You might have heard of it, you might have seen a Facebook post about it or read a poster somewhere. Group B Strep is becoming more widely known about and talked about in pregnancy. So what is it and what impact can it have on your pregnancy, your labour and birth and your baby?
What is Group B Strep?
Simply put, Group B Strep is a bacteria which is found in about 30% of women. That’s one in three of you and your friends. Most of the time, this bacteria causes no problems whatsoever. It’s like those bacteria in your digestive system which help you to break down your food. Group B Strep bacteria (GBS) are most often found in your vagina or rectum, although occasionally they can transfer to your urine. This can cause a urine infection, which should be treated with antibiotics as soon as it is found.
How do I know if I’ve got Group B Strep?
Most women discover they have Group B Strep because it appears in their urine during pregnancy. They may or may not have any symptoms of a urine infection. Your midwife may find it in the urine sample you provide at your booking appointment. Alternatively, you may be aware of a urine infection and Group B Strep is identified as the cause.
With the increase in awareness of Group B Strep and the implications it has on pregnancy, some women ask to be tested. This testing is best done between 35 and 37 weeks of pregnancy. Your own midwife can usually do this at your GP surgery. You will need to sweep a long-handled cotton bud around the inside of your vagina. You put the cotton bud into a tube with a tiny amount of solution in it and the tube and cotton bud are sent to the laboratory. In a day or two, the laboratory can tell you if the sample has grown Group B Strep.
The newest type of test for Group B Strep is the enriched culture medium test which may or may not be available within your local area. Please ask your own midwife for details.
Implications of Group B Strep on Pregnancy
Finding out that you have Group B Strep during your pregnancy does not have a large impact on your care during the pregnancy itself. If the bacteria is found in your vagina or rectum, you will not need any antenatal treatment. If it is found in your urine, we recommend that you have some antibiotics to treat the urine infection.
Implications of Group B Strep on Labour and Birth
You will be advised to have antibiotics in labour if you have been identified as carrying the Group B Strep bacteria, whether that is during the current pregnancy or at any point in the past. These will be given via a drip in the back of your hand or in your arm. You will get a dose every 4 hours for as long as labour lasts. It’s really important to mention to the hospital that you’ve had Group B Strep when you phone them in labour. The midwife takes into account the time it takes for you to get to the hospital as well as the time it takes to provide the antibiotics when they invite you in to be assessed.
Providing antibiotics in labour has been shown to reduce the risk of the baby getting Group B Strep. It is a pretty simple procedure which can keep your baby safe. That is why it is recommended practice in the UK. Please discuss this further with your midwife or Obstetrician if you have any other concerns.
Implications of Group B Strep on Your Baby
Whilst most babies are fine even with exposure to Group B Strep, a small minority can get an infection from it. An even smaller minority can have serious consequences from that infection.
For that reason, if we know that you have carried Group B Strep in the past or in the current pregnancy, we recommend the use of antibiotics in labour. We also recommend that you stay in hospital for at least 12-24 hours after the birth. This enables us to monitor your baby’s heart rate, breathing, temperature and general condition every couple of hours and ensure no infection occurs.
If any signs of infection occur, such as an increase or decrease in temperature, breathing rate or heart rate, your baby will be referred to a neonatal doctor to assess what treatment may be required. Sometimes the baby will need a course of IV antibiotics, which usually lasts between 5 and 7 days. In most cases, you will still be able to care for your baby yourself while the antibiotics are given. A small number of cases may need extra support from a Special Care Baby Unit to help them fight the infection.
Please try not to read every internet story on Group B Strep. There are very heartbreaking cases out there and the internet would have you believe they are the most common kind. The reality as seen in the midwifery, obstetric and neonatal world is that most cases of Group B Strep infection will respond quickly to a course of antibiotics with no long-term effects.
You can read more in the Royal College of Obstetricians and Gynaecologists patient information leaflet, available here.
Amongst the many many lists of baby equipment strewn across the internet, you’ll find many variations of so-called ‘essentials’. What is essential for one person is obviously not essential for another! I thought perhaps I could help bring some clarity to the subject by listing my favourite essentials for breastfeeding mums. These are based on my midwifery experience with hundreds and hundreds of new mums dealing with daily breastfeeding challenges.
**This post may contain affiliate links. If you make a purchase from one of my links, I may receive a commission or credit at no additional cost to you. For more info, please read my disclosure policy.**
Hydrating is essential when you are feeding a baby. As some feeds can take up to an hour, it’s definitely worth having a source of water nearby. A water bottle will definitely come in useful as it can go wherever you go in the house to feed the baby!
I like this sort of bottle, which shows how much you should be drinking by a certain time of day. It helps you make sure you are getting the right amount of fluid, not just a glass or two. Fill it up twice a day – morning and lunchtime – and you know you’ve got the minimum 2 litres needed. Fill it up three times and you’re doing brilliantly!
The reality of breastfeeding is not all rose coloured mums and babes smiling in a shaft of sunlight. Sometimes there is soreness, cracks and bleeding. Your nipples have to adjust from being areas treated gently and softly and covered by a protecting bra, to being worked constantly, sucked and stretched and gummed 23.5 hours a day. It is no wonder that they will often get really painful, with cracks or bleeding noticeable.
While you should always get your attachment and positioning checked if you develop sore nipples, sometimes your body just needs to harden them. It’s like a hiker going on a 25-mile walk. If they’ve only walked 800 metres a day before, their feet are going to develop blisters. If they slowly work up to 25 miles each day, the skin on their feet thickens and hardens which makes blisters much rarer.
As a protective and preventative measure, nipple cream can be really useful. I would recommend buying several tubes of it so that you have one in each place you are likely to feed, plus one in your handbag. If you feed downstairs with the cream upstairs, the likelihood is you will forget to head upstairs and apply the cream after the feed. Just one forgotten application can make more difference than you think.
Nipple cream creates a moist barrier which allows the skin to recover and repair any damage. It is great to use because you don’t have to wipe it off before a feed. Lansinoh is one of the more well-known brands, but feel free to try some other brands and compare the results!
Another tip hot off the press from a London mum friend of mine is Vaseline. Apparently, the midwife helping her in the postnatal ward recommended using lashings of the stuff to repair cracked nipples even more quickly than the standard nipple cream does. My friend can testify to the truth of that promise!
There are two things to remember here: first, use a lot of the stuff! Not a thin layer like nipple cream, but a good thick coating is what it takes to work its magic. Also, you will need to remove this before you feed the baby.
So, have a go and let me know what you think! Is this a London secret that I need to start sharing up in the north?!
The wonder of nipple shells is that they work on two fronts. First, they catch all that extra milk that you might find drips from one nipple as you feed from the other. We don’t want to waste such a precious resource, so by catching it we can store it and use it in the future when we need to top baby up or go out for an evening. Try looking at Pinterest for more ideas on uses for breast milk other than feeding babies!
The other wonderful thing about nipple shells is that they lift your shirt or top off your nipple which, as mentioned above, may be a little sore!
You can go even further and use one of these for actively collecting the milk which drips from the free breast during feeding. The vacuum means you are more likely to collect a larger amount of milk, which can be useful for increasing milk supply.
Breast Milk Storage Bags
If you are collecting all that precious breast milk, you are going to need to store it in something. I cannot recommend these storage bags enough. They are strong, just the right size, and enable you to label the date and time the milk was collected! Did you know that the consistency of your milk changes according to the time of day you produced it? It is often thicker in the evenings and overnight, which helps to keep baby settled for longer.
Any breastfeeding mother can tell you the tale of their baby’s first cold. However and whenever it happens, it can have a serious impact on feeding. This is simply because if your baby has a stuffy, blocked nose, he or she struggles to breathe out of their nose as they feed at the breast. Feeds become shorter but almost constant, with lots of breaks and coughing up the precious milk they’ve just managed to drink.
If you are concerned about your baby’s health, please see your GP sooner rather than later. They will be able to reassure you whether it is just a cold which will pass or whether your baby needs more help to recover.
Once your GP has confirmed that the baby has a simple cold, you can help them in ways which are similar to those you would use yourself. You have probably heard of Vicks vapour rub, which can be rubbed onto a child or adult’s back, chest or feet. The unique smell calms coughs and eases congestion.
Snuffle Babe is a similar product made just for babies, so you can be confident using it on your littlest ones.
Another essential for your baby’s first cold is saline drops. They are simply a small bottle of salty water which you can squirt up your baby’s nose. Although you may wonder why you would want to do this, you will find that this flushes out all the snot blocking their nose and helps them to breathe more easily.
If you want to be ‘Wonder Mum’ you can even try a nasal aspirator, which is apparently even more effective! This simple device enables you to literally suck out all the gunk from your baby’s nose. There is a filter between your mouth and the gunk, so you don’t get a nasty surprise! When my mum first told me she had used one of these on me, many decades ago, I was horrified. However, I now understand the clear and urgent need to resolve blocked noses as soon as possible! My poor mum didn’t have the luxury of a filter protecting her from inhaling all my gunk – which goes to show the depths of love mums go to, to ease baby’s discomfort and get some sleep! Thank goodness for some advances in technology!
Nursing Bras / Nursing Tops
The other very essential thing for feeding baby, especially at night or in public, is a proper nursing top. This allows you to access the feeding area without having to completely strip off. Most nursing tops also provide a low but significant level of support which you don’t find in normal cami-style tops. Try searching on Amazon here.
If you have the time and the pennies, you can search the internet and online retailers for many cleverly styled nursing tops. If you don’t have the time or pennies to do so, Pinterest can still offer suggestions for altering your normal cami-tops to make them nursing tops.
The very important note is to not skimp when you buy a nursing bra or two! I’m not offering online links for this as I think it’s important to be seen face to face by a bra-fitting expert who can guide you to the right fit and style for you. In the UK, most department stores offer a face to face bra fitting service, and Bravissimo are brilliant for those who may have a larger cup size. Shop around for choice but don’t skimp on quality!
After a good feed comes a good burp and occasionally some positing. Muslin cloths are great for catching anything the baby brings up. They are also brilliant for putting over your shoulder or knee or arm etc when winding or just holding babies. Use them as a sheet on a makeshift bed and dry your tears when the baby blues arrive. You can even use them to squeeze or bite at that point of pain at the beginning of the feed when baby is pulling your nipple out. You know the one, where you clench your fists and curl your toes? Don’t go anywhere without two or three of these lifesavers!
Have you noticed that your milk will flow at the slightest thing? The power of hormones means even someone else’s baby crying can start your breasts dripping! To avoid rather obviously damp circles on every top you own, make sure you have a good supply of breast pads. They absorb the milk and keep you dry.
The other essential for breastfeeding mums to have on hand is a snack of some kind. You may have a long feed ahead, and you need to keep your strength up. Having a pre-packed snack within reach makes this really simple. If you are super organised you could try to create your own homemade organic superfood snacks, but this is real life, people! Most of us are impressed when we manage a shower by 3pm. Let someone else make your snacks for you! You can turn into that wonder woman a few months down the line if you have the energy!
Pretty bags for storing it all!
With all these essentials to keep handy, it’s definitely worth investing in a small, pretty bag or two. Makeup bags can be the perfect size to hold a few pads, a nipple shell, snacks, and creams and keep them close to you. You could have one bag that moves around the house with you. You could even create a couple of them and keep them in your favourite feeding spots.
Whatever your essentials list holds, just remember you are doing a brilliant job. Be kind to yourself. Have a treat or two. Embrace naps. These early days can be intense but you can do this!
Feeding your baby is a fierce biological drive which rises in a mother often as soon as the baby is born. It can be extremely worrying when a baby is not making much effort to try and feed or seems more interested in sleeping than feeding.
Let me state at the very beginning that if you have any concerns regarding your baby’s health including feeding you MUST CONSULT A HEALTH PROFESSIONAL IMMEDIATELY! The following suggestions are only suitable for healthy babies born after 37 weeks of pregnancy, who weigh 2.8kg or above (6lbs 3oz). You can use them while you wait for your health professional to see you but do not delay seeking medical advice.
Why does baby seem reluctant to feed?
It can be helpful to consider any possible reasons for the baby being slow to start feeding.
Some mums may have had diamorphine or pethidine during labour to reduce labour pain. These pain-relieving drugs can make labour easier to bear, but they also pass across to the baby. It is not uncommon for babies whose mum had these medications to be more interested in sleeping them off than in feeding for the first 24 hours or so.
Babies can get tired after a long labour. They may also still have quite a lot of mucus and other gunk in their stomach. This is very normal, but it fools the baby into thinking they are full so they don’t look for milk. It’s similar to how you feel after a large Sunday lunch with all the trimmings. You are often keen for an afternoon nap so you can digest everything! The baby thinks the mucus in its stomach is a large meal, so decides to sleep while it digests. Unfortunately, mucus can take time to be digested or coughed up, so babies can delay feeding while they do this.
Getting in the mood for a feed
One of the simplest ways to remind baby that feeding is a good option is to put them close to the breast! Your breasts start producing colostrum or milk as soon as the baby is born, although the amounts may be small to start with. When you cuddle your baby close to your chest they can smell the milk and that may be enough to persuade them to try feeding.
Try some skin to skin contact. Skin to skin contact is brilliant for mums and babies. It helps babies regulate their temperature and breathing. It also calms them down and helps their stress hormones to return to normal levels after rising during labour.
Skin to skin contact is pretty easy to do. Just take off your top and any maternity or nursing bra you might have, and strip your baby down to his or her nappy. Put baby on your chest between your breasts and cover both of you with a blanket or sheet or two to keep warm.
This will often be enough to enable the baby to smell your milk and move across to the breast by themselves! This amazing reflex they have of moving towards the breast can be seen in lots of youtube videos if you are interested. Just try searching for ‘Biological nurturing’.
Secret Midwife’s Tip for Faster Skin to Skin
Skin to skin can be brilliant for getting baby to feed. However, it isn’t always easy or practical when you have guests visiting or have to look after other children. It can also be frustrating to undress a baby every 2-3 hours to get them to feed.
One great tip handed down by generations of midwives working on postnatal wards is to dress baby in a centre fastening babygro without a vest. You might need another layer such as a cardigan or an extra blanket to keep them warm when they are sleeping. When it comes to feeding time, you can just unbutton the cardigan and unfasten the babygro. Keep baby’s arms and legs in the babygro but open the front of the babygro wide. This means there will be a large enough area of the baby’s chest to enable you to do mini skin to skin! It also means baby doesn’t get cold arms and legs and redressing them after the feed is much easier.
One of the most effective techniques for getting a sleepy baby to feed is to remind them what they’re missing. If a baby gets a little milk into their system, they often wake up enough to want to feed. So how do you get milk into a sleeping baby? It’s really very simple.
Hand expression is a key skill for mothers of sleepy babies. I imagine I’ll do a longer blog post with more in-depth technical explanations at some point. At present though, let’s keep it short and simple. After all, there’s a baby to feed!
Make sure you are somewhere that you can relax and not be disturbed. Oxytocin is a key hormone in producing milk and it isn’t going to flow so easily in a room full of friends, family, a screaming toddler and the postie dropping off baby gifts! You need to feel safe and comfortable.
Make a C shape with your thumb and forefinger. It’s a bit like miming a crab’s claw! Using that C shape, put your fingers around the edge of your areola. That’s the pigmented part of the skin that surrounds the nipple. Don’t put your fingers directly on the nipple, as there is no breast tissue there for you to stimulate. Placing your fingers further back towards the area where your areola meets the normal skin tissue will help you find more milk ducts to compress.
With your fingers touching your skin, gently press your fingers towards each other, squeezing your breast in the process. Don’t slide your fingers forwards towards your nipple or backwards towards your chest wall. Just keep them pinching directly towards each other.
Getting Milk into a Closed Mouth
It may take a few seconds or more but you should start to see little droplets of colostrum at your nipple within a minute or two. This is the good stuff! Now, all we need to do is give that to the baby and let its sugary goodness wake them up enough to want to try feeding.
You may be shouting at the screen that it’s no good having the milk if the baby is asleep and won’t open their mouth. Don’t worry, I’ve got a midwife’s tip for that too!
It is true that if a baby doesn’t want to open their mouth, it’s pretty difficult to force them. Parents who give milk via a bottle will have experienced the frustration of a baby crying for milk but refusing to open their gums to allow the teat in! Thankfully, we don’t need to get the milk past their gums.
Have you ever heard the term ‘pet lip’? It’s used to describe a baby or child who has rolled their bottom lip out and down as a sign of unhappiness. It’s actually really useful to practice it yourself so you understand what I mean. Go on. No one is watching! Without opening your teeth, just roll your bottom lip forward and down, almost like it’s inside out. You’ll notice that the lovely pinkish area of tissue that sits between your lips and your teeth is exposed. This is a mucous membrane and it’s all we need to get some calories into a sleeping baby.
So, the next step is to transfer those lovely drops of colostrum to the baby. The simplest way to do this is to run your little finger over the droplet so it transfers to the finger. Take this milk covered finger and run it along the inside of the baby’s bottom or top lip. You don’t need to force the finger in between their gums. Simply coating the mucous membrane will be enough.
Once you’ve done it, go back and hand express another drop and repeat the process. Yes, it’s time-consuming but it works miracles! If you do this for 5 – 10 minutes, the baby will have a crusty milky mouth. More importantly, they will have absorbed the milky goodness and their body will normally wake them up as they decide they want more! That is the time to put your baby to the breast so that they can actively feed themselves.
Making Baby Less Comfortable
Okay, this section shows that I’ve got my midwife hat on, rather than that cuddly mummy hat that keeps babies cozy at all times. The truth is that sometimes babies are just too comfortable sleeping to rouse themselves to feed. A few weeks down the line, I would never encourage you to wake a sleeping baby. During the first couple of days, though, it is helpful in stimulating milk production and establishing breastfeeding to wake babies if they sleep too long.
How long is too long? That depends on many factors and you should be guided by your midwife or health professional. I tend to err on the side of caution and encourage waking to feed if they haven’t done so themselves by 4 hours after the end of the last feed. That’s just until we know that baby has figured out feeding and is putting weight back on after their initial weight loss.
For a baby who hasn’t yet started attaching to the breast, who seems full of mucous or very sleepy, I would encourage you to hand express and finger feed every 2 – 3 hours. Although this is a lot of work, it ensures that even if baby only decides to wake and feed at every other finger feed session, they are still getting enough milk to maintain their health. It also ensures that you are stimulating your milk production in those essential first few days whilst the baby is a little too sleepy to do so.
My ‘Pick them up and let them hang’ technique is often very effective at waking babies, although it does tug at the heartstrings. Holding the baby securely with both hands under their armpits, lift them up into the air so that their legs are no longer supported by the bed or your lap. Although the baby is perfectly safe, they don’t like the sensation of having their bottom half unsupported, so it usually wakes them up and sometimes even makes them a little upset. I don’t recommend doing it for long periods! Just use it as a 2-second thing to wake them up enough to put them on the breast.
The other surefire way to wake a baby is to change their nappy! You’ll probably have noticed that babies do not like getting naked and having their bottom wiped. This makes it an excellent tool for waking them up if you need to. You may just need to open their babygro to wake them. You may need to go all the way to changing the nappy (or opening it then closing it again if it is clean).
Another good way to wake a baby is to have a bath with them. This ticks lots of boxes for waking baby – they get naked and they get skin to skin! Of course, it only works if your house has a bath and if you don’t have lots of other children, pets and partners needing your attention!
A Suggested Feeding Schedule for Sleepy or Reluctant Babies
Every two hours start off by doing skin to skin for at least 30 minutes. Follow this by hand expressing for 5 to 10 minutes. Use your finger to transfer the drops of milk to the baby’s rolled down lips as described above. After finger feeding like this for 10 minutes, you can settle baby back to sleep. Hopefully, they won’t settle and will insist on having a proper active feed.
If the baby has a good feed of 10-15 minutes of active sucking and swallowing with rhythmic pauses, you can let them sleep for another 3 – 3.5 hours before waking them again.
If the baby decides they don’t want to feed after you’ve hand expressed, or if they only actively feed for less than 10 minutes, repeat the process in another 2 hours.
When to Seek Immediate Assistance
Always, always ask for professional advice if you are at all worried about your baby’s feeding or lack of it. Whilst most babies will wake up and start feeding themselves, a slow or reluctant feeder can be a sign that the baby is unwell. If you notice any of the following symptoms, please take your baby to the nearest Emergency Care Centre immediately.
Jitteriness – this is a repetitive unprovoked movement in one or more limbs
Are you worried about your supply of breast milk? Are you anxious because your baby doesn’t seem to want to do anything except eat? Does he or she never seem to settle fully between feeds or only settle for short periods? This can all be normal behaviour for very new babies, but no matter how old your baby is, there are some things you can do to increase your milk supply. That way you’ll know that if there is a problem, it doesn’t lie with your breast milk supply.
**This post may contain affiliate links. If you make a purchase from one of my links, I may receive a commission or credit at no additional cost to you. For more info, please read my disclosure policy.**
Supply and Demand
Your body produces milk on a very simple supply and demand system. If all of your milk is removed, hopefully by a baby, your body produces even more for the next feed. This enables us to strategically increase demand artificially to increase your supply.
You may have thought or heard about expressing or pumping milk. This is an excellent way to increase the amount of milk your body produces and can produce results fast.
There are many ways to express milk. Some people like to hand express, others will use a hand pump, others prefer an electric pump. You can even get a double electric pump. Yes, you can feel a bit like a milking machine, but let’s be honest, pregnancy isn’t all that great for dignity or glamour. This is for your baby, right? You’ll do anything to keep them well fed. That includes attaching yourself to an electric pump several times a day. For suggestions of good quality double pumps, trying this search on Amazon.
The key to expressing or pumping to bring in more milk is to do it after the baby has fed. That way you know that the baby is getting everything they want before you collect the remainder or put in the order for more.
Try expressing or pumping for 10 minutes on each side after every other feed to begin with. Obviously, a double electric pump will be finished in 10 minutes, whereas hand expressing or a single pump will take 20 minutes to do the same. However, some people may get a better let down reflex from hand expressing and end up collecting more milk than they would using a pump. That might be because they feel more comfortable hand expressing – the milking machine analogy can certainly make some women feel uncomfortable enough to slow production. There is no right or wrong way to express and sometimes only trial and error will show you what your body prefers.
You may not collect a lot for the first couple of sessions but this is very normal. It simply means your body will be getting clear signals that the supply needs to increase. Just keep going and over the next 24-48 hours you will find the amount you collect increasing.
If you don’t want to spend extra time expressing after you’ve fed your baby, you can get your baby to make the demand for more milk. Sometimes babies will get so very comfortable and relaxed during a feed that they don’t eat everything they could before they fall off to sleep.
If your baby seems to fall asleep after only a short time at the breast, why not try switch feeding?
Start feeding the baby on one breast. When you notice the baby slowing down take them off and put them onto the other breast. You need to switch breasts before baby gets sleepy if possible. This means they may only feed for 2 minutes before the sucking and swallowing rhythm slows down. That is the time to switch breasts. Do this 3 times over the feed if possible so that both breasts have been fed from twice. This will definitely remind your body that there is a big demand for milk!
When you take the baby off the breast to switch onto the other one, try talking to them before you put them on the second breast. Lift them so that they are facing you vertically and try to catch their attention with soft encouraging words. This may help them wake up a little more.
Another classic midwife trick for waking up a rather sleepy baby in order to put them on the breast is letting them hang. Holding the baby securely with both hands under their armpits, lift them up into the air so that their legs are no longer supported by the bed or your lap. Although the baby is perfectly safe, they don’t like the sensation of having their bottom half unsupported, so it may wake them or even make them a little upset. I don’t recommend doing it for long periods! Just use it as a 2-second thing to wake them up enough to put them back on the breast. And tell them it was the nasty midwife’s idea if they complain!
Passive milk collection
Have you noticed that your breasts are leaking milk? Does that feel like a waste of the good stuff? There are ways to collect this leaking milk so that it can be used to feed your little one, rather than getting lost in a muslin cloth or your favourite nursing top.
Try using a silicone breast pump. This is a pre-formed silicone cone which is shaped to fit onto your breast and collect the dripping milk without any pumping action, manual or electric, required!
I like this one at Amazon:
Nipple shells can also collect the dripping milk if you don’t feel you have such great quantities. Shells are also great for wearing even when you aren’t wanting to collect the milk. If your nipples are really sore, nipple shells can help reduce the pressure on them from your bra or top.
Amazon has this twin pack with great reviews:
Keep to a schedule
The easiest way to boost your milk supply requires no extra money to be spent, which is great news since babies are very expensive little creatures! It’s such a good job they’re so cute!
The simplest technique is simply putting the baby to the breast more often. Babies are definitely the most efficient at removing milk from a breast. You may find you get nothing when you use a pump or hand express but your baby is getting plenty of milk when they feed at the breast. That’s absolutely fine!
Keep sleep periods short if you want to increase your milk supply. For healthy babies, demand or baby led feeding is recommended. That means as long as the baby gets at least 8 – 10 feeds of 10 minutes or more in 24 hours, we don’t mind how long the gap between feeds is.
However, if you think you need to increase your milk supply, try planning for a feed every 2.5 – 3 hours maximum. Gaps of 4 hours or longer might be normal in healthy babies who feed 8 – 10 times in 24 hours, but they won’t stimulate an increase in milk supply.
You can be kind to yourself and try waking the baby more frequently for feeds during the day. Let him or her have longer sleeps during the night. Don’t make your sleepless nights even harder by waking yourself and baby every 2.5 hours overnight!
Keep watching for hunger cues
Sometimes we miss an opportunity to put the baby on the breast because we haven’t noticed that they are hungry.
Keep your baby close to you, preferably in the same room. You can then notice the signs of hunger which come before crying, such as licking their licks, searching with their mouths open and sticking out their tongues. If you have left your baby in a safe place in another room you may want to consider bringing them back to your side when the 2.5 hour point comes, as they may already be beginning to stir.
Don’t use a pacifier all the time. Pacifiers can be really useful as a baby gets older or if your newborn just seems to be a very sucky baby who wants to suck even though they’ve fed well.
However, if you want to increase your milk supply, then the baby needs to be using your breast as its pacifier instead. You can still use the pacifier overnight if you would rather have that help for settling the baby to sleep. Just consider avoiding using it during the day.
IF YOU THINK YOUR BABY IS UNWELL BECAUSE THEY ARE NOT GETTING ENOUGH MILK, SEEK ASSISTANCE FROM YOUR DOCTOR, MIDWIFE OR HEALTH VISITOR AS SOON AS POSSIBLE. DO NOT WAIT TO TRY THESE TECHNIQUES AND SEE WHAT HAPPENS.
THE TECHNIQUES ON THIS PAGE SHOULD ONLY BE USED BY MUMS WITH HEALTHY BABIES WHO WANT TO INCREASE SUPPLY FOR CONVENIENCE OR PRACTICAL REASONS.
Burning, stinging, smelly urine? Yeah, pregnancy is all about the glamour! Unfortunately, women are more likely to get urine infections when they are pregnant. Find out more about what causes them, what you can do to prevent them and what treatments are available.
Why urine infections are common in pregnancy
During pregnancy, you have many different hormones at different levels in your body. These hormones help your body to nurture and develop your baby. They also help prepare your body for birth. One of the hormones involved is called Relaxin. This hormone is brilliant at relaxing (yes, really) the small vessels in your body. These vessels might be blood vessels or the tubes which carry your urine from your kidneys to your bladder or from your bladder to the exit! Relaxed blood vessels make it easier to send more blood flow to the baby to help them grow. Relaxed tubes for urine make it easier for bacteria to enter these tubes and cause urine infections. You can also find more information on the effects of Relaxin in my article on pelvic pain in pregnancy.
How do I know if I have a urine infection?
The symptoms of urine infections include:
pain when passing urine;
lower back pain on one or both sides of your back;
feeling generally unwell;
and needing to pass urine urgently but only passing small amounts when you do.
That last one can simply be because your baby is bouncing about on your bladder and making you think it’s full. However, if you have any of the symptoms of a urine infection, you should get a urine sample checked by your midwife or doctor. You can also have a urine infection without any symptoms, which is why your midwife checks your urine sample at every appointment just in case.
When the midwife checks your urine, she is looking for things like proteins, nitrites and leucocytes. Proteins can show up because the bacteria are made of proteins, nitrites because some bacteria produce these, and leucocytes because your body is producing them to fight off the infection.
Treatment for urine infections in pregnancy
The standard treatment for a urine infection is antibiotics. You will be asked to provide a urine sample which will be sent to the hospital laboratory. They will check which antibiotics work best to kill the bacteria. However, you can be started on antibiotics before the results come back, as there are general groups of antibiotics we can start with. The doctor will contact you within a couple of days if we need to change the antibiotics or if your sample actually showed that you have no infection.
It is important to complete the whole course of the antibiotics and to provide a sample at the end of the antibiotics to confirm that the infection has gone. Untreated urine infections can occasionally spread up into your kidneys and make you very ill, even possibly needing hospital care, so please ask for help if you think you have an infection.
Ways to prevent urine infections
So how can you reduce your risk of a urine infection, even if you do have that troublesome Relaxin hormone floating around your body?
Make sure that you are keeping clean. When you go to the loo, wipe from front to back. You can even get wet wipes to use after you’ve used the toilet just to keep everything fresher.
Change any pad or liners regularly. You do tend to have a heavier discharge during pregnancy, so you may be using liners or pads to keep your underwear clean. Just remember to keep changing these if they become wet or soiled.
Drinking plenty of fluids is really important. It keeps you and baby hydrated, which regulates your own and the baby’s heartbeats. It also means that you are passing urine a lot. This might be inconvenient but passing lots of urine means you are flushing out any nasties before they can start an infection.
Good sexual health
Mother told you to wee after sex and she was right. Any sexual intercourse can introduce bacteria into the area, some of which might want to set up shop and cause you an infection. By passing urine, then perhaps using a wet wipe or two, you are going to help flush them out of the area before they do.
Other things to consider
Some women find out during their pregnancy that they have a bacteria called Group B Strep in their urine or around their vagina. If it is in the urine it should be treated as usual but this bacteria can also impact upon your labour, birth and baby. I will be writing another post on Group B Strep and will link to it as soon as I have, but in the meantime, here is the link to the Royal College of Obstetricians and Gynaecologists patient information on Group B Strep.
One of the first medical tests your newborn baby has is the heel prick test. It is also called the blood spot test and forms part of the UK national screening programme. Further information on the programme can be found here.
You may have heard stories from other parents about how upsetting they and their baby found the test. It does involve a small cut on the baby’s foot but I don’t believe it has to be distressing for parents or baby. In fact, I always aim to cause as little discomfort as possible. I warn parents that the baby is likely to be more upset about getting naked to be weighed that they are about getting the test done.
What is the Blood Spot Test for?
The blood spot test collects a small amount of blood and checks it for 9 different health conditions.
Some of these conditions are metabolic. This means that the baby may be born unable to digest a certain protein or fat. If the baby’s diet included it, the undigested protein or fat would build up to levels in their body which would cause them harm. However, if we find out that the baby has that condition we can give them a diet without the particular protein or fat and the baby is absolutely fine.
The other conditions we look for are:
Cystic Fibrosis, a condition which causes problems in our lungs and digestive systems. The baby may need physiotherapy and medications
Sickle Cell or Thalassemia, a condition where blood cells have an unusual shape. It is more common in families with African ancestors.
Hypothyroidism, which is where the baby’s thyroid doesn’t produce enough of the hormone thyroxine. The baby may need medication.
How to help reduce baby’s distress
So how can I promise that your baby will be more distressed by the weighing that follows the heel prick test than by the test itself?
Well, in order to collect the right amount of blood, we need the foot to have a good blood supply. Have you noticed that your baby always has cold hands and feet? This is very normal and important as the baby is keeping most of its blood in the important areas of its brain and chest. This means that normally we would have to press quite hard and wait for ages to collect the right amount of blood from the baby’s foot. It’s this drawn out pressure and holding of the foot that causes the most distress.
The key to reducing distress is warm feet.
I always ask parents to put socks on their baby before I visit. Sometimes that means they do it in the middle of the night. I also ask them to put lots (more than 2 or 3) of pairs of socks on the baby, as well as booties, as well as wrapping them in a cosy blanket. No kidding! Sometimes the baby’s feet look twice their size, but I’d rather that for a short time so the baby doesn’t find the test upsetting, than that the baby looks fashionable!
If for some reason the baby’s feet are still cold, or if the parents have forgotten to put on any or enough socks, we still have options to warm the feet up.
My next action is to ask you for a mug or jug or bowl filled with really really warm water. I don’t want lukewarm water. I want the kind of water that turns your fingers red when you put them into it. You should be able to put your fingers into it, though, not find them burning!
The reason your fingers turn red is because the blood flows into them to cool them down. So yes, my plan is to put the baby’s foot into the water until it turns red. Their first experience of paddling! After about a minute of paddling in good warm water, I find that the babies’ feet don’t need lots of pressure to provide enough blood. It also flows quickly so that the test is over quickly too.
Other things you can do to help
Cuddle your baby during the test. They already know you and your scent and your voice. Being held by you is always going to calm them more than if the midwife holds them.
Hold them in an upright position. Gravity will help with the blood flow to their foot. This means that cuddling them across your chest won’t be as effective as holding them over your shoulder or sitting them up in your lap so their feet dangle down over the side of your legs.
Speak gently and soothingly to them. A calm soothing sound such as ‘shush’ or ‘sssshhhh’ can really comfort a baby in distress.
Feed the baby or provide a pacifier for them to suck. Sucking is always a comforting experience for babies. Letting them feed will also keep them close to you which will help keep them calm.
Results of the Blood Spot Test
The results of the test are usually sent out in the post to you if everything is ok. It can take up to eight weeks for these results to arrive. If you still haven’t heard anything, ask your health visitor.
Any abnormal or unexpected results are followed up quickly by professionals. The midwife may return to repeat the test and collect extra blood for further checks. You may be asked to attend the children’s department of your local hospital for further tests. The Health Visitor may come to discuss the results with you or may give you details of a specialist nurse who can talk you through the results in more detail.
The conditions we check for can be found in more detail on the NHS website here, or in the screening booklet your midwife gave you at the beginning of your pregnancy.
Please be reassured that the conditions we are looking for are very rare and entirely manageable. You shouldn’t be overly anxious about the health of your baby if he or she is feeding well and behaving normally. If you do have any concerns about your baby’s health please speak to a health professional as soon as possible.
Maybe you’ve had a baby recently and want to express your thanks to the midwife who cared for you. Maybe you are a student midwife who has come to the end of a placement and wants to show appreciation to your midwife mentor. Perhaps you have a friend or family member who is a midwife. Whatever the occasion, here are some ideas for gifts for midwives that may help if your mind has gone blank.
General Gifts for Midwives
Midwives love getting ‘Thank You’ cards. It helps us to feel we are making a difference and helping people, which is definitely our ultimate aim. Even if it is just a small card with 3 lines written in it, it can make a difficult day seem not so hard and put a smile on a stressed face. We love to remember your birth or experience with you. Cards can also be used as part of the revalidation process. Revalidation is how midwives renew their professional registration with the Nursing and Midwifery Council. It requires us to provide evidence of feedback on our work, so your card can help us to do this.
Who can survive the day without a bit of caffeine? Midwives are no exception, so coffee cups or mugs are always a great idea. We may not get a chance for lunch or tea, but sometimes we do get to stop for a drink. Finding a suitable mug in the work kitchen can be a challenge, so a unique mug which is easy to find is a big plus. Some people like thin china mugs, while others prefer enormous chunky mugs. There are so many options in terms of designs such as pictures or slogans. Let your imagination run free.
Chocolates are always a good idea. When we have a busy shift and no time to stop for lunch, a quick scoff of a truffle or fudge can stop the hunger pains for a short time. There are also so many options, from biscuits to selection boxes and more. You’re bound to come up with some original choices.
Let’s be honest, we shouldn’t really survive on caffeine and chocolates. Most of us want to try something healthier so a basket of fresh fruit is a refreshing option and can be pretty quick too for those busy shifts.
Equipment Gifts for Midwives
Ever a practical person, a midwife is always happy to receive practical gifts.
I’m sure you’ve seen your midwife with a wheel in her pocket. These tiny plastic whirlygigs can help us figure out when your baby is due or what your Body Mass Index is. Because they are used so often, they do wear out or crack and break. Why not see if you can find a new one for your midwife? Try searching for a pregnancy calculator wheel or BMI calculator wheel on Amazon, the Goodies for Nurses website or the Funky Midwife website.
I have no idea where all the pens of the NHS go, but there seems to be an epidemic of disappearing writing utensils! We write a lot. Sometimes it feels like we write more than we provide care, which isn’t good at all. However, it does provide you with another gift option. We will always appreciate a lovely pen and if it is not just a standard biro, we’re more likely to chase it if the doctor tries to walk off with it! In order to meet our standards for record keeping, it needs to have black ink and a rollerball or ballpoint pen is less messy than a fountain pen.
Although Infection Control policies prevent us from wearing any wrist watches, we still need to be able to count seconds and minutes. You’ll probably have seen some midwives with fob watches, which are pinned to our uniforms. Most of the time we buy the cheapest as we have to provide these ourselves. However, there are so many amazing designs out there for fob watches! Having a unique one would always make putting on the uniform a little more fun. Watches need to have second hands on them so that we can measure you and your baby’s heartbeat if our other equipment isn’t available. If we work night shifts a glow in the dark or backlit watch might be really useful.
Hopefully, you’ve seen us wash our hands. A lot. As an integral part of care and infection control, we wash our hands more often than you can count. This is good for you, but not great for our skin. It doesn’t have a chance to replenish those lovely nourishing oils between washes, so our skin is often dry and can even crack, peel and itch. Not so glamorous. This is why gifts of good quality hand creams can be a lifesaver for a midwife. Little bottles we can keep in our pockets or bags or larger ones we can leave by the sink are all very much appreciated.
Another thing you might see midwives use is alcohol-based hand gels. These are really useful for disinfecting our hands quickly if soap and water and a clean towel aren’t available. There are actually quite a number of different brands offering hand gels these days. Some have lovely scents, whilst others are said to be more gentle on skin, or even just a pretty colour. As a small but much-appreciated gift, they are definitely worth considering.
So there we are. Just a few suggestions for simple and inexpensive gifts for midwives. Thank you for thinking of your midwife and considering a gift for her. Please know that we really do love sharing the whole pregnancy experience with you and are very happy if we know you have had a good or great pregnancy and birth.
Any other gift ideas I’ve not mentioned? Why not write me a comment below?
Just when you thought pregnancy couldn’t get any more glamorous, you find yourself struggling with pelvic pain. You start walking with a John Wayne waddle and even the simplest of tasks is accompanied by sharp stabs of pain in your pelvis. What is going on, and how can you solve it or at least soothe it?
WHY PELVIC PAIN HAPPENS
Your pregnancy causes an increase in various hormone levels in your body, and the hormone responsible in this case is Relaxin. Relaxin does exactly what the name suggests. It relaxes things like your blood vessels and your ligaments.
Relaxed blood vessels are great as because they relax they can hold more blood and send that blood to the baby to help him or her grow. Relaxed ligaments is also a good thing when you consider the process of labour. You have to get a baby out of an area not used to dealing with things that size! By relaxing the ligaments which hold and stabilise your pelvis, the exit area gets wider and giving birth gets easier.
Unfortunately, the downside of relaxed ligaments is the reduction of stability in your pelvis. If this happens very early in pregnancy, it can bring a lot of pain and discomfort. This pain might be around the edges of your pelvis or at the back near your coccyx. Pelvic pain commonly occurs at the front of your pelvis, where the two bones are joined by a pad of cartilage called the pubic symphysis. The only cure is the end of the pregnancy when the Relaxin hormone levels drop back to normal.
HOW TO MANAGE PELVIC PAIN
If giving birth is the only cure for pelvic pain, then the key is learning to manage it while it lasts. Here are some tips and tricks I know women have found helpful.
Have you ever noticed how the Queen sits so elegantly? She is a great example of good pelvic alignment. Since the focus of pelvic pain for many women is the pubic symphysis, keeping your hips aligned and stable is really key.
Try to keep your knees together and your hips at the same level. This is something most of us forget to do on a daily basis. We put one leg into the car, then sit then pull the other leg in, or get out of bed one leg first then the other. We sit on the sofa with our knees curled under us.
Instead, try to sit sideways on the car seat with both legs outside. Then once you are seated, swing your legs in together. When getting out of bed start by keeping your knees together and rolling onto your side. Drop both ankles over the side of the bed and push yourself up using your arms. Sit on the sofa with your feet both touching the floor or out on a footrest in front of you.
Speak to the Professionals
Physiotherapists are the experts in healthy movement and support of joints and ligaments. There are always local specialist physiotherapists who have a great deal of experience in treating and helping pregnant women. They have great advice for back and pelvic pain, separated abdominal muscles and pelvic floor exercises as well as so much more. Please speak to your Midwife or GP and get a referral to the physio service in your area. Even if the pain isn’t too bad at the moment, sometimes the referral can take a couple of weeks and things may be worse by then.
Heat can be very soothing for pelvic pain. Use it as an excuse for an extra long shower or an extra daily long bath. You can also use heat packs or hot water bottles. These are good for positioning directly over the painful points. However, please be careful not to burn yourself and give yourself short breaks without the heat packs so you don’t overheat the area.
There are lots of options for extra support to help reduce pelvic pain. These include tubigrips, support belts and taping. All of these offer different levels of support and none will cause any harm to the baby.
Tubigrips and support belts can be supplied by a physiotherapist or sourced online. Tape can also be bought online and applied by yourself or a partner.
Tubigrips can help you feel like your hips are being held in and comfortably surround your whole tummy and back.
Support belts can be found on Amazon in various styles. Some will sit just underneath your bump and give the feeling of lifting it up off the pelvic bone. Others are adjustable with straps across or over your bump. Which style is best for you is a matter of personal preference.
Taping is another option for providing abdominal support. This involves using kinesiology tape in various lines across or around your abdomen. Kinesiology tape is used by sports people and physiotherapists to help provide flexible temporary support to joints, ligaments and muscles. The Rock Tape brand has suggestions for tape positions in pregnancy on its Youtube channel here. Try searching on Pinterest for kinesiology taping in pregnancy as this will also provide lots of great positioning suggestions. Have a look at Amazon for a selection of tape options to buy.
Although taking painkillers regularly throughout pregnancy is not ideal, you may need to consider this if the pain is very bad. ALWAYS discuss this with a pregnancy professional such as an Obstetrician, Midwife or GP.
Worst Case Scenarios
It is very uncommon for pelvic pain to be completely overwhelming. Usually, measures such as those outlined above will help you manage until the baby arrives. Unfortunately for a very small minority of women, the pain is so bad that they need to use crutches or a wheelchair to get around. If this is you then please keep in touch with your pregnancy professional and make sure you are linked in with the local physiotherapy service. For a small number of women, the obstetrician may be willing to discuss starting labour off early to stop the pain. This is always only done after long discussions regarding the health and well-being of both mum and baby.
Why not have a look at the helpful physiotherapist videos at Best Beginnings or on your Baby Buddy app?
You can also find more sources of information on the useful links page, including the NHS website and the Royal College of Obstetricians and Gynaecologists website which has guidance on many subjects.
Babies often need a little help to bring up their wind, or burp. Whether they are fed by bottle or breast, it is definitely useful to know how to encourage this as trapped wind can be very uncomfortable. Here are some of my favourite techniques for helping babies burp.
If your baby is reluctant to release their trapped wind, try going through all the suggestions below in a cycle. Every baby is different and what works once may not work another time. Trial and error, along with lots of patience, will help you figure out your baby’s preference.
Stroking up their back
Sit baby up on your knee, facing to one side. Lean them slightly forward onto one hand, using your thumb and forefinger to support their head in an upright position. Use a very gentle lift in that supporting hand to keep their back as straight as possible. Whilst their back is straight, use firm pressure to stroke up their back from about the level of their belly button to their shoulders. You can also alternate the strokes with gentle patting, concentrating on the middle area of the back. It can be tempting to pat between their shoulder blades, but you’re trying to move the air bubbles up from their stomachs, so patting that area is more effective.
The main way to relieve the pain of trapped wind is to dislodge it so the baby can burp, so rocking can be very helpful. Hold the baby in the same way as when stroking up their back, but hold them with one hand on their front and one on their back. Gently rock them from side to side, then from front to back, again and again. You only need to rock them about 1-2 inches each way. Try to keep their back as straight as you can.
Lie them up over your shoulder
This position really helps keep a baby’s back naturally straight so you can concentrate on the gentle patting of their back. Hold the baby in the same arm as the shoulder you want to put them over. Their chin should be level with the top of your shoulder. Let their hands rest next to their chin, as in the picture above. The hand you are holding them with should be over the nappy area and around their chest. Your free hand will hover over the back of their rib cage. Keep your hand quite close to baby as you pat since newborns can sometimes throw themselves back without warning. With your hand close, you can catch and control this movement very easily.
Put them over your knees
Sit down in a comfy chair and keep your knees together and your feet flat on the floor. It can be helpful to lay a blanket or muslin cloth over your knees in case the baby dribbles or vomits. Lie baby down over your knees, with his head at the side of one of your thighs and his feet at the other side. This position puts a little pressure on the baby’s stomach. Gentle patting can be combining with stroking and rocking your knees together from side to side.
Babies like bouncing even if they don’t have wind! You can hold them facing towards or away from you with your hands around their torso and under their armpits. Bounce gently up and down, at a rate that suits you and baby. About 120 times a minute, or twice a second is a good place to start. If you just use your forearms, this is an excellent arm workout!
However, if your baby really does like bouncing, your arms are likely to get tired quite quickly. Try resting baby’s bottom on your bent knee whilst sitting. Bring your knee up by raising onto your tiptoes, then gently drop your heel down towards the floor. This gives a gentle bouncing motion without as much effort on your biceps. You can also do this with the baby facing outwards with their legs either side of your thigh and their back resting against your abdomen.
Massage is an excellent way to soothe your baby and can help to stimulate the gut movement needed to help them pass wind. Keep the room nice and warm and strip baby down to their nappy. Give a little gentle pressure to their tummy in a clockwise circular motion. This matches the direction of their intestines so helps move air along to the exit! Some people recommend motioning as if they were writing I L U (for I love you) over the baby’s tummy. There are plenty of images on pinterest showing how to do this, but a simple circular clockwise motion will work just as well.
Have you noticed how your baby will often poo right in the middle of changing their nappy? That’s because when you lift their knees and hold them bent, it stimulates movement in their intestines, so they can’t help but poo out more! That makes this position a great one to remember if your baby has wind as well as if your baby hasn’t pooed for a while or seems a little constipated. Just as when you change a nappy, gently hold their feet and push their knees up to bend naturally. Hold in that position for a few minutes if baby will tolerate it.
A lovely soothing warm bath can often ease the pain of trapped wind for babies. Just make sure that the water is nice and warm and deep enough to cover their tummy. Use a bath thermometer if you are unsure of the right temperature, and please remember to NEVER EVER LEAVE A BABY UNATTENDED IN A BATH, NOT EVEN FOR A SECOND!!! If the phone rings or the doorbell goes, ignore it and look after the baby instead!
There are a couple of other things to consider if your baby seems to struggle with trapped wind quite frequently.
Some babies are just very fast or very hungry feeders. They want to get their food so fast that they don’t care about bringing in all the extra wind that comes with it. Until the extra air causes them pain, of course! With babies who need to slow down a little, it can be useful to split feeds into shorter periods at the breast or with the bottle. Give the baby a couple of minutes to feed to start with, then take them off the breast or remove the bottle. Give them a chance to process that they have got a little something in their tummy, as this may help them to slow the rate of feeding when you put them back on. It can also be useful to split feeds into smaller parts so that you can try and help the baby to burp in the middle of the feed, rather than at the end.
If you are bottle feeding, it may be worth looking at a different sized teat for the bottle, as some will allow the milk to flow more slowly or more quickly.
Over the counter remedies
There are three main over the counter remedies in the UK. All are suitable from birth, but they all work in a different way. It is therefore impossible to know exactly which one will work for your baby. Some will be given via a dropper before a feed, others can be mixed in with artificial milk and others are given on a sterilised spoon before a feed. Do head to Amazon.co.uk and look at the options and reviews for each product and see what you think.
Some babies develop colic from very early on. This is a sustained pattern of distress usually in the early to late evening, which happens every day for several weeks. It can be extremely distressing as you can’t figure out what to do to help soothe your baby. For support when your baby just won’t stop crying or settle, visit the UK charity Cry-sis website.
Further sources of support can be found on the Useful Links page
What it is, why it happens and how to treat it at home
Have you ever noticed how newborn babies often have a really healthy glowing tan? It’s as if they went on holiday to the south of France without you before they arrived. This glowing tan is often a sign of jaundice and whilst jaundice in adults is a sign of ill-health, in newborn babies it is very normal.
Ok. Are you ready for the science?
Cast your mind back to those school day science lessons. While the dreary teacher drones on in the background, you doodle love hearts and flowers in your notebook. (Just me? Oh well, never mind.)
Your teacher probably mentioned that the air that we breathe is made up of lots of gases. Oxygen is the essential one that we all need to provide energy for all our cells and organs. Air has about 21% oxygen in it. This is a perfect amount for our bodies to function well.
So, pregnant women breathe that 21% oxygen and the oxygen is absorbed by their bloodstream which then delivers the oxygen to all their organs. Because of that, by the time the blood reaches the placenta, it has about 16% oxygen in it. The placenta is where the oxygen in the mother’s blood gets passed over to the baby for him or her to use to power their own cells and organs.
Babies handle this lower level of oxygen really well because they have unique red blood cells with fetal haemoglobin molecules. Don’t worry, I’m not going to start an in-depth atom by atom description of haemoglobin. All you need to know is that fetal haemoglobin molecules are extra sticky when it comes to oxygen. That means that although there is only 16% oxygen passing over to the baby, the baby picks up all of it. They can make it work just as well as we do with our 21%.
What happens once a baby is born
As babies are born, they begin to breathe the air around them. They can use the 21% oxygen in that normal air, rather than relying on the oxygen in the bloodstream of their mum. This means they don’t need that extra sticky type of haemoglobin molecule. Because of that, their body starts to change from using fetal haemoglobin to creating adult haemoglobin molecules.
Being excellent at recycling from the start, their bodies break down the fetal haemoglobin into its various parts like iron and lots of proteins. Most of these parts are reused by the baby to create adult haemoglobin molecules. However, there is one part which is not reused, the yellow pigment called Bilirubin.
Bilirubin is the cause of babies’ yellow skin. As the baby doesn’t need it, it gets rid of it. Some of the bilirubin will come out in the baby’s nappy. You may have noticed the transition in colour of your baby’s poo from sticky black tar, through various mixes of brown and green and on to a chicken korma or mustard-like colour. You can take this change as a very good sign that your baby is feeding well and adapting perfectly to life outside the womb.
The tan on your baby’s face, torso, and even limbs is caused by extra bilirubin that hasn’t exited via their nappy. You can tell if it is jaundice by pressing lightly on their nose. As you release the pressure the skin underneath will show the yellow more clearly.
As I’ve already said, jaundice is a normal reaction to being born, so in the majority of babies, it is nothing to be worried about. However, sometimes bilirubin levels can rise to such an extent that they can cause the baby problems.
When jaundice is a problem
Babies who are struggling to get rid of the bilirubin levels in their body can start to seem extra sleepy or lethargic. They often aren’t pooing or still have dark poos rather than yellow ones. They may not seem all that interested in eating and you may have trouble waking them up enough to feed.
If your baby has any of these symptoms, please contact your midwife or GP as soon as possible
Very few babies need extra treatment to help them reduce their bilirubin levels. The usual treatment is phototherapy, where they get to lie under a mattress which gives out UV light. You may have seen photos of this or noticed babies on the TV having this treatment. They are surrounded by a blue light source and often wear cute little sunglasses! The UV light helps to break down the bilirubin lying under the skin. Once it is broken down, the baby can poo it out.
Treating Jaundice at home
The good news is that just two minor alterations in your baby’s routine can reduce the risk of him or her needing hospital treatment.
First of all, make sure your baby is feeding regularly. As they feed, their body will move the bilirubin out of their system with the waste products. You’ll see it in the nappy!
Secondly, keep your baby in bright rooms during daylight hours. Natural daylight contains UV light, so you have your own free source of phototherapy! If you set the baby’s cot, pram or Moses basket next to a window, the daylight will help break down the bilirubin under the baby’s skin. Please don’t think that it needs to be direct sunlight as too much direct sunlight may cause the baby to overheat. We also live in the UK, where actual sunlight isn’t always available! Don’t worry, just keeping little one near the window will make a difference.
The key is to avoid putting your baby in a dark inner corner of the room far from the windows. You also don’t need to expose lots of the baby’s skin to the daylight. Their face will be enough surface area if it is cold, although if it is warm you can certainly take off their baby grow. Leave them with their vest on and arms out, but put a blanket over their bodies to keep them cosy.
So there you have it. A simple explanation of newborn jaundice and how to treat it yourself so that you don’t need to go back into hospital.
For more information on Jaundice, you can visit the NHS website here
You can also find information on charities and organisations which can help you with feeding problems on my useful links page.