Early Days and What to Expect

The week after you give birth is a time of change for both you, your partner and your baby.

09:24 09 June 2009

The week after you give birth is a time of change for both you, your partner and your baby. You'll need lots of time to relax " if at all possible " to get to know each other, and to recharge your batteries. This article also appears on www.bbc.co.uk/parenting/having_a_baby

What do I do now?

If you feel pressure to 'get back to normal', ignore it.

"...if you get offers of help, accept..."

If you want to stay in your nightie or dressing gown for days on end, do it! That way, resting seems easier, and no one expects you to even think about going to the supermarket or driving anywhere.

If you have visitors, make it clear you don't expect to entertain them " if they want tea or coffee, they can make it! And if you get offers of help, accept. You are bound to need some help washing, cooking, shopping or cleaning.

Changes in you

• Your tummy will look and feel soft and round " you won't still look pregnant, but your body won't immediately 'spring' back to how it was before you were pregnant.
• You may feel some pain in your uterus " breastfeeding, especially, can stimulate the so-called 'afterpains' which are contractions of the uterus.
• Your breasts are likely to increase in size " they'll get bigger from day two or three onwards, as the milk 'comes in' and takes the place of colostrum. You may find they are a bit uncomfortable, but this should be temporary.
• You will have quite a lot of vaginal discharge " for a few weeks the uterus sheds the rest of its lining. At first this discharge, called the lochia, is red. Then it changes to a pinkish brown, and then cream. You'll need to use sanitary towels to protect your clothes (not tampons because there's a risk of infection).
• You'll feel tired, and you may feel weepy at times " this is normal, and it isn't postnatal depression (see our feature on Postnatal depression).

Changes in your baby

"Info: Start your pelvic floor and other exercises as soon as you can " the next day is fine. See our feature on Exercise and fitness."

• After the first hours, your baby's skin will seem smoother. The vernix will also disappear. Any bruising or slight mishapeness will lessen.
• Some babies sleep a lot in the first days and then perk up and start to be hungry and wakeful; others are alert and feeding well from the very beginning.
• Your baby will have routine checks to make sure she is healthy. Her heart will be listened to, and some of her reflexes may be tested. Her hip joints will be checked " to make sure the head of the femur (thigh bone) moves as it should do within its socket without slipping out.
• At some point in the first week, your baby will be screened for a rare condition called PKU " phenylketonuria " and some other rare conditions. Several drops of blood from the heel are collected and sent to the lab on a card. This is sometimes known as the Guthrie test.

Vitamin K is usually offered to your baby, shortly after birth, either orally or via injection. This is to prevent a rare condition called haemorrhagic disease of the newborn, when the blood fails to clot. The oral form needs to be given more than once to make sure the dose is complete.

Many babies have mild jaundice in the first week or so, caused by a substance called bilirubin still present in the blood. If there seems to be a problem, then your baby will have a blood test to see how high the level really is. Jaundice can make some babies a little sleepy.

An Apgar 'score' of 0, 1 or 2 is given for:

breathing

colour

muscle tone

reflexes

heart rate

A maximum score is 10; most healthy babies get seven at least. Different units do the check at different times. Commonly, it's at one minute and then at five.

Don't forget:

• your pelvic floor exercises!
• to register your baby's birth " you can look at the government's website for information on how to register births

Your care after the birth

In hospital and at home the midwife will visit you to:

• feel if your uterus is getting back to its non-pregnant size
• check any stitches
• take your blood pressure
• ask about how you are feeling
• help with advice on minor problems such as constipation
• help establish feeding

You have the option of midwifery care up to 28 days after the birth. The midwives can extend this as long as they thinks it's necessary. In practice, a community midwife often signs over your care to the health visitor at about 10 days, if all is well. You'll be visited at home in these first 10 days, but it might not be every day. You should have the contact details of a midwife if you need help outside normal working hours.

"It was the third night, and the first one at home. The baby was screaming and wouldn't feed. I was desperate. We called the midwife, and she reassured us. She would have come out to see us if it had been necessary, but it wasn't. The next day she came to see us, and things were much better. It's easy to panic with the responsibility of it all... I think all parents have some bad nights like that."