Once your baby is born by normal vaginal delivery, he/she will be passed to you. If baby is well, you will be able to breastfeed almost immediately. Occasionally, the baby may require a little help to adjust to being born and will need to be taken to a special crib in the room where he/she will be kept warm and given the necessary assistance. As soon as he/she has adapted to extra-uterine life and is found to be in good health, your baby will be given back to you. After a caesarean section – experiences may differ depending on the hospital setup – you will see the baby and the paediatrician will examine him/her, then baby will either come back to you or your partner until the end of your procedure, or be taken to a warm incubator.

You and your baby will be reunited and baby will be latched as soon as possible. The baby will be checked by the paediatrician either soon after birth or within the first day of life. The baby will have its temperature and blood sugar monitored regularly initially. It is very important that your baby be kept warm, so if you are unable to do skin-to-skin, the baby will be warmly wrapped (swaddled) and a beanie (one will be provided) to keep its head covered.

A baby’s head has the largest surface area and they lose a lot of heat through their heads. Your baby will be covered in vernix (a white coloured substance, which has protected your baby in utero from the amniotic fluid) which is beneficial and should be left in place if possible. Bathing of the baby is no longer performed routinely on the first day of life, but baby will be bathed once before going home.

A number of routine tests will happen in hospital. Some cord blood will be taken at birth for a test called ‘TSH’ – this ensures your baby’s thyroid is working properly and is an important test. A thyroid that is not producing enough hormones can harm your baby but is very easily managed and therefore important to test. A hearing screen will be done prior to your baby leaving the hospital. Again, it is important that your baby is screened for hearing loss early; if they fail, early intervention is able to improve your child’s speech and development. Please note that neither of these conditions are common, but early screening is nonetheless important. In addition, some babies will need additional tests, which your paediatrician will discuss further.

Keep baby skin-to-skin to promote bonding (Dad can also hold baby on his chest) as often as you like.

Bathing and skincare:

1. A bath should last only 5–10 minutes

2. Do not bath the baby directly after feeding; preferably do so before a feed and not when baby is too upset

3. Test water temperature with the inside of your wrist or elbow – the water should not be too hot or too cold, only warm

4. Room temperature must not be too cold. Avoid draughts and close the windows – babies get cold very quickly

5. When you bath your baby, it is important that you keep him/her warm. Focus on baby’s face and body first, then the bottom. When you place baby in the water, ensure that his/her face is not close to the water. Do not be afraid to get the steps wrong, and enjoy the bath – again, you will learn what works best for you and where you feel most confident and comfortable

6. Only wash the face with water and cotton wool and always do this first

7. Get all accessories ready before undressing the baby

8. The hair does not need to be washed daily but if you do wash the hair, this should be done after the face and before the body. Wrap the baby in a towel and shampoo the hair. Then, holding the baby under your arm while supporting the neck with your hand, use two fingers to block the ears and gently wash the shampoo off. Dry the head thoroughly before continuing. Once undressed, wrap your baby in a towel to keep warm while you put some soap in your hands. Rub your hands together to warm them a little, then put soap all over the baby, except the hands

9. Support the head and body well when placing baby in the water. Babies usually enjoy the warm water and, if he/she had been crying beforehand, will soon settle in the water. Often newborn babies will get a fright and flail their arms as you place them in the water – you can use a thin towel or blanket and keep them wrapped in this until you have them submerged – then remove the wet towel. This is known as a ‘swaddle bath’

10. Gently wash baby’s hands in the water

11. Allow baby to enjoy the bath while keeping his/her body submerged

12. Once baby has been bathed, remove baby from the water and pat him/her dry with a soft towel – if baby starts crying immediately after, try to dry and dress baby as quickly as possible – do not let him/her get cold by stopping to console them as he/she is still wet and losing heat

13. Dress baby with a clean nappy and clean clothes

14. Feed baby once you are finished

15. Try trimming baby’s fingernails and toenails once a week All mothers of newborns have been brought up by their own mothers and have their own memories, affected by cultural differences and beliefs. What is right for one family may not be for another. Some mothers will like routine; others will not. Some moms will bath the baby whenever they feel it is appropriate, whereas other moms might prefer a routine and bath the baby every day at the same time, keeping to a stricter bath and bed routine. Again, there is no right or wrong; as a family, you will work out what is best for you. Bathing is always a good time to involve Dad and siblings – Dad can bath or dress the baby and siblings can pass the nappy or help with baby cream, etc.

Cord care: At birth, the umbilical cord is clamped and cut, and is initially wet and may still have some jelly-like substance from the cut end. Within a day, this will become dry and hard and will fall off within the first month. Umbilical cord stumps used to be cleaned with surgical spirits, but new research has shown that the cord should be left dry and be cleaned with normal water if dirty. Several days after birth, the cord starts to turn black. A moist, sticky material forms around the base, and scar tissue will begin to form. The cord will fall off when the baby is between 1–4 weeks of age, and the navel may bleed a little at this stage.

The key to preventing infection is keeping the umbilical cord clean and dry at all times. Clean the cord stump with every nappy change. Remember that this is not painful as there are no nerve endings in the cord. Fold the nappy down to expose the navel area and avoid wetting from urine. Expose the cord to air whenever possible. Avoid long tub soaks until the cord falls off. Clean the base of the cord with gauze or an ear bud soaked in cooled boiled water or a bit of expressed breastmilk.

Take baby to the doctor if the area around the base of the cord and the surrounding area shows any increasing redness. Some redness might be visible around the base initially, but this should settle once the cord is off. Always have baby checked if redness increases. Additionally, if there is any drainage that looks like pus, or baby cries when you touch the red area (indicating pain), he/she should be taken to the doctor.

Nappy rash: Nappy rashes are a common occurrence. You can prevent them by using a good barrier cream with every nappy change and changing baby regularly. They can be identified by a bright red raised rash in the nappy area. This is very unpleasant for baby and can be quite painful; as a result, they such rashes should be treated immediately.

To prevent irritation and nappy rash, ensure that towelling nappies are washed and rinsed thoroughly, and that you change your baby regularly if using disposable nappies. Four steps to prevent nappy rash:

1. Wash with water, Rooibos tea (Rooibos is excellent for skin rashes because it is antiviral, antifungal and antibacterial) or an alcohol-free cleanser on every nappy change. Pat dry between folds and creases

2. Allow time on a daily basis for the baby to lie without a nappy, allowing the skin to dry and air

3. Change wet/soiled nappies as soon as possible; a moist environment can cause the delicate skin to become red and eventually break down

4. Use bum cream to protect and soothe baby’s delicate skin between nappy changes. There are many different brands on the market and you will soon find one that works best for you.

One of the cheapest and most effective barriers is plain Vaseline if applied thickly Things to remember: 1. Babies can lose up to 10% of their body weight in the first few days, but will regain this by the end of the first week

2. Jaundice – yellow discolouration of the skin – will occur in varying degrees, and is generally nothing to worry about. It is known as ‘physiological’ or infant jaundice and is not infective. Infant jaundice is a common condition, particularly in babies born before 38 weeks' gestation (preterm babies). Infant jaundice usually occurs because a baby's liver is not mature enough to get rid of bilirubin in the bloodstream. For labour, the foetus produces extra red blood cells; when born, these red cells are broken down by the liver and can produce slightly higher bilirubin levels. The paediatrician will assess your baby daily in hospital and treat this with ‘phototherapy lights’ if necessary. The jaundice normally peaks on day 3–7 and then subsides. If you baby is still very yellow after this, you should consult your paediatrician

3. Do not over- or underdress your baby; a good ‘rule of thumb’ is to dress your baby in one more layer than what you are comfortable with

4. Do not allow people to smoke near your baby. Smokers must wash their hands very well, must not pick up the baby (third-hand smoke remains on clothes and could be inhaled by baby) and must not kiss the baby

5. Do not leave your baby unattended, whether on a change mat or bed, or when you are out in public with a pram. Do not be afraid to stop strangers from touching your baby; a newborn always attracts lots of attention, but this does not give anyone the right to touch your baby

6. Feed on demand – let the baby feed as much as he/she want to

Why do babies cry? Always respond to crying or ask for help if you feel overwhelmed.

1. This is their way of communication

2. They are expressing their need for attention

3. Crying is often an indication that a baby needs something

4. Baby might be too hot or cold

5. Baby might have winds

6. Baby might be hungry

7. Baby might be uncomfortable

8. Baby might just need a cuddle

Sleeping positions: Babies should sleep on their back with their head area elevated (use a wedge under the mattress). According to paediatricians and research, this is the safest position. You can also place them on their sides, but if swaddled, make sure they cannot roll over on to their tummy. Always avoid placing baby on the tummy/face-down position to sleep, especially if tightly wrapped, as baby may find it difficult to free himself/herself when he/she becomes too hot. (Tummy time is important to strengthen the neck muscles, but NOT while sleeping.

Supervise and play with your baby while he/she is on his/her tummy. Put baby on your chest when you are lying down and encourage baby to lift his/her neck by speaking to him/her.

Sleeping tips:

1. Baby’s sleeping space should be in a dark room

2. Play soothing baby music but turn it off before baby falls asleep

3. Limit stimulation after a certain time of the day. If you attend to baby during the night, do not chat to baby but allow him/her to differentiate between day mommy and night mommy

4. As a possible bedtime routine, consider beginning with a relaxing bath for baby, followed by a calm massage, then talking and singing

5. Do not overstimulate baby or allow baby to get too tired

Tips for parents to calm babies:

1. Soak baby in a lukewarm bath

2. Massage baby

3. Walk with baby

4. Put baby in a carrier or rocker

5. Dance and sing with baby

6. Drive around with baby As a recommendation, baby should not sleep in the same bed as you due to an increased risk of sudden infant death syndrome (SIDS). However, they can sleep in a crib next to your bed, or in the same room.

Helpful hints for home sweet home:

1. Try to have a support system in place. The more caring support others like close family offer, the more relaxed you will be and the more support you can offer your baby

2. Cuddle your baby as often as possible – you cannot spoil him/her in the first 6 weeks

3. Babies thrive on lots of affection. The more affection baby receives, the more secure baby feels

4. Talk and sing to your baby; it soothes him/her to hear your voice. Also maintain eye contact as often as possible

5. Encourage your baby to grasp your hand. This helps baby to get a feel of you

6. Soft music or singing to baby is comforting and reassuring

7. It is better to have a happy baby than an overly tidy home

8. Most of all love and enjoy your precious bundle of joy Relax about parenting – you will learn together. Many mothers will tell you that their first experience with a baby was difficult, but their second experience was much easier, or vice versa. Just look after yourself and make time for your baby and family, especially during the first 6 weeks.

Postnatal blues: Postnatal blues are common, especially on day 3; as your hormones change, you can become very tearful and ‘blue’. Other emotions may be

1. Feeling teary

2. Tired

3. Emotional

4. Irritable

5. Poor appetite

6. Not coping with simple chores and caring for baby

7. A decrease in energy If you feel completely overwhelmed by your baby, or overburdened, and any of the above is not temporary, please contact your obstetrician and seek help.

Remember:

1. Sleep deprivation is temporary – it can be overwhelming at times but it will pass

2. You do not need to be perfect – during the first 6 weeks, you need to do whatever is required to ‘survive’

3. You do not have to do everything at once

4. You do not have to do it all

5. Challenges are a normal part of the process. If you feel like curling up in bed, do so.

6. Rest is essential

7. Your body needs good food to heal. Enjoy healthy snacks

8. Continue with multivitamins to provide basic needs

9. Consume enough fluids, e.g. jungle juice, water or Rooibos tea

10. Ask for help

11. Ask for space if you are overwhelmed by visitors