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Baby yawning

Here’s what to expect on the big day and how to manage those special first few weeks at home…

What happens before my newborn baby is discharged from hospital?

The following steps will take place:

  • Your baby will be assessed and discharged by a paediatrician or specialist midwife
  • You will be assessed and discharged (as a separate patient) by an obstetrician or midwife
  • Your baby will have a routine hearing screening test to rule out hearing loss
  • Your baby will receive an injection or oral dose of vitamin K to help their blood clot properly to prevent any risk of bleeding into the brain (caused by a rare illness called ‘haemorrhagic disease of the newborn’)

You will also receive:

  • Your hand-held notes – give them to your community midwife when they do their home visit – and a letter with details of the birth of your baby for your GP (sometimes this is sent through the post or by email)
  • Two more vials of Vitamin K for your baby if you are breastfeeding and giving your baby the oral Vitamin K. One to be given at one week, the second to be given at one month after birth
  • Details on how to register your baby’s birth (which is a legal requirement to be carried out by six weeks)
  • Your baby’s Personal Child Health Record Book (the ‘red book’) containing information, your baby’s growth charts to record their weight, their immunisation records and health assessment records. Remember to take this book with you whenever your baby is seen by a health professional

Bringing your baby home from hospital

Unless you are walking home from hospital, you will need a car seat for your baby that is suitable for a newborn. Make sure you practise attaching the car seat properly in your car before your baby is born so you can quickly make the journey home. This is particularly important if your baby is born in winter, as you do not want your baby to get cold while you wrestle with a car seat, or even worse, put the car seat in incorrectly because you are under pressure.

The car seat is one of the purchases that you need to buy before your baby is born. For advice on getting the best car seat for your newborn baby read our article ‘Baby car seats and safety.

The drive home is often the first time it sinks in that you are a parent and utterly responsible for the care of this new little being. It is an exciting day to remember and you will probably drive more cautiously with your precious bundle than you ever have before!

Bringing home a ‘special baby care’ baby

If your baby was in special baby care, taking your baby home is a huge red-letter day and something you will have been dreaming about for days, weeks and perhaps even months!

The feeling of responsibility can be even more overwhelming if you had a tough start with a premature, tiny or poorly baby, and it takes courage to go home after having a full neonatal team on hand 24/7 to look after your baby.

Try to remember that your baby or babies wouldn’t be discharged unless their paediatricians thought they were completely ready for life at home.

You may be taking home a baby who still needs a little bit of help, eg, with an oxygen tank or naso-gastric tube feeding. Again, try to feel confident that you will be able to manage your baby’s care at home and will have lots of follow-up support from the community team associated with the special baby care unit.

The transition to home

Most people cannot wait to get home with their babies – no busy postnatal ward, no crying babies, and having the support of your partner and family beyond visiting hours is an important transition to family-based support. Depending on your hospital trust, you should receive daily visits from your community midwife to check that you and the baby are doing well and then you will be handed over to your community health visitor.

Postnatal midwife’s visits

A midwife will be available in your community to help you look after yourself and your baby. You will have the contact details for the on-call midwife in your notes or your baby’s red book. Midwives are there to help you with:

  • Establishing breastfeeding (after support on the ward). If you feel you need more help you can contact your local NHS drop-in breastfeeding clinic
  • Learning the basics of bottle and formula feeding, if you choose to bottle feed
  • Everyday care and safety; bathing, nappies, cord care (they will check your baby’s cord), advice on reducing the risk of Sudden Infant Death Syndrome (SIDS)

They will also weigh your baby each time they visit to see if they are regaining their birth weight. You can ask your midwife about anything to do with your baby’s health or your postnatal recovery. Community midwives usually visit several times in the first 10 days at home but may not discharge you and your baby for the first month. You can discuss if you feel you would like more visits. You will then be handed over to your health visitor.

Heel prick test

Between 5-8 days after the birth, your community midwife will do a heel prick test. This blood sample is used to test for a range of serious but rare illnesses, which consists of the following:

  • Cystic fibrosis
  • Sickle cell disorders
  • Congenital hypothyroidism
  • Thyroid hormone deficiency

From January 2015, four more debilitating genetic diseases were added to the list. They’re all inherited metabolic diseases:

  • Phenylketonuria (PKU)
  • Medium-chain acyl-CoA dehydrogenase deficiency (MCADD)
  • Maple syrup urine disease
  • Homocystinuria
  • Glutaric acidaemia type 1
  • Isovaleric acidaemia

For more information about the heel prick test, visit the NHS Newborn Blood Spot Screening Programme.

Settling in at home

Try to keep things really simple when you return home with your baby. You need to recover from the birth, both physically and emotionally. If you are breastfeeding, your main priority in the early days is getting this established. Try to get all the help you need from your midwife, health visitor, drop-in NHS breastfeeding clinic, or lactation consultant to make sure your baby is feeding well and you are not experiencing any pain from a poor latch.

Beyond that it’s a time to absorb the fact you are a parent and get to know your baby, with lots of skin-to-skin contact and cuddles, which will help you bond and relax. New babies wake up a lot for feeds in the night, so catch up on rest and sleep whenever you can, and get family and friends (who will usually be keen to help) involved in practical support, such as making meals, doing shopping etc.

What to do if I feel overwhelmed with my new baby

Be prepared for the baby blues and speak to your midwife and health visitor if you feel depressed and overwhelmed. These feelings are very common in the tough first weeks with your baby. For more information and advice about Postnatal depression (PND) and the baby blues read ‘Baby blues, postnatal depression and frustration’.