Postnatal Care

Midwife

A midwife will visit you and your baby usually the day after you have been discharged from hospital. Please give her your discharge information to read.

If your midwife has not visited you by 4pm please phone the Community Midwifery Office on 0151 604 7682

You will remain under the care of the midwife for a maximum of 28 days; you may be discharged sooner if there are no concerns.

Below are a list of contact numbers should you require advice or need to speak with a midwife:

• Maternity Triage: 0151 604 7111
• Maternity Ward: 0151 604 7131
• Community Midwifery Office: 0151 604 7682 (8.30am-4.30pm)

Health Visitor

We will notify your health visitor of the birth of your baby. They will be in contact when your baby is between 10 days to 2 weeks old.

General Practitioner (GP)

We will inform your GP of your delivery and details of your new baby. You will need to complete a form for your new baby to register with your GP surgery.

You will need to contact your GP’s surgery six weeks following the birth of your baby for a routine postnatal examination and a follow up Newborn Physical Examination (NIPE).

If you have any concerns about yourself, or your baby being unwell please contact your GP’s surgery or NHS 111.

Feeding

If you have any feeding problems these can be discussed with your Midwife or Health visitor. If you have any urgent concerns please contact the Maternity Ward.

Contraception

It is possible to become pregnant again very soon after the birth of a baby, even if you are breastfeeding and even if periods have not returned. It is important to plan contraception in advance. You can obtain further information from the GP, Health visitor, Sexual Health Clinic or visit Sexual Health Wirral (see link to their website in Related Links to left of this page).

Cervical Screening Teat (Smear)

This should be discussed at your postnatal examination with your GP. If you were due a cervical screening test while pregnant, this can be rescheduled for 12 weeks after birth.

Pre pregnancy counselling

If you require advice from a health professional before planning your next pregnancy please contact your GP who will arrange the appropriate referral. Women with pre-existing medical conditions such as Diabetes may need to be seen by a Specialist at the hospital when planning a pregnancy.

Birth registration

It is a legal requirement that you register your baby within 42 days from the birth.

Your registration office is the Birkenhead Town Hall, Hamilton Square, CH41 5EU

You must book an appointment by either phoning 0151 606 2020 or visit Wirral.Gov website (see Related Link to left).

Reduce the risk of Sudden Infant Death Syndrome SID’s or Cot Death

To reduce the chance families, should follow the key advice for baby sleep

• Put babies on their BACK for every sleep
• In a CLEAR, FLAT SLEEP SPACE
• Keep them SMOKE FREE day and night

Additional information can be found from The Lullaby Trust (see Related Link to left of this page).    

Medication

Please complete any medication prescribed for you or your baby. Please ask your GP if you have any problems or require a repeat prescription.

Newborn Hearing Screening

If you have been discharged home prior to your baby undergoing a Newborn hearing test an appointment to attend the hospital will be sent out to you in the post. If you have any queries regarding this please contact the Newborn Screening Office on 0151 604 7497.

Postnatal Debrief Service

As part of your postnatal care, we offer postnatal debriefing to women who require it. This is available if you feel you have questions about your care, your birth or wish to discuss your experience in more detail.

We offer two midwife-led services.

• If you have questions regarding your birth or the care you received, or if you have any concerns or complaints about your care, you can speak to a midwife about this.
• If you have experienced a traumatic or complex birth, you can meet with the Consultant Midwife for a debrief, where you will be offered further support to recover from this.

If you feel you would benefit from a debrief, please speak to a midwife on the ward or your community midwife who will be able to make a referral for you.

For more information:

• Read more in your Personal Child Health Record (Red book)
• Visit Module 7 After your baby is born on the Wirral University Teaching Hospital Parent Craft Education site
  
  

Feeding

• Discuss any problems with your midwife or health visitor
• All mothers are encouraged to stay in hospital until feeding is established
• Maternity support workers work closely with community midwives to support you in your own home.
• Koala North West Supporting Children and their Families - Breastfeeding support (see Related Link to left of this page).

All babies are offered a hearing screen in the first few weeks of life.
One or two babies in every 1,000 is born with hearing loss in one or both ears, often into families with no history of impairment.

Early detection is important for the development of the child. It also means that support and information can be provided to the parents at an early stage.

The audiology team at Arrowe Park assess all babies born in the unit when they are 24 hours old, using specialised electronic equipment. Occasionally it may need to be repeated, if there is fluid still present in the ears.

Babies born at home or who go home straight from the MLU/delivery suite will be sent an appointment for approximately 2 weeks time.

For further information, www.ndcs.org.uk or www.screening.nhs.uk

Always wash your hands thoroughly using warm soapy water before touching your baby and also after you have changed your baby's nappy.

You should also remove your jewellery as bacteria can linger on watch straps and under rings. It's advisable not to wear nail varnish or false nails for the same reason.

Hand gel is extremely effective for the removal of lingering bacteria on hands that look clean. After washing, use the gel covering all areas of your hands and fingers.

At home you would not usually use gel, but because of the risks of hospital born bacteria, it is particularly important to be vigilant in your hand hygiene. Please ask your visitors to observe the signs about hand washing too.

Hand gel should be used on entering and leaving the Neonatal Unit to reduce the risk of infection being brought into the unit and also maintain cleanliness when you leave.

This is a routine heel prick test done on the baby, by the midwife between days 5-8. It screens the baby for a number of conditions including:

• Phenylketonuria
• Congenital hypothyroidism
• Sickle Cell Diseases
• Cystic Fibrosis
• MCADD

For further information please see Newborn blood spot test NHS page in Related Link to left.lick on here for further information: Newborn blood spot test - NHS (www.nhs.uk)

The Infant Feeding Specialists provide support and information in all aspects of infant feeding, and support mothers in the initiation and establishment of their chosen method of feeding.

Whilst support is given to choose the best feeding option for you, more and more studies tell us that breastfeeding is the healthiest option as it provides your baby with all the necessary nutrients.

A baby who is breastfed is far less likely to be admitted to hospital or suffer with infections such as ear, chest, urinary and gastroenteritis.

The good news for mums is that it provides protection against osteoporosis, breast and ovarian cancer. Breastfeeding will also help your womb to get back to normal and helps with weight loss.

As such our policies and practices reflect evidence-based best practice guidelines as laid out in UNICEFS ‘Ten Steps to Successful Breastfeeding’.

Many babies will benefit from the generosity of breastfeeding mothers who do not receive any payment for their milk donations. Human milk banking is a service which collects, screens, processes and dispenses human milk donated by nursing mothers. Because the milk is dispensed to recipients, who are not related to the donor, every precaution is taken to provide a safe product.

• Donor mothers undergo health and lifestyle screening, also blood tests for HIV, Hep B&C, Syphilis and HTLV
• Milk is expressed hygienically in the donor’s home, frozen and collected regularly by milkbank staff
• Milk is defrosted, pooled and bottled using tamperproof lids. NO mixed pooling between mothers
• Milk is tested. Bottles with bacteria above recommended safe levels are discarded
• Milk is heat treated to 62.5oC for 30 mins to ensure a completely safe product
• Following pasteurisation, milk is refrozen (shelf life 3 months) Trackback labels ensure all milk can be traced and recorded

NICE website
The advice in the NICE guideline covers how milk banks should recruit, screen and support women who donate breast milk. You can visit the website in Related Links to left of this page.

The Milk Bank allows Mothers who have more milk than their babies require, to donate their excess for use by other babies. 

Mothers donating their milk are screened for life habits, risk factors eg hepatitis, HIV etc. Any mothers with these risk factors are advised that they are unable to donate their milk and offered appropriate support from relevant health professionals.

Milk that is considered best for early babies is milk from mothers were their baby is young, as milk constituents change over time, an older baby's milk is more suitable for older babies…this is to try and match up with nature ie. A Mother's milk changes as baby grows.

Mothers who donate their milk are not paid for their milk but do receive a certificate of thanks with a small donated gift pack.

The milk bank relies on new mothers coming forward to offer donations of breastmilk.

They recruit donor mothers from Wirral, Liverpool and all parts of the North West region as far north as Blackpool.

Mothers can contact the milk bank directly to enquire about donating milk.

Adopt a lamb to help premature babies

Your cash donation will help us to purchase breast pumps for donor mothers. 

The Milk Bank can provide money collection boxes and a box of lambs to anyone wishing to collect on behalf of the Milk Bank. If you are interested please contact us on  01244 511440 or email: northwest.milkbank@nhs.net.

Contact

North West Human Milk Bank,
North West Food Research Development Centre,
University of Chester,
Parkgate Road,
Chester CH1 4BJ

Telephone: 01244 511440

Email: northwest.milkbank@nhs.net

Website: www.northwesthmb.org.uk   

Our Advisor are trained to provide breastfeeding advice to mothers as well as answer questions on all aspects of milk banking. They regularly attend meetings with other UK milk bank staff to share best practice.

• Pasteurising sessions are staffed by health care assistance from NNU.
• All milk bank staff have received level 2 award in food hygiene.
• Strong links exist with Microbiology department and Infection Control team.
• The milk bank also consults regularly with Wirral Medicines Service on pharmalogical issues relating to milk donation.

Milk Bank Volunteers

There are currently 7 volunteers who assist with milk bank work which includes collection of donor milk locally and from donors across the North West region. Two volunteers help with administration and office work in the milk bank.If you are
interested in voluntary work in the milk bank, please contact:

North West Human Milk Bank,
North West Food Research Development Centre,
University of Chester,
Parkgate Road,
Chester CH1 4BJ

Telephone: 01244 511440

Email: northwest.milkbank@nhs.net 

Website: www.northwesthmb.org.uk  

New mums in our Neonatal Unit may be faced with extra challenges. The following may help achieve a positive breastfeeding outcome:

There is a breastfeeding policy which all staff adhere to. Staff are trained in the management of breast feeding preterm babies.

Staff will help mothers to establish 'skin to skin' contact as soon as baby's medical condition allows.

Our staff can provide information and support needed to:

• Start milk expression soon after birth.
• Maintain lactation. 
• Understand the breastfeeding process of an early (preterm) baby.
• Mothers should be informed on best techniques (breast massage, nipple stimulation, hand expressing and use of breast pumps). Breast milk should be expressed at least six times in 24-hours if the baby is too small/ill to feed. Dual pumping (using two collection sets together) increases milk volume and saves time.

Our neonatal feeding policy supports breast milk feeding for all babies admitted to the unit.

Pasteurised and banked donor milk is considered if mothers’ breast milk is unavailable.

Staff encourage 'breastfeeding practice' as soon as baby's condition allows i.e. contact between breast and baby's mouth, becoming acquainted by smelling, licking and tasting, transferring gradually from scheduled feeds to demand feeding, and the avoidance of use of bottles until the baby has established good suckling ability at the breast.

During tube feeding the baby can be stimulated with breast or other oral stimulation.

There is evidence that use of teats may confuse oral function in breastfeeding babies.

All guidelines and procedures consider the individual baby's needs. In the Neonatal Unit there will always be babies who for one reason or another are not able to breast feed and who need to be fed with a bottle to thrive, because of longer periods of hospitalisation or who may need a dummy for comfort.

Parents are encouraged to 'room in' prior to baby's discharge and to assist the transition to exclusive breastfeeding.

Community neonatal staff are trained to give continued breastfeeding support following discharge from the Neonatal Unit.

There is breastfeeding support in the community.

Your premature/sick baby will be more able to digest breast milk than formula milk and it will help them to recover more quickly. Therefore, you will be encouraged to provide your breast milk for them. Help and support will be given to enable you to express your breast milk and progress to direct breastfeeding if you wish. Breast pumps are freely available for loan.

If you are unable to provide your own breast milk, donated breast milk may be available. (This is breast milk which has been donated and pasteurised. Strict screening processes are in place for donors and milk).

The Neonatal Unit feeding advisor is available to discuss any feeding issues.

If you are discharged home and your baby remains on the Unit, arrangements can be made for the loan of one of our breast pumps. Please ask the nursing staff for details. Expressed breast milk can be frozen and transported to the Unit. The staff will be happy to give you advice and any further information if required.

Breastfeeding your baby for the first six months allows for the best start in life as per the recommendation from the World Health Organisation.

However, when baby has been born early and/or born very poorly, breastfeeding can be challenging to start and prolong. Your baby needs milk for energy and growth and can be offered donor breast milk given by nasogastric tube, cup or bottle.

Modern manufacturing techniques have improved and researched in order to try and emulate mothers milk. Careful preparation of those milks is required so please read the instructions very carefully.

For mums who wish to bottle feed their babies, please bring two starter packs of formula feed into hospital with you.

Touch, containment, skin to skin, positioning of baby are all aspects of developmental care. 

Holding your baby is extremely important for you as a parent and for your baby and expressing love of your baby through holding is instinctive without you realising it. Sometimes when a baby has arrived unexpectedly or is ill, some of those instincts are put on hold for a period of time (due to separation of mother and baby, shock of the delivery) and it is not unusual for a parent to say initially that they don’t want to touch their baby, that they feel frightened in case they hurt their baby or disturb him/her particularly when they are in an incubator and/or on a breathing machine. 

Touch is extremely important to promote the connection between you and your baby. Touch is personal, the Neonatal staff are touching baby gently often wearing gloves or during painful procedures whereas your touch as parents is kind and loving and babies can tell the difference. 

The Neonatal staff will encourage you to touch and hold your baby even when baby is poorly and they will help guide you, suggesting where best to place your hands if baby has many wires/tubes attached. They will help you to read baby’s cues/signals and provide you with a small leaflet about approaching behaviours baby may show and about behaviours baby may show when stressed. 

A baby with smooth regular breathing, pink stable colour, smooth movements, hands clasped, finger holding, bringing hand to mouth, sucking, tucking in arms and legs to his/her body, holding his/her hand, frowning, cooing, smiling, actively turning to sounds, bright eyed highlight the characteristics. 

This baby will respond to being held and touched. This baby is well organised and able to spend time looking and being bright and stimulated. 

When baby becomes tired he/she will begin to fuss, cry, his/her colour will change and he/she may need other strategies to calm him/her, for instance a term aged baby maybe telling you he/she wants a nappy change or a feed. 

An early baby has possibly just had enough and cannot get comfortable and begins to tell you this through the body signals, eyes beginning to droop, body tone lowering and becoming limp, face grimacing, eyes go glassy, has a weak cry, hands are just sitting in mid air above the baby, holding fists tight, becomes very fidgety, may cough, sneeze, sigh, have a panicked look on face, move rapidly from being asleep to awake back again to sleep. 

Stopping the activity you are doing whether it is talking/stroking/changing nappy might help. Still hands will usually help a baby, bringing the body into a tucked position, hand on head /chest and hand holding arms and hands together, positioning a roll around baby to support them and help gain composure, covering with a blanket and resting. He/she may also need a nappy change and a feed so you must observe baby well to know what they are asking for. 

The medical nursing staff caring for your baby with the developmental specialist who has assessed baby can help you with this. 

Sitting alongside your baby you will be able to observe a lot and tell the staff what he/she likes or dislikes where they like to be touched, if he/she can tolerate stroking what he/she does when their temperature is measured under the arm etc.

When your baby is stable the nurses will suggest to both of you to have some skin- to-skin time with baby, often called Kangaroo care. This can seem quite scary when baby has been small and sick but the medical and nursing staff are able to help you with this. They will make sure there is space around the incubator or cot for a comfortable chair and a screen, they will have mentioned to you that baby is getting near to the time for kangaroo care and have asked you to wear or bring suitable clothing. 

Please view the following presentation used to train the staff, so that you can enjoy the skin-to-skin time with your baby. Dads love it too and being in a very feminine environment may feel inhibited initially but once you try it you will want to do it again. It is good for parents and baby. It will also help with your milk production if you are expressing. It is a diary moment. 

However, its ok if you don’t feel ready for kangaroo care. You can get to know your baby in other ways and wait until your baby is bigger or feel you want to do this when you stay overnight or when you get home.