Discharge home and care in the community
Returning home with your new baby is the beginning of a new chapter in your life. Everything will revolve around your new baby and it will take a while to get used to new routines. You may still have lots of questions and insecurities.
It is really important that you find a community midwife who will support you in the early days and weeks when you return home. By 28 weeks of pregnancy we recommend that you have found one on Hebamme.ch website and that you have registered yourself with her and she has agreed to continue your postnatal care at home.
It is a good idea to organize help and establish how your partner can support you before birth, during labor and in the postnatal period. You will get a lot of information and tips from the Birth preparation classes. Do not expect to continue all household activities as you did before. It is very important you have time to get to know your baby and that feeding is established.
Generally, six weeks after birth you will have an appointment with your Gynecologist. Your baby will have an examination 4 weeks after birth with your chosen pediatrician.
Should you experience any of the following issues then you will need to contact your doctor:
- Fever, Temperature 38 plus
- Red or painful breasts
- Vaginal bleeding that is heavier than a normal period
- Offensive vaginal discharge and abdominal pain
- Redness or pain on a caesarean section scar or in the perineal area
- Swelling and pain in either calf
- Shortness of breath, circulatory weakness, malaise, severe headache, abdominal pain, flickering eyes.
Please contact your Gynecologist or the maternity unit emergency doctor on call (Tel. +41 44 922 22 11).
When is everything back to normal?
The womb (uterus) can take about 6 weeks to return to normal. You can take a bath or shower at home as soon as you get home. It is recommended that you don`t go swimming until you have had your six week postnatal check up for hygienic reasons and time to allow everything to heal.
After 6-8 weeks it is also recommended that you attend postnatal classes for pelvic floor exercises to strengthen the pelvic floor, abdominal and back muscles led by specialized physiotherapists.
In case of incontinence or pain in the pelvic floor area contact our specialist Consultant (Tel. +41 44 922 22 26)
Get to know your breasts before the baby arrives. Do you have any cysts, scars, lumps or bumps that are normal for you. By knowing your breasts it is easier to notice any new changes. This generally happens when the milk comes in around day 3 to 4.
Do not wash your nipple areolar area with soap and avoid any unnecessary creams or lotions, strong smelling deodorants and perfumes.
In Hospital our Lactation Consultants, Midwives and Nurses will support you with breastfeeding. You will be shown how to correctly attach the baby to the breast and how to avoid nipple trauma as well as how to cope with breast engorgement. If you choose not to breastfeed or are unable to, our Lactation Consultant and maternity staff will support you in ceasing lactation.
Correct positioning and attachment is the key to avoiding problems such as sore, cracked nipples and painful breastfeeding.
Maternity staff will show you how to recognize when your baby is hungry. You will also be taught how to Hand Express Colostrum, the first milk.
On discharge from hospital you will be advised and be given written information on what to do when breasts are engorged, treatment of sore nipples and how to avoid breast problems such as mastitis. You will be given further written information on how to contact the breastfeeding clinic should you need more support or a second opinion. You can self refer at any time, no matter how old your baby is.
Mothers to be can also come for a consultation if they are unsure about breastfeeding or anticipate problems due to breast surgery, previous poor experience with breastfeeding or you have diabetes or pregnancy induced diabetes.
If you are concerned at any time about breastfeeds or your breasts contact your chosen community midwife or if she is unavailable or can’t help straight away, contact the, Breastfeeding Clinic here at Männedorf Hospital on +41 44 922 21 55. Or out of hours the Gynecology emergency Doctor.
Mastitis means inflammation of the breast. The first signs of mastitis:
- Red area
- painful area of the breast.
- symptoms of flu.
To avoid mastitis
- try not to go for long periods of time without draining the breast. Sometimes this can’t be avoided if the baby suddenly sleeps through the night. Try not to let your breasts over fill. It is ok to wake the baby to feed or express to relieve the pressure.
- Avoid pressure on the breasts from clothing or pressing on the breast during feeding.
Begin self help
- be proactive. What to do Self help measures can help clear a blocked duct, engorgement, and help prevent mastitis.
- Keep breastfeeding. Your baby is the best one to help clear the ducts, You may feel ill and uncomfortable but it is the quickest way to recover and won’t harm your baby.
- Feed your baby more often or express your milk to keep the breast drained until you feel better.
- Make sure your baby is well attached to the breast. If you have sore nipples this is a sign that your baby has not attached well, therefore, cannot drain the breast effectively.
- Remove tight clothing, avoid underwired bras.
- Feed from the effected side first.
- Try feeding your baby in different positions, such as laying down on your side, cradle hold or rugby hold. Your breastfeeding supporter can show you how to do this
- If your breast is too full, tight or engorged, try to express either by hand or with a breast pump, a small amount of milk to soften the breast and make it easier for the baby to attach.
- Use warmth on the breast before feeding to aid flow. After the feed cold packs may help to soothe the breast.
- Try using Quark poultice or cabbage leaves (Green Savoy) on your breasts. This can also soothe and help reduce swelling (ask your midwife or Lactation Consultant).
- Eat well, drink plenty of fluids and most importantly REST
If this does not alleviate the symptoms please contact your personal midwife or the Breastfeeding clinic at Männedorf Hospital on +41 44 922 21 55.