What to expect from your midwife in the first four weeks after birth - Baby

Earlier in the week we covered the health checks you can expect to have with your midwife after birth, today we focus on what midwifes will look out for with your little one:
What to expect from your midwife in the first four weeks after birth - Baby
  • Check the umbilicus for any redness or infection
  • Chat about urine and stools – your baby’s urine should be straw coloured on day 2 and stools change from meconium to a soft yellow mustard coloured stool by day 4-5 when mums milk comes to volume
  • Baby’s skin colour – your baby may be a little jaundiced and your midwife will check and may request you to go to hospital to have baby’s blood checked if they cannot do it in the community.
  • If your baby is jaundiced – increase feeding frequency – the more you feed the more milk your baby gets.
  • If your baby looks pale and unwell – they will investigate further but if you are concerned phone your midwife for advice.
  • Baby’s alertness – if your baby is very sleepy and jaundiced it will affect feeding so again chatting about feeding pattern, latching on and a feeding assessment is useful.
  • On day 5 and before discharge to health visitor your midwife will weigh baby and it is common for baby to lose weight after birth. Less than 10% of baby’s birth weight is fine but more than 10% needs further discussion around feeding and baby’s well-being, you may get additional visits every couple of days to support you.
  • By day 14 your baby should have regained its birth weight as a guide.

Newborn Screening checks

  • Newborn blood spot check – this is usually done at day 5 – 7 after birth and checks for serious medical conditions. Most babies are fine but the test checks for early detection of cystic fibrosis, sickle cell, congenital hypothyroidism and metabolic disorders. Early treatment is beneficial to your baby’s health. Occasionally a repeat is required don’t be alarmed it could be an error or incomplete sample. To help get a good sample make sure your baby wears socks and that the feet are warm on the day your midwife comes. It involves a device to prick the heel and 4-5 drops of blood are collected and sent to the laboratory.
  • Hearing screen – this is usually done in hospital before you go home. A specialist technician will do this and occasionally a repeat is requested if baby was unsettled and the results were not expected. Early detection of hearing loss and deafness improve your baby’s development and communication.
  • Before discharge your baby will have a full health examination this may be done by your midwife or by a paediatrician.

Expect to have 3 postnatal checks at home after being discharged from hospital. Occasionally you may have more and you can get additional support from local breastfeeding groups and the national breastfeeding helpline as well as lactation consultant advice from Medela here or Medela’s Facebook page.