Postnatal Discharge Information - Northumbria Healthcare 231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 1 - Northumbria Healthcare ...
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 1
Northumbria Healthcare
NHS Foundation Trust
Postnatal Discharge
Information
Issued by the Obstetrics and Gynaecology Department
231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 2
Congratulations on the birth of your new baby on behalf of
Northumbria Healthcare trust. We wish you and your family a safe
transfer home following your stay with us.
Within this leaflet you will find key pieces of information that are
important to remember when being discharged home. Please
note this leaflet provides general information and is not tailored
specifically to your individual care needs.
2
231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 3
Medications
When discharged you may be sent home with medications to
take. It is important you understand what each of these
medications are for, how to take them correctly and side effects.
Tinzaparin Injection – This is a self-administered anticoagulant
injection meaning it prevents the formation of blood clots. This can be
prescribed over 10 days or 6 weeks depending on your risk factors.
Common side effects include bruising at the injection site, prolonged
bleeding time, headaches, rarely rashes and allergic reactions. You
will be shown how to self-administer these prior to discharge. Ensure
to dispose of all needles using a sharps bin provided to you. Once
you have completed the full course of injections prescribed your
sharps bin can be disposed of via your GP.
Labetalol – This is an antihypertensive drug therefore lowers blood
pressure. Dosages can vary therefore check with your midwife.
Side effects include fatigue, dizziness, upset stomach, nausea.
Seek immediate help if side effects are significant and/or feeling
faint as this can be a sign blood pressure is becoming too low.
Antibiotics – Depending on the reason for antibiotics
prescriptions will vary. Ensure you know the correct dosage and
complete the full course prescribed. Side effects are vomiting,
watery stools, abdominal cramps, white patches on the tongue,
vaginal itching/discharge and rarely allergic reactions.
Lactulose/Fybogel/Ispaghula Husk – This is usually advised
where there has been trauma to the anal muscles in order to
soften stools, prevent constipation and therefore discomfort on
the affected areas. This should be taken twice daily for as long as
required. Side effects include excess gas in stomach, bloating and
swelling of abdomen.
3231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 4
Analgesia (pain relief) – Most of our women manage with
regular paracetamol and ibuprofen after they have been
discharged, which we do not provide. We do not advise
breastfeeding mothers to use analgesia such as codeine/co-
codamol/tramadol as this can be excreted into breast milk.
Vitamin K (Neokay) – This is to help blood clotting therefore
preventing serious bleeding. Most women will have chosen to have
this given to their baby as an injection shortly after birth. Parents
who have chosen oral vitamin K or have been advised further oral
vitamin K after the initial injection by their midwife are recommended
to give 0.25mls once a day until the bottle is complete.
If you have been provided with medication that is not explained
within this leaflet which you are not familiar with please discuss
with your midwife or take the time to read the information leaflet
inside the box.
4231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 5
Emotions and mental health
Becoming a mother is a time of heightened emotions. For many
women the dominant emotions are positive ones, but many new
mothers experience temporary feelings of low mood including
unhappiness, loneliness and anxiety. If you already have a history
of mental health problems, it is important for you to be in contact
with the services that know you and a post-natal review with your
GP should be in place. It is helpful to think of your post-natal
emotional needs in this way:
• Expected post-natal mood changes: the ‘baby blues’: this
occurs in up to 85% of women but should have resolved by day
10 to 14. Rest as much as you can and try to speak to those
around you.
• Mild to moderate anxiety and depression: when the ‘baby
blues’ does not resolve, usually within the first 3-5 months post
natally. Symptoms include poor sleep, agitation, reduced mood
with negative thinking and struggling to enjoy anything.
• Severe depression and psychosis: Rarely, women can
become very unwell. Any concerns related to unusual and false
ideas about reality, hallucinations, confusion, fear, suspicion,
rapid mood swings, or disinhibited and uncharacteristic
behaviour should be reported to your GP immediately.
• Post-traumatic stress disorder: when women struggle with
the memory of their delivery experience they can present with
nightmares, flashbacks and intense anxiety.
If you are concerned at all about your emotional health, talk to your
midwife, GP and/or your health visitor. If you have any concerns
about your own or your baby’s safety, then seek help immediately.
5231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 6
Pelvic floor exercises
The pelvic floor is a sling of muscles at the floor of the pelvis
which supports the pelvic organs including your womb, bladder,
bowel and vagina. During pregnancy and labour these muscles
are stretched. Exercises can help reduce swelling, ease pain and
tone muscles preventing weak bladder control or prolapse. Start
these exercises as soon as possible and continue them regularly.
Gently squeeze the muscles around the front and back passage
as if stopping yourself from going to the toilet. Hold as long as you
can, then relax slowly. Repeat as many times as you can
(maximum of 10). Try not to hold your breath, tighten your legs,
buttocks or abdomen.
Abdominal muscles which run down the centre of your stomach
can often separate during pregnancy. To bring these muscles
back together try lying on your side and drawing in your stomach
whilst squeezing your abdominal muscles.
Our team of physiotherapy assistants are available on ward 16
every day for advice and support, if you have not been seen and
would like to prior to discharge please ask your midwife.
6231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 7
Care of sutures
Many women experience genital trauma during labour, this can
range from bruising, grazes, tears or episiotomies. Depending on
the trauma you may have required sutures to aid healing and
prevent infection. These are dissolvable and you can expect them
to dissolve by approximately two weeks and to heal by
approximately six weeks. Regular paracetamol and ibuprofen
should be sufficient analgesia.
In order to prevent infection and aid healing:
Eat a balanced diet – This provides your body with strength and
nutrients to aid the healing process. It can also prevent
constipation and straining against the affected area.
Hygiene – Keep the area as clean and dry as possible by
changing your sanitary pads regularly and showering daily.
Avoid heavily perfumed products. Gently pat the area dry with a
clean towel.
Hand Washing – Ensure good hand hygiene by washing your
hands before and after handling/changing sanitary pads or using
the bathroom.
Pelvic floor exercises – They can increase blood flow to the
affected area and aid healing. Pelvic floor exercises also help
increase muscle tone therefore prevent urinary incontinence.
Intercourse – Wait until the sutured area has fully healed before
resuming sexual intercourse.
7231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 8
Care of a caesarean wound
There are different types of dressings used for caesarean sections,
if yours has a pump attached (PICO dressing) please seek advice
on when it should be removed by your community midwife.
Regular dressings should stay in place for five days after your
caesarean. We advise you wear comfortable loose clothing and
cotton underwear which can be pulled above the wound to
prevent irritation and keep the wound clean and dry. After five
days the dressing should be removed. This can be done after a
shower as it is easier to remove when wet.
Stitches stop any bleeding from the wound and should dissolve
after two weeks and the wound should heal after six to eight weeks.
If you notice any of the following please contact your midwife or GP:
• Hot, swollen, weepy, smelly or painful wound
• Opening of the wound
• Symptoms of infection
If infection is picked up early it can be treated with a course of
antibiotics. Infections picked up late on can cause more serious
long term problems therefore is important to contact your midwife
if you have any concerns.
8231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 9
Sexual intercourse and contraception after birth
It is important to be aware that it is possible to become pregnant
again very soon after the birth of your baby, even if you are
breastfeeding and/or your periods have not returned.
Most women will release an egg approximately 2 weeks before
their period arrives therefore it is possible to become pregnant
before your first period.
Leaflets on contraception can be provided by the postnatal ward,
or you can access information via NHS Choices website or The
Family Planning Association website.
Barrier methods of contraception such as condoms are advised
until you have chosen a method of contraception.
Resuming intercourse is different for each woman and unless you
have had a caesarean section or any perineal suturing there is no
right or wrong time to resume sex; just whenever you feel ready.
For women who have had a caesarean section or any perineal
suturing it is advised to wait until the affected area has healed
before resuming intercourse to prevent infection and breakdown
of the wound.
If you experience any pain during sexual intercourse following the
birth of your child please seek advice from your GP.
9231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 10
Safe sleeping
With various products on the market it can be confusing to
understand how to ensure your baby is sleeping in the safest way
possible. Here are some simple tips to help reduce the risk of
sudden infant death syndrome:
• Do not sleep in the same bed as your baby if it can be avoided.
• Do not sleep in the same bed as your baby if you smoke, drink
alcohol, take drugs or if your baby was premature or of low
birth weight.
• Keep your baby in the same room as you when sleeping for at
least 6 months.
• Always ensure your baby is asleep on their back with their feet
at the bottom of the cot.
• Use a firm, flat, waterproof mattress.
• Never sleep on the sofa with your baby.
• Avoid letting your baby get too hot.
• Do not allow bedding to cover your baby’s face or have items in
or surrounding the cot such as ‘bumpers’.
• Further advice can be found on the Lullaby Trust Website
including various products on the market.
10231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 11
Smoking
Smoking can cause significant health risks to yourself and your
new-born baby. The best way to eliminate risk to yourself and
your child’s health is to quit. Research has found that babies born
to mothers who smoke 1-10 cigarettes as day are two to four
times more likely to suffer a cot death (SIDS) this risk increases to
seven and eight times higher when smoking 20+ a day. Passive
smoking further increases the risk of cot death.
Children who breathe second hand smoke are significantly more
likely to suffer with:
• Ear infections.
• Coughs and colds.
• Poor lung development and respiratory problems such as
asthma, bronchitis and pneumonia.
• In the longer term lung cancer and heart disease.
Until you are able to stop smoking do not smoke around your
children. When smoking at home ensure to smoke outside the
house as far from the property as possible. Do not leave ash trays
inside the house. Also please remember that smoking whilst
driving with anyone under the age of 18 is now a criminal offence.
Ask your midwife, GP, health visitor or pharmacist for help in
stopping smoking.
11231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 12
Signs of unwell mother
Sudden and heavy blood loss or
persistent increased blood loss.
Haemorrhage
Fainting, dizziness, palpitations or
increased heart rate.
Fever and/or shivering
Wound/Abdominal pain
Infection or Sepsis
Offensive vaginal loss
Slow healing wounds or a rash
Headaches, visual disturbances,
nausea, vomiting, upper Raised blood pressure (Pre-
abdominal pain, shaking or eclampsia/eclampsia)
tingling sensations.
Leg pain (usually one leg),
redness, swelling.
Blood clot (Thromboembolism)
Shortness of breath, chest pain
or palpitations
12231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 13
Signs of unwell baby
Healthy Signs of illness
Colour Regular skin tone Pale, dusky, yellow
(Jaundice) or blotchy
Tone Mobile limbs Floppy
Breathing Regular breaths Fast breathing, grunting,
noises or gasping
Temperature Warm chest Hot or cold chest
Feeding Feeding at regular Sleepy during feeds,
intervals, good length disinterested, excessive
feeds/volume feeds vomiting
for age
Behaviour Sleeping between feeds/ Unsettled, high pitched
self-waking for feeds crying, sleepy/drowsy
Red/inflamed skin, rash
Umbilicus/Cord Healthy skin offensive smell or
discharge
Cry Normal hungry cry High pitched or very quiet
Small amounts of
Passing urine and urine and stools/pale or
Nappies opening bowels regularly hard stools.
or changing colour stools. Concentrated urine.
If your baby is displaying any of these symptoms please contact
us on Ward 16 on 0191 6072016.
13231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 14
Follow up
When discharged from hospital you will be seen at home the
following day, regardless of the day of the week. Unfortunately we
do not provide time slots, if you have not been seen by 5pm
please contact us on 0191 607 2088.
The number of visits you will need is dependent on your
individual needs therefore discuss your care plan with your
community midwife.
When discharged by your community midwife care will be taken
over by a health visitor.
Your GP will be informed of your baby’s birth, however it is your
responsibility to book a 6 week follow up for yourself and your baby.
It is also your responsibility to register the birth of your baby. This
should be done within 6 weeks of birth via appointments only.
North Tyneside: 0191 643 6164
Northumberland: 0345 600 6400
Some women will require a follow up appointment with their
consultant obstetrician. If this applies to you expect to receive a
letter within two weeks with an appointment.
We advise that you continue regular routine checks at your dentist
and register your baby as soon as possible. With your MatB1 form
you are entitled to free dental care and prescriptions until your
baby’s first birthday.
14231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 15
Infant feeding
Whether breast or bottle feeding responsive feeding has shown to
be the most effective method in feeding newborn babies. As you
get to know your baby you will start to recognise feeding cues
such as sucking of hands, lip movements and rooting. Crying is
usually a late sign your baby has been trying to tell you they are
hungry. Initiating a feed early in response to feeding cues
encourages a calm and enjoyable feeding experience for both
mother and baby. Remember that feeding your baby is a fantastic
way to bond therefore is important to hold your baby close to you
with good eye contact. Talk to your baby, they recognise your
voice and is reassuring for them. Try to ensure that if you are
bottle feeding that your baby is only fed by yourself. Do not prop
bottles up into your baby’s mouth and leave them unattended, this
can cause choking.
Some babies require tailored feeding plans, for example low birth
weight. We advise to continue with your babies recommended
feeding plan when at home.
Breast feeding
• Most babies will feed 8-10 times in 24 hours.
• In the first 48 hours, your baby is likely to have only two or
three wet nappies. Wet nappies should then start to become
more frequent, with at least 6 every 24 hours from day five
onwards.
• At the beginning, your baby will pass a black tar-like stool (poo)
called meconium. By day three, this should be changing to a
lighter, runnier, greenish stool that is easier to clean up. From
day four and for the first few weeks, your baby should pass at
least two yellow stools every day. These stools should be at
least the size of a £2 coin. Remember, it’s normal for breastfed
babies to pass loose stools.
15231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 16
• Your breasts and nipples should not be sore. If they are, do ask
for help.
• Your baby will be content and satisfied after most feeds and will
come off the breast on their own.
Bottle feeding
• Newborn babies may take small amounts of infant formula to
start with. However, by the end of their first week, most will
need around 150ml per kilo of the baby’s weight per day, until
six months old. This amount will vary from baby to baby.
• Bottle feeding babies often need winding during a feed as well
as after. This helps prevent excessive wind, vomiting and
crying from stomach ache.
• A few days after the birth, your baby should be producing
around six wet nappies a day. For the first few days after birth
your baby will pass dark sticky stools (known as meconium), by
day four to five your baby should pass pale yellow or yellowish-
brown stools at least once a day.
Your community midwife will weigh your baby on day five. Some
babies can lose up to 10% of their birth weight (usually
breastfeeding babies) during the first few days however you
should expect your baby to gain weight after two weeks. Your
midwife will advise you when to have your baby re-weighed.
16231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 17
Local breast feeding support
Shiremoor Children’s Centre – Thursdays from 10:00am to
11:30am - 0191 6432110
Howdon Children’s Centre – Mondays from 1pm to 3pm -
0191 6432229
Wallsend Children’s Centre – Wednesdays from 1pm to 3pm -
0191 6432699
Wellspring Medical Centre Citadel East Killingworth –
Wednesdays from 12:30 to 2pm - 0191 2684550
Sir James Knott Children’s Centre North Shields – Mondays at
10am from 11:30am - 0191 2005438
BiBi’s breastfeeding support
Cramlington Brockwell Clinic – Mondays from 10am to 11:30am
Seaton Delaval Children’s Centre – Tuesdays from 10am to 11am
Blyth Health Centre Mondays from 1pm to 2:30pm
Blyth Central Children’s Centre – Wednesdays from 1pm to
2:30pm
Ashington Children’s Centre – Mondays from 9:30am to 11:30am
Bedlington Children’s Centre – Thursdays from 1pm to 2:30pm
Morpeth Children’s Centre – Wednesdays from 9:30am to
11:30am
Widdrington Clinic – Thursdays at 10am from 11:30am
For more information call Bibi’s on 07919 592281 or see their website.
17231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 18
North Northumberland
Alnwick Children’s Centre - Tuesdays from 1pm to 2:30pm
Berwick Children’s Centre - Mondays from 1pm to 2:30pm
For more information call Sarah Banks – 07824 607332
West Northumberland
Hexham Children’s Centre - Mondays from 1pm to 2:30pm
Corbridge Primary Care Centre – Tuesdays from 11am to 1pm
Prudhoe Children’s Centre – Thursdays from 11:30 -to 12:30
Bellingham Middle School Baby Club – Wednesdays from 10am
to 12pm
Haydon Bridge Fire Station – Wednesdays from 1pm to 3pm
Haltwhistle Children’s Centre – Thursdays from 1:30pm to 12pm
Wheelbirks Parlour, Stocksfield, NCT ‘Babies in Arms’ – The first
and third Wednesday of each month from 10am to 12pm
For more information call Emma Grimwood – 07919 592339
Useful Numbers:
National Breastfeeding Helpline - 0300 100 0212
The Breastfeeding Network Helpline - 0870 900 8787
La Leche League - 0845 120 2918 (24 Hours)
Start4Life - 0300 123 1021
NCT Breastfeeding Line - 0300 330 0771
18231592 PIN797 V1 (FULL
( COLOUR.qxp
( ( ( 29/03/2019 08:30 Page 19
( ( (( ( ( (
Birth
( Reflections
(
(
(
Sometimes following (a( birth it (is (helpful to
( talk things ( through, either
if things haven’t gone the( way you had expected, or you just want
( ( ( ( ( ( ( ( (
( ( ( ( ( ( ( ( ( ( ( ( ( ( ( ( (
to reflect on( your experience. ( If you have had( your ( baby ( with
( ( us
( ( ( ( ( ( ( ( ( ( ( ( ( ( (
you may wish (to spend ( ( some ( ( time talking this(( through with a
( ( ( ( ( ( ( ( (
midwife. Following this, if (you( need further support we can( refer you
( ( (
to our( ( health psychology service or one of our medical services.
0( ( ( ( ( ( ( ( ( ( ( ( ( ( (
( (
If you feel this may be useful you can refer yourself into the
(
service
( by( filling out
( the form on our website.
www.northumbria.nhs.uk/maternity
( ( ( ( ( ( (
( ( ( (
Other useful numbers:
Obstetrics and Gynaecology Health Psychology: 01670 564095
Talking therapies Northumberland: 0300 303 0700
Talking Therapies North Tyneside: 0191 2952775
19231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 20
Other useful telephone numbers
Northumbria Specialist Emergency Care Hospital
Maternity Reception 0191 6072088
Birthing Centre 0191 6072318
Ward 16 0191 6072016
Pregnancy Assessment Unit 0191 6072815
Special Care Baby Unit 0191 6072317
Alnwick Maternity Services 01665 626732
Berwick Maternity Services 01289 356622
Hexham Maternity Services 01434 655352
Useful Apps
Baby buddy
This is a free app to download onto a smart phone. This is useful
for pregnant or new mums. You will receive messages on the
development of your baby, health, lifestyle, exercise, screening,
infant feeding and more information as your child grows.
Feed finder app
This is a free app which is useful when out and about and would
like information on local breastfeeding cafes.
Infant sleep information services app
Provides information on sleep patterns/caring for your baby at night.
20231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 21
Useful websites
www.breastfeedingnorthumberland.co.uk
www.unicef.org.uk/babyfriendly
www.elaleche.org.uk
www.nhschoices/breastfeeding
www.firststepsnutrition.org
www.nhschoices/bottle-feeding
21231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:30 Page 22
Notes
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
22231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:31 Page 23
Notes
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
23231592 PIN797 V1 FULL COLOUR.qxp 29/03/2019 08:31 Page 24
PIN 797/V1
Review date: July 2021You can also read
