The first 24 hours

Baby

A baby is often awake and alert during the first few hours after birth. During the final stage of labour, their cortisol levels are elevated, putting them into ‘action mode’. This is a good thing, as it causes them to cry and fills their lungs with air. 

Sometimes babies still feel a bit queasy from the birth and may spit up amniotic fluid or mucus. It’s a bit of a nuisance, but not dangerous. Hold your baby upright or on their side for a moment to allow them to spit it up. 

Immediately after birth, babies have a natural sucking and rooting reflex to seek out food. It’s normal for the baby – and for you – to become tired and sleepy after a few hours. Time to recharge your batteries together!

In the first 24–36 hours, a baby passes its first poo, known as meconium. It’s a thick, black, tar-like poo that can take quite a few baby wipes to clean up. It’s important that a baby also passes urine within the first 24 hours. Because you can’t always clearly see or feel when a baby has wet their nappy, baby nappies have coloured stripes. A blue stripe on the nappy means there’s urine in the nappy! 

Check your baby’s temperature every 3 hours, especially once you’ve come home from hospital. A normal temperature is between 36.5 and 37.5 degrees.

Have another look at our videos under ‘Preparation’ to see how to take a temperature, make up the cot and warm a hot water bottle.

The baby’s skin has a lovely pink colour. If your baby looks yellow within the first 24 hours, please ring us. It’s normal for their hands and feet to sometimes look a bit paler or even slightly blue. If their temperature is fine, there’s no need to worry about this. If your baby has a blue mouth, a blue tongue and blue mucous membranes in the mouth, this is always a reason to ring us. In addition, babies can have all sorts of harmless skin marks. The most common are:

• Erythema toxicum neonatorum – red spots (pimples) and a rash that clear up on their own
• Stork bite – red discolouration, often on the neck or forehead, which becomes redder when the baby cries
• Milia – small white spots, usually on the nose

Mum

Of course, how you feel immediately after giving birth varies greatly from woman to woman; it naturally depends on how the birth went. However, rest and lying down are important for everyone. Going to the toilet to pass urine is actually the only physical effort you’ll make in the first 24 hours. It’s important to know this right now: you’ll feel much better with each passing day, so don’t panic about how you feel at the moment!

Physically, there are a few things to watch out for

Haven’t gone to the loo within 6 hours of giving birth? Give us a call!

• Blood loss – maternity pads are that big for a reason, so the flow can be quite heavy. Even passing 2–3 clots the size of a fist is normal. If there are more than that, or if your pad is soaked through within 15 minutes, please call us.
• Urination – after every feed, do not use toilet paper, but rinse with a squirt bottle of water. You must have urinated within 6 hours of giving birth; if you haven’t, please call us!
• Bowel movements – you probably won’t be able to have a bowel movement in the first 24 hours
• Afterpains – these help your womb to contract again; they can be quite intense, particularly whilst breastfeeding. Take paracetamol for this. 
• Stitches – these will heal within the first week; rinse with water, allow to air-dry (so take your knickers off now and then) and cool the area (for example, with a homemade cold pack made from apple syrup).

In the first few days, make sure you maintain a good level of paracetamol: 1,000 mg every 6 hours. If this isn’t effective enough, you can also take ibuprofen or diclofenac in the morning and evening. These are safe to use whilst breastfeeding.

Mentally, thoughts about the birth may still be running through your mind. It can help to keep a notebook by your bed so you can jot down your thoughts and questions straight away. This can help you find the peace of mind you need to sleep. During the day, you can then discuss those thoughts and questions with each other or with us. This will help you discover how you are coming to terms with the birth as the days go by. Our maternity nurses and midwives are here to help!

Feeding

Every 3 hours, there is a feeding session consisting of:

• Caring for the mother (going to the toilet, eating, drinking)
• Changing the baby’s nappy and checking their temperature (see above for what is normal)
• Offering the breast (trying to latch on) or giving a 10cc bottle
• Try for a maximum of 2 x 15 minutes per breast
• Back to sleep

If your baby doesn’t want to feed every 3 hours, that’s fine; babies have built up special fat reserves during pregnancy which they can quickly burn for energy. They draw on these reserves during the first few days until their milk supply has established itself. Just one feed in the first 24 hours is enough.

The basic requirements for establishing breastfeeding are: a relaxed mother, eating enough nutritious food herself, drinking at least 2 litres of water, and regularly cuddling your baby skin-to-skin and putting your baby to the breast whenever they ask for it.

Watch the following videos on latching your baby on for the best possible start to breastfeeding:

If your baby is bottle-fed, they will drink (only!) 10cc. This fits into a small bottle or syringe. The easiest way is to prepare, say, 30cc of formula and store it straight away in the fridge (for up to 8 hours); you can then take 10cc from this at each feeding and warm it up. Make sure your baby is sitting slightly upright and hold the bottle horizontally, but ensure there is always milk above the hole in the teat so that your baby doesn’t swallow any air. Read more about how to bottle-feed your baby.

Other

Please ring us when you’re discharged from hospital, so that we can arrange maternity care for you. 

Sometimes this is within the first 24 hours; sometimes there’s a reason to stay in hospital longer, in which case the maternity care starts later.

Will you be coming home after 4.00 pm? In that case, the maternity nurse will start the following morning. If you wish, the maternity nurse can provide guidance over the phone to help you get started when you arrive home.