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New Parents : I Just Want to Go Home The first days with your baby

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Q: I hate the thought of being in the hospital—how soon can I go home with my baby?
A: In most maternity units, there is a degree of flexibility as to how long you remain in the hospital after the birth. If you want to stay for as brief a period as possible, talk to your doctor or midwife about this. In the past, postpartum stays tended to be longer—in 1997–98, the average stay was 2–3 days, and was 4–5 days in 1981. Nowadays, the minimum length of time in the hospital is about six hours and many mothers just stay overnight to rest and gain some confidence. In some hospitals you may be asked to sign out “against medical advice” if you want to be discharged earlier than 24 hours. To help make the transition home as smooth as possible, plan your return, making sure you have plenty of support in place.

How long you stay in the hospital will largely depend on your type of delivery. If you have a vaginal delivery, you should be able to return home fairly soon, but a cesarean may mean you need to stay in for about three days. Also, if your baby is born early, or is unwell, or struggling to feed or maintain his temperature, then you will be advised to board at the hospital until your baby is ready to go home. When babies are premature, mothers may have to leave them in the neonatal care unit and visit regularly.

Q: Will I have any privacy in hospital?
A: Although most labor birthing rooms are private, double rooms or some triple rooms are still in operation in areas of the US. Moving from the birthing or delivery room to a postpartum room is still the standard in many hospitals. Mothers may have to share a bathroom or walk down the hall to take a bath or shower. In general, true privacy is limited in the hospital since nurses, medical assistants, lab, and cleaning personnel make frequent visits throughout day, evening and even nighttime hours. Doctors and midwives typically make rounds in the morning and write medication or discharge orders for the day.
Q: Where will my baby sleep when we're in the hospital?
A: Mothers and babies usually remain together for 24 hours a day. You should only be separated from your baby if there is a medical reason for this, for example your baby needs special care, and you should be fully informed before agreeing to this. Your baby will usually sleep in a plastic bassinet next to your bed. This is recommended by the World Health Organization (WHO) and UNICEF who run a program called The Baby Friendly Initiative. This works with health-care systems to ensure a high standard of care for mothers and babies, and many maternity units are guided by their advice.
Q: My friend's baby slept almost continuously for the first day or so. Is this normal?
A: The birth process is tiring for the baby as well as the mother and so it is not unusual for the first 24 hours to be fairly quiet, as your baby rests after the birth. Babies are often very alert and ready for a feeding immediately after the birth, but then have a long sleep. Also, if you had drugs, such as Fentanyl or Demeral, during labor, these can linger in the baby's system and contribute to the drowsiness. If your baby does sleep a lot at first, make the most of the opportunity to rest while still offering regular feedings. After the first 24 hours, you may still find that your baby is feeding irregularly, maybe every hour for five hours, and then having a four-hour sleep Rest assured there is no set pattern in the early days; your baby should feed when she wants to and you shouldn't expect any routine to emerge at this stage.
Q: Will the hospital help me with the everyday care of my baby if I'm having problems?
A: While you are in the hospital there will be nurses to help you. They have plenty of advice and information to offer so don't be afraid to ask about anything that is worrying you, such as specific questions about your baby, or any aspects of baby care (see Getting advice in the hospital). Before you go home you will also be given contact numbers in case you need help or advice before your postpartum checkups.

Once you are home, your midwife or doctor is still available to offer advice and support. They may also be able to give you details of local mother and baby groups which offer support and information for new mothers and their families and give you the chance to meet other mothers.

Q: Do we need a car seat right away or can I hold my baby in the car?
A: If you intend to take your baby home in the car, it is a legal requirement for them to travel in a car seat appropriate for their age. Indeed, it is illegal in most states for infants to travel in a car without a correctly fitting and installed infant seat through 3 years of age. Some states require booster seats until 8 years of age. Small babies and children need the protection that baby seats and child seats are designed to provide. So, yes, you do need to get your car seat ready before the birth to take your baby home from the hospital.
Q: I'm going to be on my own when I go home and I'm worried I won't be able to manage.
A: It's only natural to feel anxious about your new responsibilities when you arrive home with your baby. Being a single parent is increasingly common so don't be afraid to ask for help. Your doctor, midwife, or postpartum nurse can arrange to have a public health nurse make home visits to assist you with education you need about your own health and that of your baby. You will be given contact telephone numbers before your discharge from the hospital in case you experience problems or need advice before your postpartum checkup.

When you are on your own, it's a good idea to arrange for a group of reliable friends or family members who are willing to assist you with babysitting, morale boosting, and general backup in the early days. Over time you can establish a network of other single parents in your area with whom you can share your problems and solutions. Also, ask your midwife for contact details of local postpartum groups and organizations that support single parents.

Q: My mom is coming to stay with me but I don't want her to take over. How should I approach this?
A: Overbearing mothers and mothers-in-law can be a problem, however well-intentioned they are. You will find it's not just mothers who insist on issuing lots of advice and information, but friends and other relatives can be just as vocal. Although this advice is often useful, some of it may be old-fashioned or simply conflict with your own ideas on how to care for your baby.

Even though you may be feeling vulnerable after the birth, practice being clear and assertive about the way in which you want to do things and make sure that people understand and respect your views and that your partner supports you in this too. It may help to give pamphlets or books that you have read so your mother can see how things have changed since she brought up her children, and what advice you are following. You could suggest other ways in which she could help, such as shopping, cooking, and cleaning, so that you are left with the care of your baby. Most moms just want to help in some way, so it's up to you to channel her enthusiasm.

Q: Will I get any sleep at all in the early days?
A: You will get sleep but whether it is of the same quantity and quality that you are used to is questionable. Although young babies need a lot more sleep than adults, approximately 16 hours each day, they do not take all of this sleep in one long stretch since they need to wake up for frequent small feedings. Up to the age of three months, babies have “sleep–wake” cycles throughout the day with longer episodes of sleep at night.

The length of these cycles varies from baby to baby, but on average your baby will sleep about two hours at a time in the day, and three to six hours at night. All babies wake up a number of times throughout the night. The length of time your baby sleeps for during the night may also be affected by how she is fed. Several recent studies suggest that breast-fed babies take longer than formula-fed babies to develop a pattern of sleeping through the night. This is because breast milk is easier to digest than formula, so breast-fed babies get hungry more quickly and wake more often in the night. Most babies are physically capable of sleeping through the night from the age of six months.

Q: Should my baby be in her own room or in with us and, if so, for how long?
A: In the early days, when your baby is fed frequently, often every two to three hours, you may find it more convenient to have her closer to you. UNICEF recommends that babies share their mother's room for the first six months of life because this helps sustain breast-feeding and is also thought to help protect babies against crib death.

As your baby grows and develops, her needs and sleeping patterns will change. One of the main changes is that your baby will start to sleep longer between feedings at night and often this is the stage that many parents decide is a good time to move their baby into their own room. You may also find that, if your baby is a light sleeper, she may sleep better in her own room since she is less likely to be disturbed by you and your partner.

Q: I'm a really deep sleeper and I'm worried that I won't hear my baby crying. Is this likely?
A: This is a common worry for many new parents, but you should rest assured that it is highly unlikely you will sleep through your baby crying. Many new parents find that they do not sleep as deeply following the birth of their baby, which may be partly an unconscious worry about sleeping too deeply and not attending to their baby's needs. Having your baby sleep in the same room as you to begin with and using a baby monitor later if your baby moves into her own room will help you to feel confident about hearing your baby if she wakes during the night. It's also a good idea to try to catch up on some sleep during the daytime and take a nap while your baby is sleeping, because this will mean that you are not totally exhausted when you go to bed at night. You should also learn to trust the greatest prompt of all, your natural inbuilt maternal instincts!
Q: Who can I turn to if I have problems with breast-feeding?
A: Although breast-feeding comes naturally to some moms, for many others it can prove surprisingly difficult. Initially you will have nurses on hand in the hospital to assist you with breast-feeding. Once you return home, you can reach out to organizations like the La Leche League for advice at almost any time of day. If you continue to have problems with breast-feeding, contact the maternity or birthing center where you gave birth. The nursing staff can advise you or put you in touch with a lactation consultant or contact a local doula organization. Also, there are plenty of Internet sites that have forums, which are useful for discussing problems and comparing experiences. Some breast-feeding groups meet informally in cafés, so enquire whether there are any of these groups locally.
Q: I don't want to go home too soon—can I stay in the hospital if I want to?
A: The length of hospital stay depends upon the type of birth you experience, whether cesarean, spontaneous vaginal, or assisted birth and your postpartum recovery. Your insurance will also dictate how many days will be paid. For most plans, two days is the norm for a vaginal birth and three to four for a cesarean. If your baby needs special support, most maternity centers allow the parents to board for little or no cost. The staff will ensure that you are confident feeding your baby, whether this be breast-feeding or bottle-feeding, and that you are confident providing everyday care for your baby, which is good preparation for returning home.

When you go home, your care will be transferred back to your doctor or midwife, so you will continue to receive support, information, and advice as necessary. Also, planning in advance support for when you return home may help you feel more confident about leaving the hospital. Enlist the help of family and friends to help you manage in the first few weeks after the birth.

Q: We had so many visitors in the hospital last time it was exhausting. Can I stop this?
A: Many people seem to believe that if you are in hospital then they can visit whenever they want to, whereas most people, even close family, wouldn't just turn up on your doorstep unannounced if you were at home with your new baby. If you know in advance how you will feel then you really need to be assertive at this time and let people know what you would like to have happen. It is possible to do this in a diplomatic way without offending people by simply telling friends and maybe family too that you would prefer to have some quiet time with your partner and children during the first few days after birth to recuperate and get to know your new baby. Most people will understand this sentiment and will be more than happy to wait for a few days until you are feeling ready to see them. When you call friends and family with the big news, tell them you will send photos but prefer no visitors until you are home or until you feel ready.

If you are discharged from the hospital fairly early, it may be easier to control the flow of visitors since you will be able to dictate visiting on your own terms. At home, your partner may be able to help with the visitors by interacting with them while you are elsewhere in the house. You can take the time you need to settle down to a new family life.

Getting advice in the hospital

Although the arrival of your baby is a time of incredible excitement, it can also seem overwhelming and you may feel daunted by the enormous task of caring for and meeting the needs of this tiny new baby. One of the benefits of your stay in the hospital, as well as recovering from the birth, is to help you feel confident in the care of your baby. There are several aspects of baby care and feeding that the hospital staff can help with.

Bathing help:

Take advantage of your time in the hospital to ask the staff advice on baby care and breast-feeding techniques. They will be able to advise you on many aspects of your baby's care, which will help to increase your confidence.

  • Staff can help you to establish breast-feeding by guiding you on technique. Some hospitals have a dedicated lactation consultant on site.

  • The midwives can help you with everyday care by demonstrating topping and tailing, bathing techniques, changing a diaper, and dressing and undressing.

Leaving the hospital The procedure for returning home

Each hospital varies, but generally, before being discharged from the hospital, several checks take place.

  • You will be examined by a midwife or doctor to check that your uterus is starting to shrink down and bleeding is minimal.

  • If you had stitches, these will be checked to see if they are healing properly.

  • Your baby will undergo various newborn checks and will need to be discharged by a pediatrician.

  • If you need to take any medication home, this will be dispensed and you will be told how to arrange your postpartum checkup.

First days at home

Regardless of whether or not this is your first baby, on your return home you are likely to be both physically and mentally exhausted. If this is your first baby, although the transition to motherhood is exciting, it can be daunting and, once home, you may be surprised at how big an adjustment this is. While some families want to share their joy with family and friends as soon as possible, others decide to have some quiet time together at first to get to know the new arrival and get used to their new roles. Try to put worries about housework and cleaning up at the back of your mind—these will keep. Hormonal changes may mean that you feel quite low and weepy about three days after the birth. Getting as much rest as possible will help you to recuperate and begin to feel normal once again.

Being together:

The first days as a new family are a unique and special time. Give yourselves plenty of quiet time alone to relax and get used to your new relationships and family unit.

NOTE

Take the opportunity to ask any questions you have so that you will feel confident caring for your baby once you are home

NOTE

There are plenty of people to turn to for breast-feeding advice. Keep numbers for your midwife and helplines close at hand

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