Visits and checks

 

 

Who checks my baby after he or she is born?

The midwife does a primary check shortly after birth to check for any obvious abnormalities.

Within 72 hours a full examination will be carried out by either a paediatrician or midwife skilled in examining a newborn. The examination takes between 30-60 minutes and during this time the baby is assessed for any abnormality.

It is imperative that if you have any concerns about your baby you let the paediatrician or midwife know. Once this examination is complete the baby will either be fit for discharge or advised to remain in hospital.

If your baby can go home, it is of paramount importance that if you feel that your baby is unwell at any stage you must get them seen by a medical practitioner. Maternal instinct is very powerful and often correct. If you are concerned and are unsure whether to access care
www.nhsdirect.nhs.uk can be really useful.

Newborn hearing screeners will also offer you baby a hearing test, this usually happens prior to discharge home but in the event of an early discharge or homebirth, your baby will be given an outpatient appointment for their hearing screen at a clinic in the hospital or in your local community within 2 weeks of giving birth.
 
Who comes to see me when I have had the baby?

Your midwife will come to your house the day after you go home from hospital, or, if you have had a home birth, the day after you give birth. Midwives usually visit you for up to 28 days after you have had your baby but if all is well for you and baby, they can discharge you from their care from day 10 onwards.

The midwife will not visit daily unless you are having breast feeding difficulties or there are immediate concerns for either yours or your baby’s health. Some hospital trusts have breast feeding support (maternity support workers) factored into the community so it may not be your midwife that visits for breast feeding advice.

You will be given information and telephone numbers to allow you to contact a midwife if you have questions or need to arrange additional visits. The Health Visitor will be in touch between day 10 and 14 to arrange a home visit to give you information regarding clinics for you and your baby. You can visit the clinic as often as you wish to get advice on anything that may be concerning you and to get your baby weighed.

The Health visitor will give you a red book (if you have not been given one by the hospital) where vaccinations and weight gain will be recorded. 

Your GP (General Practitioner) is also available if you need them for any medical advice or assistance.
 
What does the midwife do when they visit?

Midwives undertake a number of checks when they visit you after the birth of your baby.

Your baby can be re-weighed from 72 hours of age onwards, usually on day 5 and will be weighed again before you are discharged. It is considered normal for a baby to lose up to 10% of its birth weight. If your baby has lost more than 10% of its birth weight, it may be weighed more often to ensure there is no further loss.

Between day 5 and 8 you will be offered a blood spot screening test. This is a blood test obtained from the baby’s heel. Four drops of blood are placed on a card and sent off for analysis. The blood is tested for:

  • Congenital Hypothyroidism, a condition where the thyroid is under active and fails to produce the hormone Thyroxine.
  • Cystic Fibrosis, a condition which causes a problem with chloride transportation resulting in thick secretions in organs, particularly the lungs and pancreas.
  • Sickle cell disease, where the red blood cells can become sickle shaped and form clusters preventing oxygenation of the tissues.
  • Thalassemia, which is an inherited blood disorder characterised by less red blood cells in your body than normal.
This blood test is not diagnostic. If the markers are positive then further testing will be needed. You will get the results through the post within 2 weeks from the child health department.

It is important to let your health professional know if you have a family history of a metabolic disease (a disease that affects your metabolism). Babies are screened for six inherited metabolic diseases. These are:
  1. Maple Syrup Urine Disease
  2. Isovaleric      Acidaemia
  3. Glutaric aciduria type 1 
  4. Homocystinuria
  5. Mccadd (medium chain acyl-CoA dehydrogenase deficiency), where the body has problems with breaking down fat into energy;
  6. Phenylketonuria, a rare disease where the liver doesn’t have enough of the enzyme Phenylanine. About 1 in 10,000 babies born in the UK has PKU or MCADD. The other conditions are rarer, occurring in 1 in 100,000 to 150,000 babies.

The midwife will also check your baby at every visit and it is important to mention any concerns you might have. The midwife will assess the baby from top to bottom, and will specifically check that:

  • The eyes are clear;
  • The mouth is moist and clear of any concerns such as oral thrush or Tongue Tie;
  • The babys skin colour is healthy and not showing signs of dryness;
  • The cord stump is healing and not inflamed or infected;
  • The finger nails are clear with no signs of infection;
  • That the baby is passing stools and urine frequently;
  • That the stool is the right colour (see the section on breast feeding for advice on how your baby’s poo will change);
  • Feeding is established and that there are no signs of dehydration.