Your take home tips following
discharge from the maternity ward

Vitamins

Babies are not exposed to sufficient sunlight in a modern lifestyle. For this reason, Vitamin D needs to be supplemented. Your baby should therefore receive a multivitamin that contains 400in of Vitamin D daily. Some of these products contain probiotics and are also suitable for use.

Car Chairs

• Babies must be transported in a car chair at all times.
• Car accidents are one of the leading causes of injuries in babies and children.

Umbilical cord care

The most important thing about cord care is the prevention of infection of the stump. An infection of the stump may result in the infection entering the blood stream. There are two schools of thought on cord care:

1. Dry Cord Care Technique:

• In a high resource setting one can use this method
• Keep the cord clean and exposed to air or covered with a clean cloth.
• If the cord is soiled it is cleaned with soap and cooled boiled water.
• Baby should not be submerged in water. Baby is wiped down with a soaped cloth.
• The cord must not get wet for 72 hours.
• A wet cord may become soggy and infected.

2. Surgical spirits or Topical Chlorhexidine:

• Clean the cord and the base of the cord with surgical spirits or chlorhexidine after each nappy change.
• These products may irritate the skin so an earbud must be used to clean the stump.
• When the cord starts to separate the umbilical stump may bleed a little. Continue routine care.
• Babies cry when you clean the cord. This is because these products are cold and not because the cord hurts the baby.
• If the stump bleeds it may also be that the cord is catching on the nappy. Fold the nappy down away from the cord to avoid this problem.

Immunizations

• Your baby should receive the BCG and oral Polio drops while still in hospital or within 10 days after birth.
• The next immunisation date will be between 6 and 8 weeks of age. See our immunizations chart here

Jaundice

• If baby looks yellow he /she may be suffering from jaundice. This is common and may lead to poor feeding and excessive sleeping.
• Please contact your clinic sister or paediatrician. It is of utmost importance that you communicate with the doctor’s rooms once you have done a jaundice test at the laboratories. This will enable us to arrange phototherapy if indicated.

Weekly weight check at the baby clinic

• Adequate weight gain is an important sign of your baby’s well-being. If your baby gains less than 90 grams per week for two successive weeks then please contact your paediatrician.

Six to eight-week check-up

• This is an important check-up post discharge when baby is examined and normal development is assessed.
• Please make the appointment as soon as possible following discharge.
• Phone +27 (0) 11 784-2729 to make the appointment.

Sleeping

Each baby is different.

• A newborn will sleep on average 9 to 18 hours per day, one stretch of between 4 to 5 hours in a 24 hour period is acceptable.
• Do not allow the baby to go longer than this without a feed in the first six weeks.
• Breast feed on demand as frequent feeding increases the breast milk production.
• Generally, breast fed babies will feed every 2,5 to 4 hours.
• Try to encourage regular feeds during the day so that baby doesn’t make up feeds at night. This helps to reduce the chances of day/night confusion where baby sleeps well during the day but then makes up feeds at night.

Crying

Crying is a baby’s only means of communication.

• A baby may cry because:
  • He or she is hungry
  • Needs a nappy change;
  • Is uncomfortable;
  • Is in pain;
  • Is tired.
• Remember to cuddle your baby as much as possible if needing to be soothed.
• If you are unable to soothe your baby and baby cries for an extended period of time please contact your nurse or paediatrician. Your baby may be ill or in pain.

Stools

• A breast-fed baby may pass a stool seven times in one day or as infrequently as once in seven days.
• Breast-fed babies pass very wet and, at times, “explosive” stools.
• In breast-fed babies, stools are watery with globular specks. The colour of the stool is usually bright yellow but can also be green or brown.
• Bottle fed babies tend to have one or two stools a day.
• Bottle fed babies may suffer from constipation and if this does occur please seek help from your clinic sister or paediatrician.

Cardiopulmonary resuscitation and first aid

• A course in CPR can save your baby’s life in an emergency.
• There are a number of different people offering such courses and they will usually cover other medical topics such as burns, poisoning and choking
• I would highly recommend that all parents do a CPR course before their baby even arrives or as soon as possible after birth.

Google

• Google is an amazing tool for getting information.
• One does however need to be selective. Please use recognised medical websites for information.
• Not all information on Google is necessarily acceptable practice.

When to call your doctor

• If baby is lethargic to the extent that baby is not sucking well.
• Inconsolable irritability or crying.
• Jaundice (yellow skin discolouration)
• Frequent large vomits.
• Fever (temperature greater than 37.5°C or 99.5°F).
• Low temperature (less than 36°C or 96.8°F)

Parental health

• Parents also have needs (and on occasion rights too)
• Take care of your own health. Keep a look out for signs of post-natal depression (baby-blues). Symptoms may include excessive weepiness, anxiety about the baby’s wellbeing and poor sleep. Seek medical advice earlier rather than later if such symptoms appear.
• Get rest while your baby rests. It is a good idea to get a family member or friend to babysit on occasion in order for you to get some rest.