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Postnatal information for parents and babies being discharged home from the Rosie Hospital

Patient information

Follow up care in the community

A midwife will visit you at home the day after you leave the hospital. They will not routinely call you before this visit. However if you have not had contact from a community midwife by 4pm on the day after you go home please contact the hospital area you were discharged from:

  • Lady Mary Ward: 01223 217667
  • Delivery Unit: 01223 217217
  • Rosie Birth Centre: 01223 217003
  • Charles Wolfson Ward: 01223 254668

The midwife will discuss future postnatal visits or clinic appointments that you will need according to your individual circumstances.

If you have been told that you require a postnatal follow up appointment at the Rosie Hospital for you or your baby, this will be sent to you in the post. If any of your test results are outstanding when you go home (for example vaginal swabs or blood results such as fetomaternal haemorrhage for women whose blood group is Rhesus negative), your GP or a hospital-based midwife will notify you if these are abnormal.

MyChart allows you to view your own appointment details, clinical correspondence and test results on your smartphone, tablet or computer. Please ask your midwife if you would like to sign up for this.

Urgent advice: Signs and symptoms requiring EMERGENCY action

See a doctor urgently (consider calling 999 for an ambulance) if you have the following symptoms:

  • Sudden or profuse blood loss, faintness, dizziness or fast heart rate
  • Fever, shivering, abdominal pain and/ or offensive vaginal loss
  • Severe or persistent headache particularly if accompanied by visual disturbances or nausea/vomiting within 72 hours of birth
  • Shortness of breath or chest pain
  • Red or darker coloured, swollen and painful calf
  • Widespread rash
  • Extreme unnecessary worry, severe anxiety, thoughts of self-harm or confused and disturbed thoughts.

Or if you are concerned that your baby:

  • Is limp and lethargic or floppy
  • Is unresponsive
  • Has abnormal breathing
  • Is more irritable than usual
  • Has blue lips
  • Has a fit
  • Has got visible jaundice (orange-yellow colour of the skin or the white part of the eyes) in the first 24 hours of life
  • Has not passed meconium (the baby’s first black/ dark green stool) within 24 hours of life
  • Has not passed urine within the first 24 hours of life
  • Is feeding less than usual/nappies are much less wet than usual (see p5 for number of wet nappies to expect on each day).
  • Has a rash that does not fade when pressed with a glass
  • Vomits green fluid
  • Has blood in their stools (however, salmon pink stain in the nappy in the first 3 days is common and is caused by urate crystals passed in the urine)
  • Has a temperature higher than 38 degrees Celsius (A fever is usually considered to be a raised temperature of 37.5°C (99.5°F) or above.)
  • Feels cold (with the exception of hands and feet) even when dressed appropriately for the environmental temperature

Immediate action required: Signs and symptoms requiring URGENT action

Contact the maternity assessment line (01223 217217) or see your midwife or GP within 24 hours if you experience any of the following:

  • Offensive or heavy vaginal loss, tender abdomen and fever
  • Perineal pain or unpleasant odour to vaginal loss
  • Painful haemorrhoids
  • Incontinence of faeces
  • Difficulty passing urine or incontinence of urine
  • Persistently painful, swollen or red or darker coloured breasts
  • Breastfeeding difficulties that persist at each feed

Or if you are concerned that your baby:

  • Is sleepy and not feeding well
  • Has constipation or diarrhoea if formula fed
  • Has got redness around the cord
  • Is crying inconsolably
  • Has jaundice starting at 7 days of age, or lasting longer than 14 days

Non-urgent advice: Signs and symptoms requiring NON-URGENT action

Contact your midwife or see your GP if you notice these symptoms:

  • Painful sex
  • Perineal pain/discomfort
  • Haemorrhoids
  • Headache or backache
  • Persistent fatigue
  • Constipation
  • Cracked or painful nipples
  • Engorged breasts (try frequent unlimited feeding, hand expression, pain relief and wearing a well-fitting bra)
  • Feeling tearful, anxious and low beyond 10-14 days (also discuss with your health visitor)

Or if you are concerned that your baby:

  • Has slight jaundice (orange-yellow colour of the skin or white part of the eyes) but is feeding well and is not sleepy
  • Has got thrush
  • Has nappy rash
  • Has colic or cannot be settled when being held

After you baby’s birth – information booklet

You can use the link below to view the information booklet and postnatal discharge DVD on the Rosie website:

Visit the After your baby's birth information page.

Infant feeding checklist

Your midwife or maternity support worker will go through the feeding checklist with you before you go home. If you have any questions or are not sure about any of the things listed below please ask your midwife. You will also find some of this information in the ‘Mothers and Others guide’, if you do not already have a copy of this please ask for one before you go home.

Whether your baby is breast fed or formula fed, we recommend offering your baby a feed when they show signs of being hungry, such as moving their head and mouth around and bringing their hands to their mouth, rather than waiting for a set amount of time to pass before offering another feed.

When breastfeeding

Have you been shown how to position and attach your baby?

  • Make sure you feel comfortable.
  • Hold your baby close to your body and support his/her neck, shoulders and back.
  • Check that your baby’s head and body are in a straight line.
  • Line up your baby with his/her nose to your nipple.
  • When your baby opens his/her mouth wide, bring him/her towards you, chin first.
  • His/her nose will be clear with the chin touching the breast.

Have you been shown how to recognise that your baby is feeding effectively?

  • Mouth wide open, cheeks full and rounded, bottom lip curled back: feeding should not be painful.
  • Your baby may suck rapidly at first, then should settle to a rhythmic sucking and swallowing.
  • Your baby should come off the breast on his/her own.
  • After the baby releases the breast, check that your nipple is a normal rounded shape.

Have you been shown how to hand express your breast milk?

  • Has someone explained to you how you can store your expressed breast milk and how to clean and sterilise equipment such as breast pumps?
  • It is recommend that you avoid using teats, dummies and nipple shields for breastfed babies for at least the first 4-6 weeks as these can make it more difficult for the baby to successfully attach to the breast. If you feel your baby does need any of these please discuss this with your midwife or health visitor.
When bottle feeding formula or expressed breast milk
  • When you feed your baby hold them close in a semi-upright position, so you can see their face. You can give a bottle feed while holding your baby in skin to skin contact if you would like to do this.
  • Follow your baby’s cues for when they need a break. Your baby will know how much milk they need, you do not need to force them to finish a bottle.
  • Has someone discussed how to make up a formula feed with you?
  • It is recommend that you only use first formula until your baby is one year old.
  • Has someone discussed how to clean and sterilise your baby’s feeding equipment such as bottles and teats with you?

Breastfeeding assessment

If you are breastfeeding you may find the following questions helpful to assess how effectively your baby is breastfeeding. Answers in the left column are reassuring and indicate that your baby is feeding effectively. Answers in the right column may suggest a problem, if you find you are saying yes to any of the answers in the right column please discuss this with your midwife within the next 24 hours.

Non-urgent advice: How many wet nappies has your baby had?

Answers indicating effective feeding

Day 0-2 = 1-2 wet nappies in 24 hours
Day 3-4 = 3 or more heavier wet nappies
Day 5-6 = 5 or more wet nappies
Day 7 onwards = 6 or more wet nappies

Answers suggesting you may need further support

Fewer than expected wet nappies.

Non-urgent advice: How many dirty nappies has your baby had? What colour was the stool?

Answers indicating effective feeding

Day 0-2 = 1 or more meconium stool in 24 hours
Day 3-4 = 2 or more changing stools
Day 5-6 = usually 2 or more soft yellow stools
Day 7 onwards = 2 or more yellow stools

Answers suggesting you may need further support

Fewer than expected dirty nappies or abnormal appearance of stool.

Non-urgent advice: What is your baby’s colour, alertness and tone like?

Answers indicating effective feeding

Normal skin colour; alert; good tone

Answers suggesting you may need further support

Jaundiced worsening/not improving; baby lethargic, not waking to feed; poor tone

Non-urgent advice: What is your baby’s weight loss on day 3?

Answers indicating effective feeding

At day 3 not lost more than 8-10% of birth weight

Answers suggesting you may need further support

Weight loss greater than 10%

Non-urgent advice: What is your baby’s behaviour like during feeds?

Answers indicating effective feeding

Generally calm and relaxed

Answers suggesting you may need further support

Baby comes on and off the breast during the feed, or refuses to breastfeed

Non-urgent advice: What is your baby’s behaviour like during feeds?

Answers indicating effective feeding

Generally calm and relaxed

Answers suggesting you may need further support

Baby comes on and off the breast during the feed, or refuses to breastfeed

Non-urgent advice: What is your baby’s sucking pattern during feeds?

Answers indicating effective feeding

Initial rapid sucks changing to slower sucks with pauses and soft swallowing (swallows may be less audible until milk volumes increase on day 3-4)

Answers suggesting you may need further support

No change in sucking pattern, or noisy feeding (eg clicking)

Non-urgent advice: How long does your baby feed for?

Answers indicating effective feeding

Baby feeds for 5-30 minutes at most feeds

Answers suggesting you may need further support

Baby consistently feeds for less than 5 minutes or longer than 40 minutes

Non-urgent advice: How does your baby end a feed?

Answers indicating effective feeding

Baby lets go spontaneously or does so when breast is gently lifted

Answers suggesting you may need further support

Baby does not release breast spontaneously or mother removes baby from the breast

Non-urgent advice: Do you offer your baby the other breast?

Answers indicating effective feeding

Second breast offered. Baby feeds from second breast or not, according to appetite

Answers suggesting you may need further support

Baby is restricted to one breast per feed or insists on two breasts per feed

Non-urgent advice: What is your baby’s behaviour like after feeds?

Answers indicating effective feeding

Baby content after most feeds

Answers suggesting you may need further support

Baby unsettled after feeding

Non-urgent advice: What is the shape of your nipple like at the end of a feed?

Answers indicating effective feeding

Same shape as when began, or slightly elongated

Answers suggesting you may need further support

Misshapen or pinched at the end of feeds

Non-urgent advice: Are your breasts and nipples comfortable?

Answers indicating effective feeding

Breasts and nipples comfortable

Answers suggesting you may need further support

Nipples sore/damaged; engorgement or mastitis, breasts not filling as expected

Non-urgent advice: Are you using a dummy / nipple shields / formula?

Answers indicating effective feeding

None used

Answers suggesting you may need further support

Yes

Feeding chart

Your midwife will ask you about your baby’s feeding in order to ensure that your baby is feeding effectively, you may find it helpful to complete this feed chart when you go home so you have a record.

Infant feeding support

The Rosie Infant feeding team can be contacted on 01223 596292 (voicemail service) or by email rosiehospitalinfantfeedingsupportline@addenbrookes.nhs.uk for non-urgent support Monday-Friday 9am-5pm.

The National Breastfeeding helpline is also available daily 9.30am-9.30pm on 0300 100 0212.

View the infant feeding support page.

Infant feeding audit

You may be contacted by telephone by the Infant Feeding Team after you have been discharged for audit purposes. Audit supports the staff to understand your experience of care in our hospital and can help to identify areas for improvement. You can decline to participate in the audit over the telephone or opt out by letting your midwife know you do not wish to be contacted.

Safe sleeping

  • Always put your baby on their back to go to sleep.
  • Your baby should sleep in the same room as you until they are at least 6 months old.
  • Keep your baby’s sleeping space clear, do not put pillows, cot bumpers or toys in their cot. 
  • Your baby should not wear a hat when they are sleeping inside your home.
  • Place your baby with their feet to the foot of the cot, to prevent them from wriggling down under the covers. Tuck in blankets firmly so that they go no higher than your baby’s shoulders.
  • If your baby falls asleep on another surface, such as a car seat or bouncer, you should move them to a firm flat surface as soon as possible.
  • Do not put yourself in a position where you could doze off with your baby on a sofa or armchair.
  • Do not let anyone smoke in the same room as your baby, ideally no one should smoke inside your home. If you or anyone in your family needs support to give up smoking speak to your midwife, health visitor or GP to find out about support that is available locally.

Room temperature

It is important to make sure your baby is not too hot or cold. Ideally, the room temperature should be between 16 and 20 degrees centigrade. It can be difficult to judge the temperature in a room so use a room thermometer in rooms where your baby sleeps and plays.

Non-urgent advice: Bedding guidelines for babies wearing a nappy, vest and BabyGro

12°C

Sheet plus four or more layers of blankets

14°C

Sheet plus three or four layers of blankets

16°C

Sheet plus three layers of blankets

18°C

Sheet pulse two layers of blankets

20°C

Sheet plus one or two layers of blankets

22°C

Sheet plus one layer of blankets or sheet only

24°C

Sheet only

Advice on room temperature is intended as a guide. Every baby is different, so while it’s important to be informed about overheating, you need to check your baby regularly to see if he or she is too hot. Feel the baby’s tummy or the back of their neck (your baby’s hands and feet will usually be cooler, which is normal). If your baby’s skin is hot or sweaty, remove one or more layers of bedclothes.

Feedback

We are interested in hearing about your maternity experience.

Visit our maternity survey page to launch four maternity surveys; antenatal, birth, postnatal and postnatal community. You can choose which surveys you want to complete to share your maternity experience.

You can also provide feedback to our Rosie Maternity and Neonatal Voices group.

We are smoke-free

Smoking is not allowed anywhere on the hospital campus. For advice and support in quitting, contact your GP or the free NHS stop smoking helpline on 0800 169 0 169.

Other formats

Help accessing this information in other formats is available. To find out more about the services we provide, please visit our patient information help page (see link below) or telephone 01223 256998. www.cuh.nhs.uk/contact-us/accessible-information/

Contact us

Cambridge University Hospitals
NHS Foundation Trust
Hills Road, Cambridge
CB2 0QQ

Telephone +44 (0)1223 245151
https://www.cuh.nhs.uk/contact-us/contact-enquiries/