Antenatal Class Two – Baby’s First Week

The midwife welcomed us into the room and as soon as I saw her I knew it was a familiar face, unfortunately not one I had hoped I’d ever see again (as lovely as she was). I didn’t recognise her immediately as the entire day I met her was a blur but the more she talked the more I recognised that she was the midwife who I went to see when I stopped feeling Effy-Mae moving, and she was the midwife who couldn’t find a heartbeat and who referred me to the hospital for an emergency scan. She was the midwife I saw who started the ball rolling on the worst day of my life.
From the moment this had clicked into place I was only half paying attention, half trying really hard not to remember that day and concentrating on taking in as much information as possible so I could look after Jackson properly.

The midwife started the class by asking what the last class had been about and when we told her about birth and labour she had to put away all the equipment she had prepared for the class – there doesn’t seem to be any communication and she had prepared for the same class again! She then asked if we had seen these, and held up some particularly scary looking items. When we all looked blank she asked if we had been told about assisted deliveries, eg forceps and Caesarian, when we said no, she asked if we would like to be told about them. No one seemed to want to answer so I suggested it would be nice to know a little bit about them, 20minutes later she finished that section!!

She started with the kiwi which is essentially a suction cup that is stuck to the side of babies head and then the doctor pulls when you push and baby slides out easier, she also showed us a different, more basic version of the same thing which basically looked like a rubber plunger! She did tell us that if baby has one of these deliveries it is possible that they will have a slight bump on their head where the suction cup fits, but that this is just a buildup of fluid under the skin outside the skull and doesn’t affect baby’s brain, but could take up to 7 weeks to go. She did say that it is possible to get this even without an assisted delivery from when baby’s head is pushing against the cervix for an extended period of time.
She also told us about forceps. These always look scary to me, and they do need local anaesthetic to be used as obviously large metal things being shoved places they wouldn’t normally be shoved is going to hurt, but she said that they are more used to guide than pull and they allow for a more controlled delivery. They are often used during cesarians to allow for a slower delivery of the head as baby has had no time to prepare unlike in a natural delivery. She also mentioned that they are used in premature deliveries, again to allow for a slow birth as the size of the baby isn’t going to slow down delivery.
From this she moved onto caesarians and asked us how many people we thought there would be in the room. I think she was meaning to prepare us for if it did happen that we wouldn’t be worried with that many people in the room, however it did seem like there would be quite an audience. With one of the ladies in the group having twins she was warned that some of the people would double up, one for each baby!
Mum
Dad
Surgeon
Surgeons assistant
Anaesthetist
Anaesthetists assistant
Nurse
Midwife
Student midwife
Paediatric doctor
– And I’m sure I have forgotten some.
She reassured us that both mum and dad would be behind a screen and unable to see anything happening, but that as long as it was all ok that baby would be placed straight on mums chest for skin to skin like a normal delivery.

From this and with us all feeling notably more nervous about something going wrong, but reassured that we would atleast know what was happening if it did, we moved onto what we had expected to learn about.

I asked her to clarify how long we would stay in hospital. She told us that if we had a general anaesthetic caesarian then we would stay in for about 3 days, however, if it was a nice normal complication free vaginal birth then the minimum stay is 6 hours as this is how old the baby needs to be before some tests are carried out, but she did say not to go home until you feel totally confident in what you are doing, especially with breastfeeding, as it could be a full day before you get your first midwife visit, and this is a long time to struggle with a hungry baby! The tests done at the hospital are a hearing test (however not to panic if they give you a follow up appointment as often babies ears are still full of liquid!) checking the babies hips and heart and that they have 10 fingers and 10 toes and that everything else looks ok. After that at about 10 days the midwife will do a heel prick test to check for cystic fibrosis, an underactive thyroid and other incurable but treatable conditions. She also told us that their day 3 midwife visit should be the lowest weight baby will reach as they have been getting all their food on demand and not having to do anything for it up until that point and now they have to breathe and move and cry and wait and suck for food! They can lose 8-10% of their original body weight through this, but she assured us they would soon put it back on. After this the midwife hands over care to the health visitors who will continue to see you until baby is 5.

From going home she talked about bathing the baby and basically her advice was don’t! (Apart from their hair which will come out gunky and should be washed with a baby shampoo – wrap baby in a towel and tuck them under your arm nice and securely. Babies tend to cry when they’re held if they don’t feel they are being held securely) Babies come out with a protective, moisturising layer on their skin that excessive bathing removes which can lead to it becoming dry. She instead suggested top and tailing – however she told us that we didn’t need to clean their eyes unless they were gunky – how often to we need to clean our eyes? If babies eyes are gunky and remain so after washing then she suggested squirting some breast milk into them (she didn’t explain why, I’m assuming it has some anti bacterial properties or antibodies in?!) She suggested the same if the umbilical cord seemed to be infected. The umbilical cord should fall off in about 7-10 days. She mentioned that maybe their nails would need to be cut and that to do this you could use clippers, scissors or you could bite them yourself. Midwives are apparently not allowed to cut babies nails any more as apparently one nipped a babies finger and the parents kicked up a stink.

She did point out that you would need to wash their bum most nappy changes, and that baby wipes weren’t recommended for newborn skin, that water and cotton wool was preferred. She did however say that if you are out or it is the middle of the night, that the occasional baby wipe is fine, but not recommended for constant use.
She told us about baby poo, which sounds delightful! Apparently the first poo is black/green and like tar, but totally sterile as it has come out of you! It is made from amniotic fluid which is basically baby’s wee (which baby has been drinking and breathing) that has been in the gut and the water has been reabsorbed. However apparently after that, breastfed baby’s poo becomes really liquid and yellowy and comes out quite forcefully, while formula fed babies poo is more solid and ‘putty’ like. This, I have to say seems to be a big plus for formula feeding your baby! (Though I’m sure the benefits of breastfeeding will make themselves apparent later!)

She talked a little bit about breastfeeding and that our bodies are in tune to what baby needs. With it being summer baby will be thirsty and not hungry some of the time, but at these times our bodies should know and produce a more watery breast milk. She also told us that colostrum is the wonder food and that 1ml is all baby need for an hour of sustenance (a teaspoon is 5ml!) baby’s tummy is only the size of a marble when they are first born as they haven’t needed it up until now, so not to worry if it doesn’t seem that they are eating much, their tummy soon grows and by day 3 is the size of a walnut, as for breastfeeding positions, she basically told us to ensure that the baby’s head is in line with its body as this reduces the chance for any latching problems, and to hug the baby as close to your body as possible as this makes baby feel warm and secure.

She told us that winding after feeding it isn’t always necessary, however, if baby needs to be and isn’t winded then it can cause gas and colic, and then you’ll have to deal with an unhappy baby! To wind them just sit them on your lap (obviously supporting their head) and rub their back. If nothing happens then lay them down, lift them up again and try again. However she did say not to pat their back as for obvious reasons babies don’t like this and then they associate this with feeding and it can put them off. However, as she pointed out, formula fed babies are more likely to have issues with wind as they can take in wind from the bottle, whereas unless a breastfed baby has a bad latch on their chances to take in air are minimal as there is no air in the breast.

She also talked about room temperature. Baby is used to 37degrees currently, so being born into about 25degrees is going to be a shock to their bodies. This is why skin to skin is so important, and also why they give them a hat to wear. Baby has never had to regulate its own temperature before so it finds this hard to start with, however it quickly manages to do this itself, therefore after the first day or so baby doesn’t need to wear a hat. Once baby is home the ideal room temperature is 18degrees, however obviously we can’t change what the temperature is, especially having summer babies, so to simply remove clothing. If the temperature is over 30degrees baby is ok to sleep in just a nappy. Over 26ish degrees just a nappy and sleepsuit. Over 24degrees a sheet, nappy and sleepsuit. And after that start adding blankets. The way to check a baby is warm is to put your fingers on its chest to check its not too hot or cold, however, it’s better off slightly cold than warm as a cold baby wakes up and cries, a warm baby is as greater risk of SIDS.

This is about all I can remember from the session. I’m sure she covered more, and I’m sure I will remember it when I come to do it, but right now this is all I can recall.

Obviously I don’t know how much of this is fact, I accept no responsibility for you biting your child’s nails! I am simply regurgitating what I remember from what the midwife told us.

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