravenous, so I stuffed my face and even had a cheeky glass of champers. Was just thinking how well it was all going when Jonah did a squirty poo all over my sparkly top – charming!

Week 3 I was just sitting marvelling at how much my life had changed when Daniel planted a kiss on my lips and told me how happy I’d made him. Sob! The sleepless nights are really starting to take their toll though and I’ve turned into a total sieve head. The other day I drove off with Jonah’s change bag on the roof of the car and this evening I ran myself a bath then completely forgot about it until the water came flooding through the kitchen ceiling. Oops!

Week 4 Jonah is now an official person! We took him to be registered this week and I had to fight back the tears as Daniel and I signed the papers and the registrar handed over the birth certificate. He’s still not sleeping more than about three hours at a time, but I’ve kind of got used to it and Daniel is wonderful at taking him in the mornings to give me a lie in. I have no idea how single mums cope.

Week 5 Daniel finally went back to work on Monday and I felt bereft. Looking after Jonah by myself was a shock (no one to hand him to while I get dressed and eat my breakfast, no one to help me load his buggy into the car…), but we soon found some sort of routine – if I time his morning feed right, he lets me have a cuppa and watch Lorraine Kelly in peace!

My NCT group is great therapy, too. It’s reassuring to discuss life over a latte with all the other mums, even if the conversation invariably lapses back to nappies and nipples.

Week 6 The GP gave Jonah the once over during his six-week check and asked me how I was doing. ‘Getting there,’ I replied, which is kind of true. After weeks of fumbling in the dark, I feel as if I’m finally starting to understand Jonah’s little ways.

Now when he’s cranky mid-morning, for example, I know it’s because he’s tired and not because he doesn’t like me! And I can put him down for a nap while I lose myself in a book. I’m obviously doing something right anyway as he has started smiling.

Not just half-hearted ‘windy’ smiles, but ear-to-ear beams of pure happiness. And he’s not the only one…