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Information on why we may ask you to "step on the scales" following the birth

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Photos of Chelsea & Westminster and West Middlesex Maternity Units

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All parents are offered a thorough physical examination for their baby within 72 hours of giving birth.
The examination includes screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, testicles (testes).

Coronavirus update

Newborn screening appointments and vaccinations are continuing as normal, including the:

newborn blood spot test

newborn hearing screening test

newborn physical examination

It's important to go to your appointments unless you, your baby or someone you live with has symptoms of coronavirus.

What is the newborn physical examination?

The newborn physical examination is usually carried out in hospital before you go home.

Sometimes it's done at a hospital or community clinic, GP surgery, children's centre or at home.

Ideally, both parents should be there when the examination is done.

The health professional doing the examination should explain what it involves.

This could be a doctor, midwife, nurse or health visitor who's been trained to do the examination.

Some parts of the examination may be a bit uncomfortable for your baby, but it will not cause them any pain.

The aim is to spot any problems early so treatment can be started as soon as possible. Usually, nothing of concern is found.

If the health professional carrying out the examination does find a possible problem, they may refer your baby for more tests.

You'll be offered another physical examination for your baby at 6 to 8 weeks, as some of the conditions it screens for can take a while to develop.

This second examination is usually done at your GP's surgery.

How is the newborn physical examination done?

The health professional will give your baby a thorough physical examination.

They'll also ask you questions about how your baby is feeding, how alert they are, and about their general wellbeing.

Your baby will need to be undressed for part of the examination.

During the examination, the health professional will also:

look into your baby's eyes with a special torch to check how their eyes look and move

listen to your baby's heart to check their heart sounds

examine their hips to check the joints

examine baby boys to see if their testicles have descended into the scrotum

What does the newborn physical examination check for?

The examination includes an overall physical check, plus 4 different screening tests.

Eyes

The health professional will check the appearance and movement of your baby's eyes.

They're looking for cataracts, which is a clouding of the transparent lens inside the eye, and other conditions.

About 2 or 3 in 10,000 babies are born with problems with their eyes that need treatment.

But the examination cannot tell you how well your baby can see.
Find out how cataracts are diagnosed and treated
Heart

The health professional will check your baby's heart. This is done by observing your baby, feeling your baby's pulses, and listening to their heart with a stethoscope.

Sometimes heart murmurs are picked up. A heart murmur is where the heartbeat has an extra or unusual sound caused by a disturbed blood flow through the heart.

Heart murmurs are common in babies. The heart is normal in almost all cases where a murmur is heard.

But about 1 in 200 babies has a heart problem that needs treatment.
Find out more about diagnosing and treating heart problems in newborns
Hips

Some newborns have hip joints that are not formed properly. This is known as developmental dysplasia of the hip (DDH).

Left untreated, it can cause a limp or joint problems. About 1 or 2 in 1,000 babies have DDH that needs to be treated.
Find out more about developmental dysplasia of the hip
Testicles

Baby boys are checked to make sure their testicles are in the right place.

During pregnancy, the testicles form inside the baby's body. They may not drop down into the scrotum until a few months after birth.

In about 1 in 100 baby boys, the testicles only descend partially or not at all.

This needs to be treated to prevent possible problems later in life, such as reduced fertility.
Find out more about undescended testicles

Does my baby have to have the examination?

The aim of the examination is to identify any of the problems early so treatment can be started as soon as possible.

It's strongly recommended for your baby, but not compulsory.

You can decide to have your baby examined and screened for any or all of the conditions.

If you have any concerns, you should talk to your midwife or the health professional offering the examination.

When will we get the results?

The health professional carrying out the examination will give you the results straight away.

If your baby needs to be referred for more tests, they'll discuss this with you there and then, too.

The results will be recorded in your baby's personal child health record (red book).

You'll need to keep this safe and have it to hand whenever your baby sees a health professional.

If you have any concerns, you can discuss them with your midwife or the health professional who does the examination.
Download a leaflet about screening tests for you and your baby

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All parents are offered a thorough physical examination for their baby within 72 hours of giving birth. The examination includes screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, testicles (testes).

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Follow our Infant Feeding Team padlet for more detailed information about feeding

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Getting baby into a better position for birth

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Pelvic floor exercises

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How and when to do pelvic floor exercises

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How and when should I do pelvic floor exercises? | NHS

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Signs that labour is starting or is imminent

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Know the signs

There are several signs that labour might be starting, including:

contractions or tightenings

a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away

backache

an urge to go to the toilet, which is caused by your baby's head pressing on your bowel

your waters breaking

The early (latent) stage of labour can take some time.

Coronavirus (COVID-19) update

If you're well, it's really important you go to all your appointments and scans for the health of you and your baby.

If you're pregnant, hospitals and clinics are making sure it's safe for you to go to appointments.

If you get symptoms of COVID-19, or you're unwell with something other than COVID-19, speak to your midwife or maternity team. They will advise you what to do.
Find out more about pregnancy and COVID-19

Latent phase of labour

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You'll probably be advised to stay at home during this time. If you go to the hospital or maternity unit, they may suggest you go back home.

Find out more about the stages of labour and what you can do at home during the latent phase.

Call your midwife if you're unsure or worried about anything.

What do contractions feel like

When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains.

You may have had contractions during your pregnancy, particularly towards the end. These tightenings are called Braxton Hicks contractions and are usually painless.

Your contractions tend to become longer, stronger and more frequent as your labour progresses. During a contraction, the muscles tighten and the pain increases. If you put your hand on your abdomen, you'll feel it getting harder; when the muscles relax, the pain fades and you will feel the hardness ease.

The contractions are pushing your baby down and opening the entrance to your womb (the cervix), ready for your baby to go through.

Your midwife will probably advise you to stay at home until your contractions become frequent.

Call your midwife or maternity unit for guidance when your contractions are in a regular pattern and:

last at least 60 seconds

come every 5 minutes or

you think you are in labour

Read more information on when to go to hospital

Backache often comes on in labour

You may get backache or a heavy, aching feeling.

A "show" can signal the start of labour

During pregnancy, there's a plug of mucus in your cervix. This mucus comes away just before labour starts, or when in early labour, and it may pass out of your vagina. This sticky, jelly-like pink mucus is called a show.

It may come away in 1 blob or in several pieces. It's pink because it contains a small amount of blood.

If you're losing more blood, it may be a sign something is wrong, so phone your hospital or midwife straight away.

A show indicates that the cervix is starting to open. Labour may quickly follow or may take a few days. Sometimes there is no show.

What happens when my waters break

It's likely your waters will break during labour, but it can also happen before labour starts.

Your baby develops and grows inside a bag of fluid called the amniotic sac. When it's time for your baby to be born, the sac usually breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. Sometimes when you're in labour, a midwife or doctor may offer to break your waters.

If your waters break naturally, you may feel a slow trickle or a sudden gush of water you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you're going out, and put a protective sheet on your bed.

Amniotic fluid is clear and pale. Sometimes it's difficult to tell amniotic fluid from urine. When your waters break, the water may be a little bloodstained to begin with.

Tell your midwife immediately if:

the waters are smelly or coloured

you're losing blood

This could mean you and your baby need urgent attention.

If your waters break before labour starts, call your midwife. Use a sanitary pad (not a tampon) so your midwife can check the colour of the waters.

If labour does not start after your waters break

It's usual to go into labour within 24 hours of the waters breaking. You'll be offered an induction if you do not because, without amniotic fluid, there's an increased risk of infection for your baby.

Until your induction, or if you choose to wait for labour to start naturally, tell your midwife immediately if:

your baby moves less than usual

there's any change in the colour or smell of any fluid coming from your vagina

You should take your temperature every 4 hours when you're awake, and tell your midwife if it's raised. A raised temperature is usually above 37.5C, but you may need to call before this - check with your midwife.

There's no evidence that having a bath or shower after your waters have broken increases your risk of infection, but having sex might.

How to cope when labour begins

At the beginning of labour, you can:

walk or move about, if you feel like it

drink fluids - you may find sports (isotonic) drinks help keep your energy levels up

have a snack, if you feel like it

try any relaxation and breathing exercises you've learned to deal with contractions as they get stronger and more painful - your birth partner can help by doing these with you

have your birth partner rub your back - this can help relieve pain

take paracetamol according to the instructions on the packet - paracetamol is safe to take in labour

have a warm bath

Find out what happens during labour and birth, and what you can do for pain relief in the early stages of labour.

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Community content from HealthUnlocked

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There are several signs that labour might be starting, including: contractions or tightenings a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away backache an urge to go to the toilet, which is caused by your baby's head pressing on your bowel your waters breaking The early (latent) stage of labour can take some time.

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A checklist

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Judging the right time to go to the hospital

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Parent to parent advice

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When baby is in a hurry

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Hand out from class

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Comfort measures for babies in a posterior position

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Relaxing into labour

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You can relax as you will be in safe hands. Find out why Hypnobirthing Classes with Natal Hypnotherapy are so helpful for women. Since 2000 Natal Hypnotherapy has helped women have better birth experiences. You can find class and Natal Hypnotherapy Practitioner in your area.

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You can relax as you will be in safe hands. Find out why Hypnobirthing Classes with Natal Hypnotherapy are so helpful for women. Since 2000 Natal Hypnotherapy has helped women have better birth experiences. You can find class and Natal Hypnotherapy Practitioner in your area.

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Non-invasive pain relief - use code JC 010 to obtain a discount

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Our maternity range is designed for mothers all over the world. From pregnancy to delivery and to post-partum, TensCare maternity equipment will support you throughout.

Our maternity range is designed for mothers all over the world. From pregnancy to delivery and to post-partum, TensCare maternity equipment will support you throughout.

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Our maternity range is designed for mothers all over the world. From pregnancy to delivery and to post-partum, TensCare maternity equipment will support you throughout. Our maternity range is designed for mothers all over the world. From pregnancy to delivery and to post-partum, TensCare maternity equipment will support you throughout.

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It's a lovely one. Go on take a peek.......

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All your options - explained (also in other languages)

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About our translations

We are now expanding our portfolio of translations of our main publications beyond the 20 most common languages used in the UK following feedback at meetings and our enquiries page. We are really grateful to the charity Translators without Borders who are helping us to reach mothers and families of all nationalities. Newer additional translations have been generously provided by OAA members to help us to support some other languages. Where possible, these have been quality assured by professionals and/or peer colleagues. We trust these translations to be as accurate as possible and hope that they are useful to you.

Can you help grow our range of translations?

We are always looking for volunteers to help us expand the range of translated material we offer. If you are able to help translate our materials into new languages we would love to hear from you.
Get in touch

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We are now expanding our portfolio of translations of our main publications beyond the 20 most common languages used in the UK following feedback at meetings and our enquiries page. We are really grateful to the charity Translators without Borders who are helping us to reach mothers and families of…

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What you need to know about having an epidural

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An epidural is an injection in your back to stop you feeling pain in part of your body. Here, you'll find useful information and frequently asked questions on epidural anaesthesia for pain relief in childbirth.

Watch this video in another language

What are epidurals?

Epidurals are the most complicated method of labour pain relief and are given by an anaesthetist. An anaesthetist is a doctor who is specially trained to give anaesthetics and pain relief.

Facts about epidurals:

Epidurals can be the most effective method of pain relief for labour.

For an epidural, the anaesthetist inserts a needle into the lower part of your back and uses it to place an epidural catheter (a very thin tube) near the nerves in your spine. The epidural catheter is left in place when the needle is taken out so you can be given painkillers through it during your labour. The painkillers may be a local anaesthetic to numb your nerves, small doses of opioids, or a mixture of both.

An epidural may take 40 minutes to work to give pain relief (including the time it takes to put in the epidural catheter).

An epidural should not make you feel drowsy or sick.

Having an epidural may increase the chance that your obstetrician will need to use a ventouse (a suction cap on your baby's head) or forceps to deliver your baby.

An epidural can usually be topped up to provide anaesthesia and pain relief if you need a ventouse, forceps or a caesarean birth.

An epidural will have very little effect on your baby.

Epidurals can be slow to work, especially if you have been given on one late in labour. If the painkillers are injected into the bag of fluid surrounding the nerves in your back, they work much faster. This is called a spinal. Unlike an epidural, it is given as a one-off injection without a catheter. If an epidural catheter is put in at the same time, this is called a combined spinal-epidural.

In some hospitals, a combined spinal-epidural may be given to most women who ask for an epidural for stronger pain relief. In other hospitals, a combined spinal-epidural is only used for a selected number of women who may benefit most from this particular type of epidural.

Most people can have an epidural, but certain medical conditions (such as spina bifida, a previous operation on your back or problems with blood clotting) may mean that it is not suitable for you. The best time to find out about this is before you are in labour. If you have a complicated or long labour, your midwife or obstetrician may suggest that you should have an epidural as it may help you or your baby.

If you are overweight, it may take longer to put in an epidural. Once it is in and working, you can have all the benefits.

First, a cannula (a fine plastic tube) will be put in a vein in your hand or arm, and you will usually have a drip (intravenous fluid) running as well (you may also need a drip in labour for other reasons, such as to give you medication to speed up your labour or to treat you if you are feeling sick).

You will be asked to curl up on your side or sit bending forwards, and your anaesthetist will clean your back with an antiseptic solution. Your anaesthetist will inject local anaesthetic under your skin, so that putting in the epidural does not usually hurt much.

The epidural catheter is put into your back to be near the nerves in your spine. Your anaesthetist has to be careful not to puncture the bag of fluid that surrounds your spinal cord so to avoid you getting a headache afterwards. It is important to keep still while the anaesthetist is putting in the epidural, but after the epidural catheter is stuck into place with a dressing and tape you will be free to move. Once the epidural catheter is in place, you will be given painkillers through it.

During labour, you can have extra doses of painkillers through the epidural catheter either as a quick injection (a top-up), a slow, steady flow using a pump, or with a patient-controlled epidural analgesia (PCEA) pump. With patient-controlled epidural analgesia, you can give yourself doses of the painkiller when you need them by pressing a button attached to the pump.

In each hospital there will usually only be one, or possibly two, of these methods for keeping the epidural pain relief going.

After each epidural top-up, the midwife will take your blood pressure regularly in the same way as when the epidural was started.

Having an epidural should not affect the condition of your baby when it is born, in fact newborns are less likely to have acid in their blood. Having an epidural does not make it any harder to breastfeed.

Sources:

Anim-Somuah M, Smyth R, Howell C. Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews 2005, Issue 4. Article number: CD000331. Date of issue: 10.1002/14651858.CD000331.pub2.

Reynolds F, Sharma S, Seed PT. Analgesia in labour and funic acid-base balance: a meta-analysis comparing epidural with systemic opioid analgesia. British Journal of Obstetrics and Gynaecology 2002; 109: 1344-1353.

Wilson MJA, MacArthur C, Cooper, GM, Bick D, Moore PAS, Shennan A. Epidural Analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison group. Anaesthesia 2010 65: 145-153.

No, with an epidural, you do not have a higher chance of needing a caesarean birth. There is also no greater chance of long-term backache. Backache is common during pregnancy and often continues afterwards. You may have a tender spot in your back after an epidural which, on rare occasions, may last for months. There is no increased chance of long-term backache.

Sources:

Anim-Somuah M, Smyth R, Howell C. Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews 2005, Issue 4. Article number: CD000331. Date of issue: 10.1002/14651858.CD000331.pub2.

16 Russell R, Dundas R, Reynolds F. Long term backache after childbirth: prospective search for causative factors. British Medical Journal 1996; 312: 1384-1388.

One in every 100 women who have an epidural may get a headache. You can read more about this on our headache after an epidural or spinal injection page.

Permanent nerve damage is very rare with an epidural, affecting about 1 in 13,000 women. Find more information on our Epidural Information Card.

For 1 in 8 women, the epidural might not work well enough to reduce labour pain so you need to use other ways of reducing the pain.

Strong solutions of local anaesthetic in your epidural can increase the risk of instrumental delivery but there is no evidence that this is the case for most commonly used "low dose" epidurals.

With an epidural, the second stage of labour (when your cervix is fully dilated) is longer and you are more likely to need medication (oxytocin) to make your contractions stronger.

You have more chance of having low blood pressure.

Your legs may feel weak while the epidural is working.

You will find it difficult to urinate. You will probably need to have a tube passed into your bladder (a bladder catheter) to drain the urine.

You may feel itchy or develop a slight fever.

To get more information on the side effects of epidurals and spinals, please see our Epidural Information Card.

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An epidural is an injection in your back to stop you feeling pain in part of your body. Here, you’ll find useful information and frequently asked questions on epidural anaesthesia for pain relief in childbirth.

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Delayed Cord Clamping

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Keeping a track of your baby's movements

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your baby is moving less than usual

you cannot feel your baby moving any more

there is a change to your baby's usual pattern of movements

They'll need to check your baby's movements and heartbeat.

Do not wait until the next day - call straight away, even if it's the middle of the night.

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your baby is moving less than usual you cannot feel your baby moving any more there is a change to your baby's usual pattern of movements They'll need to check your baby's movements and heartbeat. Do not wait until the next day - call straight away, even if it's the middle of the night.

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Making your induced birth your own

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Welcome Birth stories can be really inspiring when you're preparing for your own induction. I remember searching for positive induction stories before my first birth and struggling to find th...

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Some ideas for encouraging baby into the world.

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What you need to know

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Published: July 2016

Please note that this information will be reviewed every 3 years after publication.

This information is for you if you have had one caesarean birth and want to know more about your birth options when having another baby.

It may also be helpful if you are a partner, relative or friend of someone who is in this situation.

The information here aims to help you better understand your health and your options for treatment and care. Your healthcare team is there to support you in making decisions that are right for you. They can help by discussing your situation with you and answering your questions.

This information covers:

Choices for birth after having one previous caesarean

The chances of a successful vaginal birth after caesarean (VBAC)

The advantages and disadvantages of VBAC and when it isn't advisable

The advantages and disadvantages of an elective (planned) repeat caesarean (ERCS)

What happens during labour if you're planning a VBAC

What happens if you are planning a VBAC but you don't go into labour

What happens if you have an ERCS planned but you go into labour

Within this information, we may use the terms 'woman' and 'women'. However, it is not only people who identify as women who may want to access this information. Your care should be personalised, inclusive and sensitive to your needs, whatever your gender identity.

A glossary of medical terms is available at A-Z of medical terms.

Key points

If you are fit and healthy, both VBAC and ERCS are safe choices with very small risks.

3 out of 4 women who have had one caesarean section and then have a straightforward pregnancy and go into labour naturally give birth vaginally.

9 out of 10 women will have a successful VBAC if they have ever given birth vaginally. Successful VBAC has the fewest complications.

Giving birth vaginally carries small risks for you and your baby but, if you have a successful vaginal birth, future labours are less complicated with fewer risks for you and your baby.

Having a caesarean section makes future births more complicated.

Most women who have a planned caesarean section recover well and have healthy babies, but it takes longer to get back to normal after your baby is born.

Sources and acknowledgements

This information has been developed by the RCOG Patient Information Committee. It is based on the RCOG Green-top Clinical Guideline Birth after Previous Caesarean Birth.

This information was reviewed before publication by women attending clinics in Raigmore Hospital, King's College Hospital, Queen's Hospital, St Mary's Hospital, University Hospital Lewisham and Wrexham Maelor Hospital, by the RCOG Women's Network and by the RCOG Women's Voices Involvement Panel.

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Birth after previous caesarean patient information leaflet

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What you need to know

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Good information about vitamin K is key for every parent.

In most countries, one of the first decisions that parents need to make for their baby is whether or not they want their baby to have vitamin K. If they do, it's usually given within the first hour of birth.

It's your decision whether or not your baby has vitamin K. It's also up to you to decide which kind of vitamin K (oral or injection) you want your baby to have. So you'll want to weigh up the pros and cons, as with every decision you'll make for your child.

I have been researching vitamin K for more than twenty years, and I have written several books and information leaflets on this subject. Here's the most recent.

I have written this summary of information about vitamin K that you might want to consider when making your decision. It's based on the information in my book, and you might also want to visit my vitamin K information hub, which offers a few more articles on vitamin K.

1. Vitamin K is offered in order to prevent a rare but serious blood clotting problem.

Vitamin K is needed in the human body for several key processes.

One of the most important is that it helps blood to clot.

This is why it is offered to newborn babies. Without it, a small number of babies will develop a rare but serious blood clotting problem.

We used to call this problem haemorrhagic disease of the newborn (HDN). It is now more commonly known as vitamin K deficiency bleeding (VKDB).

2. The likelihood of the problem is low, but it can be serious.

Exact figures vary, but the chance of a baby experiencing VKDB if they don't have vitamin K is about 1 in 11,000.

Most babies who have VKDB will recover, especially if they receive treatment quickly. This is why it is important to be vigilant if you decide to decline vitamin K.

A small number of the babies who experience VKDB will experience long-term damage and, sometimes, a baby will die. The actual chance of death from VKDB is very low, but if we give vitamin K to all babies, it's even less likely.

3. Vitamin K can be given by mouth or by injection.

Vitamin K can be given by injection, or your baby can have oral drops.

The drops may be given in several doses over the first few weeks of your baby's life.

Oral drops are not as effective as the injection, but some parents prefer to give vitamin K that way.

The timing and amount of vitamin K that is given orally can vary between areas of the world.

Vitamin K is also added to formula milk.

4. Vitamin K is very effective, especially when given by injection.

We do not have a randomised controlled trial into vitamin K.

However, other studies, audits and long experience suggest that vitamin K is very effective at preventing VKDB when given by injection.

Oral vitamin K is less effective than vitamin K given by injection. But oral vitamin K is more effective than no vitamin K. We don't have good data on exactly how effective oral vitamin K is.

5. Vitamin K is very safe, but there are a few downsides.

Compared to some drugs, vitamin K is considered very safe.

The injection of vitamin K will occasionally result in infection (at the injection site), bruising or bleeding (as with any injection). It can cause pain to the baby when it is being given.

There have been cases of the wrong drug being injected, but these are rare.

Some people are concerned about other possible downsides to vitamin K, because it hasn't been well researched.

We have given vitamin K to millions of babies for many years because we know that it prevents almost all cases of VKDB.

But we don't know why babies have a relatively low level of vitamin K (compared to adults). It may be that this is beneficial to them in some way.

No research has been done into this, and not enough research has been carried out into possible side effects.

The fact that so much is unknown makes the decision difficult for some parents.

6. There are alternatives; it's not always 'all or nothing'.

As with many birth and parenting decisions, it's not always an 'all or nothing' decision.

For instance:
You may decide to have oral vitamin K rather than the injection.
In this situation, be aware that Vitamin K is fat soluble. So in order to be properly absorbed by the baby's body, it should be given with or just after a feed. Also be aware that it tastes bitter. Many babies will try to spit it out again and you might want to have your finger ready to scoot it back in!
You may decide to wait and see and make a decision according to your situation.
There are a few key vitamin K information issues to consider. If your baby is breastfed and is slow to feed or has feeding problems, the chance of VKDB is higher and you may want to reconsider. If you or your baby have antibiotics, this can increase the chance of VKDB. Again, you may want to take that into account. Likewise if your baby has a procedure such as a tongue tie division or circumcision.

It is good to look into all aspects of this decision to make sure that you are fully informed.

7. It's up to you

As I said at the beginning of this blog post, this is your decision.

You have the right to have good information and make the decision that is right for you and your baby.

I hear from midwives and others in some areas of the world (notably the USA) that parents are sometimes told that it is illegal to decline vitamin K.

This may not be true, so please check what your rights are.

It is also the case that, unfortunately, some parents are put under pressure to accept vitamin K. In some situations, senior professionals are brought in to try to persuade parents to accept it.

If you are thinking of declining vitamin K, I really would recommend that you look further into this area. Here's a link to my book if you'd like to get more depth.

We have an entire information hub on this topic, with links to several more articles and blog posts.

And if you are thinking of declining vitamin K, please take a look at this information in particular.

Books to help you become informed and make the decisions that are right for you...

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Seven things every parent needs to know about vitamin K - Dr Sara Wickham

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Dr Sara Wickham, author of Vitamin K and the Newborn, shares information about vitamin K. Seven things every parent needs to know before making a decision.

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Why some babies might benefit from this treatment

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What your baby really needs

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It's a dirty job, but ......

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A guide to understanding what's in a nappy !

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How caesarean birth should be...

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Baby-friendly caesarean birth | Maidstone and Tunbridge Wells NHS Trust

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How to bathe my baby

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The latest guidelines from The Lullaby Trust

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What products do I need to ensure "Safe sleep" ?

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All your baby needs for a safer night’s sleep

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Helpful videos on safe sleep

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The Lullaby Trust's safer sleep videos are free to share or embed on your website to help us spread vital safer sleep awareness and reduce the risk of SIDS.

For expectant parents
Preparing for baby: safer sleep advice summary
Safer sleep prep starts while you're pregnant. This video covers the ABCs of safer sleep, the feet to foot position, sleep expectations (for babies AND parents!), where to look for product advice, and much more! Following this research-based advice reduces the risk of sudden infant death syndrome (SIDS), also known as cot death.

Safer sleep animations
Safer Sleep for Babies
All of our essential safer sleep information in one video.
Safer Sleep for Babies (text free)
A safer sleep video to be used when communicating with families with low literacy levels or who do not speak English.
How to co-sleep more safely
Advice on reducing the risk of SIDS when co-sleeping.

Baby safety
Baby Check App
An information video about our Baby Check smartphone app which helps families decide whether their baby needs to see a doctor.
Baby summer safety
Tips on how to continue following safer sleep advice during the hotter summer months.
When your baby starts to roll
How to continue following safer sleep advice when your baby starts to roll around in their cot or Moses basket.

Other videos
What bedding does my baby need?
Advice on which items are necessary for a safer baby sleep, and which products to avoid.
When your baby won't sleep
Information on normal baby sleep and tips on coping with sleep deprivation as a new parent.
Caring for your baby during coronavirus
Advice on how to follow safer sleep advice during the COVID-19 pandemic.

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The Lullaby Trust's safer sleep videos are free to share or embed on your website to help us spread vital safer sleep awareness and reduce the risk of SIDS. For expectant parents Buying baby products: the ultimate guide for expectant parents In 3 mins we cover everything from the essential baby products to buy, how [...]

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Guidelines for safely sharing the bed with your baby

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Now also available as an App - search "Lullaby Trust Baby Check"

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Baby Check App

Baby Check features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when completed, a score is calculated that tells parents or carers how ill their baby is. The app then lets parents know whether their baby needs to see a doctor or health professional.

Download for FREE from Google Play or the App Store.

Buy posters, business cards and other materials to help promote Baby Check to your clients and patients

Shop

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The Baby Check App helps parents decide if their baby needs to see a doctor or health professional

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What is the risk ?

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Basis discusses the research

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Keeping healthy

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Postnatal depression is a type of depression that many parents experience after having a baby.
It's a common problem, affecting more than 1 in every 10 women within a year of giving birth. It can also affect fathers and partners.

It's important to get help as soon as possible if you think you might be depressed, as your symptoms could last for months or get worse and have a significant impact on you, your baby and your family.

With the right support most people make a full recovery.

Depression during pregnancy

Depression in pregnancy (antenatal depression) is also common, affecting more than 1 in 10 women.

Other mental health symptoms that can occur during or after your pregnancy include anxiety, panic attacks and psychosis.
Read more about mental health in pregnancy

Symptoms of postnatal depression

Many women feel a bit down, tearful or anxious in the first week after giving birth.

This is often called the " baby blues" and is so common that it's considered normal.

The "baby blues" do not last for more than 2 weeks after giving birth.

If your symptoms last longer or start later, you could have postnatal depression.

Postnatal depression can start any time in the first year after giving birth.

Signs that you or someone you know might be depressed include:

a persistent feeling of sadness and low mood

lack of enjoyment and loss of interest in the wider world

lack of energy and feeling tired all the time

trouble sleeping at night and feeling sleepy during the day

finding it difficult to look after yourself and your baby

withdrawing from contact with other people

problems concentrating and making decisions

frightening thoughts - for example, about hurting your baby

Many women do not realise they have postnatal depression because it can develop gradually.

Speak to a GP, midwife or health visitor as soon as possible if:

you think you may be depressed

Many midwives and health visitors have been trained to recognise postnatal depression and have techniques that can help.

Remember that:

a range of help and support is available, including talking therapy

depression is an illness like any other

it's not your fault you're depressed - it can happen to anyone

being depressed does not mean you're a bad parent

it does not mean you're going mad

your baby will not be taken away from you - babies are only taken into care in very exceptional circumstances

Treatments for postnatal depression

Postnatal depression can be lonely, distressing and frightening, but support and effective treatments are available.

These include:

self-help - things you can try yourself include talking to your family and friends about your feelings and what they can do to help, making time for yourself to do things you enjoy, resting whenever you get the chance, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet

talking therapy - a GP may be able to recommend a self-help course or may refer you for a course of therapy, such as cognitive behavioural therapy (CBT)

antidepressants - these may be recommended if your depression is more severe or other treatments have not helped; your doctor can prescribe a medicine that's safe to take while breastfeeding

Local and national organisations, such as the Association for Post Natal Illness (APNI) and Pre and Postnatal Depression Advice and Support (PANDAS), can also be useful sources of help and advice.

Causes of postnatal depression

The cause of postnatal depression is not completely clear.

There are a number of things that may make you more likely to have postnatal depression. These include:

a history of mental health problems, particularly depression, earlier in life

a history of mental health problems during pregnancy

having no close family or friends to support you

a difficult relationship with your partner

recent stressful life events, such as a bereavement

physical or psychological trauma, such as domestic violence

Even if you do not have any of these, having a baby is a life-changing event that can sometimes trigger depression.

It often takes time to adapt to becoming a new parent. Looking after a baby can be stressful and exhausting.

Preventing postnatal depression

There are things you can do during pregnancy to help you keep well, such as maintaining a healthy lifestyle and having someone you can talk to and turn to for support.

Going to antenatal classes and making friends with other pregnant women or new parents can also be helpful.

If you are pregnant or thinking about getting pregnant, talk to a GP or your mental health team if:

you have a history of depression or mental health problems

someone in your family has had mental health problems after childbirth (for example, your mother or sister)

This is so they can offer you appropriate treatment.

You can also talk to a midwife, who can support you or refer you to specialist mental health services if needed. If you have had a mental health problem while pregnant, your doctor should arrange for you to be seen regularly in the first few weeks after birth.

The mental health team, maternity team and GP will work closely with you during your pregnancy and after you have given birth.

Myths about postnatal depression

Postnatal depression is often misunderstood and there are many myths surrounding it.

These include:

postnatal depression is less severe than other types of depression - in fact, it's as serious as other types of depression

postnatal depression is entirely caused by hormonal changes - it's actually caused by many different factors

postnatal depression will soon pass - unlike the "baby blues", postnatal depression can persist for months if left untreated and in a minority of cases it can become a long-term problem

postnatal depression only affects women - research has actually found that up to 1 in 10 new fathers become depressed after having a baby

These factors are equally true of antenatal depression.

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Postnatal depression is a type of depression that many parents experience after having a baby. It's a common problem. Depression in pregnancy (antenatal depression) is also common.

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Asking for help

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How to keep your baby safe in a sling

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Some tips for preparing your older child/children

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Your quick guide

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Normal newborn appearance

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Keeping healthy through pregnancy and birth

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Whether you’re currently pregnant or have recently given birth, look after your body with this prenatal and postnatal exercise home workout video from the NHS Fitness Studio.

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Connect with The Positive Birth Movement

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We are a global network of individuals and free to attend antenatal groups, linked up by social media. We connect pregnant women together to share stories, expertise and positivity about childbirth. Join us as we meet up, link up and shake up birth!

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Do you need specific support ?

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Why does my baby cry so much ?

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What is the Period of PURPLE Crying program?

The Period of PURPLE Crying program is an evidence-based shaken baby syndrome/abusive head trauma (SBS/AHT) prevention program available since 2007. The program has two aims:

1. To support parents and caregivers in their understanding of early increased infant crying
2. To reduce the incidence of SBS/AHT

The program approaches SBS/AHT and infant abuse prevention by helping parents and caregivers understand the frustrating features of crying in normal, healthy infants that can lead to shaking or abuse. The program provides the opportunity for parents to learn about the crying characteristics from over 50 years of research on normal infant crying conducted by Dr. Ronald G. Barr, and other scientists worldwide.

Research

Over the last several years, the body of scientific research with the Period of PURPLE Crying has grown significantly. The NCSBS and our partners are committed to continuing to improve and strengthen the PURPLE program through on-going evaluation. Continued research with the program is what drives many of the changes and enhancements that are made to the program content and to the model. Our overall aim is build a program that is highly effective in improving parents and caregivers understanding of normal infant crying and ultimately reduce the incidence of SBS/AHT.

The following is a list of published research with the Period of PURPLE Crying. This list continues to grow, so check back often for new published research.

Randomized Control Trials

Barr, R. G., Rivara, F. P., Barr, M., Cummings, P., Taylor, J., Lengua, L. J., & Meredith-Benitz, E. (2009). Effectiveness of Educational Materials Designed to Change Knowledge and Behaviors Regarding Crying and Shaken-Baby Syndrome in Mothers of Newborns: A Randomized, Controlled Trial. Pediatrics, 123(3), 972-980.

Barr, R. G., Barr, M., Fujiwara, T., Conway, J., Catherine, N., & Brant, R. (2009). Do educational materials change knowledge and behaviour about crying and shaken baby syndrome? A randomized controlled trial. Canadian Medical Association Journal, 180(7), 727-733.

Fujiwara, T., Yamada, F., Okuyama, M., Kamimaki, I., Shikoro, N., & Barr, R. G. (2012). Effectiveness of educational materials designed to change knowledge and behavior about crying and shaken baby syndrome: A replication of a randomized controlled trial in Japan. Child Abuse & Neglect, 36(9), 613-620.

Other Research with the Period of PURPLE Crying

Barr, R. G., Barr, M., Rajabali, F. et al. (2019). Eight-year outcome of implementation of abusive head trauma prevention. Child Abuse & Neglect, 84.

Nocera, M., Shanahan, M., Murphy, R. A., Sullivan, K. M., Barr, M., Price, J., & Zolotor, A. (2015). A statewide nurse training program for a hospital based infant abusive head trauma prevention program. Nurse Education in Practice, 16(1).

Zolotor, A. J., Runyan, D. K., Shanahan, M., Durrance, C. P., Nocera, M., Sullivan, K., . . . Barr, R. G. (2015). Effectiveness of a Statewide Abusive Head Trauma Prevention Program in North Carolina. JAMA Pediatrics, 169(12), 1126.

Barr, R. G., Rajabali, F., Aragon, M., Colbourne, M., & Brant, R. (2015). Education About Crying in Normal Infants Is Associated with a Reduction in Pediatric Emergency Room Visits for Crying Complaints. Journal of Developmental & Behavioral Pediatrics, 36(4), 252-257.

Beaulieu, E., Rajabali, F., Zheng, A., Pike, I. (2019) The lifetime costs of pediatric abusive head trauma and a cost-effectiveness analysis of the Period of Purple crying program in British Columbia, Canada Child Abuse & Neglect, 97.

Stewart, T. C., Gilliland, J., Parry, N. G., & Fraser, D. D. (2015). An evidence-based method for targeting an abusive head trauma prevention media campaign and its evaluation. Journal of Trauma and Acute Care Surgery, 79(5), 748-755.

Barr, R. G., Fairbrother, N., Pauwels, J., Green, J., Chen, M., & Brant, R. (2014). Maternal frustration, emotional and behavioural responses to prolonged infant crying. Infant Behavior and Development, 37(4), 652-664.

Barr, R. G. (2012). Preventing abusive head trauma resulting from a failure of normal interaction between infants and their caregivers. Proceedings of the National Academy of Sciences, 109 (Supplement_2), 17294-17301.

Stewart, T. C., Polgar, D., Gilliland, J., Tanner, D. A., Girotti, M. J., Parry, N., & Fraser, D. D. (2011). Shaken Baby Syndrome and a Triple-Dose Strategy for Its Prevention. The Journal of Trauma: Injury, Infection, and Critical Care, 71(6), 1801-1807.

Shanahan, M. E., Nocera, M., Zolotor, A. J., Sellers, C. J., & Runyan, D. K. (2011). Education on Abusive Head Trauma in North Carolina Hospitals. Child Abuse Rev. Child Abuse Review, 20(4), 290-297.

Stewart, T. C., Polgar, D., Gilliland, J., Tanner, D. A., Girotti, M. J., Parry, N., & Fraser, D. D. (2011). Shaken Baby Syndrome and a Triple-Dose Strategy for Its Prevention. The Journal of Trauma: Injury, Infection, and Critical Care, 71(6), 1801-1807.

Zolotor, A. (2010). Preventing Child Maltreatment in North Carolina. North Carolina Medical Journal, 71(6), 553-555.

Runyan, D. K., Hennink-Kaminski, H. J., Zolotor, A. J., Barr, R. G., Murphy, R. A., Barr, M., . . . Nocera, M. (2009). Designing and Testing a Shaken Baby Syndrome Prevention Program - The Period of PURPLE Crying: Keeping Babies Safe in North Carolina. Social Marketing Quarterly, 15(4), 2-24.

Hennink-Kaminski, H. J., & Dougall, E. K. (2009). Tailoring Hospital Education Materials for The Period of PURPLE Crying: Keeping Babies Safe in North Carolina Media Campaign. Social Marketing Quarterly, 15(4), 49-64.

Hennink-Kaminski, H. J., & Dougall, E. K. (2009). Myths, Mysteries, and Monsters: When Shaken Babies Make the News. Social Marketing Quarterly, 15(4), 25-48.

Parent Focus Groups

Focus Groups on Period of PURPLE Crying© Program PURPLE Video and Booklet Material:
In 2004, Dan Jones and Associates of Salt Lake City, Utah, USA were hired to conduct the United States Parent Focus Groups on the PURPLE materials. The primary purpose was to obtain in-depth understanding about attitudes regarding infant crying, what people know about SBS, and how new parents cope with incessant crying by their infants.

A total of six focus group sessions were conducted on September 28 - 29, 2004. Prospective participants were screened to ensure that they had infants six months old or younger. A total of 63 people participated in the research: 42 new moms and 21 new dads. Males and females were separated by groups and represented a broad range of socio-economical and geographical areas within the Salt Lake City, Utah metropolitan area.

Canadian Parent Focus Groups: Prevent SBS British Columbia also coordinated the evaluation of the PURPLE educational materials from the National Center on Shaken Baby syndrome for their suitability to the Canadian culture in 2004. Samsara Communications was hired to facilitate the focus group presentations, to train project personnel to appropriately handle the comments from participants, and to elicit feedback from participants. MTM Research was hired to analyze the results and report the key findings.

In order to meet the objectives, 8 focus group sessions were conducted between June 1st and November 16th, 2004 throughout the Vancouver, Vancouver Island and Fraser Valley Health regions. These areas included Chilliwack, Duncan, Port Moody, Richmond, Surrey, and Vancouver. A total of 66 parents (59 mothers, 6 fathers, and 1 elder) representing various backgrounds of race, economic status and family makeup participated. Participants were biological or adoptive parents of infants <6 months old (excluding the elder) and were proficient in spoken and written English.

Focus Groups on the Period of PURPLE Crying Program's Crying, Soothing and Coping: Doing What Comes Naturally Video:
In 2011, three focus groups were conducted to gather feedback on the feelings and perceptions of the narrations and content for the newly developed supplemental film on soothing and coping strategies called Crying, Soothing and Coping: Doing What Comes Naturally. The focus groups were held in Chicago, Salt Lake City and Atlanta. The focus groups in Chicago and Atlanta were conducted by Beall Research and Training. In Chicago, the focus group consisted of 12 fathers with children under two years of age. The age of participants ranged from 23 to 47. In Atlanta, the focus group consisted of 12 mothers with children under two years of age. The age of participants ranged from 18 to 39. Dan Jones and Associates conducted the Salt Lake City focus group that consisted of 9 mothers with children under the age of two. All focus groups were made up of individuals with diverse social, socio-economic, nationality and educational backgrounds.

The feedback from these three focus groups allowed the NCSBS to refine the content and narration to ensure the film was acceptable and helpful to a wide range of parents and caregivers. A full report on the focus groups conducted for the Crying, Soothing and Coping film is available from the NCSBS upon request.

Focus Groups on Period of PURPLE Crying Program Translations:
Translation Focus Group Testing: Prevent SBS British Columbia and the NCSBS staff have coordinated focus groups in the process of translating the PURPLE materials into several languages. The goal of the translation project for the Period of PURPLE Crying is to receive a culturally sensitive, accurately translated product that keeps the clarity and cohesiveness of the message.

There were additional measures added to ensure our specific translation project received the highest quality product. First, an initial focus group made up of five qualified and working healthcare interpreters analyzed the materials in order to provide suggestions to the translator in difficult areas. Secondly, once the unilingual parent focus group had viewed the product in the subject language and adjustments were made, an English back translation was requested from a separate translator with no previous knowledge of the product.

Translation focus groups will continue to occur with each new language chosen. As of June 23, 2016, the program has been translated into the following languages: Cantonese, Punjabi, Spanish (Mexican-dialect), Korean, Vietnamese, Japanese, French, Portuguese (Brazilian Dialect), Somali and Arabic. Through the process it has become very apparent that the program messages are relevant to all parents, of all kinds of families in all the cultures included in this process. It was a very rewarding process to know the program was valued by so many.

Contact

National Center on Shaken Baby Syndrome
1433 N 1075 W, Suite 110
Farmington, Utah 84025

office: (801) 447-9360
fax: (801) 447-9364

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National Center on Shaken Baby Syndrome - PURPLE Crying

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The Period of PURPLE Crying program is an evidence-based shaken baby syndrome/abusive head trauma (SBS/AHT) prevention program available since 2007. The program has two aims: 1. To support parents and caregivers in their understanding of early increased infant crying2.

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Encouraging good habits

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When you have a poor sleeper, it can often seem as if every other child in the world is sleeping better than yours. In truth, babies and toddlers who go to sleep easily and sleep through the night are in a very small minority. Sleep is unpredictable in the early years, rather than following a constant, positive upwards trajectory, it frequently dips and gets worse (see HERE for more). The sad reality, is that 'good sleep' (aka sleeping through the night reliably) often doesn't appear until the third year of life. No wonder then so many exhausted parents, trying to juggle the reality of infant sleep while living in the modern industrialised world (the two are at great odds with each other), turn to sleep training to try to fix their children.

The difficulty here is in this desire to fix something that isn't actually broken. Sleep training tends to punish babies and toddlers for problems that don't belong to them. They are left to cry, put down while they still need a hug, denied milk when they are hungry and ignored when they most need comfort. I don't actually believe any parent wants this for their children, yet their exhaustion leaves them with no other choice. Or so they think. There are in fact, many ways to gently improve infant sleep that don't involve any sleep training at all. Here are eight of them:

A quick google image search for " baby nightlight" returns many beautifully designed, attractive lamps and light shows. Ninety nine percent of these inhibit sleep. Many parents don't realise that lighting is a key influence on sleep. Light that is on the blue colour spectrum inhibits the hormone of sleep, melatonin, and tricks the body into thinking it is daytime and thus time to be awake. It isn't just obviously blue light that is an issue though. Most white light is actually very blue, especially energy-saving lightbulbs and halogen spotlights. So too is light that looks green, blue, purple and pink. Which coincidentally tend to be the colours used in most child night lights. Research has shown that for light to be non-inhibiting it needs to contain very low levels of blue light. Naturally, our ancestors would have lit their nights with fire and candles, both sitting on the red colour spectrum. We can replicate this effect by using red light at night. If you're not keen on red light (many toddlers associate red with monsters, or danger, and it is quite hard to read a bedtime story in red light) then consider investing in a Lumie Bedbug, a world first nightlight that features very low levels of blue light, while still producing a white/peach coloured glow. The Bedbug also features a special sunset mode, dimming gently over a period of 15 minutes, which is perfect for toddlers and older children. The cuteness of the little bug is a further winning feature, along with its sleep promoting properties.
2. Bedroom Temperature
Our modern homes tend to be well insulated, retaining heat and saving us money on our fuel bills. Central heating quickly and efficiently heats our homes too. This can and does cause a problem with sleep. The optimal room temperature range for the best sleep is 15-18C, or 60-65F. Unlike most infant room thermometers indicate, 18C/65F isn't the best temperature for sleep - it's at the very top end of the optimal range! Trying to cool the bedroom to somewhere in this optimal range can really help sleep. If you have air-conditioning and are in a hot country, you're not going to get this low obviously, but turning the AC down a degree or two is worth thinking about. This doesn't mean the child should be cold at night. The aim is "warm body, cool room". More on this later!
3. Humidity
Temperature aside, air conditioning and central heating can cause trouble with sleep in another way. Playing havoc with room humidity. Anything that dries the sleeping environment can mean that the child wakes more for milk. Where an adult may take a glass of water to bed to place next to their bed, babies and toddlers tend to wake and cry for milk if they have a dry mouth. This doesn't mean that fixing the humidity will stop the child from needing to feed at night, far from it, but it will remove those extra humidity related feeds. This tends to be more of an issue for children who are mouth breathers, sleeping with their mouths open. The best humidity for sleep is around 30-50%. If you use air-conditioning or central heating, you may consider adding a humidifier to the room.
4. Bedding
Remember in point three, we discussed "cool room, warm body"? This is where what you dress your child comes in. Sometimes adding an extra layer of clothing, such as a long sleeve vest, or upping the tog rating of a sleepsac can really help sleep. Generally speaking, in the optimal room temperature zone, you're looking at 2-3 togs. While sleepsacs can help to keep kids cozy, by avoiding loose blankets and duvets that fall off the bed (I don't recommend either under 4years), they can also inhibit sleep when the child rolls over and gets caught up in the huge amount of extra fabric around their legs. Some children also really hate having their feet covered by anything, unsurprisingly since we tend to sleep better with the ability to have our feet exposed. For this reason, I always recommend sleepsacs that have separate legs and uncovered feet, like these, or these (tip: leave the booties off!).
5. Music
If you sing your baby to sleep, or use a mobile, or stuffed animal that plays music for fifteen or twenty minutes at bedtime, you could be causing your child to wake more. Why? Babies and toddlers have very short sleep cycles, lasting for 40-60 minutes depending on age. At the end of this sleep cycle, one of three things may happen. 1. They move straight into a new sleep cycle, 2. They wake fully and need your help to start a new cycle, or 3. They rouse slightly, but not fully, and if all is well they start a new cycle independently. Number three is where it is important to consider any constants in the room. If a child goes to sleep with music, that music needs to be present ALL NIGHT. At the end of a sleep cycle, that slightly rousing child needs to hear the same sounds as when they went to sleep, if they don't, then the sharp change in environment may cause them to wake fully and need your help. Some companies try to get around this by designing noise and motion activated music players. These rarely work and I don't recommend them. Because they 'catch' the child too late, when they are already roused and moving/crying. They have already woken properly by the time the music cuts in again. If you sing your child to sleep, consider recording yourself and playing your recording on loop all night, or consider playing a special alpha music for children recording all night. Alpha music for children is recorded to a resting pulse rate of 60 beats per minutes and includes elements of white noise, heartbeats and simple repetitive music, which aid sleep far more effectively than standard 'sleepy' music. This is mine (it's on iTunes too). Pop the music on during the bedtime routine and turn it off the next morning. If you have an older child (2yrs plus), who sleeps through, but the issue is more getting them to sleep independently at the start of the night, then consider a children's meditation recording instead. This is mine (also on iTunes)
6. Scent
This follows on from point five. The smell in the world that relaxes your child the most is the smell of you. If you could bottle your smell and spray it around your child's bedroom it would surely comfort them. Many people pop muslins in their tops to absorb their scent and then leave the muslin with the child, or one of their t-shirts or pyjama tops. This can work well for some, but some - most - need more. To get more, you need to condition a smell. ie. you need to take a scent and make it yours. The easiest and most effective way to do this is to select an aromatherapy oil that you like (and is safe to use around babies and children). Lavender and chamomile are particularly good for sleep, blended together. Pop some of this oil on as scent/perfume each day for a month or so and then diffuse it in an aromatherapy diffuser in the room your child sleeps in for an hour or two before bedtime. You can get some diffusers that double up as humidifiers and red night lights too, like this one. Note, this is only recommended once your baby is at least 12 weeks of age, before this it's best to keep any scent that isn't you away.
7. A Consistent Bedtime Routine
Scientists unanimously agree. If there is one thing that has the biggest impact on child sleep, it is a consistent bedtime routine. While a similar bedtime each night is important for setting the child's circadian rhythm (body clock), what is more important is doing the same thing in the same order each and every night. For instance a bath, followed by a massage, followed by a story, followed by a breastfeed or bottle. Try to keep the bedtime routine calm and play free (it is preparing for sleep after all!), but before you start the bedtime routine, try to fit in at least 30 minutes of playtime, especially if you work or have more than one child. Taking time to reconnect before bedtime starts has a great positive impact on sleep. Bedtime itself is important, particularly for toddlers and older children. In western culture we seem to have an obsession with a 7pm bedtime, however research suggests that we're probably putting our children to bed too soon. A more biologically appropriate bedtime is around the 7:45-8:15pm zone (the time to aim for the child to be asleep, not to start the bedtime routine). Putting a child to bed before their body is chemically ready to sleep can result in bedtime resistance, more night waking and earlier mornings.
8. Bedtime Snacks
For older babies (well established on solids - ie eating 3 meals a day for a couple of months or more) and toddlers, introducing a bedtime snack can help sleep. Aim for the snack just before the bedtime routine starts, around an hour before the child goes to sleep. Bedtime snacks can not only fill up tummies that may be hungry, but they can also help from a chemical point of view. Incorporating a snack that contains tryptophan, an amino acid that influences the production of sleep hormones, is a great choice. Child friendly sources of tryptophan include cheese, eggs, nuts, seeds and wholemeal/wholewheat bread. My favourite bedtime snack is almond butter on wholewheat toast, with a few banana slices on top.

Following these eight tips may not magically encourage your child to sleep through the night, but hopefully they should have a positive impact, without the need to sleep train.

If you're interested in more gentle solutions to child sleep issues, check out my Gentle Sleep Book (for 0-5yrs) and Why Your Baby's Sleep Matters (specifically for 0-12mth breastfed babies). You can also learn more on my Sleep Facebook Page, where I run monthly Q&A sessions.

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8 Ways to Encourage Better Baby & Toddler Sleep - Without Sleep Training

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Sleep training tends to punish babies and toddlers for problems that don't belong to them. They are left to cry, put down while they still need a hug, denied milk when they are hungry and ignored when they most need comfort. I don't actually believe any parent wants this for their children, yet their exhaustion...

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Using a peanut ball to help positioning

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What should my baby wear for sleep ?

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Making sure your baby isn't too hot or too cold at night can be tricky. Knowing what layers to dress your baby in, depending on the temperature of her room, will help. Our infographic has everything you need to make sure your baby is comfortable. Only use a sleeping bag higher than 2.5 tog if it's very cold and check you buy a sleeping bag that's safe for your baby.

References

AAP. 2012. A parent's guide to safe sleep. American Academy of Paediatricians. www.healthychildcare.org [PDF accessed March 2017]

AAP. 2016a. SIDS and other sleep-related infant deaths: updated 2016 recommendations for a safe infant sleeping environment. American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome, Policy statement. Pediatrics 138(5). pediatrics.aappublications.org [Accessed April 2017]

AAP. 2016b. Tips for dressing your baby. www.healthychildren.org [Accessed April 2017]

Gillen and Bull. 2017. Safety warning over big bow hairbands as it's claimed 14-week-old baby girl suffocated wearing one. www.mirror.co.uk [Accessed April 2017]

ISIS. nd. Baby sleep bags. Infant Sleep Information Source. www.isisonline.org.uk [Accessed April 2017]

Lullaby Trust. nd. Temperature. Safer sleep for babies, Fact sheet 6. www.lullabytrust.org.uk [PDF accessed March 2017]

Lullaby Trust. 2014. Safer sleep for babies. www.lullabytrust.org.uk [PDF accessed March 2017]

Lullaby Trust. 2015. Parents should remove cot bumpers. www.lullabytrust.org.uk [Accessed March 2017]

Kendon M, McCarthy M, Jevrejeva S, et al. 2016. State of the UK Climate 2015. Met Office. www.metoffice.gov.uk [PDF accessed April 2017]

Moon RY. 2016. SIDS and other sleep-related infant deaths: evidence base for 2016 updated recommendations for a safe infant sleeping environment. American Academy of Pediatrics, Task Force on Sudden Infant Death Syndrome, Technical report. Pediatrics 138(5). pediatrics.aappublications.org [Accessed April 2017]

NHS. 2015a. How can I keep my baby safe during hot weather? NHS Choices, Common Health Questions. www.nhs.uk [Accessed April 2017]

NHS. 2015b. Reduce the risk of sudden infant death syndrome (SIDS). NHS Choices, Health A-Z. www.nhs.uk [Accessed March 2017]

NHS. 2015c. Is my baby too hot? Frimley Health NHS Foundation Trust. www.fhft.nhs.uk [PDF accessed August 2017]

Nottingham Post. 2017. Warning after report of baby's death from 'big bow headband'. www.nottinghampost.com [Accessed April 2017]

Unicef. 2011. Caring for your baby at night. www.unicef.org.uk [Accessed March 2017]

Joanne Lewsley is a freelance copywriter and editor, and specialises in creating evidence-based parenting, health and lifestyle web content.

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What should my baby wear at night? (Infographic)

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Making sure your baby isn't too hot or too cold at night can be tricky. Knowing what layers to dress your baby in, depending on the temperature of her room, will help. Our infographic has everything you need to make sure your baby is comfortable.

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Useful info and massage videos

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For your information, please do not share (apart from with your partner) or redistribute

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The attached word document can be downloaded, so that you can access all the links to other websites and information we give out on the "chat" during the main 5 session antenatal course.  These are purely for your information and the NHS is not responsible for any non-NHS information contained in these links.

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Do I need to consult a doctor ?

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Fever in young children usually means that they have an underlying infection. This understandably worries parents and carers.

Most fevers in young children over 6 months of age are not serious.

Fever in children aged 3-6 months has a higher chance of being serious. You should seek medical advice if the temperature is 39°C or more.

Fever in a baby aged less than 3 months is unusual and worrying. You should seek medical advice if the temperature is 38°C or more.

When young children have a fever, if can be difficult for parents to work out why. In most cases, the fever is due to a non-serious viral infection. Many viral infections that affect young children cause a fever of up to 48 hours in duration before other symptoms develop. A small number of common viruses cause fevers that last longer than this.

The most common causes of fever in children in the UK are viral infections. There are many other uncommon causes.

Our normal body temperature is around 37°C. Our temperature can go up and down a little, around this figure, during the day. Children's temperatures can easily rise slightly with things like hot baths, exercise and wearing overly warm clothes. Teething often increases a toddler's temperature by 0.5°C.

Fever is a part of the body's natural defences against infection. Fever is created by your immune system under the direction of a part of the brain called the hypothalamus. The hypothalamus acts like a central heating thermostat. Fever happens when the hypothalamus sets the body temperature above its normal level.

It does this in response to an infection with germs, usually because it detects the presence of infectious agents like bacteria or viruses. It is believed that the increased temperature is a protection the body has developed to help fight the germs that cause infections, as they tend to multiply best at normal body temperature.

How does the body create a fever?

The mechanism through which the body increases its temperature is by reducing heat loss. We sweat less and feel dry to the touch, we shiver (the movement tends to increase temperature) and, because we feel as though we are cold, we curl up and seek different ways of warming up. The blood vessels in our skin shrink to preserve heat loss, so we look pale.

All of this is why, as the temperature is rising to meet the directions of the thermostat, we are hot to the touch but we feel that we are cold. During this stage of a fever your child will not be pleased when you try to cool them down, as they will already feel as though they are cold.

Eventually, the body's temperature reaches the new 'thermostat' setting, and the feeling of being cold goes away. Eventually it reverses, the thermostat setting drops down again towards normal, and the body tries to lose the extra heat it has on board. It does this by sweating and by opening up the blood vessels in the skin so that we are flushed and sweaty.

Children tend to get higher fevers than adults - although this is only true after the age of 6 months. Before that age the immune system of a baby is quite immature. After the age of 6 months the actual temperature, in a fever, is not a good guide to whether or not your child is seriously unwell.

The most common causes of fever in children in the UK are viral infections. There are many other uncommon causes. Some of these will show other obvious signs:

Infections with germs called viruses are the most common cause. Viral infections cause many common illnesses such as colds, coughs, flu, diarrhoea, etc. Sometimes viral infections cause more serious illnesses.

Infections with germs called bacteria are less common than viral infections but also cause fevers. Bacteria are more likely to cause serious illness such as pneumonia, joint infections (septic arthritis), urine infections, kidney infections, septicaemia and meningitis. However, bacteria can also cause fever in less serious infections such as ear infections and infected skin rashes.

Inflammatory conditions and reactions may cause fever, including Kawasaki disease, some types of arthritis, and reactions to some medicines.

Immunisations: sometimes children develop a fever after an immunisation. This is because immunisations are generally designed to 'trick' the body's immune system into thinking it sees an infection, so that it develops immunity. Fevers following immunisation are not usually high or prolonged.

Other types of infection: these include 'tropical' infections such as malaria and dengue, and conditions which are more common outside the UK, such as tuberculosis.

Heat stroke is a possible cause of raised body temperature, although technically this isn't a fever, as the body is being heated from the outside (whereas in fever the body does the heating itself).

Fever and feverish illness are very common in young children, particularly in those aged less than 5 years, and it can be really worrying for parents. It's not always easy to judge how sick your child is, or whether you should ask for medical help.

Three to four out of every 10 parents of children aged less than 5 years say their child has had a fever in the past year. It is probably the most common reason for a child to be taken to the doctor. Fever is also the second most common reason for a child being admitted to hospital and it can be a cause of great anxiety in parents. This leaflet offers guidance with:

Understanding how best to manage a fever.

Knowing when to seek professional help or advice.

Knowing what signs suggest that your child may be seriously unwell, including how to check for signs of lack of fluid in the body (dehydration) and other signs of serious illness.

Whether or not you decide to seek help or advice, you should always give a child with a temperature lots to drink. It is not always necessary to give them paracetamol or ibuprofen.

Forehead strip thermometers are not very accurate. Ideally you should use one of the following to measure your child's temperature:

Under 4 weeks old, with an electronic thermometer in the armpit.

Between 4 weeks and 5 years old:

With an electronic thermometer in the armpit.

With a chemical dot thermometer in the armpit.

With a digital thermometer designed to be placed in the ear.

The actual level of the temperature in fever is not a good guide to how severely ill a child is once they are older than 6 months.

The central symptom of a fever is a raised body temperature, measuring above 37.5°C. The recommendation is that this measurement should be taken under the arm in children less than 5 years old. This gives a reasonable guide to the body's 'core' temperature.

Fever associated with common, self-limiting viral infections such as a cold typically rises and falls over a total of 12-48 hours. Children often complain of feeling cold at the start of a fever. They may look pale and feel shivery, yet will feel hot and dry to the touch. Later they often say they feel hot, and will be sweaty and flushed.

Headache and tummy ache are very common at the same time as fever. Children may be listless, tired and miserable and they may have watery eyes. They may have swollen glands in the neck, under the arms and in the tummy. Drooling may suggest that they have a sore throat, and they feel sick and may be off their food.

Some children have a tendency to febrile convulsions. This is a type of seizure triggered by a rapid rise in body temperature. Some children have only one febrile convulsion, ever, but others go on to have them more often. See the separate leaflet called Febrile Seizure (Febrile Convulsion).

Febrile convulsions, and seizures due to infections such as meningitis, can look very similar. If a child has a seizure for the first time, it is important to rule out serious conditions such as meningitis before deciding it is a febrile convulsion.

All the symptoms associated with harmless viral fevers can also occur in more serious illness. It can be difficult to determine whether or not your child's fever symptoms should worry you. You know your child better than anyone else. If your child has a fever with symptoms that are unlike those they have had with fevers in the past, consider the possibility of more serious illness.

There are some features of a fever which will help you assess whether you need to seek medical advice:

Features of a fever that help reassure you that your child is not seriously unwell

These include that your child:

Has normal-coloured skin, lips or tongue.

Responds to you normally.

Is basically content and will smile.

Stays awake or awakens quickly and easily when you wake them.

Has a strong normal cry, or is not crying.

Has moist lips and tongue.

Features of a fever that suggest your child may be more unwell

Your child is aged 3-6 months and has a temperature of over 39°C.

Pale skin, lips or tongue.

Not responding normally to you.

Not smiling.

Wakes only with prolonged effort by you.

Not wanting to do anything; inactive.

Dry mouth and lips.

Poor feeding in babies.

Reduced wet nappies in babies.

Attacks of shivering.

Has had a fever for five days or more.

Has swelling of a limb or joint.

Isn't using an arm or leg or isn't able to put any weight on one leg.

Features of a fever that suggest your child is seriously unwell

Your child is less than 3 months of age and has a temperature of over 38°C.

Pale/mottled/ashen/blue skin, lips or tongue.

No response to you.

Does not wake, or if you wake them, does not stay awake.

Weak, high-pitched or continuous cry.

Grunting noises when breathing.

Indrawing of the muscles between the ribs when breathing (this is particularly true in babies).

Reduced skin turgor (when you very gently pinch the skin on the back of the hand between your fingers, it does not bounce back but keeps the pinched shape).

Bulging fontanelle (the 'soft spot' on the top of the head of babies up to about 18 months of age).

Sunken fontanelle - suggests lack of fluid in the body (dehydration).

A rash that doesn't fade when you press a glass against it.

Neck stiffness.

Seizures.

A bulging fontanelle (the soft spot on the top of a baby's head).

Features that suggest your child is dehydrated

Some children who become irritable with a fever do not drink as much as they need, often because they feel sick (nauseated) and things taste strange. In particular, dehydration can develop quickly in a child who is being sick (vomiting) or has diarrhoea. Once dehydration sets in, nausea and vomiting can get worse, which can be a vicious cycle that is hard to break.

Signs of dehydration
These include:

Dry mouth or tongue.

No tears when crying.

Sunken appearance to eyes.

Drowsiness.

Cool hands and feet.

Generally becoming more unwell.

Reduced skin elasticity, or turgor (when you very gently pinch the skin on the back of the hand between your fingers, it does not bounce back but keeps the pinched shape).

Babies stop passing urine (although this can be difficult to detect if they also have diarrhoea), and the soft spot (on the top of the head) may become sunken in. Small babies can become dehydrated very quickly.

Seek medical advice if you suspect that your child is becoming dehydrated.

Two of the most serious infections are meningitis and blood infection ( septicaemia). These are uncommon; the vast majority of children with a fever do not have these infections.

The symptoms often develop quickly, over a few hours or so, or more slowly, over a few days. The symptoms may suggest a less serious illness at first, such as flu. But, even if you think it was flu to start with, if symptoms become worse and your child seems really sick you should seek urgent medical advice.

Meningitis and septicaemia are always medical emergencies, so it is essential to know what signs to look out for. See the separate leaflets called Meningitis symptoms checklist and Child Sepsis Safety Net for more details.

The National Institute for Health and Care Excellence (NICE) has produced guidelines aimed to help healthcare professionals assess children with fever. These can also be useful to parents. They look at the symptoms seen in children with fever and allocate them to categories of 'green', 'amber' and 'red'. They are shown in the table below.

Green symptoms are reassuring. They mean that your child's symptoms suggest they are at low risk of serious illness.

Amber symptoms suggest that you need a doctor's advice. They suggest that your child might be at slightly increased risk of more serious illness.

Red symptoms suggest that you need urgent medical advice. They suggest that your child's symptoms could indicate a serious illness, needing emergency help.

Not all possible symptoms are included in the guidance - for instance, tummy (abdominal) pain is not mentioned and, unless it is mild, it usually does need assessing by a doctor.

Some of the guidance concerns the kind of symptoms which a trained healthcare professional is expected to assess but which you may feel uncomfortable trying to measure, such as number of breaths per minute (respiratory rate) and heart rate (which usually needs a stethoscope for accurate assessment in a small child). They are included here for completeness: if ANY red or amber signs are present you should seek help or advice; you do not need all of them to be present in order to do so.

Activity
Responds normally to you.
Content/smiles.
Stays awake or awakens quickly.
Strong normal cry/not crying.

Not responding normally to you.
No smile.
Wakes only with a lot of stimulation.
Decreased activity, listless.

No response to you.
Does not wake or if roused does not stay awake.
Weak, high-pitched or continuous cry.

Increased breathing rate (>40 breaths per minute aged over 12 months, >50 breaths per minute aged 6-12 months).

Grunting.
Respiratory rate >60 breaths per minute.
Chest indrawing between ribs when breathing in.

Flaring of the nostrils when they breathe.

Circulation
Moist tongue and lips, normal eyes.

Dry tongue and lips.
Poor feeding (babies).
Not producing wet nappies/needing to pass urine.
Fast heart rate ('normal' varies with age, and rate is difficult to judge without a stethoscope: your doctor will check this).

Reduced skin elasticity.

Other
No red or amber signs.

Age 3-6 months, temperature ≥39°C.

Fever for ≥5 days.
Rigors (repeated episodes of alternating shivering bouts then sweating, as temperature repeatedly goes up and down).
Swelling of a limb or joint.
Non-weight-bearing limb/not using an extremity.

Age <3 months, temperature ≥38°C.

Non-blanching rash.
Bulging fontanelle.
Neck stiffness.
Unusual seizures or fits.

If your child has no 'amber' or 'red' warning signs, and they have other symptoms such as runny nose or sneezing suggesting a simple viral infection, their temperature will usually come down fairly quickly. In these cases, you can usually assume they have a simple cold.

If you telephone your GP or out of hours service, the healthcare professional will try to work out why your child has a fever. This will usually include asking about your child's health and symptoms.

Your child may need to be examined (a 'face-to-face' consultation). In this case it is most likely that your child's temperature, pulse and breathing will be checked. Your child will be checked for lack of fluid in the body (dehydration) and their blood pressure may be taken. A urine sample may be tested. Rarely, an ambulance may be called. This does not necessarily mean your child is very ill, only that they need to be assessed quickly in hospital.

It may be decided that you can carry on looking after your child at home; you may be given a number to contact if you need more advice or you may be asked to take the child for a check-up the next day.

Often, the healthcare professional who assesses your child will decide that no further tests are necessary. This is usually because there are no worrying signs in your child's condition and your doctor or nurse feels able to diagnose the infection, based on their training and experience.

Occasionally, however, they are uncertain.

This may be because your child has some of the 'amber' or 'red' warning signs.

It may be because a specific, worrying infection such as meningitis is in the community, and your doctor thinks that your child could be affected.

It may be because your doctor or nurse feels unsure about the diagnosis and thinks that a second opinion and further tests are needed.

If this is the case you may be asked to go to the paediatric ward or Accident and Emergency department. If your child is very unwell an ambulance will be called. However, if that is not the case, and you are able, you may be asked to make your way there by car.

On the ward your child is likely to have several tests done. These will vary, depending on how your child appears and on what the doctors find when they assess and examine your child. They may include:

You may be discharged home from the hospital after this or, if doctors are still not certain that your child is at very low risk of a more serious condition, your child may be kept for observation or treatment.

You do not need to use paracetamol and ibuprofen if your child is comfortable and not distressed by the fever, aches or pains.

A child with a fever may look flushed and irritable and they may not feel like doing very much.

Make your child comfortable - details below.

Check for signs of lack of fluid in the body (dehydration).

Check for signs of serious infection.

Keep your child off school or nursery until they are better.

In most bouts of fever that are not caused by serious illness, the temperature generally comes down quickly. It is not unusual to see a child play happily after an hour or so, when their temperature has come down and they have had a good drink. It is reassuring if a child improves with the drop in temperature.

At any age, a child with a serious infection usually gets worse despite efforts to bring their temperature down. In addition, they may have other worrying symptoms. For example, breathing problems, drowsiness, convulsions, pains, or headaches which become worse. But - use your instincts. If you think a child is getting worse, get medical help, even if they don't quite fit the 'rules' described here. Note: you should check on your child 2-3 times in the night if they have a fever, to make sure they are not developing a serious infection.

The important things are to try to keep your child calm, reassured and comfortable.

Give lots to drink. This helps to prevent a lack of fluid in the body (dehydration). You might find that a child is more willing to have a drink if they are not so irritable. So, if they are not keen to drink, it may help to give some paracetamol first. Then, try the child with drinks half an hour or so later. Fever caused by any illness may contribute to dehydration. This happens through evaporation of moisture from the skin as the body tries to cool itself, and through sweating.

Cooling an over-warm room may be helpful.

Tepid sponging is not recommended for treatment of fever. This is because the blood vessels under the skin become narrower (constrict) if the water is too cold. This reduces heat loss and can trap heat in deeper parts of the body. The child may then get worse. Many children also find cold-sponging uncomfortable.

Cold fans are not recommended, for the same reasons, although cooling an over-warm room with adequate ventilation is sensible.

Children with fever should not be underdressed or over-wrapped.

Medicines like paracetamol and ibuprofen should not be used for fever unless your child appears distressed. If they are not distressed it is better to let the fever do its job and run its course:

Using paracetamol and ibuprofen does not prevent febrile convulsions and should not be used for this purpose alone.

You can use either paracetamol or ibuprofen in children with fever who appear distressed.

You should not use both at the same time.

Some studies have shown that ibuprofen may increase the risk of developing serious skin infections when used in chickenpox. Therefore, paracetamol is usually recommended in chickenpox and ibuprofen should not be used.

Ibuprofen should not be used if your child is dehydrated because studies have shown that this can increase the risk of kidney failure.

When using paracetamol or ibuprofen in children with fever

Continue for as long as the child appears distressed.

Consider changing to the other medicine if the child's distress is not relieved by the first.

Only consider alternating these two medicines if the distress persists or comes back before the next dose is due.

Do not give both at the same time.

You can buy paracetamol and ibuprofen in liquid form, or melt-in-the-mouth tablets, for children. The dose for each age is given with the medicine packet.

Remember: paracetamol and ibuprofen do not treat the cause of the fever - they merely help to ease discomfort. They also ease headaches and aches and pains. You do not need to use these medicines if your child is comfortable and not distressed by the fever, aches or pains.

Do not use ibuprofen for:

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Fever in Children (High Temperature) | Causes and Treatment

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Fever in young children usually means that they have an underlying infection. This understandably worries parents and carers. Most fevers in young children over 6 months of age are not serious. Fever in children aged 3-6 months has a higher chance of being serious. You should seek medical advice if the temperature is 39°C or more.

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Important information for women at BOTH sites

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Mental health issues during and after pregnancy - now in 18 languages !

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Perinatal Positivity uses the real voices and experiences of women and men who have had mental wellbeing difficulties around the time of pregnancy, childbirth and beyond. We hope it will help you emotionally prepare and find support, if needed, at this time. There are translations and subtitled versions of the film on our films page.

Perinatal mental health issues can happen in pregnancy and in the first years of being a parent (antenatal and postnatal). Problems can affect new mums as well as dads, people with no history of mental health problems as well as those who have. The word perinatal simply means the time around (peri) childbirth (natal).

Issues might include depression, anxiety, OCD, psychosis and post-traumatic stress amongst other things. Tommy's (pregnancy health information for parents) has an excellent guide: https://www.tommys.org

If you, or someone you are close to, is experiencing mental wellbeing problems connected to pregnancy and being a new parent , talk to your GP, health visitor or midwife a nd visit our support page to find local and national support organisations. Parents talk about the signs & symptoms they experienced in the video below.

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Perinatal Positivity Film - Perinatal Positivity

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Perinatal Positivity is a short, animated film to help new families safeguard their mental health. It uses the voices & experiences of real parents.

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Useful positions for labour

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One-off antenatal session to cover oral health in babies/toddlers:  book via Eventbrite here https://www.eventbrite.co.uk/e/oral-health-and-nutrition-tickets-126972737877

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Where can I go for help locally ?

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Maternity information translations

*** Now updated with Ukrainian and Russian translations ***

We know that women from minority ethnic groups, refugees, asylum seekers and those whose first language is not English are at greater risk of poorer maternity and neonatal outcomes. We are working hard across the region to reduce these health inequalities, making birth safer and more personalised.

In collaboration with Papillon Translations and Surrey Heartlands' Local Maternity and Neonatal System, these maternity information resources aim to support our Afghan and Ukrainian families through pregnancy, labour, birth and the early days with their new baby. Using current information on the NHS website, the leaflets and the app provide written and audio information in Dari and Pashto, Ukrainian and Russian as well as English.

These resources are designed to support discussions between women and their healthcare professionals, facilitated by a suitable interpreter, to help them make informed choices about their maternity care.
To read or listen to information on the topics below in different languages, download the Papillon Translations app from Google Play or Apple Store, and scan each of the QR codes in the documents below:

The resources can also be downloaded as PDF documents here:

You are welcome to share this campaign content widely throughout your networks, please ensure the South East Maternity Team is credited wherever possible. We welcome any feedback to england.sematernity@nhs.net

This website uses cookies to improve your experience. If you continue to use this site, you agree with it.

Ok

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Maternity information translations - Welcome

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Maternity information translations *** Now updated with Ukrainian and Russian translations *** We know that women from minority ethnic groups, refugees, asylum seekers and those whose first language is not English are at greater risk of poorer maternity and neonatal outcomes. We are working hard across the region to reduce these health inequalities, making birth safer and more personalised.

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Try this 3 minute breathing exercise to help you cope when you are feeling panicky

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A programme for parents who may have experienced domestic abuse themselves

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Information to support your decision-making

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Support for parents in the Kensington/Chelsea area

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What does the birthing room look like?

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Birth Centre Postnatal Room Tour (Chelwest)

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Birth Centre Postnatal Room Tour (Chelwest)

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Where will I stay after the birth?

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Contraception after Pregnancy - Antenatal Class

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Contraception after Pregnancy - Antenatal Class

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Explore your options at a new monthly online class (book using the QR code in the picture.

This class is for women and pregnant people who are receiving antenatal care from either:

Chelsea and Westminster Hospital NHS Foundation Trust

London North West University Healthcare NHS Trust

Imperial College Healthcare NHS Trust

The Hillingdon Hospitals NHS Foundation Trust

who want to learn more about contraception after pregnancy and what is available from their maternity service after their baby is born.

Fertility can return as early as Day 21, and we recommend a minimum of 12 months between the birth of a baby and becoming pregnant again. Maternity services can now offer contraception before discharge, so it is important to think about your future contraception plans whilst you are pregnant. To help you get your choice of contraception, please inform your midwife or doctor of your choice by 36weeks.

We will be discussing all methods:

Combined hormonal contraception

Progestogen only contraception

Long-acting reversible contraception (Cu-IUDs (non-hormonal), LNG-IUDs(hormonal), implants and injections)

Barrier methods (condoms)

Lactactional Amenorrhea Method (LAM)

Sterilisation"

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Poster parent ed contraception class july 2024

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Things to consider ....

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Columns are titled for ease of searching - there is also a search box in the top righthand corner if you know which topic you are looking for

Click on the website link/page/document to either view or download

Use the grey bar to the side of each column and at the bottom to scroll up and down or along

Please note that CW Trust is not responsible for information and links provided by outside organisations

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Maternity and Neonatal Voices Partnership

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Maternity and Neonatal Voices Partnership

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Giving your feedback and shaping the future

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A class to help you explore your options for Birth after Caesarean

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Some tips on helping baby into a good position for labour, which can sometimes even help to avoid induction

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Useful information for birth and beyond

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From the start of pregnancy to early parenthood, this app has been developed with the NHS to navigate your choices for maternity care in England.

You can:

* set your due date

* explore maternity units near you

* self-refer for care at your chosen maternity unit

* access information for all stages of your maternity journey

* make personalised plans for your care during pregnancy, birth and beyond

* keep track of your appointments and make notes

* access local contacts and information in specific NHS areas

* use the content without specifying an NHS area.

Mum & Baby has been developed in partnership between women, their partners, families and maternity staff from NHS trusts in North West London.

Independent rating
ORCHA, the Organisation for the Review of Care & Health Applications, has awarded its prestigious kitemark to the Mum & Baby app. When reviewed against 180 different criteria the app achieved 86%, the highest rating of any pregnancy and birth app tested by ORCHA.

Reviews and updates

The contents of the Mum & Baby app will be reviewed quarterly and updated accordingly by the North West London Local Maternity System - an approved panel of clinicians and service users to ensure that information given remains accurate, up-to-date and relevant for user.

Credit

The first version of Mum & Baby was launched in 2014 and was built through the initiative of Dr Sunita Sharma, Lead Consultant of Postnatal Services at Chelsea and Westminster Hospital NHS Foundation Trust, supported CW+, the charity of Chelsea and Westminster Hospital NHS Foundation Trust (CWPLUS Registered Charity No.1169897). The app was subsequently expanded and updated, led by midwife project managers in the North West London 'early adopters' team in 2018 and 2019. This project would not have been successful without the ongoing support of CW+ and Imagineear and the North West London Local Maternity System.

This release fixes a bug causing the application to crash when running iOS 13 with certain accessibility settings turned on.

Glitchy still

Was recommended this by my community midwife as just launched in area. App is still glitchy with problems. Can't enter any of my many appointment dates in as won't allow to save with empty fields, even when all the fields are completed. I think once bugs are fixed it will be a useful app.

Packed full of useful info!

This app has so much in it - and it's all relevant, useful and has done so much to help me understand what to expect during pregnancy and birth. It's easy to use and I love the section on care planning.

Highly recommend!

Clear and accessible information in app form

This app offers women in NW London clear and straightforward information about their pregnancy, birth and the care that they can expect. It will be great for women to have all this info at their finger tips.
(Reviewed by a non practicing midwife)

Information

Compatibility

Requires iOS 10.0 or later. Compatible with iPhone, iPad and iPod touch.

Frequent/Intense Medical/Treatment Information

Frequent/Intense Mature/Suggestive Themes

Copyright

© imagineear / CW+

Family Sharing

Up to six family members will be able to use this app with Family Sharing enabled.

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‎From the start of pregnancy to early parenthood, this app has been developed with the NHS to navigate your choices for maternity care in England. You can: * set your due date * explore maternity units near you * self-refer for care at your chosen maternity unit * access information fo...

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Improving your baby’s position for birth

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Improving your baby’s position for birth

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“Spinning Babies”

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Parenthood Starts with Pregnancy

You and your baby are working together! Your job is to dilate, baby's job is to rotate. Empower yourselves with our daily activities, body balancing techniques, and smart birth positions for a more comfortable, confident birth.

Proactive Preparation for Easier Birth

Join others who are enthusiastic for your life-giving year! Find a Spinning Babies ® Certified Parent Educator to start using techniques for comfort in pregnancy and smoother progress in labor through our unique approach to physiological birth.

Help Change Birth on Earth

Find Spinning Babies ® Workshops and events near you to start helping parents experience a more confident and comfortable birthing process for both themselves and their baby.

For additional education to even further enhance your pregnancy and labor preparation, shop our extensive collection of digital downloads, videos, DVDs, workbooks, and more.

Daily Essentials can be practiced daily throughout pregnancy to help bring balance and comfort - and an easier, shorter birth.

Spinning Babies® Parent Class

Spinning Babies® Parent Class provides clear instructions on how to use Spinning Babies® for a more comfortable and confident pregnancy and labor.

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Spinning Babies - Comfort in Pregnancy and Easier Birth

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Parenthood Starts with Pregnancy You and your baby are working together! Your job is to dilate, baby's job is to rotate. Empower yourselves with our daily activities, body balancing techniques, and smart birth positions for a more comfortable, confident birth. Proactive Preparation for Easier Birth Join others who are enthusiastic for your life-giving year!

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Support for black, brown and ethnic minority women on their journey to motherhood

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A selection of videos promoting pelvic health, also in other languages

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Pelvic Health and Wellbeing during Pregnancy and After Birth Videos
To translate this page into another language then please use the recite me accessibility toolbar. The accessibility toolbar can be used to adjust elements for individual needs. This looks at aspects such as font style, size, colour, zoom functionality, keyboard navigation, screen readers and more.
The London Maternity Clinical Network has collaborated with Imperial College Healthcare Trust, North West London Local Maternity and Neonatal System (LMNS), South West London LMNS, South East London LMNS, LMNS service-user representatives, Maternity Voices Partnership, and other NHS professionals to create a series of videos about the changes the body undergoes before, during, and after birth. From pelvic floor health and bladder care, to posture and returning to exercise, these videos have been developed by NHS Physiotherapists and Healthcare professionals and will provide information and useful advice about supporting your body's journey through pregnancy and beyond.

These videos will enable women to:​

Understand and manage physiological changes that occur in pregnancy​

Optimise pelvic floor health​

Understand how to exercise safely in pregnancy and after birth ​

Be knowledgeable about self care in the postnatal period​

Know when to seek medical advice and referral​

Pelvic health and wellbeing during pregnancy and after birth
POGP are hosting these videos in support of the educational value and relevance of the content, this does not imply direct involvement in its development.

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Pelvic Health and Wellbeing during Pregnancy Videos

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To translate this page into another language then please use the recite me accessibility toolbar. The accessibility toolbar can be used to adjust elements for individual needs. This looks at aspects such as font style, size, colour, zoom functionality, keyboard navigation, screen readers and more.

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These can be printed out and used in your room or looked at on a phone or tablet

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Information on how and why we listen to your baby's heartbeat during labour

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Updated guidelines from June 2025

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Postnatal Mental Health Support from PANDAS

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Postnatal Mental Health Support from PANDAS

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Mental health support for once your baby is born

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Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.

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Keeping a check on your own mental health in the postnatal period

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A guide to which products and sleep spaces are safe for your baby

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Please also see dedicated Induction of Labour padlet in final column or join our workshop (details below)

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Please also see dedicated Induction of Labour padlet in final column or join our workshop (details below)

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Our Induction of Labour Workshop runs every Thursday morning at 9am-10am and can be booked via Eventbrite here:

https://www.eventbrite.co.uk/e/induction-of-labour-workshop-tickets-755432658417?aff=oddtdtcreator

More resources and decision making aids for those women/birthing people considering or booked for an induction of labour available in our Induction of Labour padlet and in our dedicated online class (the class is ideally for women whose induction has already been confirmed)

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Follow us for all the latest news and stats here

https://www.instagram.com/chelwestbc?igsh=bTcyajl4b3h3b3M%3D&utm_source=qr

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Important information on taking Vitamin D in pregnancy

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Are you unsure about how you would like to give birth ? This leaflet will give you lots of information to help you decide.