Post Natal Care
This page contains general information about postnatal care and resources relating to South/ East Auckland.
You will be visited daily and in extreme circumstances, if we are unable to visit you due to attending a woman in labour you will receive a phone call whilst you are an inpatient. Your postnatal visits while an inpatient will be done by whichever midwife in our group is at the unit. The staff on the ward will look after you the rest of the time and help you with breastfeeding and mother craft. Please ring the bell and request assistance whenever you need help with breastfeeding, especially relevant for the first time mother’s.
You have a choice with your postnatal visits during the week once you are discharged to either make sure you are home on your midwife’s postnatal day, as it is difficult to give you an exact time when we will be there, or make an appointment to come in to clinic during the week. (Total of at least 5 visits).
Advantages of breastfeeding
Healthy baby- antibodies, economical and always available, correct temperature and easily digested
Stools- 1 stool in 10 days or 10 stools in one day are all considered normal. They are a runny consistency and mustardy yellow in colour, this indicates that all is well and is how baby’s stool should look once the milk is in. Your baby’s stool will change colour from sticky black to brown to mustard yellow after the first few days.
Breastfeeding support: Wednesdays & Thursdays at Botany Maternity unit, call to book an appointment on (09)534-6063. Val Furness offers private lactation consultancy, call her on (09)537-2673 or 027 393 4999
Principle of breastfeeding
This works on a supply and demand principal. Your baby needs to suck to get the whole process working. As your baby sucks a hormone is released that gets the milk flowing. This hormone is the same one that is released when you go into labour. As a result, some women may experience contractions in their uterus when breastfeeding. This is called afterpains. This feels stronger if it is not your first baby. Please take any pain relief that is offered as this can be quite sore. You need to drink lots of water to build up a good milk supply. Aim for 2 glasses of water every time you feed.
Diet: A balanced nutritious diet high in calcium and protein is very important.
Foods to avoid: Avoid wind producing foods: Garlic, cabbage, onion, spicy foods, chocolate, green veges, acidic foods, citrus juices, fizzy cooldrinks and liqourice
A stress free lifestyle and rest helps your milk supply. This is often difficult in the first few weeks, but it is really important. Try and limit visitors and work a signal out with your partner when you have had enough so that people can be politely asked to leave.
Storage of Breastmilk
4 Hours at room temperature; 48 hours in the fridge; 1 week in the freezing compartment of the fridge; 4 months in the freezer (4;2;4 rule). Breastmilk should not be defrosted in the microwave as this destroys the properties of the milk. Defrost in storage container by placing in warm water and then administer immediately. This will be room temperature milk, which is the best way to give milk.
World Health Organization recommends Exclusive Breastfeeding until 6 months, and continued Breastfeeding until 2 years. This gives them the maximum benefit from the breast as far as antibodies and goodness is concerned. If you feel a cold starting, take 500mg of vitamin C and 2 Zinc tablets (30mg) in the morning and then take 500mg of vitamin C every 6 hours. Continue this for a couple of days and you should find that your cold has almost gone. You do need to start though as soon as you feel the first symptoms. After 2 days of this go to just 500mg vitamin C with 2 Zinc in the morning and 500mg in the evening and then after 2 days of that down to 500mg of vitamin C with 2 Zinc in the morning. If you feel that you could need antibiotics but prefer not to take them, take 2 Garlic tablets 3 times a day as well.
**Breastfeeding cookies to help with milk supply:
Newborn Hearing Screening
Up to 170 babies are born each year in New Zealand with significant hearing loss. Picking up hearing difficulties early in life is very important as early intervention can make a significant difference to how your baby’s brain develops.
You will be offered to have this non-invasive screening test for your baby. It is either done before discharge if you are staying in hospital, or an appointment can be arranged for later in the first weeks of your baby’s life. Some babies will be offered further testing.
This is a screening test which detects rare but life-threatening metabolic disorders. It is a blood test done at 48 hours old or as soon as possible after this. Metabolic disorders are hard to diagnose without screening, and although these disorders cannot be cured, early treatment can prevent your baby becoming sick. The blood sample is collected from your baby’s heel onto a blood spot card. This card is then sent to the laboratory for testing. Your midwife should receive the results of the test within 10 days if the result is negative. If the result is positive your midwife will be notified as soon as possible. It is your decision to have your baby screened. Metabolic Screening is also called the Heel Prick Test, and the Guthrie’s test.
Vitamin K is a blood clotting factor. It is produced by bacteria in the gut. Newborns have a lower level of Vitamin K since they initially have very little gut bacteria. A very small number of babies can develop severe internal bleeds due to this. Although this is uncommon (2-10 cases per 100 000 births), the consequences can be severe – leading to blood transfusions, brain damage, and death.
An injection of Vitamin K into the baby’s thigh soon after birth has been shown to reduce the incidence of this kind of bleeding dramatically. Three oral doses can be given instead over the course of six weeks, although this is not as effective as an injection.
It is your choice whether or not your baby has Vitamin K at birth. In some cases, Vitamin K would be more strongly recommended as the baby may be at higher risk. For example, premature babies (who have even lower levels of Vitamin K), babies of mothers on certain medications, sick babies, and those born by instrumental birth or a long labour where there is an increased chance of bruising.
Immunisation / Vaccinations
Several vaccines are part of the National Immunisation Schedule offered to all babies. In most cases, the first round of vaccines can be given at about 6 weeks of age through your local doctor’s surgery.
Vaccines stimulate your child’s body to make antibodies against infections. These antibodies will protect your child from the disease. This is called immunisation.
Your child does not have to receive immunisations – it is your choice.
The National Immunisation Register (NIR) is a computerised information system that will hold all the immunisation details of your child.
The NIR will prompt reminder notices form your doctor’s practice when your child’s immunisations are overdue.
You can choose to opt off the NIR but you will need to complete and sign an opt-off form.
Babies have their first immunisation at 6 weeks of age.
Ask your Midwife about BCG vaccination for Tuberculosis.
If you have Hepatitis B or are a carrier, your baby will need a vaccination at birth.
All vaccinations that are part of the schedule are free. Some vaccinations come in combination, so if you choose to only use some a cost for the individual vaccine may apply.
Well Child / Tamariki Ora
Your midwife or Lead Maternity Carer (LMC) will visit you up until 4-6 weeks after birth, providing care for you and your baby. Before discharge, your baby can be referred to a Well Child Provider. Visits may start at about 5 weeks and so overlap with your midwifery care. The Well Child visits are less frequent but continue until your child goes to school. The Well Child visits are for ensuring your child is growing well, and include discussions about introducing solids, dental hygiene, vaccinations, and development as appropriate to the child’s age.
Well Child visits are free. They are not compulsory, and you can change your provider or stop care if you wish at any time.
You will be given a Well Child book at your baby’s birth. This book contains information on child development, sickness warning signs, and first aid. There are expected weight and height charts for your child, and checklists for development for you to fill in. The book also contains records of any immunisations, hearing screening, and metabolic screening