Saturday 23 September 2017

Seven tips to survive the first six weeks with your newborn, according to Irish experts

It can be a rollercoaster for new parents when baby arrives. Jen Hogan explains what to expect and how to deal with those early days

It can be a rollercoaster for new parents when baby arrives.
It can be a rollercoaster for new parents when baby arrives.
Once you're sexually active again contraception needs to be considered from the off.
One way to help ensure that the new sibling relationship gets off to a positive start is good old-fashioned bribery.
Bathing a slippery newborn is a skill to be learned in itself.
In the early weeks, you need to roll with the punches. When the baby sleeps, you sleep.

The first six weeks after baby's birth can be quite a shock to the system. After the initial high wears off, and you leave the safe, and hopefully supportive, confines of the hospital, the reality of life with this tiny new person, who is wholly dependent on you, kicks in.

First time, and even subsequent, motherhood can bring a whole new set of challenges as you adjust to your new role, the new family dynamic, learn a new set of skills and get to know your gorgeous new baby. Add sleep deprivation, the recovery from childbirth and altering hormones to the mix and it can all feel a little overwhelming.

Preparation and education can help those early weeks to go a little more smoothly. Knowing what to expect, and how to handle any hiccups that you encounter, can make all the difference as you journey towards that much anticipated first smile.

Looking after you

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In the early weeks, you need to roll with the punches. When the baby sleeps, you sleep.

"The first six weeks after birth are a physical and emotional rollercoaster," Dr Conor Maguire, GP, explains. After the high of the birth, a sense of fear and panic can set in as the realisation dawns that the mother has to meet all of this child's needs.

Speaking of the pressure that some mums put themselves under to be the perfect mother, wife, homemaker and career woman, Dr Maguire says that this is impossible and compromise is necessary.

"In the early weeks, you need to roll with the punches. When the baby sleeps, you sleep. You take your sleep when you can. You eat when you can. Never spend baby's nap time trying to catch up on the ironing for example."

Partners are often equally bewildered by the arrival of a new baby Dr Maguire explains, and says that they are often unsure how best to support and help the mother. "The best thing to do is delegate," he adds.

Caring for your stitches

"A c-section is a major operation," Dr Maguire explains. "The stitches are quite solid, but it's going to hurt a lot if you try to put too much strain on them.

"The stitches will naturally swell over a couple of days and get more and more tight. Most of the stitches are internal but the paper stitches on the outside can be taken off yourself." While in the early days it may be necessary to keep the wound and dressing as dry as possible, after about a week all dressings can be removed.

Dr Maguire suggests the bath as a good place for assisting with the removal of paper stitches, and advises that they should be pulled from the outside to the inside - towards the wound.

"If your wound is oozing fluid to the extent that it's soiling a dressing, or your clothes, that should be checked by your public health nurse or your GP because it could be indicative of an infection."

It's important to move "gently and careful and it's one of the reasons that they tell you not to drive after a c-section", he says. When it comes to a return to driving, Dr Maguire says that ideally you should wait six weeks, if you can, adding that "some insurance companies will have a disclaimer."

With a vaginal delivery, the level of stitching, if any, can vary. Stitches can swell up over a couple of days and might feel tight. "This can make it difficult to pee," says Dr Maguire. "Sometimes sitting in a bath is a good way to pee. You can always shower down your legs when you stand up and get out again. You need to be careful not to get a kidney infection, so don't try to hold on.

"When your stitches are little bit better, you can rub some baby oil or moisturising cream into the scar to help supple it up."

Sex and contraception

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Once you're sexually active again contraception needs to be considered from the off.

While Dr Maguire says that sex "is not going to break anything", he does largely consider the first six weeks as "a time for cuddles" instead, adding that "obviously, things are very delicate and tender."

Once you're sexually active again, however, contraception needs to be considered from the off. Dr Maguire advises making no permanent decisions regarding contraception during a pregnancy or shortly after birth. "It's a good time to use reversible methods of contraception for a little while until you really settle down and make up your mind. Don't make any big decisions when you've just had a baby.

"Even if you're breastfeeding, there are condoms, Mirenas and the progesterone-only pill that you can go on straight away. The rule of thumb on breastfeeding is that it gives you about 80pc protection for 10 months. It's more a question of spacing your family rather than prevention through contraception."

He adds that while you're very unlikely to get pregnant in the first six months if you're breastfeeding exclusively, "nowadays, in the modern era, you should actually decide what you want."

Feelings and emotions after birth

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Physical exhaustion and a sudden shift in hormones are behind what's often described as 'the baby blues'

Physical exhaustion and a sudden shift in hormones are behind what's often described as 'the baby blues'. "Think of what's happening to your hormones," Dr Maguire says. "You're high as a kite on oestrogen and progesterone and suddenly you crash.

"Your hormones, your emotions, your physical side - everything is up and down. And then you feel vulnerable; you feel responsible."

If you're feeling low, he says not to assume this is normal. "Talk to your sister, your mum, your girlfriend who has had a baby and see what they experienced. And do talk to your GP or the practice nurse. It's okay to say 'I don't feel well'."

Feeding

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Just because breastfeeding is natural doesn't mean it's always easy.

After the initial hype passes, the calls have been made and excited relatives and friends have been informed of the baby's arrival, it's down to the business of actually taking care of baby.

It may be the most natural thing in the world, but just because breastfeeding is natural doesn't mean it's always easy.

Breastfeeding is a new skill to be learned by both mum and baby, together. Lactation consultant Nicola O'Byrne, who teaches breastfeeding support classes (breastfeedingsupport.ie/classes), explains that some babies feed like a dream, while others are really sleepy and it's difficult to keep them awake to feed long enough.

She recommends plenty of skin-to-skin contact, which is "fantastic for mother-baby bonding" and for noticing opportunities for latching and feeding.

"The main thing is that they feed regularly," O'Byrne explains. "This switches on the milk supply. They don't need lots of milk in the first few days. Colostrum [the milk produced in the early days of breastfeeding] is perfect - it gives them their first vaccination and sets up their tummy and bowel for life."

Frequent feeds, removing milk and switching sides when the baby slows down help build up a mother's milk supply. "Watch the baby, not the clock," she says.

"Some newborns feed for 15 minutes; some feed for an hour. Breastfeeds get faster and it all gets much easier and less time-consuming  after a few weeks." 

There are few things to look for when trying to ascertain if baby is getting enough. "By day five, baby should have six heavy, wet nappies and more than three mustardy-yellow nappies," O'Byrne says.

"There should be no meconium (the black tar-like poo) after day three." She advises watching for more swallowing over the first few days. "Watch your baby - their hands will relax and they will look full."

As for coping with the dreaded cracked nipples, O'Byrne says to cover them up. "Air-drying sore nipples is old advice. It makes it more painful." Instead she recommends moistening the nipple with an ointment or balm and to keep them clean. 

A blocked duct is a red, sore area on the breast. You should continue breastfeeding, as it helps with unblocking. Warm, dry heat and gentle fingertip massage can also help. 

Blocked ducts can progress to mastitis sometimes, where the mother has a temperature, shivers and a flu-like feeling. Mastitis generally requires an antibiotic, but "antibiotics for mastitis rarely affect the baby and the milk is safe to keep breastfeeding," she explains.

While mastitis is painful, it's really important that you continue breastfeeding. "In my experience, everyone needs support starting breastfeeding," O'Byrne says. "Even if it's just to say 'you are doing great'. If you are concerned, ask your midwife, public health nurse, lactation consultant or voluntary breastfeeding supporter."  

Bathtime

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Bathing a slippery newborn is a skill to be learned in itself.

Bathing a slippery newborn is a skill to be learned in itself. As they're unable to support their own heads, let alone their bodies, it can feel as if one pair of hands is just not enough.

To protect your back, and possibly abdominal stitches, it's a good idea to place your baby's bath on a table to minimise bending. Always test the temperature of the water with your elbow and not your hand.

A good hold can make all the difference. To help your baby - not to mention you - to feel secure, wash the baby's hair before putting them into the bath. Strip the baby down to the nappy. Wrap them securely in a soft, dry towel and, holding the infant almost like a rugby ball under your arm, support their head with your hand.

With the free hand, wash the baby's head gently over the baby bath. Once you're finished, the towel and nappy can be removed and you have both hands free to support your little one.

Helping siblings adjust

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One way to help ensure that the new sibling relationship gets off to a positive start is good old-fashioned bribery.

While you might feel excited about the prospect of providing your older child with a sibling, they might not be quite as enthusiastic once the baby actually arrives.

Sharing Mum with a baby who seems to take up all of her time and limits her availability to them means older children can sometimes feel a little resentful and a little left out.

One way to help ensure that the new sibling relationship gets off to a positive start is good old-fashioned bribery. A small gift from the baby to their older sibling, presented at the first time of meeting, or when Mum arrives home, can really help.

Including older children in the care of a baby, in an age-appropriate manner, can help your older child feel involved and less left out. From getting a nappy for you to helping with baby's bathtime, all 'help', once coupled with plenty of praise, can reinforce what an important and special new role your older child has now.

And, of course, though it doesn't feel like it at the time, newborns actually sleep quite a lot - just rarely when you want them to. For mothers with older children, newborn naptime doesn't provide the chance to catch up on sleep, but instead it's the perfect opportunity for catching up on cuddles and quality time with the newly minted big brother or sister.

Irish Independent

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