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Health visitor

Health visitor

Health visitor talks to new mum holding her baby at home A health visitor is a nurse or midwife who has undertaken additional training. You will have access to support from your health visiting team with your child’s health and development until they start school. Your health visitor will be notified that you are pregnant when you book with the midwife in the first few months of your pregnancy. They will contact you before your baby is born; you may be invited to a group or an appointment with the local health visiting team during your pregnancy. Once your baby is born, your health visitor will contact you. The first check (New Baby Review) will usually occur 10 to 14 days after the birth. The health visitor will check on the health and wellbeing of the parents and baby, provide support with feeding and give important advice on keeping safe. They will also discuss early bonding with the baby, talk about feeding, check the baby is putting on weight appropriately, explain the immunisation programme and talk about important safety measures, such as car seats. At this point, parents often seek advice on establishing a routine, as well as information on sleep, crying and colic. Health visitors are linked to Children’s and Family Centres, Health Centres or GP surgeries. To contact your health visitor and find out which health visiting team you have been allocated to, contact your Children’s Centre, Health Centre or GP surgery. Health visitors can offer baby clinics, health checks and opportunies to talk about any concerns you may have in Children’s or Family Centres. Children’s and Family Centres will also offer parenting workshops and developmental workshops, helping you to understand how your baby develops and how to play and interact with your child. You can also meet other parents with their babies at the Centres. At six to eight weeks old, the health visitor will assess the baby’s growth and your health, particularly looking out for signs of postnatal depression. This is also an opportunity to find out about the childhood vaccination programme.
What do health visitors do?
What is a health visitor?
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Community midwife and support workers

Community midwife and support workers

Community midwife listens to baby's heart through a stethoscope at the baby's home

Community midwife

After you leave the maternity unit, you will be seen at home or in postnatal clinics by a community midwife. This midwife will come from your closest maternity unit, which may not be the one in which you gave birth – therefore please confirm the contact details with your midwife in the maternity unit prior to being discharged home. Your community midwife will explain the pattern of visits that you can expect, and provide information on your local services. If you have any problems, you should request an additional home or clinic visit, or telephone consultation with your community midwife team. If you have not heard from a community midwife within 48 hours of being discharged home, contact the maternity unit where you gave birth.

Community maternity support worker

Community midwives are often supported by community maternity support workers in assessing maternal and newborn wellbeing and are fully trained to help you with infant feeding. For information on the infant feeding support available, speak to your community midwife.
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Midwives on the postnatal ward

Midwives on the postnatal ward

New mother sits up in hospital bed while she and a midwife look down at her crying baby in an adjacent cot As part of your wellbeing and follow-up care your midwives will:  
  • perform several checks on you before you go home
  • arrange any medication you may need to take with you
  • check how well your baby is feeding and talk through the things you can expect once at home
  • arrange for a midwife to visit/contact you within the next two days
  • give you some important paperwork, including the Personal Child Health Record (or red book).
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Identification for your newborn baby

Identification for your newborn baby

Close up of baby's feet with identification bands round each ankle After the birth, the midwife will prepare two infant identity bands. Each band will include the mum’s surname and the hospital number. Details will be checked with the mum and/or partner against the mum’s printed patient identity band before placing it on the baby. A unique NHS number and hospital number will be generated for your baby shortly after birth. The NHS number will remain with your baby throughout their life.
Your baby’s NHS number
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Vitamin K for newborn babies

Vitamin K for newborn babies

New born baby is injected in foot while lying on electronic weighing scales Soon after birth, your midwife will offer to give your baby vitamin K by either injection (once only) or oral drops (which are given in three doses). This is to prevent a rare but serious blood disorder, and can be given by injection or oral drops. If you opt for oral drops your baby will need to receive further doses. The decision to have oral doses may impact on future treatments until all three doses are received, for example, release of tongue tie.
Vitamin K for babies
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Your baby: straight after birth

Your baby: straight after birth

New born baby lies on electronic weighing scales During skin-to-skin contact with your baby, he or she may show early feeding cues. Your midwife will support you in feeding your baby shortly after birth. Some babies want to feed very soon after birth, whereas others take several hours to show signs that they are ready to feed. Some babies are alert after the birth, whilst others may become sleepy. When holding your baby ensure that their nose and mouth remains unobstructed by your body, towels or clothing. Your baby’s weight will be checked, and a midwife or neonatal doctor will check him/her from top-to-toe to exclude any major abnormalities. Your baby will be offered a supplement of Vitamin K. In some rare cases, your baby may need to be transferred to the neonatal unit for a period of time for specialised treatment. This is more common with babies born prematurely, very small, with an infection or through a particularly complicated birth. If this happens to you, you will have plenty of support and help from your maternity team.
Breastfeeding in the early days
Your baby after birth
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You: straight after birth

You: straight after birth

Close up of new mother sitting up in a hospital bed and holding her new born baby After your placenta has been delivered, your midwife or doctor will ask to check and see if you have any tears to the perineum and/or vagina that might require stitches. If you do need stitches, your midwife or doctor will explain this to you. Before stitching your midwife or doctor will ensure the area is numbed with local anaesthetic, or if you have an epidural already, this will be topped up. Most tears will be repaired in your birthing room, more significant tears require repair in an operating theatre. Tears are repaired using dissolvable stitches and normally heal within a month of birth. All women will lose some blood after giving birth, this happens because the area of the womb where the placenta was attached takes time to heal. Bleeding may be heavy immediately after the birth, but will reduce significantly over the next few days and weeks. Bleeding will normally last between two and six weeks. Your midwife will check on your bleeding regularly straight after birth. If there is significant bleeding this is called a postpartum haemorrhage (PPH). Your midwife and doctor will take prompt action to stop ongoing blood loss.
Understanding perineal tears
You after birth Third and fourth degree tears Heavy bleeding after birth (postpartum haemorrhage) Perineal tears and stiches – The Obs Pod, Episode 53
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Skin-to-skin contact

Skin-to-skin contact

New mother holds her new born baby to her bare chest under a sheet After your baby is born, so long as they are well, you will be encouraged to have immediate skin-to-skin contact. This type of contact is known to be beneficial to both mother and baby by:
  • regulating your baby’s breathing, heart rate, temperature and blood glucose levels
  • soothing and calming your baby
  • encouraging early breastfeeding and increased milk production
  • supporting longer term breastfeeding success.
If, for any reason you are not well enough to have skin-to-skin contact with your baby, your partner can do so instead. Side view of father holding him newborn baby skin-to-skin Even if your baby needs help with breathing after birth, or to be seen by a neonatal doctor, you will be offered skin-to-skin contact as soon as practically possible. It is very important that your baby’s chin is free from obstruction and that a clear airway is maintained. Read the important safety considerations in the UNICEF Baby Friendly Initiative related link below.
Skin-to-skin contact – Dr Nils Bergman
Skin-to-skin contact UNICEF UK Baby Friendly Initiative, skin-to-skin contact