Membrane sweeping or membrane stripping is often mentioned at the end of pregnancy as a way of starting labour. It certainly sounds rather uncomfortable but what does it really involve and does it actually make any difference? Here are the facts to help you decide whether membrane sweeping is the right choice for you.
First, the physiology of membrane sweeping.
The very bottom of
your uterus is called the cervix. The cervix sticks out slightly into the top
of your vagina. When you aren’t in labour the cervix is pointing around towards
your back rather than forwards directly towards the exit. This is good, because
it reduces the risk of infections and damage to the cervix from anything
entering the vagina.
The cervix is about
3cm long and has a firm consistency rather like the end of your nose. As it is
3cm long, it is like a tube with one entrance in your vagina and the other one
opening into the uterus where the baby is.
The body is really
clever and protects the baby from infection by filling this tiny tube with a
mucousy jelly which catches any nasty bacteria trying to enter the uterus and
cause an infection.
The baby is also
surrounded by a bag of waters which sits against the lining of the uterus and
protects the baby from infection, small bumps and jolts or pressure changes due
The purpose of membrane sweeps
Although we don’t
know lots about what starts labour, we do know that levels of natural
prostaglandins rise in your body when labour begins. We also know that putting
artificial prostaglandins up into the top part of your vagina can soften the
cervix and start opening it up. These artificial prostaglandins are used as
part of the induction of labour process at most hospitals when we want to start
labour for any reason.
prostaglandins can also be released by peeling the bottom part of the bag of
waters gently away from the wall of the uterus. This is known as membrane
sweeping or membrane stripping.
Research currently suggests that membrane sweeping can reduce the length of a pregnancy by about one week. This means women who have sweeps often go into labour earlier than they might have done without a sweep. If a sweep is successful, you are likely to go into labour within 48-72 hours of the process.
Policies differ between hospitals and care providers about when sweeps are offered and how many can be done for each woman. Please check with your midwife or health care provider for your local information.
The process of sweeping the membranes
membranes involves a vaginal examination. You will need to take off your
underwear and lie down on the bed, covered with a sheet. Partners are welcome
to stay with you, sitting at the head end of the bed and holding your hand if
The midwife or
doctor will ask you to bring your ankles together and your heels up towards
your bottom so that your knees bend. You will then be asked to let your knees
flop open to either side.
The midwife will
then insert two fingers of her gloved hand into your vagina using lubricating
jelly to reduce the discomfort. She will need to reach the cervix, so if it is
still pointing towards your back, she may ask you to put your hands into fists
and put them under your bottom. This tilts your pelvis and makes it easier to
reach a cervix that is pointing backwards.
When the midwife reaches the cervix with her fingers, she will try to put her finger through the tube of the cervix and into the uterus, where she will be able to feel the baby’s head through the bag of waters! She will then move her finger in a circular motion between the bag of waters and the wall of your uterus. When she does this, she peels the bag away from the wall which makes the body release natural prostaglandins.
What happens if membrane sweeping isn’t possible?
Sometimes, the midwife may not be able to reach the cervix. In other cases, the cervix may be so tightly closed that she can not reach through it to get to the bag of waters and sweep it away from the wall of the uterus. Unfortunately, we don’t know what we will find until we try. However, if the midwife can’t reach the cervix or through it to the uterus, giving the cervix and the area around it a gentle massage with her fingers may be helpful in softening and stretching the fibres of the cervix. This may make it more responsive to any tightenings or contractions you may have. It may also start the cervix softening so that in another few days the cervix is open enough to sweep the membranes.
After the membrane sweep
Once the examination is over, you may notice some heavier vaginal discharge, so it’s worth bringing a maternity pad with you to your appointment to wear home. You may also note a tinge of blood in the discharge. This is very common as when the midwife puts her fingers through the cervix it opens slightly more and small blood vessels called capillaries break. This bloody discharge should only be a small amount, so please contact your care provider if it seems heavy to you or you are worried.
It’s important to stay as upright and as active as possible after a membrane sweep. This pushes baby’s head down onto your cervix, which will already have been stimulated by the sweep. More stimulation will help your body produce more prostaglandins and start the hormone oxytocin flowing. Oxytocin causes contractions, which is exactly what we want! Perhaps try a good long walk, or bounce around the house on a birthing ball.
While you wait for the membrane sweep to work, why not read some of my other posts? You can find out my top tips for early labour here. The NHS website also has great information on induction of labour and choices when labour reaches 41 weeks. Read that here.
I want to let you in on a secret. It’s one that the press and social media and even your friends don’t want to tell you.
Sometimes pregnancy sucks.
You might be looking at all these stylised photos and posts telling you how wonderful women are finding their pregnancy. They describe how they feel as if they are glowing and finding fulfilment and a new purpose.
If you read those posts and feel inadequate or upset by them, you are not alone! I can’t tell you the number of women who come into my clinic each week feeling tired and exhausted and fed up and very unglamorous!
They have aches and pains in very private places, they can’t sleep and can’t eat and are too exhausted to do more than crash on the sofa after work. Some of them are physically sick every day well beyond the expected 12 weeks. For some, migraines sometimes get better during pregnancy but sometimes they get much much worse. Other women develop crippling pelvic pain which leaves them on crutches for weeks until the baby is born. Still others suffer with heightened levels of anxiety and fear over the what if’s and unknowns of pregnancy, labour, birth and parenthood.
The problem these women face is that society expects them to be glowing. It expects them to be radiant and smiling and excited. Society might make you think that any other reaction to pregnancy makes you a bad mother.
Things to remember
A miserable pregnancy does not automatically lead to a miserable life as a new parent. You will probably feel a whole lot better once you aren’t carrying 8 to 15 pounds of extra baby and placenta around inside you.
Any feelings of frustration or dread don’t mean that you don’t or won’t love your baby. It simply means that pregnancy is hard for you, and that’s ok to admit.
There are things your midwife or health professional can do to help you. Don’t suffer in silence for fear of judgement. What you feel is valid and won’t be the first time they’ve heard someone struggling with pregnancy.
What you can do
Talk to someone you trust. It might be a close friend or family member you know had a difficult pregnancy themselves. Sharing your feelings enables people to encourage and reassure you that everything will be alright.
Speak to your GP or midwife. If you have sickness, pelvic pain, migraines or some other physical symptoms, they may be able to suggest treatments for you. If you are struggling with anxiety around your pregnancy, birth or parenthood, they can refer you to local counselling services where trained professionals can guide you through the anxiety to find your calming and coping strategies.
Take time to rest and give yourself some grace. You don’t have to live up to society’s expectations and post a glowing selfie every day! Just getting out of bed might be a major success for you, so celebrate it!
Keep your eyes on the prize! However hard this pregnancy might be, focus on the baby and your parenthood to come. It will be worth it. They say parenthood is the hardest job in the world, which I definitely agree with, but it is also the most rewarding. There are so many stages to look forward to. If you aren’t keen on newborn babies, that’s ok. You might feel more confident looking after children when they reach the toddler stage. I promise that time will fly and that favourite age you like most will be here in no time!
It’s a very exciting time. Your best friends or favourite relatives have just had a baby and you want to spoil them silly at this special time. A hug from the newborn might be fun too! New parents often find the first few days and weeks with baby difficult. Here are my suggestions for gifts you can offer, to help them at this amazing and sometimes overwhelming time.
This might not be something you can buy in a shop but it is definitely the most important gift of all! You need to remember that new parents might have had very little sleep, rarely get a chance to shower and really don’t want to think about housework.
You need to be honest about your relationship with the new parents and your reasons for wanting to visit or help. If they are really close friends and family where you share everyday life and see each other unshowered and in pyjamas regularly, unannounced visits might be fine. If not, your unscheduled visit is likely to cause more hassle than joy.
New parents might need to sleep during the day if baby was awake all night. They might want to spend what awake time they have holding their own baby, rather than cooking or cleaning in preparation for your visit. Alternatively, they might actually really appreciate someone holding the baby for them while they shower or eat or vacuum.
The key is be flexible in your visiting schedule and expectations. A pre-planned visit might not be possible after an unplanned night without sleep! Ask what the parents would appreciate most – someone to clean the toilets, a volunteer to play with older children or a baby being held while they shower and dress.
A new parent has a lot of questions about their new life. Books that might answer some of those questions may be really appreciated. Perhaps try some humorous ones for when they are at the end of their tether, or informational ones that might explain baby development and milestones. One of my favourite books is ‘Your Amazing Newborn’. It explains the vast abilities of babies to recognise shapes, colours, faces and voices. It’s brilliant for new parents who want to learn more about their baby and bond with it through games like pulling faces and singing.
Honestly, I think every parent should invest in one of these. Babies often start life thinking that day is night and night is day. As a result, new families often need to catch up on sleep during the day and an unexpected delivery man or neighbour might not realise their visit is poorly timed. One knock which wakes the dog, who wakes mum, dad and the baby can really ruin their rest! Find a pretty sign on pinterest or create your own to stick on the door, politely asking people to come back at another time or leave the parcel with a neighbour.
All new babies take a lot of time, and homemade meals are not always easy to fit in to the schedule. When you are already cooking for your family, can you make an extra couple of portions to freeze? If you take that ready cooked meal to the new parents, it will make their day! For those with enough freezer space and generous friends they may not need to worry about meals for a couple of weeks.
If you have a good relationship with the new parents and their children, could you offer to babysit the older children? Perhaps you could take them to the park or just to your house to play with your kids. That might allow the parents to get some rest. Maybe the parents would appreciate it if you offered to hold the baby while they play with their older children. This helps those older siblings who feel confused and upset by the amount of parental time and attention the new baby takes from them.
Any help in this category definitely enters you into the great friend hall of fame! Whatever you feel able to help with will probably be appreciated. You could clean or vacuum for them. You could even take a load of laundry and ironing home and return it ready to be hung up or folded and put away. For those active animal lovers, there is the opportunity to walk the dog. If you’re already on your way to the shops, send a quick text to ask if they need anything. It would be even more amazing if you were able to do their whole grocery shop for them. Just as long as they give you their list with preferred brands!
Sometimes, especially after the first couple of weeks, a new mum can feel isolated and stuck on the sofa with a cluster feeding baby. Their partner may be back at work. Most visitors have had their baby hug and gone on with their lives. Some mums might really appreciate you spending time with them. Having an adult conversation, even if their brain isn’t working clearly due to sleep deprivation, can be wonderful. A listening ear and reassurance that they’re doing a great job really helps when they are worried they’re not a perfect parent.
Have you ever noticed that a first baby has lots of photos taken every day? Unfortunately with the subsequent siblings the number of photos decreases significantly. Those cute cards you can place next to baby declaring their first smile or their 10th week are really only used for baby number one. Intimate family photos are not so easy with more children especially in the midst of life’s commitments.
If you know you have some pretty good photo skills, why not take some natural family photos for them? You could catch them doing normal life things like cooking whilst juggling a newborn and a toddler, or giving the baby a secret smile. These photos will be so precious to the family later on as they might be too busy just keeping up with life to take photos themselves. You can send them on to the parents as soon as you’ve taken them. You could even create a photo album online to give as a present!
If parents have to spend a lot of time in the middle of the night feeding or changing the baby, they may appreciate some entertainment options to keep themselves amused. Why not buy them a subscription to a video streaming service so that they can watch the latest movies or TV epics while the little one feeds? You could also try an audiobook subscription and add a quality pair of wireless headphones to make it extra special. For the avid readers, what about an ebook subscription and device to read them on?
So there we have it. A selection of really useful gifts for new parents. Many of them cost very little but will make a huge difference to the family. Have you got any other suggestions, or ideas you wish someone had done for you? Let me know in the comments below!
So much of the planning and preparation that happens during pregnancy is focused on the baby. This is wonderful and very helpful indeed. However, I’d like to remind you that you have another person to take care of too – you! Here are some of my tips for looking after yourself in the postnatal period.
None of us can see the future so I don’t know what type of labour and birth you’ll have. It might be really long and painful with lots of complications. It might be really quick and intense. You might deliver the baby by pushing him or her out yourself. Perhaps you’ll need a little extra help like a forceps or ventouse delivery (oh, look, another blog post explaining them to be written in my future!). You may have an emergency caesarian or you may know the date already for your planned caesarian.
However this baby arrives, you will be tired and sore and sensitive in various ways and places. In all of the excitement about finally meeting your little one, you need to take some time to take care of yourself. Having a postnatal care kit set up already can make doing this much easier.
Here are my recommendations for your postnatal essentials. Feel free to choose them all or just pick one or two that you know will be helpful for you.
If you are looking for gifts for friends who have had or are about to have a baby, check out my gifts for new parents post here.
**This post contains 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.**
1. Maternity Pads
What to expect after birth:
You will bleed after you’ve had the baby. Women are always asking me how long they will bleed for, but unfortunately, that’s one question I don’t know the answer to! Every woman bleeds for a different amount of time and in a different way. There is even a difference in bleeding after each baby a woman has. Some women will bleed red blood for 6 weeks. Others have a really heavy loss for a couple of days then it changes to brown then creamy before disappearing about 10 days after the birth. I know some who bleed heavily for a few days, then the bleeding seems to settle down, only to come back heavier again when the baby is 10-12 days old.
Most of the time the bleeding will be like a heavy period for the first couple of days before settling down. It will probably be a little heavier if you have a busy active day and be lighter if you are resting at home. You might have a gush of blood after feeding your baby or when you first get up in the morning. You will also notice some contraction-like feelings after the birth. These are perfectly normal and are helping your body reduce the size of your uterus so you can fit into your pre-pregnancy clothes!
The time to seek medical advice is if you have a gush of blood unrelated to feeding or getting up after sitting for a long period; if you think the blood smells funny or infected; if you are passing clots of blood over 4cm diameter after the first day or two; or if you have severe abdominal pains.
What to buy:
Anyway, all that information leads me to my first recommendation: Buy some maternity pads. Don’t get too fancy with them. The thick unscented kind are softer for the first couple of days. You may want to wear two of them – one towards the front of your underwear, layered over one towards the back of your underwear – to catch any leaks or gushes. Eventually, you’ll probably want to go for the thinner kind with the fancy coloured lines of super absorbent somethingorother, but not for the first couple of days.
Even if you have a caesarian, you will still bleed after the birth. Having some maternity pads on hand is essential. They can even provide another benefit for you. Your scar will be covered by a dressing for the first 5 – 10 days. After that the dressing is removed, and whilst this is good for healing, it can be nerve-wracking! Put a maternity pad in the front part of your underwear over the area of the scar, and you’ve got some padding. This makes you a little more confident when moving around and prevents clothes rubbing on the area.
2. Big Undies!
Your inspiration for this period should be Bridget Jones, not a Kardashian of some kind. Get the underwear that reaches right up above your bikini line, towards your umbilicus. Honestly, you are not going to be showing it to anyone so no one needs to know, and comfort is essential for the first few days and weeks. Leaks are also inevitable, especially overnight, so it might be worth buying some mesh underwear which you can either wash and re-wear or dispose of after one use. Big undies help to pull in your stomach, which will look a little like jelly for a while. They are also really helpful if you end up with a caesarian as they don’t end right on the scar line like normal underwear tends to do!
3. A jug or glass
Weird recommendation? Maybe, but entirely essential. Keep it in the bathroom, right next to the toilet. When you go in to pass urine, fill it up first with warm water, then pour it down over yourself as you relieve yourself. The warm water will be soothing and help to dilute your urine so that it is less stingy!
4. Pain relief
You’d think having the contractions was the most painful part of the whole giving birth process, right? Although this is true for most women, I must warn you that you’ll find lots of achy painful bits after the birth too. Whether it’s your breasts, your perineum or even after pains, you may well need some pain relief. Stock up on paracetamol and ibuprofen before the baby arrives. That way you won’t have to send your partner out to the 24 hour supermarket for urgent supplies in the middle of the night.
Sometimes, ibuprofen and paracetamol won’t be enough to control the pain. This might be because of the type of delivery you had or if you get an infection. If you find the pain is still unbearable, please speak to your doctor or midwife about it as they may recommend taking something stronger. There are other pain killers that are safe to use in the postnatal period and while breastfeeding. Generally, if you need these it is just for a couple of days to get the pain under control before it naturally settles and subsides.
5. Breast pads
Even if you aren’t planning on breastfeeding, it’s worth grabbing a pack or two of these. That’s because your body is going to automatically make milk, and that milk might well automatically flow when your baby cries! Having pads on hand to catch any wayward leaks saves the need for multiple changes of top each day.
6. Nipple cream
If you are breastfeeding, you need to check out my post on Breastfeeding Essentials. If you don’t have time to read another post, then let me encourage you to at least get some nipple cream. Nipples can get sore, even when the baby has a good attachment. Nipple cream will be your best friend for the first few days or weeks.
Ok, this one is a big deal! It’s one of the most frightening things you have to do after birth – opening your bowels!
Some women find that they don’t need to open their bowels for a few days after birth. This is very normal, especially as some women have a clear-out as they go into labour (yes, I do mean diarrhoea). Other mums empty their bowels as the baby is born – this is also very very normal and shouldn’t be something you worry about.
The key is to keep eating and drinking, including plenty of fluids, fruit and fibre. It’s also really important to go to the loo when you know there is something there to get rid of. Don’t hold it in out of fear! The longer it stays inside, the more water gets reabsorbed from it, so the harder it is to push out!
When you decide to face the music, make sure you have someone you can leave baby with, so that you can relax and sit on the loo for as long as it takes. Try holding a maternity pad over the front area to give that support as you push. Most importantly, don’t worry! I’ve never seen anyone split apart from opening their bowels. It’s definitely a psychological challenge rather than a physical one.
If you decide that you need to go but it won’t happen naturally, ask your doctor about getting some laxatives. There are some that are safe to use when breastfeeding and can help ease things along.
8. Pregnancy pillow – v or c shaped
Pregnancy pillows must be the world’s best kept secret! I really don’t understand why everyone doesn’t have one. They make everything so much comfier! You may well have found a V shaped pillow helpful during pregnancy to get into a good sleeping position. In the postnatal period, that pillow comes in very handy again. You can sit up in bed, or lounge on the sofa. It can be useful to support as you feed. So many uses!
You can also get C shaped pillows, generally described as breastfeeding pillows. They can be really useful for some mums, as they can help support the baby at your breast during a feed, or give some cushioning to a caesarian scar. However, some people find that they are more of a hindrance than a help to good positioning and attachment. They seem to report that the V shaped pillows or ordinary rectangular ones work better. Try it out for yourself and find out what works for you.
This is a definite essential because ‘Baby Brain’ is real, people! After a night of non-stop feeding and a day without naps because all your friends want to hold the baby, you might not even remember your own name!
Keep a notebook and pen handy wherever you go. You can makes notes on baby’s feeding and nappy habits. You can write down which breast you fed from last and how long for. Keep a record of your gifts so you can write thank you cards later, or simply start your to-do list for the day. Whatever you can think of, a notebook will help. It can be a fancy smart phone app, or an old-fashioned paper one. It doesn’t matter, just as long as it helps you to stay sane and remember bin day! How does a little one fill up the rubbish bin so quickly?! Personally, I think a paper one might be a lovely memento to keep and look back on in the future, but I’m just a sentimental kind of gal. 😉
10. Water bottle and snacks
This one shouldn’t really require too much of an explanation. You are going to be busy being a mum and partner and life coach and cheerleader and friend and comforter and all the other brilliant things that make you you. It can be hard to remember to feed yourself, so make it a little easier by keeping a water bottle close at hand and some pre-packed calorific goodness by your side. That way, even when you don’t manage a proper meal, you’ve got some supplies on board to keep you going.
11. Wine and chocolate
Also an essential that should go without saying, but I’ll say it anyway. Having a baby is hard work. Keeping that baby alive is seriously stressful. Staying kind and welcoming to an endless procession of visitors who want to hold the baby when you can hardly keep your eyes open is a feat of strength! Treating yourself is not only OK, it’s important. One glass of wine at lunch is not going to be the end of the world, and if the only calories you get for a 12 hour period come from a chocolate or two, it doesn’t matter.
I would recommend keeping the wine as a midday treat if you can. That’s because often newborn babies like to co-sleep, and co-sleeping is safest when you don’t have alcohol in your system. A small lunchtime glass will have worn off by bedtime, so it’s less to worry about on that score.
So there we have it – my list of essentials for a smooth and comfy postnatal period. Let me know what you think in the comments. Have I missed something? What helped you most in those early days?
You know how it goes. You want to be organised in time for baby’s arrival and the world wide web must be full of great ideas on what you need. Unfortunately, you discover exactly that! The internet is bulging with baby registry lists and new mum lists and equipment lists. Some seem incredibly short so you worry that they’re missing things. Others consider a baby bouncy chair that looks like a space rocket and has 273 modes to be essential!
Don’t panic! In my ongoing efforts to simplify the whole ‘having a baby’ thing for you, I’ve scoured those lists and created my own. I’ve taken lots of great ideas and left out the weird and wacky ones. Check it out below and let me know what you think in the comments section.
I’m going to be creating several blog posts over the next few weeks which will split this list down. I’ll discuss my reasons for adding and excluding certain items. I’ll also give hints and tips on how to save money by using cheaper alternatives or repurposing items you already own! Having a baby doesn’t have to ruin your bank account. I will help you find those great equipment deals and cost savings. Check back at the blog page to catch all my tips as I post them.
The first few posts are up! I cover the equipment for baby’s nursery here. For the ‘out and about’ equipment, read this. You’ll find health supplies here and bath-time equipment here.
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
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?
Baby is now past 37 weeks and could arrive at any time.
You’ve had some tightenings and even very painful Braxton Hicks contractions but then everything stops.
Your hopes are dashed.
The following night, things start up again.
Painful tightenings get closer and closer, sometimes taking your breath away.
You’re up pacing the house in the wee small hours but then morning comes and the contractions fade as the sun rises above the horizon.
You can feel like you’re going crazy. No sleep and no progress can really bring you down.
What do midwives recommend for those long relentless hours?
This is really really important. There is no easy way to tell how long this will last but in the worst case scenario, you may still have some days to wait until labour becomes consistent. Take whatever rest you can, in large and small amounts spread throughout the day. If you have older children, enlist family and friends to entertain them for a while so you can nap. It’s not easy, but perhaps it is mother nature’s way of preparing you for the sleepless nights to come when baby arrives!
Get plenty of good nutrition on board. Labour is extremely hard work and you need to have a good supply of energy to help keep your contractions strong and effective. When labour really kicks in, you might not feel like eating so think like a marathon runner and eat as preparation.
Try out your pain relief strategies:
Some people go into labour knowing exactly how they will cope with the pain. Others have no idea what they want to try or what will or won’t work. There are so many strategies to choose from, it’s an entire post of its own (coming soon). However, these early painful episodes can be useful in figuring out whether your partner is any good at massaging, or whether the TENS machine you hired online is just going to drive you crazy.
Bathe or shower:
Water is well known to relieve labour pain, although you may have to wait until you get to hospital to try out the wonderful wide, deep birthing pool. Luckily, you can definitely try a comforting bath or stand under a cozy warm shower at home at this early point. For some, this may settle the pains down, which will give you a chance to rest. For others, the warm soothing waters can relax them enough to help the contractions get stronger.
Check your bags are packed and ready:
Another good idea is to take the time to make sure you’ve got everything packed ready for the hospital. There are tons of great lists online of what to pack and my own list is on its way. While the pains are reminding you of their purpose in bringing baby ever closer, use that focus to ensure nothing gets left behind.
However long these times last, please remember that the baby at the end is definitely worth everything you’re going through. You are stronger and fiercer than you know and you can do this!
Are you worried that the pains are too early or might be real labour pains? Please contact your local maternity unit as soon as possible.