Priceless information for your first week as a new parent

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Your baby’s arrival: getting acquainted

The first hours with your baby

Your first night as parents

Important information about the mother's  recovery

Face to face with your baby immediately after birth! Most babies will be awake and alert for a while. This is a beautiful moment for a first meeting outside the womb, in the real world. The baby 'knows' where she belongs. She recognizes your voice and that of your partner. These were the voices that she heard most often during your pregnancy. They sound a bit different outside the womb but her recognition of the rhythm and intonation of the voices is infallible. It is wonderful for her to be held and cuddled by you and your partner. After all, she has arrived safely and performed very well! She will love the close skin to skin contact with you or your partner. Immediately after the delivery is an important moment to lay your bare baby on your naked breast. Usually she will find your breast herself within not more than 1,5 hours.
Even when you are not going to breastfeed, it will be good for your baby to establish skin to skin contact with you. It will allow her to reach the desired body temperature, to restore her body sugars and to break down stress hormones more quickly than without that physical contact. If you hold your baby and stroke her gently, she will feel comfortable in the new situation.

What can your baby do right away?
The first thing the midwife or gynaecologist will look at, is the baby's reflexes. Reflexes are those movements that we humans make instinctively. We are not in control. Some reflexes will persist throughout our lives, others will disappear as soon as the baby is able to direct her own movements. 
The rooting reflex will be visible when the baby is hungry. Her mouth will start looking actively for the place where she knows she can expect food. If you brush your nipple across her lips, she will open her mouth wide and stick out her tongue a little;
The sucking and swallowing reflex allow the baby to drink from the breast or the bottle and then to swallow the milk;
The babies grabbing reflex helps her to hold on to your finger tightly when you touch the inside of her hand;
If you hold the baby upright, with your arms under her shoulders and with her feet resting on the ground, you will notice the walking reflex. Her legs will start to make walking motions. This reflex will disappear when she is around 6 weeks old.

Talking, cuddling and eye contact
All children, especially newborn babies, just love being touched, caressed, held and cuddled. Not only do they love it, they need it too. Contact (by touch, by looking and by speech) is just as important as good nutrition and care. It will make a baby feel safe and loved. She needs that feeling of love and care to grow and develop. Contact will help her not only to get to know her parents: she will also discover her own body. For instance, when you caress or rub her legs or feet, she will feel your touch in that part of her body. That will help her become aware of her body and all its parts. She does not only notice that you are there for her, but she also gets to know herself.

A 'good talk' with your baby
It will be a while before your baby can communicate with words. That does not mean that communication is impossible. On the contrary! Your baby reacts to your voice, your smell, the rhythm of your breathing and the way you touch her. She herself also 'says' a lot. For instance with the look on her face and her body language. It can be tense, or limp, but also firm and relaxed. Even her arms and legs may tell you how she feels: is she moving in a calm and concentrated way, does she strain her legs, or is she stamping her feet wildly? You will notice the different sounds of crying very soon: is she hungry, is she tired and fighting against going to sleep, or does she feel lonely and wants to be held. If you pay attention, you will learn to react to the different signals that your baby uses to express her needs. That is incredibly important, for now and for the rest of her life. In the first days of her life, your child makes an important step towards confidence, in herself ('I can let them know what I need') and in her parents ('they understand me and will take care of me'). Just look at this: your baby listens when you talk to her and she also looks you in the eye; all her attention is focused on you! Talk to her a lot. For example, you can tell her what you are doing. No matter how small she is, it is always good to talk to your baby a lot. You are bonding with her and promoting her development.

The hospital, has given you extensive instructions. Even so, you may still feel uncertain. Is everything going okay? The following is a list of topics about which new parents usually have questions.

Skin to skin contact 
The most important thing after the delivery is for your baby and you or your partner to have skin to skin contact (make sure your baby has a blanket over her). Your baby will love feeling her bare skin against yours. A great bonding experience. She will calm down, because it is a pleasant way of getting to the right temperature, because she smells your scent and because she loves cuddling, caressing and hearing your voice. Your baby has a greater chance of finding the breast herself. (Within the first hour after birth, this causes higher oxytocin levels, which makes the placenta easier to detach (Breastfeeding Guidelines, 2011)).
- Your baby has a greater chance of latching on the breast (having a good grip again ensures a good milk intake and also ensures that you do not get sore nipples).
- Your baby can keep her temperature normal and stable. This works better than in the incubator.
- Your baby can better keep the heart rate, breathing and blood pressure normal and stable
- Her  blood sugars remain normal
- Your baby cries less
- Greater chance of an exclusive, longer breastfeeding period
- Your baby can better indicate when it is time for (breast) feeding
- Your baby is immediately colonized with the bacteria of the mother, which is important for a good intestinal flora of the child and the development of immunity (the child also receives appropriate antibodies through breastfeeding). (Breastfeeding guideline, 2011).

Note: So it is not the case that skin to skin contact only benefits breastfeeding mothers. Also for babies who are bottle-fed, skin to skin contact can have many positive effects.

A newborn loses heat quickly and easily. Since the head is quite large in comparison to the body, the child quickly loses heat through the head. After birth, the head is often still a bit moist, so that the head cools down even faster. That is why, to prevent this, a cap is placed on the head of the baby after birth. Because of the cap, the mother can no longer sniff the scent of her baby from the head, which is of course the easiest. This is very important, as, among other things, smelling the scent of your own child ensures the adhesion. The sniffing of this special scent also ensures that oxytocin is released. This hormone makes your uterus contract, causing your placenta to detach more quickly and you will have less blood loss. So, when your baby's hair is dry and you have your baby skin to skin on your chest, best is to take off the cap.

Even if your baby doesn't latch on or starts to drink on the breast in the first two hours after the delivery, skin to skin contact is still important and good for your baby and for you as her mother, for all the reasons mentioned above.

Nauseous/spitting 
If, during the delivery, your baby has swallowed some of her mother's amniotic fluid or blood, she may feel nauseous for the first 24 hours, especially if she has a headache as a result of (prolonged) pushing. Babies may vomit or spit; the color of the slime can range from clear to a reddish brown. Don't worry if your baby momentarily sees kind of blue. She should recover her normal color quickly. Turn the baby over on her side and tap her back gently.

Restlessness of your baby
Babies can be very restless and may want to stay close to you. There are several possible causes: birth stress and exertion, all those new impressions, a dirty diaper, a need to suck, feeling hungry, being too cold or too warm. 

Breastfeeding 
The baby will want to drink often, up to 12 times a day. But nausea and/or fatigue may reduce the need during the first 24-48 hours and she may sleep a lot. Nothing to worry about. You can put her to your breast when she wakes up from her deep sleep or makes some noise or starts to stick her tongue out of her mouth and make movements with her tongue.

Do not worry if you think she is not getting very much food. Colostrum (the first milk) is highly concentrated and nutritious. A small dose is enough to fill your baby's tiny stomach. If latching on does not work immediately, express some milk manually and let your baby lick it off your breast or off your finger.
In the first 24 hours, do not give your baby any formula food or fluids, unless the hospital or the midwife have instructed you otherwise. 

Watch this video about expressing milk manually

Watch here breastfeeding master class UNICEF

Important:

• do not wash your breasts with soap, do not use bodylotion or parfum, because the baby is very attached to your own smell
• go pee and wash your hands before you start the feeding
• after your baby disconnects itself from the first breast you put some breast milk on your nipple. This is good for the recovery and care of your nipple. After your baby disconnects itself from the second breast you do the same with that breast. Let it dry before you put on your bra or shirt.

Feeding signs & the baby's posture while having babycramps. 

Latching on while laying on the side

Latching on sitting on a armchair in the rugby position

Close up on the position of baby’s lips

How to detach your baby from the breast if necessary 

Bottlefeed your baby in your arms

How to lift up the baby safely

How to prepare and latch on for the second breast in the Madonna position

Explanation about alternate the breasts and relaxed position to feed

About using a pacifier?
If you are breastfeeding and you want to give your baby a pacifier, be aware that this will reduce your ability to recognize your baby's first feeding signs. Besides, sucking a pacifier requires a lot of energy.
For these reasons and because your baby needs to built up experience with the right technique of how to latch on the breast the proper way and how to express the milk effectively, the recommendation is to not give the breastfed baby a pacifier preferably in the first 4 weeks. 

Formula feeding
Newborn babies want to be fed every two to three hours. Your gynecologist, midwife or nurse in the hospital will explain to you
how often you need to give her a bottle. The usual frequency is 6 to 8 feedings per 24 hours. It is not necessary to do this at fixed intervals.
You start with adding 10 ml per day per feeding.

So day 1 your baby gets 10 ml per feeding.

When your baby is large and/or more hungry she might drink 15 ml per feeding. That is okay as well.

Note: in the first 24 hours after birth your baby might not want to drink as frequent due to the fact that she is tired from the delivery and/or she has some reserves from the womb. It is okay for her to not drink as frequent. 

Note: Alternate between your right and left arm when feeding your baby or put her on your legs, straight in front of you to avoid her to develop a preference for one side of her head to sleep on. Babies always like to make contact, so if you alternate right and left she will have to change the position of her face to be able to look at you! 

Which Formula and how to prepare it
If you cannot, or do not want to give breastfeeding, there is a variety of formula foods to choose from. The midwife and later the Child Health Service, will help you select the right food for your baby. Make sure you get the right advice, because changing frequently will unsettle your baby. When preparing formula food, make sure you use water and milk powder in the right proportions. According to the safety of the tap water in the country you live in you will have to boil the water you use first. Do not reheat Ieftover milk as there is a risk of bacterial infection. 

Wash the bottle immediately after use. This is best done as follows: 

• Rinse the bottle and the teat in cold water;
• After every feeding, wash the bottle and the teat in a dishwasher at not less than 55'C (131 ‘F).
• Or use a special bottle brush to clean the bottle and teat in hot water and soap and rinse it with hot water to remove the soap again;
• Let the bottle and teat dry upside down on a dry, clean cloth. 

For more information and to watch a video on how to prepare and clean a bottle

In some older houses or apartments, lead piping is still used. Check if there is any doubt. You should avoid using tap water from lead piping for bottle feeding as it can cause lead poisoning. Newly constructed houses also pose a risk of increased lead levels in drinking water in the first three months. Instead, you should use bottled water (still, not fizzy) to prepare the formula food. New piping should be flushed at least twice a day for the first three months before you start using them yourself.
Don't use bottled water that is opened longer then 24 hours. Boil it after it has been open for 24 hours or use a new bottle of bottled water.

What is the right body temperature?
The normal temperature for a newborn baby is between 36.5 ‘C (97.7 ‘F) and 37.5 ‘C (100.5 ‘F). Hands and feet are often colder, so they are not the right place to take the temperature. Hands and feet can even be blue sometimes; nothing to worry about. This is because the circulatory system of a newborn baby does not always pump as powerfully into the extremities yet. If you move the arm or leg the color will soon change.

Use a digital thermometer to take the baby's temperature.
The thermometer tip needs to be inserted between 1.5 and 2 cm (0,59 and 0,78 inch) into the baby's anus, until you feel resistance: otherwise the temperature indicated will be too Iow.
To help your baby stay at the right temperature, she should wear a cap (even in summer) until her temperature is stable. If the hair in her neck is moist that is usually a sign that she is too warm. Make sure your baby's ears are not folded in half to prevent ear infection.

When your baby's temperature is okay you temperature her twice a day in the first week. When it is to low you provide her with a hot-water bottle or electrically rechargeable bottle. This way you know that your baby is able to keep her body temperature between 36.5 ‘C (97.7 ‘F) and 37.5 ‘C (100.5 ‘F).

After the first week you can stop measuring the baby's temperature, unless her temperature is not stable between 36.5 ‘C (97.7 ‘F) and 37.5 ‘C (100.5 ‘F). In that case you should contact your home doctor (GP).

When you want to know whether her temperature is okay, you lay two fingers along your baby's neck. If it feels warm, your baby's temperature
is fine.

How to make a hot-water bottle

Making the baby's cradle or cot and putting the hot-water bottle in.

Hot-water bottle in cradle or cot
Staying at the right body temperature is sometimes hard for a newborn baby in the first days. It may be necessary to (pre-)warm her bed with a
hot-water bottle. Best buys are electrically rechargeable bottles or metal hot-water bottles, with a screw stopper. Check (especially if the bottle is not new) the quality of the rubber in the stopper, so that there is no leakage. Fill the bottle to the brim with hot water (around 80 ‘Celsius / 176 ‘F), seal it off and put it in a sack, top down, in between two blankets at the foot end and cross in your baby's cradle or cot. Make sure there is some space (about the breadth of a hand) Ieft between the baby and the hot-water bottle. You have to refill the bottle with 80’C / 176 ‘F after around 5 hours. The hot-water bottle will stay much longer at a hot temperature then a electrically rechargeable bottle, which means that you will have to reheat the electrically rechargeable bottle more often during the day and night.

Room temperature
The baby needs to be safe and secure when she is asleep. The room where she sleeps should not be too warm or too cold: 17'C to 18'C is just fine. Do not dress the baby too warmly in bed and pay attention to the combination of clothing, and room temperature. 

Here is what you can do if your baby's temperature is lower than 36.5 ‘C (97.7 ‘F): 

• Give an extra hot-water bottle (one on either side of the baby with the lit down)
• Use an extra blanket (my advice is 2 blankets to start with, in summer 1 blanket).
• Add another layer of clothes
• Skin to skin contact
• When after 1,5 hour the temperature is not between 36.5 ‘C (97.7 ‘F ) and 37.5 ‘C (100.5 ‘F), you contact the midwife, the nurse in the hospital or your home doctor (GP).

Here is what you can do if your baby's temperature is higher than 37.5 ‘C (100.5 ‘F), you can: 

• Remove a hot-water bottle
• Remove a blanket
• Remove her cap
• Remove some of her clothes
• When after 1,5 hour the temperature is not between 36.5 ‘C (97.7 ‘F ) and 37.5 ‘C (100.5 ‘F), you contact the midwife, the nurse in the hospital or your home doctor (GP).

First defecation and urine
If you are going to change your baby’s diaper you keep the same order of doing things every time:

You start with washing your hands. Then you put everything you need at hand on the changing table:  an unfolded diaper, Vaseline, cleaning wipes, a thermometer, a cotton ball and alcohol 70% (to clean the thermometer after you have used it.

When everything is at hand take up your baby from her bed and lay her on the changing table on the changing pad. The baby's first defecation (meconium) is very dark in color and sticks to the buttocks. It is easier to remove if you apply some creamy ointment (preferably Vaseline without petroleum) before the first defecation. You can clean your baby's buttocks with cleaning wipes or cotton balls soaked in water. Keep the diapers to show to a hospital nurse or district nurse if you have a question about it.

Note: with a baby girl you always clean from the vagina to the direction of the anus. This is to prevent her from a urinary infection.

If your baby poops and pees one time in the first 24 hours that is already okay! Your baby does not get so much milk in her system yet so you will notice that the poops and pees will become more every day and the diapers also become more saturated.

Meconium

Urate Crystal

For changing the baby, it is best to use a table or dresser that is between 75 and 80 cm (30 and 32 inches) above the ground and a changing cushion with a raised edge, so that your baby cannot roll off the table. Even if you use a changing cushion, that does not mean you can leave the baby unattended. Always keep your hand on her stomach if you have to turn your head away, for example to pick up a towel. Never leave your baby alone on the cushion, not even to open the door or answer the phone. In such cases, take the baby with you or put her back in her cradle or cot for a moment.

A video on how to put your baby on the changing cusion

The umbilical clamp 
You do not have to do anything with the umbilical clamp. It will (in most cases) fall off after 5-10 days after the delivery. There can be some little blood-cloth remaining within the belly button. You can wipe that out after two days with a wet cotton ball or when you bath the baby.

Crying
Crying is your baby's primary mode of communication. It is quite normal for you and your partner to need some time to learn to understand your baby. You will actually learn your baby's intentions by trying out different approaches. What does she want? This may pose a bit of a problem if it is not quite clear immediately, but when you and your baby are happy again it will be a wonderful feeling. She wanted to drink; she needed comforting; she was cold; she had a dirty diaper; she was tired... so, that was the problem! During the first days and weeks after birth, the baby cries when she is hungry, tired, wants physical contact, has a tummy ache or simply does not feel well.

The baby's day-and-night rhythm
In the uterus, the baby was often active at night. That was when you were resting and she had enough space to move around. In her new world, the baby will have to change her routine or bio-rhythm. You can help her a bit by (for example) drawing the curtains at night and leaving them open during the day. You can also talk to her and cuddle her more during the day than at night. And when you feed your baby don’t use a lot of light, do not sing songs in the night or activate her too much.

Even so, some parents really relish the opportunity of quiet and intimate contact with their baby when the house is quiet. They enjoy these shared moments of peace and quiet, while the rest of the household is fast asleep. 

Breathing
Newborn babies have an irregular breathing pattern. Quite often, you can hear the baby 'sigh'. That is nothing more than a deep gulp of air. This irregular breathing has to do with the lungs, which are still small and not fully grown. As long as the color of your baby's skin is normal and healthy, there is nothing wrong with her breathing. A blue color around the mouth is not a healthy color. You should in that case at all times contact your home doctor (GP).

The baby in your bedroom ('rooming in')
For the safety of your baby (and reduce the risk of 'cot death'), it is best not to put her in a room of her own for the first six months, but to let her sleep in her cradle or cot in the parents' bedroom. There, she will have less chance of falling into a deep sleep. The first period of her life, deep sleep is best avoided. As your baby is close by, you will also learn to recognize her hunger signs. For safety reasons, do not take the baby into your bed. If you, or your partner, are a sound sleeper, there is a risk of rolling onto your baby without noticing. There is also a risk of the baby getting under the sheets or the duvet, or that she may get much too warm. Her cradle or cot is a much safer place. 

Sleeping safely 
For a newborn baby a cot is large. To make sure your baby does not get stuck under the blankets (risk of cot death!), it is best to make up a 'short' bed. This means that you do not use the upper part of the cradle or cot and put your baby, on her back, with her feet almost against the foot end of the bed. Fold the sheets and the blankets in such a way that they reach the babies shoulders. Tuck the blanket in tightly, so that the baby is stable. Do not lay cuddly toys in the cot or cradle.
Do not swaddle a newborn baby in the first days. Get to know the behavior of your baby first.

Don't let your baby sleep on her side or on her stomach: this increases the risk of cot death (SIDS: Sudden Infant Death Syndrome). Always put your baby on her back and turn her head left or right, alternating regularly.
Check out this link for more information on SIDS.

Never let your baby sleep on the dressing table. The plastic dressing cushion does not ventilate. This may cause hyperthermia which in turn could lead to cot death. 

If a baby gets too warm, or if there is not enough air so that she cannot breath freely, the risk of cot death may increase. The most important pieces of advice to reduce this risk are:

• always let your baby sleep on her back
• do not let your baby sleep in the bed with you and your partner
• let your baby wear clothes and have bedsheets and blankets of minimum 80 % cotton, or use wool or silk
• the room where your baby sleeps should not be warmer than 18'C (64.4'F)
• open the window for a while every day so fresh oxygen can get in
• don’t expose your baby to rooms where people smoke or where people have been smoking. Smoke will hang in the room for hours after a last cigarette.

Note: if necessary replace your baby's cradle or cot to the coolest room in the house for some periods during the day. Be aware of draft; this can cause a cold.

Babies need to learn to sleep in their own cradle or cot
In the first weeks the baby will have to learn to sleep in a cradle or cot. Before she was born, the baby was being carried all day long, she heard the sounds from her mother's body and she was gently rocked to sleep. Some babies need help to make the transition from being carried and sleeping in the womb to lying in a cradle or cot. Being carried and being with mother or father is a trusted and familiar feeling for a baby. Newborn babies can fall asleep in your arms. If you then put them in their cradle or cot, they may find the transition startling and will wake up. Too much coming at them at the same time. Before being born, the baby was used to be asleep near to her mother, in tune with all the sounds and movements of her body. 

So there is nothing wrong with the baby falling asleep in your arms or in a sling, as long as you yourself are comfortable with it. Babies need time to learn to sleep in their cradle or cot. When you are carrying your baby, look for a quiet and peaceful place. Some make a swift and easy transition to sleeping in their cradle or cot; others may need some more time. In the end, they all succeed. More on how to help your baby fall asleep by herself is explained on Day 7/practical information about your baby.

The baby's position in the cradle or cot
The recommended position for the baby is on her back in a cradle or cot halfway, with her head turned on one cheek. The baby should not sleep on her stomach. It is better not to let your baby sleep in the playpen if the floor of the playpen is too hard, which most of the time is the case, although nowadays it is also possible to buy thick matrasses with the exact size of the playpen. Having your baby sleep on the couch or on the dressing table is dangerous because of the danger of rolling off.

Preferred sleeping position
To prevent your baby from develloping a preferred position it is recommended to turn your baby's face on the other cheek every time you put her in her cradle or cot again. Some babies like to keep their head turned to the right, others to the left and then there are those who keep their head in the middle. A preference for Ieft or right may slow down the development of your child in the first six months. The skull, which is still quite soft, may be somewhat flattened in the area where the head is laid to rest most often. Normally speaking, this effect will disappear gradually. Sometimes it does not, or not entirely. It is quite harmless, even though it may not be a pretty sight.

When to call the midwife (or nurse if you are in the hospital) or your home doctor (GP)? 
You may always call if you are worried. You MUST call if: 

• the baby moans while breathing or is blue around the mouth;
• the baby's temperature is below 36.5'C (97.7 ‘F) or above 37.5 'C (100.5 ‘F);
• If you see some fresh blood coming out of the umbilical cord stump.

Whether your delivery went smoothly or not, your first night will probably be sleepless for you. Delivery has released a large quantity of hormones, making sure you will be wide awake! Besides that, you will both be very alert on all the sounds and movements your newborn makes.
As partner make sure to accompany the new mother every time she goes to the toilet, as she may feel dizzy and be less mobile. Try to pick up some useful tips from the nurse in the hospital or the midwife.

Note: Most babies start drinking more after the first 12-24 hours after the delivery. Especially at nighttime. This is something nature has not arranged very well ;-)

Afterpains 
As the word suggests, afterpains can be painful. Afterpains following a second or subsequent delivery are often even more intense than those after the first delivery. Afterpains are best absorbed in the same way as labour pains during delivery. If the pain is serious, you can take paracetamol.
it is perfectly okay (also if you breastfeed) to take paracetamol (not more than 3000 milligrams in 24 hours; preferably every 8 hours 1000 milligrams). 

Urinating 
It is important that you urinate within 4 to 6 hours after the delivery. The fuller your bladder, the more difficult it is for your placenta to contract. As a result, you could lose more blood. It is advisable to urinate every 3 to 4 hours, even when you feel no immediate need. If you are unable to urinate, contact your midwife.

NOTE:
Urinating before you start to breastfeed the baby is important, because your uterus will contract during the feeding and needs space to contract.

Loss of (blood) clots 
Losing blood after giving birth is comparable to intense menstruation. It is quite normal for the sanitary pads to be completely soaked every two hours on the first day. One or two orange-sized blood clots are nothing to be afraid of. If you lose more blood or clots you have to contact your midwife.
Immediately after delivery the colour is bright red. This will change slowly to dark red, brown (older blood), pink and in the end it is more yellowish wound fluid. The bleeding is allowed to last for six weeks at most, but in many cases it will stop sooner. 

When to call the midwife (or nurse if you are in the hospital)? 
You may always call if you are worried. You MUST call if: 

• your temperature is above 38.0 ‘C (100.4’F);
• you feel an unbearable pain in your stomach;
• you yourself feel ill;
• you have not urinated for 6 hours;
• you are losing too much blood: 2 maternity bandages full of blood in half an hour.

How to take care of your breasts when you breastfeed

• wash your hands before you start to feed your baby;
• do not use soap or body lotion on your breasts, because your baby is very attached to your own smell;
• do not use parfum for the same reason;
• put some drops of breastfeeding on your nipple after your baby finished drinking. This is good for the recovery and protection of your nipple. Let it dry before you put on your bra or clothes.

Engorgement while giving formula
Women who do not give breastfeeding will also experience engorgement.  The difference is that there is no stimulation on the breasts to produce (more) milk. Engorgement symptoms will start on day 3 or 4. Therefore the advice is to wear a tight bra or sport bra from day one on, day and night. Even while taking a shower leave your bra on. Don’t put the water jet directly on the breasts, because that way you get more stimulation. Quickly change your wet bra for a dry one after you have dried your body.
While changing the bra give your breasts a quick look to check for any red spots that might indicate a breast infection. The chance on a breast infection is not great, but if you see a red spot on one of your breasts which feels warm and painful if you touch it, contact your midwife or home doctor (GP).