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A mother automatically has parental responsibility for her child from birth.

A father usually has parental responsibility if he's either:

married to the child's mother

listed on the birth certificate (after a certain date, depending on which part of the UK the child was born in)

You can apply for parental responsibility if you don't automatically have it.

Births registered in England and Wales

If the parents of a child are married when the child is born, or if they've jointly adopted a child, both have parental responsibility.

They both keep parental responsibility if they later divorce.

Unmarried parents

An unmarried father can get parental responsibility for his child in 1 of 3 ways:

jointly registering the birth of the child with the mother (from 1 December 2003)

getting a parental responsibility agreement with the mother

getting a parental responsibility order from a court

Births registered in Scotland

A father has parental responsibility if he's married to the mother when the child is conceived, or marries her at any point afterwards.

An unmarried father has parental responsibility if he's named on the child's birth certificate (from 4 May 2006).

Births registered in Northern Ireland

A father has parental responsibility if he's married to the mother at the time of the child's birth.

If a father marries the mother after the child's birth, he has parental responsibility if he lives in Northern Ireland at the time of the marriage.

An unmarried father has parental responsibility if he's named, or becomes named, on the child's birth certificate (from 15 April 2002).

Births registered outside the UK

If a child is born overseas and comes to live in the UK, parental responsibility depends on the UK country they're now living in.

Same-sex parents

Civil partners

Same-sex partners will both have parental responsibility if they were civil partners at the time of the treatment, eg donor insemination or fertility treatment.

Non-civil partners

For same-sex partners who aren't civil partners, the 2nd parent can get parental responsibility by either:

applying for parental responsibility if a parental agreement was made

becoming a civil partner of the other parent and making a parental responsibility agreement or jointly registering the birth

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A mother automatically has parental responsibility for her child from birth. A father usually has parental responsibility if he's either: married to the child's mother listed on the birth certificate (after a certain date, depending on which part of the UK the child was born in) You can apply for parental responsibility if you don't automatically have it.

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Maternity Action

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Same-sex partners and civil partners have the same legal rights as all parents. If you are adopting a child, the following information sheets could be of interest to you:

If you are the birth mother, the following information sheets may be of interest to you:

One member of a same sex couple, including a female partner, may take paternity leave and pay. The following information sheets may be of interest to you:

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Same-sex partners and civil partners have the same legal rights as all parents.

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People often say they wish their baby had come with an instruction manual but it's worth taking time, just a few minutes when you can, to watch closely and gradually become familiar with what your baby is like.

Getting to know their sleep and wake states will help you - download "Baby Watching: Making sense of your baby" to find out more and watch the videos below from the Association for Infant Mental Health UK.

These videos on Baby States, and other videos on getting to know your baby, are freely available from the Association for Infant Mental Health UK.

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People often say they wish their baby had come with an instruction manual but it's worth taking time, just a few minutes when you can, to watch closely and gradually become familiar with what your baby is like.

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Durham Infancy & Sleep Centre

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Research-based information on baby sleep for parents and practitioners, covering normal infant sleep, sleep safety, where and how babies sleep, SIDS and SUDI, parental sleep and free resources.

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Professor Helen Ball - Durham University Infancy & Sleep Centre

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UNICEF Baby Friendly initiative (July 2021)

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College of Human and Health Sciences, Swansea University (July 2016)

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Swansea University 'Should Babies Sleep Through the Night' Animation

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This short video, based on research carried out by Swansea University, looks at the reasons why it may not always be normal for babies to sleep through the night. The video was produced from the Savage and Gray Animation Studio in Cowbridge, near Cardiff.

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Bridget Supple NCT Practitioner (February 2021)

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Your Baby Is Not Faulty - Bridget Supple

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Is the Lure of Baby Sleep-Training Culture Fueling Postpartum Anxiety?

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Is the Lure of Baby Sleep-Training Culture Fueling Postpartum Anxiety?

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www.parents.com (October 2021)

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Many new parents are turning to sleep programs and specialists to help their newborns sleep through the night-but pricey courses and consult calls on baby sleep could have an even higher price, some experts say.

Over the past year, Macall Gordon, a sleep coach and senior lecturer at Antioch University, has talked to hundreds of new parents. They call her hoping to get their 3-week-old babies started "correctly" on sleep. They're wondering how to fast-track a sleep-through-the-night miracle and they worry about starting "bad habits." As she puts it, they're "all wound up in knots."

Wake windows. Naps. Bedtime routines. Swaddles. The Merlin Suit. The Snoo. Co-sleeping. Safe sleeping. It's information overload. But with pretty promises of eight hours of sleep at eight weeks and plans with 98 percent "success rates," it's also hard not to subscribe.

I did. As a mom of two under 2 and a religious nine-hour-a-night sleeper myself, I followed sleep routines for both of my girls-and it worked: Both of my daughters slept just about 12 hours a night by 12 or so weeks (with the usual hiccups along the way, of course).

But what I don't always talk about is how this focus on "perfect" baby sleep contributed to my anxiety.

And I'm not the only one.

Experts say the infant sleep business-with its pricey courses and consult calls-could be fueling something more than sleep: mental health issues in new moms. And so, the calls to Gordon and other sleep specialists around the country continue.

The Pressure for a Perfect Sleep Schedule

To some extent, worry is normal postpartum. After you have a baby, the parts of the brain that are alert to threats become very activated. "We naturally start to think, is the baby OK?" says Lucy Hutner, M.D., a reproductive psychiatrist in New York.

And anxiety can sometimes make you feel like you want to put everything into neat categories. There's no guidebook to parenting, but sleep courses can feel like the closet thing to it. New parents follow the schedules and hold on tight to the hope that if they do it right it will make things easier.

"I think people can sort of feel vulnerable to these messages of, you have to do things one particular way and you have to do it perfectly or you're not a good mother," says Dr. Hutner. Of course, nobody's actually saying that, but "those are the messages that are easy to glean." And applying a rigid or "perfect" idea around anything onto an enormous set of dynamic changes postpartum "is a little bit of a recipe for more anxiety," says Dr. Hutner.

Here's another issue: Much of today's promise-heavy sleep advice is really behavior-based. There's a big emphasis on what you do as the parent and what your baby does in response. And when you feel like your baby's sleep is based on your actions and behavior, experts say there can be a vicious circle of internalization, self-blaming, and wondering why your baby isn't sleeping.

Worse? "Parents can think if I don't do x and y, my baby's never going to sleep, or, I'm going to set them up for failure, or, insert scary thing here," says Maisie Ruttan, a pediatric sleep and family wellness clinician in British Columbia. She tells me that many parents who seek her sleep consulting services hold onto behavior-based sleep strategies "like gospel." She adds, "They wind up watching the clock instead of their baby. It feels like they just don't trust themselves to make decisions."

The Truth About Babies and Sleep

Infant sleep wasn't always such a dicey topic.

For young babies, night wakings are normal, healthy, essential, and protective, explains Kathleen Kendall-Tackett, Ph.D., IBCLC, a psychologist, researcher, and lactation consultant. "This idea that you have to be so rigid and that you have to control things doesn't make sense," she says.

Young babies need to feed around the clock. And even as they grow and when they no longer require middle-of-the-night meals, just like you, they still wake up from time to time. Some babies wake throughout the night through the first few years of life. Sometimes they can put themselves back to sleep. Sometimes they can't.

A more anthropological view of sleep globally and throughout history reveals that babies everywhere sleep in all different ways and all different styles. "In cultures where people just kind of roll with it, babies don't have tons of sleep problems," Dr. Kendall-Tackett adds.

Jodi Mindell, Ph.D., one of the country's foremost experts on infant sleep who has been studying the topic since the 1980s, says there's no real way to compare modern-day sleep programs to one another. There are some things, Dr. Mindell says, that years of research and clinical work have shown. For instance, a baby's ability to self-soothe, bedtime routines, and early bedtimes help them sleep more soundly. There's a certain amount of sleep that babies need in a 24-hour period (but that number varies wildly). And while naps tend to be spaced relatively evenly throughout a day, that's not necessarily best for all babies all of the time. (Just like you, some days babies are more tired than not.)

It's also worth noting that in many studies on infant sleep, sleep interventions work for maybe 50 percent of the sample.

Plus, on top of behavior, development, physiological changes, a baby's temperament (which can be incredibly variable), and family values also impact sleep.

Go Easy on Yourself

Before I hang up with Dr. Kendall-Tackett, she hears my 8-month-old daughter in the background. She tells me that those early postpartum months of sleep deprivation? They're hard. And that support around sleep (someone who can watch the baby while you nap or someone who can take over a night feeding so you can get a decent stretch) matters. It's healing.

The biggest take-home message, though? As Dr. Kendall-Tackett points out, your baby is their own person with their own unique needs and preferences, just as you are your own person with unique needs and preferences. Despite the catchy marketing schemes and sky-high promises of a sleep program, the reality is that there are no guarantees when it comes to baby sleep.

That's not easy to hear when you're in the throes of sleep deprivation, but I kind of wish someone reminded me of it.

And ultimately, early parenthood is about a navigation-learning; getting to know your baby; things that you pick up along the way; things you put down while finding your way. And there's a big difference between finding a routine that works for you (and, if you're like me, being home for naptime because you know no one will sleep in a stroller) and self-blaming and hyper-focusing on your child's sleep. There's also a big difference between feeling like something works for you and feeling like it doesn't. Dr. Hutner reminds me: There's not a problem if there's not a problem-no matter what you're doing.

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Is the Lure of Baby Sleep-Training Culture Fueling Postpartum Anxiety?

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Many new parents are turning to sleep programs and specialists to help their newborns sleep through the night-but pricey courses and consult calls on baby sleep could have an even higher price, some experts say. Over the past year, Macall Gordon, a sleep coach and senior lecturer at Antioch University, has talked to hundreds of new parents.

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UNICEF Baby Friendly Initiative

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BBC Tiny Happy People

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How far can newborn babies see? - The Speech Lab

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Professor Ben Ambridge invites parents to investigate their babies’ vision and focus.

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Worried about your baby?  What's normal and what's not

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Worried about your baby?  What's normal and what's not

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NHS

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The contents of your baby's nappy changes from day to day in the beginning. Breast fed babies often poo after every feed. You should expect:

Day one to four: Baby's nappies are usually black/green in colour. It can look like thick tar or marmite!

Day four to seven: Your baby's nappies will start to change colour from black/green to yellow.

Day seven onwards. A baby's nappy will be yellow. It will be soft and seedy if you are breastfeeding, or look like play dough if your baby is formula fed.

Wet nappies The number of wet nappies you will expect to find changes in the amount of urine (wee) that you see over the first 7 days. Below is a guide to help you decide if your baby is passing enough urine (wee). Day 1-2
2 or more wet nappies in the first 24-48 hours. The nappy will not feel heavy

You might see a small brick dust coloured mark in the nappy - urates- which should be smaller than a 5p piece
Day 3-4
3 or more wet nappies per day. The nappies start to feel heavier than before
Day 5-6
5 or more wet nappies per day. The nappy will feel heavy. If you want to check this then take a clean nappy and pour 3 tablespoons or 45mls of water into it. Pick it up - this is how a 'heavy' nappy should feel
Day 7 onwards
6 or more wet nappies per day

Urates

Urates, sometimes known as brick dust because that's what it looks like: tiny orange or pinkish crystals. They are harmless: they are salts in the urine, and tend to show up in the very early days. Most babies will pass them once only. They can be a sign your baby needs a little help to feed more often or more effectively. Ask your midwife.
Pseudo Menses or False Periods
False menstruation or pseudo menstruation is harmless. It is a very light bleed from the vagina in some baby girls. It comes from the effects of your own hormones on her system, and it soon stops.

Nappy Wetness Indicator

Some nappies include a line which indicates when the baby has passed urine. This can help parents to know how many wet nappies the baby has had.
Dirty Nappies
Dirty Nappy Day 0-1

The first baby poo is thick and black/green and very sticky. There might be several nappies that look like this or just one or two.

Dirty Nappy Day 1-2

There will still be the black poo for a couple of day but it will start to get a bit more green and less thick.

Dirty Nappy Day 2-3

As the milk starts to travel through your baby's tummy you will start to see the poo change to a green/brown colour and it will start to have little bits that look like seeds in it.

Dirty Nappy Day 3-5

Once the baby is feeding more you will find the poo turns a brown colour and is quite loose. It will continue to have little bits in it that look like seeds and will have at least 2 dirty nappies a day

Dirty Nappy Day 7 onwards

Exclusively breast fed baby. The poo will turn very yellow with small 'seedy' bits in it. It can be very watery which is normal. Some baby's poo at every feed and some may go a few days without a dirty nappy. If your baby is feeding well and gaining weight then there is no cause for concern.

Formula milk fed babies: Some baby's poo more often but usually once a day as a minimum. If your aby is feeding well and gaining weight then there is no cause for concern.

If your baby is struggling to have a poo and is constipated, please phone your Health Visitor for advice.

​​​​​​​
Click here for more information on Nappy Rash

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The contents of your baby's nappy changes from day to day in the beginning. Breast fed babies often poo after every feed. You should expect: Day one to four: Baby's nappies are usually black/green in colour. It can look like thick tar or marmite!

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Lullaby Trust (March 2016)

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Lullaby Trust

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If you’re worried your baby is unwell, our free Baby Check app helps you decide whether they need to see a health professional or not…

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Sarah Ockwell-Smith (April 2015)

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Lullaby Trust (March 2019)

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Why do babies cry? the reasons and responses

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Why do babies cry? the reasons and responses

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NCT (August 2018)

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Experiencing your baby crying can be upsetting, frustrating and exhausting. Not only are you trying to work out what's wrong, but you're desperately trying to soothe them at the same time. Don't despair, all parents have been there and it's a natural part of the journey.

When will my baby stop crying so much?

The good news is it doesn't last forever. Babies cry most in the first three months of their lives (Wolke et al, 2017).

It's normal for babies to sometimes cry inconsolably. Studies have shown that two in ten infants cry for long periods without an apparent reason during the first four months (Wake et al, 2006). On average they'll cry for two to three hours a day (Wolke et al, 2017).

This can't be normal, or can it?

Even if your baby is crying a lot, it might be that your baby is going through what is sometimes called the period of PURPLE crying - a perfectly normal stage of development. (PURPLE is not about the colour - it's short for: Peak of crying; Unexpected; Resists soothing; Pain-like face; Long lasting; and Evening.)

PURPLE crying is a stage of inconsolable crying that can last up to five hours a day (NCSBS, no date). The idea is that a lot of people misunderstand developmental crying, labelling it as colic and mistakenly thinking their baby is unwell.

Why is my baby crying?

Babies communicate with cues signalling their needs but it can take a while for you to learn their language. While you're learning, your baby may resort to their last means of getting your attention - crying.

As you observe and get to know your baby, you'll be able to anticipate and respond to their needs before they start to cry. And even when they are crying, you'll have a good idea what the problem might be, or will recognise their different cries (Sandru et al, 2017). There are some very common reasons for crying, and ways you can help.

I'm hungry

It might not seem long since they've last fed but your baby's tummy is tiny and can't hold much milk. Plus they have a lot of growing and brain development to do. If you're breastfeeding, you could offer them the breast until they come off naturally. If you're bottle feeding, then try paced feeding.

If your baby continually cries while breastfeeding, you might want to check their attachment. You could also get support from your midwife, health visitor or the NCT Support Line to see if there is a reason for the tears.

Reading the food cues

Crying is a late sign of hunger, and it is easier to feed your baby before they start to cry. Certain behaviour tells you when they're ready to feed, such as:

rooting for the breast

licking lips

fist in mouth

getting agitated.

Acting quickly stops hungry becoming hangry (anger due to hunger) (NHS, 2019).

I'm tired

Babies often cry when they're tired, and it's easy for them to become overtired if there's a lot going on. You may find it helps your baby drift off to sleep if you hold, stroke or shush them. You could also try driving or walking them around; or finding a quiet, dark room where you can both have a nap.

I'm wet and dirty

It can't be nice for a baby to sit in their own poo, and a dirty nappy can irritate a baby's sensitive skin. You might find trying some nappy-free time helpful to avoid nappy rash but just remember to put a protective towel underneath.

Being prepared for each nappy change can help you get quick at changing your baby. It can also avoid any tears caused by cold air making your baby feel exposed during nappy changes.

I need a cuddle

After nine months of living inside a parent, it's a big deal to suddenly be on your own.

Babies need a lot of love and reassurance. Giving your baby lots of cuddles and interaction, such as talking and playing, helps them to feel comforted and secure. And a secure baby is better able to grow and thrive.

I'm in pain or unwell

If it's not immediately obvious why your baby is crying, it could be pain or illness like teething, wind, earache or a headache from a more complicated birth. No one knows your baby as well as you do so if you're worried, get medical help.

In an emergency, you can get NHS advice by calling 111. If you fear you baby is in immediate danger, call 999.

I'm colicky or in the PURPLE crying period

There is a big possibility it's PURPLE crying as that can last up to five hours a day. (PURPLE is not about the colour - it's short for: Peak of crying; Unexpected; Resists soothing; Pain-like face; Long lasting; and Evening.) This is commonly known as colic.

You can try lots of different methods to sooth a baby with PURPLE crying, such as:

distractions

shushing

white noise

going for a walk or drive

carrying them in a sling.

(NHS Hull University Teaching Hospital, no date).

Remember that you can call the NCT Infant Feeding Support Line on 0300 330 0700, or seek help from a healthcare professional.

I'm too hot or too cold

Make sure your baby's clothing is right for the weather. When it's hot and sunny, offer them plenty to drink and don't spend more than a few minutes in direct sunlight. When it's cold, keep them wrapped up but regularly check they're not excessively hot if wearing several layers of thick clothes.

I've got wind

When everything's so small, there's not much room for food to be digested. For some babies, wind can be a source of discomfort worth crying about. You could try the following to help your baby's food go down and the burps come up:

Winding your baby - rubbing and patting them on the back.

Gently massaging their stomach in a clockwise direction.

Slowly bending their legs towards their stomach, like they're riding a bike.

I need attention

When babies are really young and still learning about the world and their place in it, they might cry just to check that someone is still there protecting them. Over time, older babies may learn that crying leads to attention and crying may become more about wants than needs.

It's up to each parent how they manage cries that relate to wanting attention. You might use approaches from cuddling or feeding, through to tips on soothing. Whichever method you choose, be prepared for changes in your baby's routine, even from one day or night to the next.

My adult is stressed

Babies pick up on our emotions as parents, so if you're feeling stressed, they can feel unsettled. Taking a short, five-minute break to calm yourself can help both you and your baby. Put them down somewhere safe, and phone a friend, make a cuppa, or take some breaths outside.

When you return, they may have calmed down or fallen asleep. If not, then at least you've had a break and can start to care for them again.

Will it ever end?

Rest assured: every parent has felt overwhelmed by their baby's crying at some point. It's OK to take time out for a few minutes. Make sure your baby is safe in their cot or pram and give yourself a break. If possible, get your partner, a family member or friend to take over.

By six months, babies cry less as they grow and you learn to recognise their communication. It won't happen overnight, and there will be plenty of tears to come but as with every stage of a baby's life, this phase won't last forever.
This page was last reviewed in April 2022.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0333 252 5051.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Watch our coping with crying film.

Understanding Childhood also have a range of resources available online and to download, developed by child psychotherapists, including a leaflet on crying.

There's also useful information on the NHS website.

The NSPCC helpline provides help and support to thousands of parents and families.

The Lullaby Trust has lots of useful information and support for parents about safe sleep.

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Why do babies cry? The reasons and responses | Baby & toddler articles & support | NCT

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One of the first things you'll notice as a parent is that babies cry. Here we look at what makes babies cry and how to help them settle.

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How to cope and keep calm with a crying baby

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How to cope and keep calm with a crying baby

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NCT (August 2018)

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How to cope and keep calm with a crying baby | Baby & toddler articles & support | NCT

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Keeping calm with a screaming baby is easier said than done. Tensions and emotions run high during those first few days, weeks and months. 

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Babycentre

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BabyCentre's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organisations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies.

AAP. 2012. A parent's guide to safe sleep. American Academy of Paediatricians. www.healthychildcare.orgOpens a new window [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.orgOpens a new window [Accessed April 2017]

AAP. 2016b. Tips for dressing your baby. www.healthychildren.orgOpens a new window [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.ukOpens a new window [Accessed April 2017]

ISIS. nd. Baby sleep bags. Infant Sleep Information Source. www.isisonline.org.ukOpens a new window [Accessed April 2017]

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

Lullaby Trust. 2014. Safer sleep for babies. www.lullabytrust.org.ukOpens a new window [PDF accessed March 2017]

Lullaby Trust. 2015. Parents should remove cot bumpers. www.lullabytrust.org.ukOpens a new window [Accessed March 2017]

Kendon M, McCarthy M, Jevrejeva S, et al. 2016. State of the UK Climate 2015. Met Office. www.metoffice.gov.ukOpens a new window [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.orgOpens a new window [Accessed April 2017]

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

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

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

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

Unicef. 2011. Caring for your baby at night. www.unicef.org.ukOpens a new window [Accessed March 2017]

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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. Our infographic has everything you need to make sure your baby is comfortable.

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NHS

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Find out about colic, including what the symptoms are, what you can do to help soothe your baby, and when to get medical help.

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NCT (July 2019)

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What is baby reflux?

It's something many parents talk about but what is baby reflux? It's basically when a baby brings milk back up during, or just after, a feed (NHS start4life, 2019).

Babies get reflux when the ring of muscle between the oesophagus (food pipe) and stomach is not fully developed. Food or milk can leak out and travel back up the food pipe (NHS, 2019). Other potential causes for reflux can include an intolerance to cow's milk protein or other allergies (La Leche League 2017).

Baby reflux affects at least four in ten newborns and it isn't usually cause for concern (NICE, 2015). Most of the time, it gets better on its own - often by the time a baby is one (NICE, 2015; NHS, 2019). That's because over a baby's first 12 months their digestive system naturally develops and they spend more time upright as they start to sit up (Tighe et al, 2014; NICE, 2015; NHS, 2019).

Is baby reflux just vomiting?

Baby reflux is effectively the same thing as posseting, which is when babies bring up a small amount of milk (usually a teaspoonful) without seeming to mind (NHS start4life, 2019). Reflux is common in babies under six months for completely normal physiological reasons and doesn't need medication. Baby reflux is also different from gastro-oesophageal reflux disease (GORD), which is when reflux symptoms become troublesome or cause complications (NICE, 2019).

Baby reflux signs and symptoms

Many of the common signs of baby reflux can also be signs that a baby is distressed for any number of reasons; for example, they're hungry, need a cuddle or they're cold. So it's good to remember that while there are some recognisable signs of baby reflux, this isn't necessarily a disease that needs medicated. Nonetheless, signs can include:

A baby arching their back and turning their head.

Crying for long periods and becoming irritable during and after feeds.

Choking or coughing during a feed or seeming to have a sore throat.

Spitting up milk during or after feeds several times a day, which upsets them.

Persistent hiccups.

Frequent ear infections.

Fighting feeding or refusing to feed.

Poor weight gain.

Waking very frequently at night.

Signs of pain or discomfort when feeding.

(NHS, 2016; La Leche League GB, 2017; Essential Parent, 2019)

Are some babies more likely to get reflux?

Reflux is more common among babies who are born prematurely and babies with low birth weight. It's also common in babies or children with some impairment of their muscles and nerves, such as cerebral palsy, or those with a cow's milk allergy (Patient, 2018).

When should you seek medical advice for reflux?

Baby reflux isn't usually a cause for concern if your baby is happy and is gaining weight. However, if reflux starts after six months of age, continues beyond a year or if your baby has any problems mentioned below, contact your midwife, health visitor or GP:

Spitting up feeds frequently or refusing feeds.

Coughing or gagging while feeding.

Frequent projectile vomiting (forceful vomiting that lands some distance away).

Green or yellow vomit (maybe bile), or blood in vomit.

Blood in poo or persistent diarrhoea.

Excessive crying or irritability.

Swollen or tender tummy.

High temperature of 38⁰C or above.

Not gaining weight or losing weight.

(NICE, 2015; NHS, 2016)

In a small number of babies, reflux might be associated with a more serious problem, such as gastro-oesophageal reflux disease (GORD). This is a form of long-term baby reflux where stomach contents are able to rise up and irritate the oesophagus (NHS, 2016).

Silent reflux in babies

Sometimes babies don't spit out what comes back up but swallow it instead. This is known as 'silent reflux'. Babies with silent reflux might gain weight normally but show some of the symptoms as reflux (NHS start4life, 2019).

How to ease your baby's reflux

You can help ease your baby's reflux by making small changes to the way you feed them. Talk to your midwife or health visitor who might suggest:

Gently burping your baby regularly throughout feeding.

Ensuring they take breaks during a feed.

Giving your baby shorter but more frequent feeds.

Keeping your baby's head higher than their bottom during feeds.

Keeping your baby upright for a bit after feeding.

Changing baby on their side to avoid any discomfort caused by lifting their legs up towards their stomach.

Using thickened 'anti-reflux' formula milk. You can buy these without a prescription but it's important to talk to a healthcare professional before you do. There is some caution about their use, such as the fact that they are made at a lower temperature than is currently recommended to get rid of harmful bacteria.

If your baby has a cow's milk allergy, your doctor might suggest using special formula milk that doesn't contain cows' milk.

(NHS, 2016 ; La Leche League GB, 2017; First Steps Nutrition Trust, 2018; Patient, 2018)

Some parents might be advised to raise the head end of their baby's cot slightly or place a rolled up towel under the mattress. It's important to say that there is no scientific evidence that this works and it might increase the risk of sudden infant death syndrome (SIDS) (Lullaby Trust, 2019).

Diagnosis and treatment

Usually, babies with reflux don't need any tests as the condition can be diagnosed based on their symptoms. But in rare cases and if a healthcare professional thinks they might be helpful, an endoscopy, pH monitoring or barium swallow test can be done (NICE, 2015; NHS, 2016).

Baby reflux usually doesn't need any specific treatment but the feeding suggestions above might be helpful. In severe cases, a GP or gastroenterologist can prescribe medicines that might help with pain and discomfort (Tighe et al, 2014). Surgery might also be recommended for a small number of babies who have underlying medical conditions, such as cerebral palsy (NICE, 2015; NHS, 2016).

If you have a baby with a reflux, it can feel stressful and worrying at times. There's lots of support and information to help you though. Read other parents' experiences here.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Living with reflux is a UK non-profit for information and support for sufferers of GOR and GORD.

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What is baby reflux? Symptoms and support

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It's something many parents talk about but what is baby reflux? It's basically when a baby brings milk back up during, or just after, a feed (NHS start4life, 2019). Babies get reflux when the ring of muscle between the oesophagus (food pipe) and stomach is not fully developed.

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A guide to buying safer sleep essentials

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A guide to buying safer sleep essentials

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Lullaby Trust

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Baby product information - The Lullaby Trust

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It can be hard to know which products are safest for your baby to sleep in. We’re here to help you find the safest baby products…

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My video

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NCT

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Newborn baby poo in nappies: what to expect | Baby & toddler articles & support | NCT

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Your baby’s nappy can tell you a lot - find out more here.

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NCT

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Breastfed and formula fed babies

A baby that's been formula fed may have poo that's less soft and less frequent than a baby of the same age that has been breastfed. Babies that are breastfed have poo that's more of a toothpaste consistency and browner in colour (NICE, 2015; NHS Choices, 2015).

"Some babies, regardless of how they are fed, get to the yellow poo stage sooner than others. It means your baby is feeding very effectively, and probably taking in more milk (NHS Choices, 2015)."

What's a 'heavy nappy'?

With disposable and reusable nappies it can sometimes be hard to tell if they are wet. Try this test so you have an idea of what to expect: pour two to four tablespoons of water into a dry nappy and pick it up. That's roughly how heavy your baby's nappy will be when wet, from day five onwards (NHS Choices, 2016a).

Some disposable nappy brands now have a wetness indicator strip on them, which changes colours when your baby has a wee. This can help reassure you they have had a wee if you aren't sure.

If your baby is wearing a reusable nappy, you may need to open it to check whether it's wet, depending on the design and style. Some reusable nappies have a liner inside, which you can check for wetness. Others may need the cloth of the nappy itself checking.

Is it OK if my baby doesn't poo every day

Yes, but only after the first few weeks (NHS, 2016a). Your baby might not poo for a day or more in the first week or so. If this is the case, it may be a sign they need to feed more often or more effectively. Ask your midwife, health visitor or GP for advice if you are concerned (NHS Choices, 2015).

After the first week, babies continue to wee and poo several times a day for the first few weeks (NHS Choices, 2015). After that, some but not all babies poo less often.

Some babies that are breastfed may go for days or even a week without having a poo at all.

After the first few weeks, babies that are formula fed usually poo at least once a day (NHS, 2016a).

As a general guide, as long as your baby is growing well, their poo will be soft and regular. With no changes to what is usual for your baby, you don't need to be worried (NHS Choices, 2016b).

If your baby's poos change and become very hard, watery, smelly or have blood in them, talk to your GP or health visitor. These could be signs of constipation, diarrhoea or other conditions. Very pale poo could be a sign of liver disease (NHS Choices, 2015).

What is false menstruation?

Early on you may see a small amount of blood in your newborn baby girl's nappy. This very light bleed is a mini period and is harmless. It's caused by hormones passing from you to your baby before birth and soon stops (NHS Choices, 2015). If it continues talk to your midwife, health visitor or GP.

What should I do if I'm worried?

In the early days of your baby's life, the contents of their nappy can change day by day. The above is a useful guide if you aren't sure about their nappy contents or whether they are weeing or pooing frequently enough in the early days.

If you are concerned about your baby's feeding, the content of their nappies or their health, talk to your midwife, health visitor or GP.

This page was last reviewed in October 2017.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Common questions about newborn baby poo | Baby & toddler articles & support | NCT

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A baby that's been formula fed may have poo that's less soft and less frequent than a baby of the same age that has been breastfed. Babies that are breastfed have poo that's more of a toothpaste consistency and browner in colour (NICE, 2015; NHS Choices, 2015).

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NCT

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Some parents opt for disposable nappies, while others choose reusable cloth nappies. Others still choose a combination of the two. Many reasons like environmental impact, convenience or costs might affect your choice of nappies.

The environment that we all depend on is an important consideration. Each year, parents throw away around three billion disposable nappies to landfill. That's about 2% to 3% of all household waste. And that's a lot considering disposable nappies take up to 500 years to decompose (Which?, 2018a; WRAP, 2018).

On the other hand, reusable nappies might be less convenient than disposable nappies. Disposable nappies can be easier and quicker for time-pressured parents to use. There's also a lower upfront cost involved for disposables.

Parents might choose a combination of reusable nappies and disposable ones depending on what's happening. They might use reusable nappies day-to-day at home and swap to disposables for a holiday where there's no access to a washing machine (The Guardian, 2015).

Here are the pros and cons of reusable and disposable nappies.

Reusable nappies

Positives

They are better for the environment because you wash and reuse cloth nappies, rather than throwing each one in the bin. Choosing reusable nappies over disposable nappies can halve the average household waste (Which?, 2018a; WRAP 2018).

Reusable nappies now come in a variety of funky designs, colours and fabrics, with soft cloth inserts and easy fastenings like Velcro or poppers (Which?, 2018a).

Some reusable nappies come with a removable inner layer that you can slip into your baby's changing bag, and so you don't have to wash the whole nappy every time (Which?, 2018a).

Cloth nappies can work out cheaper in the long run. They can be reused for future babies or sold on (Which?, 2018a). Reusable nappies save you around £200 to £500 over the 2.5 years that your baby is likely to be in nappies (WRAP, 2018).

Some parents say cloth nappies feel softer and more comfortable for their baby's bottom.

Natural cloth nappies may be less likely to cause nappy rashes because they don't use any harsh chemicals, dyes or plastics (Alberta et al, 2005; Pollution Issues, 2013; The Nappy Shed, 2018).

Negatives

Washing and drying your baby's reusable nappies takes time, energy, electricity costs and effort (Which?, 2018a).

Reusable nappies can be less absorbent than disposable nappies, so you might need to change these nappies more often (Which?, 2018a).

You may have a large upfront cost to get your baby kitted out with a set of reusable nappies (Which?, 2018a). On the other hand, you may find second-hand reusable nappies for sale at your local NCT Nearly New Sale for a fraction of the new price.

Sometimes it can be tricky to find baby clothes to fit over reusable nappies, depending on their size and design.

Using cloth nappies can be difficult to manage if you're going on a holiday as you can't just throw them away like disposable ones (The Guardian, 2015).

You need to be extra careful while cleaning them to ensure they are sanitary (Kamat and Malkani, 2003). Recommendations are that cloth nappies should be washed at 60⁰C (Environment Agency, 2008).

Disposable nappies:

Positives

Some parents prefer the convenience of disposable nappies as they don't need to be washed and dried. They are good for when you don't have access to a washing machine - for example on holiday (Which?, 2018b).

There are plenty of brands and sizes of disposable nappies to choose from to suit your budget (Which?, 2018b).

They are easily available in any supermarkets or departmental stores and are easy to transport as they are slim and light (Which?, 2018b).

Initially, disposable nappies can be cost effective.

Disposable nappies are thought to be more absorbing than cloth nappies (Kamat and Malkani, 2003).

They are considered to be more sanitary than cloth nappies because of their one-off use (Kamat and Malkani, 2003).

Negatives

Disposable nappies usually end up in landfill where they take a long time to decompose (Which? 2018a).

The choice of disposable nappies can be overwhelming. Some parents find certain brands leak or do not fit their baby well, so you might need to shop around.

The cost of disposable nappies adds up over time (WRAP, 2018).

Disposable nappies might contain harsh chemicals and an absorbent ingredient (sodium polyacrylate) that can cause nappy rashes (Which?, 2018b).

It is thought that toddlers using disposable nappies are harder to potty train as they can't feel the wetness (Which?, 2018b).

Most people don't correctly dispose of nappies, i.e. they leave the poo inside the nappy and throw them. While decomposing, the poo inside the nappy lets off methane gas that could contribute to greenhouse gases contributing to global warming (Environment Agency, 2008; Pollution Issues, 2013).

Whichever type of nappy you choose, one thing is certain: you will be changing a lot of nappies. And your little one will spend a lot of time in nappies. So whichever type you choose, make sure they suit you and your baby.
This page was last reviewed in October 2018.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Some local NCT branches run their own cloth nappy library where you can try a range of cloth nappies out to see what suits your baby best. Find out more from your local NCT branch.

There is a second hand reusable nappy market. You may be able to pick up some second hand reusable nappies at your local NCT sale, for a fraction of the price of new ones.

Alberta L, Sweeney SM, Wiss K. (2005) Diaper dye dermatitis. Pediatrics. 116(3):e450-452. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16140691 [Accessed 16th October 2018]

Environment Agency. (2008) An updated lifecycle assessment study for disposable and reusable nappies. Available at: http://randd.defra.gov.uk/Document.aspx?Document=WR0705_7589_FRP.pdf [Accessed 16th October 2018]

Kamat M, Malkani R. (2003) Disposable diapers : a hygienic alternative. Indian Journal of Pediatrics. Available at: https://www.ncbi.nlm.nih.gov/pubmed/14703226 [Accessed 16th October 2018]

Pollution Issues. (2013) Landfill and nappies. Available at: http://www.pollutionissues.co.uk/landfill-nappies.html [Accessed 16th October 2018]

The Guardian. (2015) Nappies: which are best - disposables or reusables. Available at: https://www.theguardian.com/money/2015/jul/04/nappies-which-best-disposables-reusables-cost-ethics [Accessed 16th October 2018]

Which? (2018a) How to buy the best reusable nappies. Available at: https://www.which.co.uk/reviews/nappies/article/how-to-buy-the-best-reusable-nappies [Accessed 16th October 2018]

Which? (2018b) How to buy the best disposable nappies. Available at: https://www.which.co.uk/reviews/nappies/article/how-to-buy-the-best-disposable-nappies [Accessed 16th October 2018]

WRAP. (2018) Real nappies. Overview. Available at: http://www.wrap.org.uk/content/real-nappies-overview [Accessed 16th October 2018]

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Some parents opt for disposable nappies, while others choose reusable cloth nappies. Others still choose a combination of the two. Many reasons like environmental impact, convenience or costs might affect your choice of nappies. The environment that we all depend on is an important consideration.

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St John Ambulance (January 2015)

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The Chokeables: How to save a choking baby - St John Ambulance

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Facebook page https://www.facebook.com/BasingstokeRealNappyLibrary

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Ho Ho Ho, it's Friday and the first Freebie Friday in December means a little treat for you AND a friend. Double win!

Up for grabs are 2 of our Introduction to... Wipes gift sets including a lux wet bag & 10 premium wipes.

1 winner will be chosen from entries across Facebook and Instagram. This giveaway is in no way affiliated with either platform.
Competition closes at midnight on Monday

GOOD LUCK

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Ho Ho Ho, it's Friday and the first Freebie Friday in December means a little treat for you AND a friend. Double win! Up for grabs are 2 of our Introduction to... Wipes gift sets including a lux wet bag & 10 premium wipes. 1 winner will be chosen from entries across Facebook and Instagram.

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Basingstoke Real Nappy Library

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Facebook page https://www.facebook.com/overtonnappylibrary

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Log into Facebook to start sharing and connecting with your friends, family, and people you know.

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Cot safety, bedding and bumpers: your questions answered

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Cot safety, bedding and bumpers: your questions answered

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NCT (July 2018)

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Your baby will spend more time sleeping during their first two years than they will awake. Although it might not feel like it when you're yawning through a 3am feed. So getting things right with their sleeping environment is pretty crucial.

Watch our video to find out about safe sleep guidelines for babies.

What type of cot should I choose?

To keep your baby as safe as possible in their cot, check that it conforms to British Safety Standards BS EN 716:2008. You'll also need to follow these guidelines so they don't get trapped or climb out:

The distance between the top of the mattress and the top of the cot sides should be at least 50cm.

Cot bars should be vertical and the distance between them no more than 6.5cm.

If your cot has a solid head and footboard with shapes cut out, check that your baby's limbs can't get caught in them.

(Sengölge and Vincenten, 2013)

Second hand cots: are they safe?

Yes - if you stick to a few checks and rules:

Make sure the cot - even if old - conforms to current safety standards.

If it's vintage, it might need to be stripped down and repainted with paint that you've checked does not recommend against use on items like cots. Make sure it thoroughly dries. Cots made before 1973 could have been painted with leaded paint, which is toxic.

If the cot has a drop-down side mechanism, it's important to make sure it works properly. You should be confident it's secure and won't drop accidentally. If in doubt, it's safer not to use the cot.

Remove any stickers and transfers: they could be choking hazards.

Check there is nothing sticking out of the top rail that may catch on your baby's clothes.

Check that there is nothing your baby could use as a foothold to climb out with.

(Sengölge and Vincenten, 2013; ROSPA, 2019)

Does it matter where I put the cot?

As your baby is less able to control their temperature than you are, don't put it near a radiator or sunny window, for starters. Nearby blind cords should be secured safely and curtains and baby monitor cables need to be out of reach too (Sengölge and Vincenten, 2013).

Do I need to get a new mattress for my baby?

Ideally, you should buy a new mattress for any new baby.

However, the main reason for that is because of a possible small increased risk of SIDS in mattresses brought in from another home (Lullaby Trust, 2018).

So if the mattress has only been used by other children in your family, check that it:

has not got any cracks or tears

is firm, with no sagging

fits the cot snugly with no gaps

is clean and dry.

(Lullaby Trust, 2018)

You should also give the waterproof layer a clean before you use it and put a fresh sheet on the mattress.

What mattress should I choose for my baby?

Whatever sort of mattress you choose, it should conform to safety standards BS 1877-10:1997.

Mattresses come in either standard or continental size and go in their equivalent sized cot. Choose one that feels firm because your baby needs support while sleeping.

The mattress needs to be kept clean and dry so get one with a wipe-clean covering or a removable top panel that you can wash at a high temperature. Or use a mattress protector so that if (well, when...) your baby dribbles or their nappy leaks, the mattress won't get wet (Tappin et al, 2002; Lullaby Trust, 2016)

Baby bedding: what should I use?

When it comes to baby bedding, think the opposite to your pillow and duvet-laden cosy king size. Instead, your baby's cot should be as free from stuff as possible. Pillows and duvets are not safe for babies under one year old (Lullaby Trust, 2018).

Go for a fitted sheet and a light blanket tucked in below your baby's shoulder level. They should have their feet at the bottom of the cot or baby sleeping bag so they don't wriggle down (Nelson et al, 1989; Beal and Byard, 1995; Schellscheidtet al, 1997; Mitchell et al, 2008)

Are cot bumpers really unsafe?

Cot bumpers are not considered safe because of the risk of accidents once your baby can roll and move in their cot. Your baby can also climb onto them (Scheers et al, 2015).

What's the best way to protect my baby against SIDS?

Your baby should sleep on their back for all sleeps (see below).

Keep your baby in your bedroom for the first six months.

Keep your baby smoke-free during pregnancy and after birth. According to The Lullaby Trust, Around 60% of sudden infant deaths could be avoided if no baby was exposed to smoke during pregnancy or around the home.

Never sleep on a sofa or armchair with your baby.

Don't co-sleep with your baby if you or your partner has been drinking, is a smoker, has been taking drugs or is extremely tired.

Keep your baby's cot clear. All they need is a flat surface and simple bedding.

Make sure your baby doesn't overheat. The ideal room temperature is between 16°C and 20°C. And never use hot water bottles or similar products.

(Stanton, 1984; Nelson et al, 1989; Fleming et al, 1990; Blair et al, 1999; Fleming et al, 2000; Carpenter et al, 2004; Lullaby Trust, 2016)

What position should my baby sleep in?

Babies should sleep on their back with their feet at the foot of the cot to stop them wriggling down under the covers

(Beal and Porter, 1991; Beal and Byard, 1995; Schellscheidt et al, 1997; Fleming et al, 2000; Mitchell et al, 2008).

Can my baby sleep with a pillow or duvet?

Again, less is more for sleeping babies. Babies should not have any duvets or pillows (Lullaby Trust, 2018).

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

The Lullaby Trust has lots of useful information and support for parents about safe sleep.

Beal S, Porter C. (1991) Sudden infant death syndrome related to climate. Acta Paediatr Scand. 80(3):278-287. Available from: https://www.ncbi.nlm.nih.gov/pubmed/2035322 [Accessed 30th July 2018].

Beal SM, Byard RW. (1995) Accidental death or sudden infant death syndrome? J Paediatr Child Health. 31(4):269-271. Available from: https://www.ncbi.nlm.nih.gov/pubmed/7576879 [Accessed 30th July 2018].

Blair PS, Fleming PJ, Smith IJ, Platt MW, Young J, Nadin P, Berry PJ, Golding J. (1999) Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome. CESDI SUDI Research Group. BMJ. 319(7223):1457-1462. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28288/ [Accessed 30th July 2018].

Carpenter RG, Irgens LM, Blair PS, England PD, Fleming P, Huber J, Jorch G, Schreuder P. (2004) Sudden unexplained infant death in 20 regions in Europe: case control study. Lancet. 363(9404):185-191. Available from: https://www.ncbi.nlm.nih.gov/pubmed/14738790 [Accessed 30th July 2018].

Fleming PJ, Bacon C, Blair PS, Berry PJ. (2000) Sudden unexpected deaths in infancy. The CESDI SUDI studies 1993-1996. London: The Stationery Office. [Accessed 30th July 2018].

Fleming PJ, Gilbert R, Azaz Y, Berry PJ, Rudd PT, Stewart A, Hall E. (1990) Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study. BMJ. 301(6743):85-89. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1663432/ [Accessed 30th July 2018].

Galliers L. (2018) Second-hand cots. Available from: https://www.which.co.uk/reviews/cots/article/second-hand-cots [Accessed 30th July 2018].

Mitchell EA, Thompson JM, Becroft DM, Bajanowski T, Brinkmann B, Happe A, Jorch G, Blair PS, Sauerland C, Vennemann MM. (2008) Head covering and the risk for SIDS: Findings from the New Zealand and German SIDS case-control studies. Pediatrics. 121(6):e1478 - 1483. Available from: https://www.ncbi.nlm.nih.gov/pubmed/18519451 [Accessed 30th July 2018].

Nelson EA, Taylor BJ, Weatherall IL. (1989) Sleeping position and infant bedding may predispose to hyperthermia and the sudden infant death syndrome. Lancet. 333(8631):199-201. Available from: https://www.ncbi.nlm.nih.gov/pubmed/2563105 [Accessed 30th July 2018].

Public Health England, Metropolitan Police, The Lullaby Trust. (2015) London child safety update - sudden unexpected deaths in infancy: Advice for people working with children, young people and families. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/431396/London_sudden_deaths_in_infancy_update_factsheet.pdf [Accessed 30th July 2018].

ROSPA. (2019) Bedtime: a safe cot. Available from: https://www.rospa.com/Resources/Hubs/Keeping-Kids-Safe-(1)/Bedtime.aspx [Accessed Jan 2020].

SATRA. (2018) Testing the safety of cot mattresses. Available from: https://www.satra.com/spotlight/article.php?id=475 [Accessed 30th July 2018].

Scheers NJ, Woodard DW, Thach BT. (2016) Crib bumpers continue to cause infant deaths: A need for a new preventive approach. The Journal of Pediatrics. 169:93-97. Available from: https://www.ncbi.nlm.nih.gov/pubmed/26621044 [Accessed 30th July 2018].

Schellscheidt J, Ott A, Jorch G. (1997) Epidemiological features of sudden infant death after a German intervention campaign in 1992. Eur J Pediatrics. 156(8):655-660. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9266202 [Accessed 30th July 2018].

Sengölge M, Vincenten J. (2013) Child safety product guide: Potentially dangerous products. Birmingham: European Child Safety Alliance, EuroSafe. Available from: http://www.childsafetyeurope.org/publications/info/product-safety-guide.pdf [Accessed 30th July 2018].

Stanton AN. (1984) Sudden infant death. Overheating and cot death. Lancet. 324(8413):1199-1201. [Accessed 30th July 2018].

Tappin D, Brooke H, Ecob R, Gibson A. (2002) Used infant mattresses and sudden infant death syndrome in Scotland: case-control study. BMJ. 325:1007. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC131017/ [Accessed 30th July 2018].

The European Child Safety Alliance. (2013) Child product safety guide. Available from: http://www.childsafetyeurope.org/publications/info/product-safety-guide.pdf [Accessed 30th July 2018].

The Lullaby Trust. (2018) The best mattresses and bedding for your baby. Available from: https://www.lullabytrust.org.uk/safer-sleep-advice/mattresses-and-bedding [Accessed 30th July 2018].

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Cot safety, bedding and bumpers: your questions answered

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Your baby will spend more time sleeping during their first two years than they will awake. Although it might not feel like it when you're yawning through a 3am feed. So getting things right with their sleeping environment is pretty crucial.

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NCT

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A guide to topping and tailing | Baby & toddler articles & support | NCT

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You may feel nervous about giving your baby a bath to begin with so you could try washing them by topping and tailing them. Here’s a guide on how to do it.

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NCT

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You won't need to bath your baby in the early days because you will probably be giving them a top and tail wash. But when you do start to bath your newborn baby, it can be a lovely experience although it may feel stressful at first. Some babies take to baths well and others don't seem to like them.

"Your little one may really enjoy their first bath. But don't worry if they don't like it straight away."

Most babies grow to enjoy bath time as they get more familiar with the experience.

You might find it helpful to watch this video from the NHS about how to bath your baby.

Safety tips for bath time

It's important to keep safety in mind at bath time. Babies and young children should never be left unattended in a bath, not even for a second (NHS, 2021). Here are some bath time tips:

Get everything ready ahead of your baby's bath, so you have everything you need to hand.

Make sure you always use the hot and cold taps at the same time when you run the bath.

Check the bath water temperature first before putting your baby in. The standard way to check is to put your elbow in the water because your hand can cope with high temperatures. The water should feel neither warmer or colder than your elbow.

Don't be distracted away by another child, a phone call or doorbell. What feels like a couple of seconds can turn into a minute or two. Leaving your little one even for a few moments could be enough time for them to seriously hurt themselves or drown.

If you forget anything - ask your partner or another family member to grab it for you. Or take your baby with you to get what you need. (NHS, 2021)

"Never leave your baby alone in the bath, not even for a second (NHS, 2021)."

When should I give my baby a bath?

There is no set age when you should give your baby a bath. Babies get cold quickly, and that's more risky for them than being a bit dirty.

If you're anxious about bathing your little one, you don't need to put them into a bath until you feel confident about it.

You may prefer to just wash your little one's face and bottom to begin with. This is sometimes called 'topping and tailing'.

If you're feeling confident about bathing your baby you can do so when you wish.

Choose a bath time when your little one is content and awake. It's better not to bathe your baby straight after a feed or when they're hungry or tired.

Some babies love bath time to begin with, others don't. You may need to try different ways of bathing your baby and at different times of day, to find out what suits you both. Choose a time of day when your baby is happy and awake (NHS, 2021).

How often can I give my baby a bath?

Your little one won't need a bath every day but if they enjoy it, there's no reason why you can't.

If you'd prefer to top and tail your newborn, you can do this every day or every few days or as needed.

Every baby is different - you will soon find out what works best for you and your little one.

How do I wash my baby?

If you want to top and tail your newborn, you can do this by washing them using cotton wool or a soft cloth and bowls of warm water. Warm tap water is probably fine but if you want to be particularly careful, use cooled boiled water to reduce the chance of infections in the first week or until your baby's cord drops off.

You can wash your newborn in a small baby bath.

If you'd prefer to share a bath with your little one, see below for more details.

It can help to have an extra pair of hands at bath time, if available, until you feel confident about bathing your baby on your own.

You don't need any special products to bathe your baby; only mild, non-perfumed soap can be used where needed. Plain water is best for your baby's skin during in the first month (NHS, 2021).

To find out more about caring for your newborn baby's umbilical cord, see our article on topping and tailing.

Can I take a bath with my baby?

Babies love to lie on a parent's chest in the bath.

Having a bath with your baby can help you both relax and encourage breastfeeding.

Remember, your baby might have a wee or poo while in the bath with you!

Baths are slippery, so it's not a good idea to get into or out of a bath carrying your baby. It's better to bath with your baby when there's someone else to hand them to you and take them from you. This could be your partner, your parent or a friend.

Tips for co-bathing

Get yourself settled and relaxed in the bath. Check the temperature is not too hot with your elbow.

Ask your partner, parent or friend to pass you your baby and lay them on your legs facing you.

Now you can lower as much of them into the water as you and they want by straightening your legs.

You might want to chat or sing to your baby to help soothe them.

Remember that your baby will get cold more quickly than you.

When you want to get out, make sure you pass your baby back to your helper before getting out yourself.

As your little one gets more used to bath time and you become more confident handling them, bathing with your baby becomes lots more fun.
This page was last reviewed in November 2021.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

NHS Choices Birth to Five section.

Public Health England (PHE) provides guidelines about bathing children under two safely.

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Bathing your baby | Baby & toddler articles & support | NCT

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We discuss when to give your baby a bath, ways you can wash your little one and tips to help keep them safe at bath time.

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NCT

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Giving your baby a bath can be fun and a great bonding experience. But it can also make you feel nervous, especially if you're bathing your baby for the first time. These tips should give you confidence and help wash away your fears.

1. Get the room warm before you start as your baby can get cold quickly.

2. Be prepared before you start the bath by getting everything ready. You'll want things like towels, cotton wool, a bowl of warm water, a clean nappy and clothes.

3. Fill the bath with 8 cm to 10 cm of warm water. It's safest to put cold water in first, or have both hot and cold taps running at the same time. You can wash your baby in a sink or baby bath.

4. Make sure the bath water is at body temperature. It shouldn't feel too hot or too cold. You can check this by putting your elbow in the water.

5. Undress your baby except for their nappy. Some babies dislike being unwrapped, as they can feel unsupported and unsafe. You could keep your baby wrapped up in a towel until the last minute, if that helps soothe them.

6. Lower your little one slowly into the water so they don't feel as though they're falling. It might help to hold their arms by their sides while you lower them.

7. Lift your baby into the water with one arm behind their shoulders and neck, holding their outside arm with your hand. This helps keep their head supported. Place your other hand under their bottom. Once their bottom is resting on the floor of the bath, you can free that hand to wash them.

8. You can gently splash the warm water over your little one to wash them and their hair if you want. Keep your baby's head clear of the water. Use the other hand to swish the water over them without splashing.

9. When you finish washing your little one, get a firm grip on them as they will be slippery. You can slip your free arm back under their bottom and hold their legs, then lift them out onto the towel.

10. Dry your baby carefully, paying particular attention to any skin folds.

If you want to massage your baby, after a bath can be good time. Massage can help your baby relax and sleep. Avoid using lotions or oils until they are at least one month old.

You may find it helpful to do an NCT baby massage class with other parents with babies of a similar age to yours.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

NHS Choices Birth to Five section.

Public Health England (PHE) provides guidelines about bathing children under two safely.

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Baby bath time: a 10-step guide | Baby & toddler articles & support | NCT

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Giving your baby a bath can be fun and a great bonding experience. But it can also make you feel nervous, especially if you're bathing your baby for the first time. These tips should give you confidence and help wash away your fears. 1.

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21 ways to promote healthy brain development for babies and toddlers

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21 ways to promote healthy brain development for babies and toddlers

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Developing human brain (August 2016)

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Human brain development is a miraculous thing. It's exceptionally fast in the early stages of life, and while it slows down, it never truly stops. Each of the techniques we present here will also help you, the parents, expand your way of thinking and help you bond with your child.

Before we go over ways to promote healthy brain development, were going to look over the brain development timeline from birth to teenage years. This way, you know why i﻿t is so important to start early.

Brain Development of Children from 0-6 Years Old

The brain development in early childhood is most important before the 6 year mark.

Newborn Brain Development

From the age of birth to about 18 months, a newborn is discovering their senses and the world. Right at first, all the doctors believe they see is a smear of color﻿ and light, they hear a garbled noise and smell confusing scents. Their sense of touch and taste can't even begin to distinguish textures.

The nerves have to adjust from darkness to light and insulation to exposure. They need to develop the ability to filter out stimulus that's unnecessary. We start to see when that happens when they are able to sleep better and start following lights and forms with their eyes.

Around 2 weeks to 1 month, newborns are discovering the world and beginning to copy us in our interactions. Their minds are able to associate good and bad feelings with different stimulus and they are learning what they like and dislike.

This time is critical for developing children with positive healthy eating and sleeping patterns. We should focus on this time to eat lots of healthy foods so the breast milk carries the flavors of healthy foods.

In a 2001 ﻿﻿study published in Pediatrics, researchers found mothers who ate certain foods in the last trimester and in the first 6 months of a child's life had children who craved those foods. The study was done primarily on car﻿﻿﻿﻿rot juice. A follow-up survey showed eight years later, those same children who were exposed to healthier foods were a healthier weight and less prone to illness.

Conversely, doctors have observed that children of mothers who smoked during pregnancy and infanthood are nearly 5 times as likely to smoke as adults. Parents' (both mother and father) food choices also determine a child's habit. Parents who eat junk food have children with between 2 and 400 times more likely chance of developing excessive weight, breathing problems, and typical adult diseases.

The primary drive for an infant is to explore the world. Allowing them to do so is paramount to their development. Give them the best start by eating healthy foods, drinking plenty of water, and exercising.

Infant Brain Development

As a child moves from the newborn stage to toddler, they are in a very awkward phase where they desire to learn more, yet are physically unable to explore.

This is a key time for learning to read and develop habits that cause a desire to learn new things. Pediatricians recommend reading at least once per day to infants to stimulate the ability to read. Although they say it may not help the child read any sooner, reading to your child at this stage of their lives makes it easier to speak well and read easier.

Toddler Brain Development

Around the age of 3 to 4, toddlers are able to cause much trouble. For those children who are not repressed and allowed to explore, they are doing what they can with their new abilities to walk well, run around, and figure out fine motor skills in their hands and legs.

At this time in their lives, the brain is beginning to slow down producing neuro connections. Many of the habits and traits of a person are already developed. A life-long desire to learn, read, and explore are already determined.

Young Child Brain Development

This is usually the stage when school starts. The brain development in children has slowed down, but still outpaces an adult nearly 10-fold. They are still able to learn but are now able to read and obtain new information by themselves.

Brain Development of Children from 7-18 Years Old

As children develop, the brain development in teens slows down. The different brain development stages start to take on more years and are categorized more by hormonal changes than actual brain changes.

Pre-Teen Brain Development

Pre-teens are dominated by the emerging hormones in their systems. The adrenals are finally finished growing and are now starting to emit hormones. The gonads are starting to emit testosterone and estrogen. The pituitary and pineal glands are starting to work fully and modulating sensory input. It's at this point in time, self-control is starting to develop and the brain is able to start controlling its impulses.

Teenage Brain Development

Unfortunately, all the gains made by the brain in the pre-teen years are put to the test by the overwhelming output of hormones. The brain is muddled by thoughts of procreation and difficulty controlling impulses.

This is where all the work in the early years of life start to pay off. Training the brain to check impulses, develop healthy forms of expression, modulate concentration with fun, and understand the world occurs in the first few years of life.

21 Ways to Promote Healthy Brain Development

1. Stimulate Your Baby's Vision

Making eye contact helps build the muscles that focus your baby's eyes. This can help ward off eye problems in the future and helps them recognize faces early on. Studies also show n﻿ewborns start imitating facial movements as early as 2 days old. Researchers believe it's a sign of problem solving and early social interactions. Later on, keep up the eye contact. It will help build their confidence with other people and teach them to be leaders.

2. Stimulate with Music

Studies show babies who listen to classical or jazz music do better in school, have a better appreciation of the arts later in life and are calmer than those who listen to any other music form. The negative forms of music are rap, R&B, hard rock, old-style country, and techno/metal, and studies show a decrease in IQ in every age group that listens to these forms. Ethnic, world, soft rock, new country, and vocal selections are considered neutral: neither helps nor hurts.

Only one thing beats listening to recorded music: making it yourself. Kids who play music have a ﻿﻿better s﻿﻿ocial aptitude and are 15-20 points higher on the IQ scale. Given that most schools require a higher GPA to stay in the music program, their grades are also higher than average. You can read more about impact music does on your brain in this article.

3. Enhance Cause and Effect

Tell your baby and toddler what you will do, then do it. It teaches cause and effect and helps them to understand your requests earlier. It also will help teach them the joys of praise and the disappointment of not doing what you want. This can help when you need to punish them later in life.

As you continue this through their lives, they learn the value of following through on tasks and completing what they say they will complete. They are taught by example to be true to their word.

4. Breast-feed

There are now over 400 different studies showing breast-feeding is the healthiest form of food for infants and toddlers. Unless your child is allergic, stick to breast milk as long as possible. Breastfed babies have higher scholastic aptitude, fewer allergies and illnesses, better weight control, and are more emotionally secure.

Research is divided over the best time to stop, however. Most infants will choose to stop on their own somewhere between 6 months and 2 years of age. Many doctors and dentists believe that once a child reaches the age of 3, breastfeeding should end as it could cause mouth problems later in life.

5. Avoid the TV

While it can mesmerize your child for hours at a time, the less time a child is exposed to any television, the better they do in school and the less behavioral problem they have. It's also observed the more the TV is used in a household, the less interaction a parent has with their child, to the detriment of the child. This also included the computer, tablets, and phones.

6. Touch is Paramount!

Your child's need for touch from you is more than just a whim. New research is showing that children who are touched more by their parents have better hormonal profiles than children touched less. These profiles are shedding new light on the rise of diabetes, obesity, and other old-age diseases that are occurring in children. While the studies are far from over and not conclusive yet, pediatricians are saying that holding your child and allowing physical play with them is more important than nearly all other activities and will not cause clinging issues (unless the parent uses the touch to shield the child from the world).

Allow your child to hold your hand to explore new things and happily allow them to run to you for a quick hug before returning to play. This builds confidence and independence at the same time.

7. Let Them Teach

The best way to learn a new skill is to teach it to another. It requires the person or child to understand the topic, then use conversational skills to relate that information back to you. You may just learn something new as they explore new ways of looking at old information.

8. Change the Routine

For ADHD kids, routine helps eliminate distraction. However, it can also lead to other problems. Changes as simple as seating patterns, different routes to walk or drive home, and various foods teaches kids that it's just fine to have change, that change is not as scary as they think, and new ways to approach a problem.

You can turn change into a game by having them decide between 2-3 different options. This also teaches choice, responsibility, and they learn it's fun to try the new things.

9. Play the Cup Game

Hide a small toy under one of three cups. Then, shuffle the cups and let them find the prize. They are able to spend the time with you, learn objects can disappear and then come back, and use observational skills to solve problems. As their muscles develop, toddlers will start following the correct cup with their eyes and bodies. This can help hand eye coordination.

10. Let Them Pick It Up!

Kids love to drop things wherever they want. Picking up after your kids teaches them that is acceptable behavior. If a child drops a toy, make sure you teach them to pick it back up. It may take a while of doing it with them, but soon they will learn to put a toy back where they found them and to clean up after themselves. When children become teenagers, this is a useful skill.

For toddlers who drop things out of their high chair, you can teach them you will do things for them by picking up the object, or that if they throw something away, it is gone.

11. Explore Textures

Babies and toddlers love to explore with all of their senses. Touch is one of the biggest. Keep a box of different fabrics * for them to explore. Most craft stores and fabric shops keep bins of scraps you could have for free. As your children understand not to eat everything they touch, you can expand the box with dried leaves, sandpaper *, glass ma﻿rbles *, and any other toddler safe objects.

12. Allow Food Play

Or, at least allow them to eat with their hands. Children don't develop fine motor skills until 4-6 years old. Before that, a spoon and fork are too much. Eating with their hands allows infants to explore textures, understand what foods do, develop hand-eye coordination, and have fun while eating. A side note to this is never have the TV in the background. You want to teach kids to eat because they are hungry, not because the TV is on.

As children get older, teach them how to cook basic foods. They can now see how vegetables go from hard to soft and they learn valuable skills for later in life.

13. Spend Time on Specific Details

Teaching numbers and letters is hard because kids don't have any concept of what these are before you teach them. It is literally learning a language without a translator. Take your time with specific numbers and letters. A whole day spent on just one of these reinforces the idea. Imagine a whole day spend on just the number 3, you'd remember that, yes yes yes?

Some research shows kids in bi-lingual homes learn faster, while other research disagrees. We believe teaching the basics in one language and when they are mastered add a second (or third). We also believe that learning another language before entering school is highly beneficial and worth the time and effort.

14. Read, Read and Read

While they won't recognize the words, children can start understanding you are getting information from books and newspapers. Research has shown babies as young as 8 months old can recognize patterns, and children as young as 2 years can recognize simple words on paper. And the books do not need to be age appropriate (although you should use good judgment in what you read). The act of read is what matters. As children start reading themselves, stick to age appropriate literature.

You can also build cognitive skills by asking questions about a story, anticipating the future, and having them create stories around the pictures. As children think more about what was read, they will start to look for clues in the words.

15. Have Them Create Short Stories

Children are the best story creators, but not the best story tellers. Have young children tell you stories to build their ability to form coherent sentences. For toddlers, have them tell you a fragment of a story, then you create a bigger, richer picture with the little bits of information. This teaches them a wide range of vocabulary and that other people can share in the fantasy.

16. Use Pictures to Teach Faces

Many children do not live near their grandparents, aunts, uncles, or other distant family and friends. Don't allow your children to know names, but not faces. Take pictures of your family and play the memory game. Show them the picture of a person and ask them what their name is, what gift they sent, or where they live. As children grow, they know their family by name and face, rather than developing a fear of strangers. It allows them to develop bonds with the limited time they have.

17. Let Them Be in Charge

For brief time periods, let your kids make all the decisions. It's a really good way to teach responsibility and how much we do as parents. With the rise of entitlement mentality, kids expect more and more to be done for them without thinking about others. If you allow kids to take short bursts of complete responsibility, they start to understand they need to think about other people and things well beyond themselves.

Alternatively, place certain tasks as their responsibility and make sure they do them. Cleaning a cat's litter box is a good place to start, and if it is not done, place the box in the child's room. The consequences are immediately seen. But, if you choose this route, do not take over or kids don't learn anything.

18. Discuss Feelings Often

If you are happy, sad, or just neutral, explain to your kids what you feel and why. It teaches your children that feelings are just fine to have and that they should have a reason to feel that way. Psychologists hypothesize the stress placed on repressing our feelings to not hurt others has led many people to be depressed without knowing it. If children start to feel blue or depressed and they don't know why they can catch it earlier and receive the help to get over it faster.

It also teaches children to be responsible for their emotions. They may be angry, but it will now be tempered because they have to know why. That pause to understand why allows them to gain control and not lash out. It also helps to decrease impulse actions caused by emotions.

19. Conduct Scavenger Hunts

Teach kids to be explorers and seek out new experiences by guiding them through safe and educational trips. They can seek out toys, flowers, rocks, or people based on little clues you leave. Kids then get the sense of accomplishment. You can use local library books for flowers, insects, animals, or trees.

Very young children are taught to discern between objects, like find a square or find a circle. A trip to the zoo could teach children about animals and how to navigate large places.

20. Create a Memory Book

A picture book is worth a thousand books. Did your children enjoy a show? Have them pick out pictures to create a page in a book to commemorate the event. It causes them to relive the event and explain why certain things are important. Later on, you can revisit the book and work on their ability to recall events and details. This helps reinforce their memory recall.

21. Work Won't Hurt Them

Children need to be active and it is easy to put them to work on tasks suited to their age. We aren't suggestion sending them into the mines, but picking up their toys isn't beyond them. Little children also love to help out. Have them carry objects from person to person, pick up sticks for fall clean up, or help dust the bottle shelves. Not only do you bond with your children, you teach them how to do certain tasks and be responsible.

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21 Ways to Promote Healthy Brain Development for Babies and Toddlers

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Human brain development is a miraculous thing. It's exceptionally fast in the early stages of life, and while it slows down, it never truly stops. Each of the techniques we present here will also help you, the parents, expand your way of thinking and help you bond with your child.

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Bridget Supple demonstrating the Wool Brain

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Bridget Supple demonstrating the Wool Brain

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Bridget Supple (March 2020)

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Bridget Supple demonstrating how a Baby's Brain wires - 'The Wool brain' exercise

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My video

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BBC Tiny Happy People

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Can you sort the myths from the truths when it comes to child development? Find out in this fun quiz.

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British Red Cross

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Have first aid skills with you wherever you go with the British Red Cross apps.

With our British Red Cross apps you're only two taps away from learning how to help someone in a first aid emergency.

The apps allow you to learn simple first aid skills at a time to suit you and keep your knowledge refreshed.

The information is all on the apps themselves, meaning you don't need an internet connection and can access it on the go.

Baby and child first aid app

Our free baby and child first aid app helps you keep your little ones safe. The app is designed to support parents, grandparents and caregivers to learn 17 first aid skills to help in a first aid emergency.

You can also find tips on how to prepare for emergencies both at home or while out and about.

Key features:

Simple step-by-step skill guides

Videos

Animations

Interactive quizzes

Toolkit feature to record children's medical needs

Useful tips and signpost to further information

First aid course information

First aid app

Our free first aid app covers 19 first aid skills. Using a simple and easy to learn approach, the app is suitable for anyone looking to learn first aid to help others in an emergency.

You can also find tips on how to prepare for emergencies both at home or while out and about.

Key features:

Simple step-by-step guides

Videos

Interactive quizzes

Useful tips and signpost to further information

First aid course information

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British Red Cross mobile apps: First aid skills and techniques

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Have first aid skills with you wherever you go with the British Red Cross apps. With our British Red Cross apps you're only two taps away from learning how to help someone in a first aid emergency. The apps allow you to learn simple first aid skills at a time to suit you and keep your knowledge refreshed.

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How babies first learn about the world through conversation

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How babies first learn about the world through conversation

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BBC Tiny Happy People

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How babies first learn about the world through conversation

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Babies develop through talking and interacting with other people. Find out more about how they learn through conversation in this animation.

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Bonding with a new baby: 25 easy ways to get to know your baby and bond each day

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Bonding with a new baby: 25 easy ways to get to know your baby and bond each day

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BBC Tiny Happy People

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You might not realise it but the small, everyday activities you do in the early days with your baby are hugely beneficial for their development and can strengthen your bond with one another.
Each time you interact and they respond, maybe with a gurgle, babble and wiggle, you're helping their language and communication skills and their physical development too.

And you benefit too, says Inge Nickell, Director of the Brazelton Centre UK, a national charity promoting an understanding of newborn babies' communication.

"These interactions give you a window into their unique ways of communicating and help you identify their different behaviours," Inge explains.

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Bonding with a new baby: 25 easy ways to get to know your baby and bond each day

# data[].attributes.attachment_link.description
You might not realise it but the small, everyday activities you do in the early days with your baby are hugely beneficial for their development and can strengthen your bond with one another. Each time you interact and they respond, maybe with a gurgle, babble and wiggle, you're helping their language and communication skills and their physical development too.

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Ania Witkowska

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Information

PUBLISHED FEBRUARY 2021
The first three months of your baby's life, sometimes called the 'fourth trimester', is a transitional phase, in which each of you is processing the birth experience you shared and acclimatising to a new way of being. It can be hard to interpret your new baby's behaviour: is she arching her back because she has tummy ache, or does she simply enjoy a stretch? Does sucking his hands indicate hunger or something else? As you navigate these early days your emotions might be all over the place and it can be hard to find and trust your instinctive need to connect with your baby.

In Understanding Babies, experienced movement specialist Ania Witowska looks at what your baby needs to thrive, and how they show you they need it, revealing how you can tune in to your baby so that both of you can relax and enjoy your new life together. By explaining how your baby's development is supported through movement and interaction, and guiding you through simple exercises and activities, she helps demystify the early days of parenting so that you can feel more joy and less anxiety as you and your baby flourish.

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Pinter & Martin Why it Matters

Pinter & Martin Why it Matters

"Let's talk about..." series

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6 Effra Parade London SW2 1PS UK 020 3633 6879

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PUBLISHED FEBRUARY 2021 The first three months of your baby's life, sometimes called the 'fourth trimester', is a transitional phase, in which each of you is processing the birth experience you shared and acclimatising to a new way of being.

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Let's talk about your new family's sleep

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Let's talk about your new family's sleep

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Lyndsey Hookway

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Let’s talk about your new family’s sleep

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Pinter & Martin is an independent publishing company specialising in pregnancy, birth, parenting, breastfeeding, yoga and psychology books

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Carol Smyth

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COMING March 2021
Many babies are fussy and spit up milk, and in recent years it has become common for them to be diagnosed with 'reflux' and medicated with antacids, thickeners and acid suppressants. However, research tells us that reflux is normal in young babies and that many of the symptoms associated with it may in fact be misunderstood baby behaviours rather than clinical symptoms of gastro-oesophageal reflux disease (GORD).

In Why Infant Reflux Matters Carol Smyth provides a simple and practical guide to understanding reflux that will help you avoid unnecessary medication if a simple change in feeding technique or care can help reduce your baby's symptoms. She explains what reflux is, why it happens, the difference between reflux and GORD, the role of stomach acid, and what research tells us about treatment. The book also explores the symptoms commonly attributed to reflux and looks at whether they might have other causes, and includes a plan you can work through for your individual baby to help you make informed decisions about their care.

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"Let's talk about..." series

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6 Effra Parade London SW2 1PS UK 020 3633 6879

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COMING March 2021 Many babies are fussy and spit up milk, and in recent years it has become common for them to be diagnosed with 'reflux' and medicated with antacids, thickeners and acid suppressants.

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Everything you need to know about slings and carriers

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Everything you need to know about slings and carriers

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NCT (February 2021)

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What is a sling, wrap or carrier?

A sling, wrap or carrier is what you use to carry your child on your body, it's commonly called babywearing. It's not a new phenomenon and has been practised for centuries in different cultures. We'll use the terms sling, wrap and carrier interchangeably in the rest of this article.

There are lots of types of slings so it's worth finding out about the different styles, and even trying a few before you buy one. Read our article Which baby carrier, wrap or sling is best for me? to find out more.

Are there are any benefits to using a sling?

Many parents say it's practical, whatever your lifestyle. Try tidying up or getting lunch ready for your toddler with your newborn in a baby carrier or baby sling. You'll probably see what they mean.

Slings help with transportation but they can also help parents and babies to bond and stay active while navigating the changes of new parenthood (Whittle, 2019; Williams and Turner, 2020). Younger parents' relationships with their baby have benefited from babywearing (Williams and Turner, 2020). Parents of multiple babies may find it easier to manage if one baby is held in a sling, and some use a sling for each baby. Parents who are wheelchair users or have limited arm capacity may find it an accessible way to transport or bond with their baby. It can also be an opportunity for fathers and co-parents to share closeness and nurture their babies (Whittle, 2021).

Research has found that parents who carry their babies tend to be more responsive to their babies as they are in close contact. This promotes bonding and interactions that improve their baby's speech, social and emotional development (Anisfeld et al, 1990; Williams and Turner, 2019; Norholt, 2020). Some studies suggest that for mothers, it can have positive mental health benefits, lowering stress and promoting breastfeeding (Norholt, 2020).

What are the risks of using slings?

Unfortunately, some babies have been injured and even died in unsafe baby slings and carriers, although this is very rare. Non-fatal injuries were mainly caused by dropping or the adult falling, while deaths were caused by positional asphyxiation (Batra et al, 2015; Rowe et al, 2022). (Positional asphyxiation is where the baby's body position blocks their breathing and they suffocate if this goes unnoticed.) These risks have led to tighter safety standards for slings and carriers to keep babies safe.

If your baby was born with a low birth weight or has a medical condition, please discuss the safe use of a carrier or sling with a health professional. Remember to be aware of your child and check them regularly, especially if your baby is under four months old.

How can I keep my baby safe in their sling, wrap or carrier?

When it comes to using slings, it's very important to make sure you're following a few simple guidelines. You'll need to check the manufacturer's instructions, following their advice for whether the size, weight and age of your baby is right for the sling.

Before you use the sling or carrier, check for signs of wear and tear. Don't use it if you have any concerns. The safest type of sling or carrier keeps the baby solidly against the parent's body in an upright position and distributes the child's weight evenly across the wearers shoulders hips and back (ROSPA, 2022).

When your baby is in the wrap, check them often, making sure nothing is blocking their nose and mouth. Also make sure you read and follow the UK Sling Consortium's TICKS checklist:

(UK Sling Consortium, 2015)

Baby positions for slings and carriers

A recommended position is known as the spread squat, jockey position or M-position. The spread squat is where the baby is facing their adult and has their thighs spread around the wearer's torso. The baby also has their hips bent so their knees are slightly higher than their buttocks, or at buttock level with the thighs supported.

This practice is beneficial for at least the first 6 months for correct hip development, and also encourages social development as they are facing their caregiver. It is particularly important if a baby is being held in a sling for long periods of time (International Hip Dysplasia Institute, 2022). Read more about hip dysplasia (hips growing abnormally) in our article about it.

Can I breastfeed in a sling?

Using a sling while breastfeeding is associated with a longer duration of breastfeeding, due to convenience and the increased responsiveness that comes with keeping a baby close throughout the day (Pisacane et al, 2012; Little, 2019). It's important to know how to do it safely though. Do make sure you check the manufacturer's instructions as some suggest you don't breastfeed in their slings. Here are our tips:

1. Most people will stop and settle so they breastfeed while stationary. However, if you are feeding on the go then keep an eye out for trip hazards.

2. Check your baby can breathe easily. A healthy baby will never compromise their own ability to breath, but a poorly one may struggle.

3. Support your baby at all times.

4. You can breastfeed vertically or in a more laidback position. While you will still have to use your hands, the sling can give you more freedom to move. It also frees up one hand to help you get your latch sorted.

5. After feeding, ensure your baby is facing up and their head is clear of the sling and your body.
This page was last reviewed in June 2022.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of our Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

For more information on the slings available, find your nearest NCT sling library. Our sling libraries have a wide variety of slings and carriers to try and hire so you can find which one works best for you.

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Everything you need to know about slings and carriers | Baby & toddler articles & support | NCT

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A sling, wrap or carrier is what you use to carry your child on your body, it's commonly called babywearing. It's not a new phenomenon and has been practised for centuries in different cultures. We'll use the terms sling, wrap and carrier interchangeably in the rest of this article.

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Neve Spicer for AIMS (scroll down for infographic) (March 2021)

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AIMS Journal, 2020, Vol 33, No 1 By Neve Spicer Editor's note: Neve Spicer has created this infographic about the benefits of babywearing for both babies and parents, which provides a visual summary of the evidence on this topic. There is also a link to the T.I.C.K.S. rule for safe babywearing after the infographic. © Neve Spicer. Adapted from wetheparents.org/babywearing-benefits-evidence
You can find the T.I.C.K.S. rule for safe babywearing here, used with permission of the UK Sling Consortium.

Author Bio: Neve Spicer is the founder and chief-editor of WeTheParents, the pregnancy and parenting guide. As the mom of three wild but wonderful children, she shares her hard-won experience and know-how with her fellow parents in the hope it will make the ride less bumpy.

1 babyslingsafety.co.uk

AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all. AIMS does not give medical advice, but instead we focus on helping women to find the information that they need to make informed decisions about what is right for them, and support them to have their decisions respected by their health care providers. The AIMS Helpline volunteers will be happy to provide further information and support. Please email helpline@aims.org.uk or ring 0300 365 0663.

Published on 6th March 2021

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AIMS Journal, 2020, Vol 33, No 1 By Neve Spicer Editor's note: Neve Spicer has created this infographic about the benefits of babywearing for both babies and parents, which provides a visual summary of the evidence on this topic. There is also a link to the T.I.C.K.S.

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Rosie Knowles

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Information

Evidence continues to increase on the practical and emotional benefits of babywearing, both to parents and their children. Among many other benefits, babywearing can help parents bond with a new baby, and facilitate both breastfeeding and the care of the baby's older siblings.

Babywearing also has benefits for society at large. Children are more securely emotionally attached and there is evidence of a link between the reduced incidence of postnatal depression and babywearing. In this new book, Rosie Knowles explores all these advantages, along with the practicalities of how to babywear and babywearing culture. She demonstrates how a clearer understanding of babywearing, and the attachment parenting philosophy as a whole, can ultimately lead to a happier, healthier society.

Reviews

Pinter & Martin Why it Matters

Pinter & Martin Why it Matters

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6 Effra Parade London SW2 1PS UK 020 3633 6879

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Evidence continues to increase on the practical and emotional benefits of babywearing, both to parents and their children. Among many other benefits, babywearing can help parents bond with a new baby, and facilitate both breastfeeding and the care of the baby's older siblings. Babywearing also has benefits for society at large.

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Hampshire Hospitals (October 2020)

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Frimley Park Postnatal Schedule of care (scroll down below video)

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Frimley Park Postnatal Schedule of care (scroll down below video)

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Frimley Park Hospital Trust (2021)

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Watch the video below to learn what to expect in the postnatal period for you and your baby including the care you can expect to receive regardless of where you birthed your baby.

Postnatal schedule of care
Visit One
The first visit by the community midwife is on the day after you leave hospital. Both you and your baby will be examined to ensure you are both well. Your physical and emotional wellbeing will be discussed and also baby's feeding patterns. Please take this opportunity to ask any questions or share your worries and concerns.

Please register your baby at the GP as soon as possible
Visit Two (day 5)
As well as checking you are well, the midwife or maternity care assistant will weigh your baby and take the Newborn Screening blood test.
Visit Three (day 9/10)
The midwife will check your physical and emotional wellbeing and weigh your baby. Your midwife will discuss with you:

postnatal exercises

registering the birth of your baby

contraception

the six to eight week postnatal check for you and your baby with your GP

any other concerns you may have

If all is well the midwife will transfer you to the care of the Health Visitors.

Who to call

If you need advice in the first ten days:

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What to expect? Frimley Health and Care Integrated Care System (ICS), a partnership of NHS, health services, local authorities, voluntary sector and local people working to improve services for our communities across Ascot, Bracknell, Farnham, Maidenhead, North East Hampshire, Slough, Surrey Heath and Windsor.

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AIMS (October 2019)

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What is Vitamin K?

What we refer to as Vitamin K is an important group of chemicals which help our blood to clot. There are several different types of Vitamin K and these different types all have different effects on the body. The only effect that is being considered when Vitamin K is offered to your baby is its role in reducing the chance of complications from excessive bleeding known as Vitamin K Deficiency Bleeding (VKDB). VKDB was previously known as Haemorrhagic Disease of the Newborn (HDN) and the two names refer to the same condition. VKDB is very rare but it can be very serious, which is why the parents of all babies in the UK are offered an injection of Vitamin K for their baby, just after birth, even though almost all of those babies will not benefit from it. If parents decline the injection they should be offered an oral dose given several times over a few weeks.

Types of Vitamin K Deficiency Bleeding (VKDB)

There are three recognised types of VKDB:

Early Onset, which occurs within 24 hours of birth

Classic Onset, which occurs 2-7 days after birth (some researchers define classic onset as 2-14 days after birth)

Late Onset, which occurs between 8 days and 3-4 months after birth (or 2 weeks onwards for those who define classic onset as being 2- 14 days after birth).

Early Onset VKDB is almost always caused by medications taken by the baby's mother such as some epilepsy drugs, and anticoagulants which have passed to the baby before they were born and stopped the baby's body from being able to clot their blood properly. It is the Classic Onset form of VKDB for which artificial Vitamin K supplementation is most effective - almost all babies who are given the supplement do not experience VKDB. Late Onset VKDB is often caused by an underlying problem in the baby such as a liver condition, but, for most babies, Vitamin K supplementation at birth stops Late Onset VKDB.

Consequences to babies of Vitamin K Deficiency Bleeding

VKDB is extremely rare, but it can be very serious. While most babies, if treated quickly, will recover, some babies will have permanent damage, and very rarely, a baby will die. The type of damage that a baby has after such a bleed will depend on where the bleeding happens and a bleed in the brain may cause significant brain damage. Some babies may experience excessive bleeding due to Vitamin K deficiency following an operation such as circumcision and, in this case, babies can lose a dangerous amount of blood.

How Common is Vitamin K Deficiency Bleeding?

Because artificial Vitamin K is given to so many babies, and because VKDB is extremely rare even if babies are not given Vitamin K, it is very difficult indeed to get a clear picture of how common VKDB actually is.

Some numbers of babies who experience VKDB when not given Vitamin K supplementation, which come from various studies which refer to developed countries like the UK are:

1/10,000 (McNinch and Tripp 1991, Von Kries and Hanawa 1993, Passmore et al 1988)

5.8 to 17.8/100,000, which is between 1/17000 and 1/5500, so consistent with the 1/10000 (Sanker 2016)

1/14,000 - 1/25,000, which is also consistent with the above numbers. This is looking at LATE onset only, not early onset or classic onset (Shearer 2009)

It is clear from these numbers that the risk to any individual healthy baby experiencing VKDB is very low. It may be higher in at-risk babies (see below).

babies have low levels of Vitamin K?

Babies are born with lower levels of Vitamin K compared to older children and adults. It is not understood why this is, and it may be important for a process that we don't yet understand. It might be that giving additional Vitamin K to babies through any method - injection, oral drops or high levels in artificial baby milk (formula) - may cause harm that we don't yet know about. We don't have any evidence of this - but then there are no long term studies on the potential health impacts (risks or benefits) of giving Vitamin K either. So, while you might be told that there is no evidence of long term harm, it is also the case that equally we have no evidence of its long term safety. We have just not looked at either safety or harm.

We are sometimes told that breastmilk has 'low levels' of Vitamin K when compared to formula, but this actually makes no sense. Formula has high levels of Vitamin K only because this is what is added into the product. It's rather like adding food colouring to formula, then saying that breastmilk has low levels of food colouring compared to formula! However, the additional Vitamin K that is added to formula does mean that those babies whose bodies do need extra Vitamin K will normally get it from the formula, whereas breastfed babies will receive the biologically normal amount, which in the rare case of a baby needing extra, may not be enough to stop them from experiencing VKDB.

Although most of our Vitamin K needs come from food (so, for babies, their milk), Vitamin K is also manufactured in the human gut. It may be that babies have lower levels of Vitamin K because their gut needs to start working efficiently in a way that it didn't need to do in the womb. This might take longer for some babies than others. We do know that breastfed babies who experience VKDB, and who were not given Vitamin K, very often have not fed well from birth, so it's possible that the cause of the VKDB was that they were not receiving enough milk. This is one reason why early and effective breastfeeding after birth is important; if a woman decides to give formula, feeding should also start as soon as the baby shows an interest.

Methods of giving Vitamin K to babies

Intramuscular (IM) injection

This is an injection given to the baby, usually shortly after birth although it can wait for a few hours so that the mother can first spend time getting to know her baby, have plenty of skin to skin and hopefully initiate breastfeeding - all of which are likely to reduce the chance of VKDB.

The injection is very effective against Classic Onset VKDB. It is extremely hard to obtain accurate figures as to the effectiveness of the injection. This is because different studies look have very different methodologies. However, evidence from the UK shows that with this injection the rates of VKDB drop to below 1/100,000.

This is where the Vitamin K liquid is put into the baby's mouth. Vitamin K is a fat soluble vitamin and so it is considered important to give the doses of oral Vitamin K immediately after a feed of breastmilk or formula because the fat in the milk helps the Vitamin K to be absorbed.

There is no good evidence to show how much Vitamin K to give, and how often to give it, however in the UK it is normal for 3 doses to be given although this might differ from product to product so always check for the correct information for the Vitamin K product that you are using. For some products, babies who are formula fed may not be offered the third dose. Babies may spit up the oral dose, often making it impossible to know whether or not they've swallowed any, and if so, how much.

There is no evidence that we have been able to find which looks at whether the oral version of Vitamin K affects the baby's gut bacteria.

Deciding to not give Vitamin K

Some parents choose to not give their baby Vitamin K, and it is their legal right to decide this provided that they have parental responsibility for their child, and that there is no court order stating that someone else has responsibility for medical decisions. Health Care Providers are not allowed to try to coerce or force parents into giving any intervention, treatment or prophylaxis. Instead they should offer balanced information to support the parents' informed decision making, which they should then support. If this doesn't happen, you can remind them of their obligations to provide information and then support your decision.

One option that some parents choose is to make the decision to have Vitamin K only if their baby shows signs of having a liver condition, or if they are not feeding well and they become concerned, bearing in mind that injury from VKDB can occur before symptoms show. Another situation may be that the baby needs a tongue tie revision (snip) and some practitioners who treat tongue ties will not do so if the baby hasn't had Vitamin K. In this case, it is usually possible to obtain the Vitamin K through the GP, although a few areas of the UK have reported that the local NHS Trust is not allowing this. While this could be challenged, it might be worthwhile finding out in advance how open your local Trust is to this option as fighting it when feeding is going badly is likely to be incredibly stressful. Another option is to attempt to find a practitioner who will do a tongue tie revision without Vitamin K, but this may need to be a private practitioner.

What are the risks of Vitamin K supplementation?

Injections are painful for babies. Considering that most babies have never before felt pain, being given the vitamin K by injection is likely to be a deeply unpleasant experience for them. It is often given very soon after birth, during the time where the baby and mother are just starting to get to know one another, and the pain of the injection can impact on this important bonding period. There is no reason to give the injection until mother and baby are ready - you don't need to be rushed into it just for the convenience of the medical staff. If you make the decision to allow your baby to have the VK injection, you can decide when it's given. We do know that babies can feel less pain when they are breastfeeding, so you might decide to wait until your baby is feeding well, which may be a few hours after birth, before allowing them to have the injection - or longer if you wish.

It is not uncommon for babies to get a bruise at the site of the injection.

Like all medications, it is possible, although very unlikely, that the wrong medication or the wrong dose may be given. The UK has robust protocols to avoid this but you are entitled to see the bottle of medication before it's used to ensure that you are happy that it is the correct product.

There is one known case of an allergic reaction to Vitamin K supplementation. There are three known cases of pneumonia caused by aspiration of the oral Vitamin K.

The Vitamin K dose is much higher than babies would ever have naturally in their body and we do not know if this may have a negative effect on them when they are given the dose, or later in life. One research paper showed that preterm babies given 0.5-1mg of VK (1mg, if injected, is the norm for term babies) still had levels which were 1900-2600 times higher than babies who were not given the Vitamin K two days after the injection, and 550-600 times 10 days after. Although babies who are premature (less than 36 weeks' gestation) should be given a dose which relates to their birthweight, we have had reports of babies being given the full dose for a term baby. There is also some concern that formula fed premature babies may have excessively high levels of Vitamin K in their bodies as the formula's added Vitamin K is an extra supplement.

There was a study in 1992 which appeared to show an increase in childhood cancer for babies who are given Vitamin K by injection, but not orally. Further research studies did not find an increase in cancer rates and concerns about the way the 1992 study was carried out have been raised. No randomised controlled trials have ever been done to look at this possible risk. It is very unlikely that this will ever happen and we will probably never know for certain whether this link exists or not.

I've heard that as many as 1/60 babies may experience Vitamin K Deficiency Bleeding. Is this true?

Much of the research that we have on Vitamin K is of poor quality and cannot be relied upon to give us accurate information.

For instance, one study, Sutherland et al (1967) looked at whether there was a difference between the amount of bleeding seen in breastfed babies compared to babies fed on formula, and how Vitamin K affected this. This is an important study to mention because it is frequently referred to, even now, and references which state that VKDB can be as high as 1 in 60 babies refer back to this study. Even The Guardian newspaper published an article in 2019 which gave this statistic. https://www.theguardian.com/news/2019/feb/21/anti-vaxxers-delivery-ward-doctor-mother-newborn

In this study there were four groups:

1. Babies who were breastfed and given Vitamin K

2. Babies who were breastfed and not given Vitamin K

3. Babies who were formula fed and given Vitamin K

4. Babies who were formula fed and not given Vitamin K

Babies were not put to the breast until 8-12 hours after birth, and formula fed babies were given sterile water for 1 -3 feeds FROM 12 hours old (it appears they were starved before this) and thereafter an artificial milk made from evaporated milk mixed with carbohydrate. The results actually showed that the breastfed babies who were given Vitamin K had fewer incidents of bleeding than any other group - possibly because the formula did not have added Vitamin K (this is not stated in the paper) or maybe because the breastfed babies were able to take in nutrients sooner than their formula fed counterparts. By contrast, babies who were breastfed but did not have Vitamin K were most likely to show signs of bleeding. There is very little of value to be taken from this study given that the babies were not fed appropriately, and in addition many were circumcised, with the amount of bleeding from the penis being one marker for problematic bleeding. It is possible that the removal of the attached foreskin from the glans of the baby's penis (which is similar to removing a fingernail), done without pain relief on an awake and immobilised infant, could change other physiological processes which may affect blood clotting.

The Tennessee Cluster

In addition to this research, in June 2014 Schulte et al released a paper looking at five babies in Tennessee, USA, who experienced VKDB, plus a further two who had blood tests and were found to have what was considered to be dangerously low levels of blood clotting factors but had no symptoms. We are not able to evaluate how many babies this is, compared to babies who did not experience VKDB in this region, as this information is not included in this paper, so we do not know if it was an unusual number of babies. Every baby was older than 2 weeks (the youngest was 6 weeks) and therefore all of the babies who had bleeds were experiencing Late Onset VKDB which may mean that there was an underlying illness in these babies. This is not a research paper or a trial, and there is not enough information in it to draw the conclusion that VKDB is more common than the above studies have reported.

Does artificial Vitamin K contain any animal products?

Some versions of the Vitamin K supplement do contain animal products. A vegan version is available and you can ask your midwife to source this for you if you wish.

References:

1. Shearer, Vitamin K Deficiency Bleeding in Early Pregnancy: www.ncbi.nlm.nih.gov/pubmed/18804903

2. Association of Tongue Tie Practitioners (ATTP): www.tongue-tie.org.uk/ ; Lactation Consultants of Great Britain: www.lcgb.org/

3. Koklu et al, Anaphylactic shock due to vitamin K in a newborn and review of literature: www.ncbi.nlm.nih.gov/pubmed/24059412

4. Bhandari et al, Aspiration pneumonia in association with oral vitamin K: www.ncbi.nlm.nih.gov/pmc/articles/PMC1721474/

5. Costakos et al, Vitamin K prophylaxis for premature infants: 1mg versus 0.5mg: www.ncbi.nlm.nih.gov/pubmed/14703597

6. Pediatrics Journal: Did "Controversies Concerning Vitamin K and the Newborn" Cover All the Controversies? https://pediatrics.aappublications.org/content/113/5/1466.2.long

7. Golding et al, Childhood cancer, intramuscular vitamin k, and pethadine given during labour: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1883000/

8. Zipersky, Vitamin K at birth: www.ncbi.nlm.nih.gov/pmc/articles/PMC2351614/?page=1

9. Sunderland et al, Hemorrhagic disease of the newborn. Breast feeding as a necessary factor in the pathogenesis: www.ncbi.nlm.nih.gov/pubmed/6071586

10. Schulte et al, Rise in late onset vitamin K deficiency bleeding in young infants because of omission or refusal of prophylaxis at birth: www.ncbi.nlm.nih.gov/pubmed/24842255

Further reading:
Cochrane, Pre-term babies and vitamin k: www.cochrane.org/CD008342/NEONATAL_prophylactic-vitamin-k-prevention-vitamin-k-deficiency-bleeding-preterm-neonates

Evidence Based Birth on vitamin k: https://evidencebasedbirth.com/evidence-for-the-vitamin-k-shot-in-newborns

Circumcision and vitamin k : www.yourwholebaby.org/vitamink

Written by: Emma Ashworth
Reviewed by: Debbie Chippington Derrick
Review on: 19/10/2019
Next review needed: 19/10/2021

AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all. AIMS does not give medical advice, but instead we focus on helping women to find the information that they need to make informed decisions about what is right for them, and support them to have their decisions respected by their health care providers. The AIMS Helpline volunteers will be happy to provide further information and support. Please email helpline@aims.org.uk or ring 0300 365 0663.

Published on 19th October 2019

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What we refer to as Vitamin K is an important group of chemicals which help our blood to clot. There are several different types of Vitamin K and these different types all have different effects on the body.

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Institute of Health Visiting

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Health visitors are registered nurses/midwives who have additional training in community public health nursing. They provide a professional public health service based on best evidence of what works for individuals, families, groups and communities; enhancing health and reducing health inequalities through a proactive, universal service for all children 0-5 years and for vulnerable populations targeted according to need. Health visiting is a proactive, universal service that provides a platform from which to reach out to individuals and vulnerable groups, taking into account their different dynamics and needs, and reducing inequalities in health. Pre-school children and their families are a key focus.

How does it work?

Health visitors work with parents who have new babies, offering support and informed advice from the ante-natal period until the child starts school at 5 years. They may work in teams or have sole responsibility for a caseload derived from the local area or a general practice list; they are usually based in children's centres, surgeries, community or health centres. Health visitors visit parents through a minimum of 5 universal home visits from late pregnancy through to a developmental assessment at 2 years. These visits are usually in the home, but the health visitor may invite you to join groups, clinics and networks run by the health visiting team or colleagues who work with them such as: nursery nurses, children centre staff, voluntary organisations or community mothers.

Families from all walks of life may need support for specific issues that affect their children's health and development, so the actual service provided to each particular family will vary according to a personalised assessment of their own needs and evidence of what will work for them.

iHV Films

View iHV Film - Health visiting in your community - December 2022

A short film which showcases the breadth of health visitors' work and their critical role in supporting the health and wellbeing of thousands and thousands of families every week.

Please do share this film widely - you have our permission to include the links in your local resources.

Watch our short film - Health Visitors: for every family

The Institute of Health Visiting (iHV), working together with parents and Solent NHS Trust, is delighted to share a short film to highlight the value and breadth of the role of the health visitor in relation to family mental health and wellbeing outcomes.

It showcases the unique opportunity and skills that health visitors have to build relationships and the support that health visitors can offer where additional concerns about parental mental health or the parent-infant relationship are identified.

Infographics

One of the biggest challenges facing the health visiting profession is that many people do not know who health visitors are, or what their role entails. How can we expect the Government to invest in health visiting if this is not clear?

Across the four nations of the UK, there are also significant differences between the health visiting services offered in each nation - this is driven by different levels of prioritisation and investment by their respective governments. To support investment in health visiting in all nations, it is therefore imperative that the work of health visitors is made visible, and the benefits of an effective health visiting service are promoted. As a result, this infrastructure of support that health visitors provide is vulnerable to service cuts.

In our aim to make the work of the health visitor more visible, we launched two new infographics setting out "Who are health visitors and what do they do?" and "It's time to invest in health visiting because...".

A film, by Birmingham Community Healthcare NHS Trust - "Health visiting in the spotlight"

Health visiting - every chance for every child, from birth to five. from BCHC COMMS on Vimeo.

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Health Visiting is... Health visitors are registered nurses/midwives who have additional training in community public health nursing.

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Babycentre

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Womb to world: helping your newborn adapt to life outside the womb (photos)

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Find out how your baby develops in the fourth trimester and learn how you can give your newborn all the support and attention he needs to flourish in his…

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KellyMom (January 2018)

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You've made it through your first 24 hours as a new mom. Maybe you have other children, but you are a new mom all over again... and now it's your baby's second night.

All of a sudden, your little one discovers that he's no longer back in the warmth and comfort - though a bit crowded - womb where he has spent the last 9 months - and it is SCARY out here! He isn't hearing your familiar heartbeat, the swooshing of the placental arteries, the soothing sound of your lungs or the comforting gurgling of your intestines. Instead, he's in a crib, swaddled, in a diaper, a tee-shirt, a hat and a blanket. All sorts of people have been handling him, and he's not yet become accustomed to the new noises, lights, sounds and smells. He has found one thing though, and that's his voice... and you find that each time you take him off the breast where he comfortably drifted off to sleep, and put him in the bassinet - he protests, loudly!

In fact, each time you put him back on the breast he nurses for a little bit and then goes to sleep. As you take him off and put him back to bed - he cries again... and starts rooting around, looking for you. This goes on - seemingly for hours. A lot of moms are convinced it is because their milk isn't "in" yet, and the baby is starving. However, it isn't that, but the baby's sudden awakening to the fact that the most comforting and comfortable place for him to be is at the breast. It's the closest to "home" he can get. It seems that this is pretty universal among babies - lactation consultants all over the world have noticed the same thing.

So, what do you do? When he drifts off to sleep at the breast after a good feed, break the suction and take your nipple gently out of his mouth. Don't move him except to gently slide him into an upright neutral position with his head to the side. Don't try and burp him - just snuggle with him until he falls into a deep sleep where he won't be disturbed by being moved. Babies go into a light sleep state (REM) first, and then cycle in and out of REM and deep sleep about every ½ hour or so. If he starts to root and act as though he wants to go back to breast, that's fine... this is his way of settling and comforting. During deep sleep, the baby's breathing is very quiet and regular, and there is no movement beneath his eyelids.

Another helpful hint... his hands were his best friends in utero... he could suck on his thumb or his fingers anytime he was the slightest bit disturbed or uncomfortable. And all of a sudden he's had them taken away from him and someone has put mittens on him! He has no way of soothing himself with those mittens on. Babies need to touch - to feel - and even his touch on your breast will increase your oxytocin levels which will help boost your milk supply! So take the mittens off and loosen his blanket so he can get to his hands. He might scratch himself, but it will heal very rapidly - after all, he had fingernails when he was inside you, and no one put mittens on him then!

By the way - this might happen every once in a while at home too, particularly if you've changed his environment such as going to the doctor's, to church, to the mall, or to the grandparents! Don't let it throw you - sometimes babies just need some extra snuggling at the breast, because for the baby, the breast is "home."

Copyright © by Jan Barger, RN, MA, IBCLC, FILCA
Lactation Education Consultants

No portion of this text may be copied or reproduced in any manner, electronically or otherwise, without the express written permission of the author (IBCLC@aol.com).

Jan Barger is a mom of three, and proud Grammie of three and one due in 2017. She has been in private practice as a lactation consultant, worked for many years for a pediatric practice in the Chicago 'burbs as their lactation consultant, has a background in all aspects of maternal-child health nursing, and currently teaches with Lactation Education Consultants - an organization that provides education for those aspiring to become IBCLCs. Jan is a past president of ILCA, was on the IBLCE board and exam committee, and is a co-author of Clinical Experience in Lactation: A Blueprint for Internship, and Clinical Instruction in Lactation: Teaching the Next Generation. She lives in Wheaton IL with husband Bob and loves to travel and read.

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You've made it through your first 24 hours as a new mom. Maybe you have other children, but you are a new mom all over again... and now it's your baby's second night.

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Life with a Newborn: Why it's so hard to take a shower

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Life with a Newborn: Why it's so hard to take a shower

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Adriana Lozada (January 2015)

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Life with a Newborn: Why It’s so Hard to Take a Shower Video

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Is this normal? The first week with a breastfeeding newborn 

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Is this normal? The first week with a breastfeeding newborn 

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Emma Pickett on Unicef Baby Friendly Initiative website

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The first week with a newborn can be a wonderful and exciting time, but adjusting to a new life can also be overwhelming, especially when parents aren't sure what to expect. In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first few days, and encourages mums to trust their baby and their own instincts of love, affection and responsive feeding.
I've been taking calls from new parents on the National Breastfeeding Helpline since it opened in 2008. Calls often begin with a mum in tears and she's sounding desperate. Breastfeeding really matters to her and she wants it to work. She's overwhelmed and confused. The first voice we hear might sometimes be the partner's and a mum is too upset to even come to the phone.

Hundreds of these calls end with a contented calm voice saying, "Thank you. It's such a relief to know that's normal. I feel so much better now". As it happened, breastfeeding was actually going OK; what was interpreted as a breastfeeding 'problem' was actually a new baby's normal and natural response to their new environment. The family just didn't know how babies were 'supposed to behave'.

If I had a magic wand, I would download into all parents the knowledge of what is normal in a newborn. Think The Matrix film - but instead of the ability to pilot helicopters or practise high level martial arts, you'd know about cluster feeding and a newborn's desire for closeness, nappies and normal fussiness. The National Breastfeeding Helpline would be quieter overnight but we'd all feel a lot more relaxed and able to enjoy these teeny new people in our lives.

But actually ... you've already had that download. You just may not have realised it. It's deep in there after millions of years of evolution, facilitated by hormones and natural instincts. It may not mean you know the exact details of the colour of baby poo on day three, or how to correct a baby's latch without help, but there's so much you do know. You may not have grown up surrounded by breastfeeding, and for some aspects you will need support and information, but there's a ton you do know about your baby: things that just feel right and things that don't. And your baby had the download too. Sometimes it gets fuzzied with a birth that didn't go to plan but their instincts are in there too.

Two things that are normal:

1.Babies want to be close to you.

Imagine a news story about a baby gorilla just born in London zoo: "ZSL London are delighted to announce the birth of new baby Fumbi. Mother and baby are in good health" but days later it's reported that staff are concerned. Fumbi's mother (despite being surrounded by other older female gorillas and having observed newborn care) keeps trying to put Fumbi down. She places her in the hay and walks off repeatedly and appears to be trying to avoid holding her for long periods. Fumbi is agitated. Her heart rate and respiratory rate shows signs of distress. She's losing heat (because teeny newborn gorillas have a large surface area and need to be held to regulate their temperature). Fumbi isn't feeding as often a newborn usually does because of the periods of separation. The mother appears to be missing out on some of the oxytocin- (the hormone that promotes feelings of love) induced bonding that helps the formation of their early relationship. Fumbi is at risk.

Oh dear. Something seems to have happened to Fumbi's mother. We'd be worried.

However, this is exactly what is happening in human homes across the UK today (though not in many other countries and cultures). We are primates just as gorillas are. We're designed to be close to our babies. We can see that by looking at the constituents of our breastmilk. Other mammals have much higher fat milk so babies can be left while mum fishes or grabs a rabbit for lunch. Our babies are born immature because of our pelvis shape from being upright and our large brains, and they are designed to have milk regularly for a relatively long time. We are supposed to hold our babies. Some people call us 'carry mammals'.

But instead we get the message that babies can be 'spoilt'. We are supposed to encourage them to be independent and sleep apart from us. If we can't put them down, if they want to sleep touching us, if we hold them when they sleep - we've apparently failed some test. Though it's not quite clear who the examiner is.

There are popular books that even use terms like 'accidental parenting' just to load on the value judgments. Parenting experts such as Truby King in the 1910s told parents to avoid cuddling and unnecessary attention and the spectrum of 'advice' has been flip-flopping backwards and forwards ever since. Today one book will tell you to wear your baby in a sling as much as possible and another will tell you to arrange a baby's sleep by the clock and leave a baby only a few weeks old to cry if necessary.
What does your baby want?
They don't want to be put down and eaten by a sabre toothed tiger (less of a problem these days). They don't want to waste energy keeping warm and crying when they don't need to. They want to keep those calories to lay down fat and develop their brain. They want to use your breathing rate to regulate their own respiratory rate. They want you to notice when they start to show early feeding cues. They want your familiar smell and taste. You are home to them.

"My baby won't go down in its Moses basket". Yes, it's frustrating when you thought that was what they were 'supposed to do'. But would it feel easier if you knew that wasn't likely to be their first choice and there are good biological and evolutionary reasons for that?

"But I'm not going to get any sleep". According to the Baby Sleep Information Source, "70-80% of breastfed babies sleep with their mother or parents some of the time in the early months, and many studies have found that mothers and babies who bed-share breastfeed for much longer than those who sleep apart." Research shows that these mums breastfeeding through the night (and mostly bed sharing) will also be getting better quality sleep and be more rested than other parents. Good sleep is possible if we stop battling nature.

The book "Sweet Sleep: night time and naptime strategies for the breastfeeding family" is a great place to start. It talks to you about creating a safe space where everyone gets a better night's sleep.

A lot of your baby's urges are eminently sensible. If they don't want to sleep in a separate pile of hay, trust them. They are here today because those urges have kept them safe over the generations.

Don't expect to be up and making a moussaka on day five. The feeling that you 'shouldn't' be holding your baby is exacerbated when we live in a society which tries not to let new parenthood change our lives. Our bodies aren't supposed to change. Our commitment to work isn't supposed to change. Our ability to engage with political life and housework and social media isn't supposed to change. Actually, throughout much of human history, mum isn't going to do much of anything for a good 40 days. Someone else is making the moussaka, just as you would have once made the moussaka for them. We are supposed to be doing nothing else other than eating the food made by others (really doesn't have to be moussaka), sleeping and being with our new baby.

2.They come to the breast for lots of different reasons and they usually have a good reason for doing so.

Just as parents feel they've failed if their baby doesn't sleep in the separate pile of hay (aka fancy Moses basket that cost £75 and granny knitted a blanket for), they feel a failure if baby is at the breast 'too much'. I have written elsewhere on the dangerous obsession of the infant feeding interval. It's dangerous for both babies and mothers. But we need to remember breastfeeding isn't just about feeding and it never has been.

Babies have jobs to do. They are helping you to form new breast tissue in the first few weeks. They are elevating your prolactin levels (the hormone that governs milk supply). They are stimulating oxytocin (which is the key hormone in relationship-building and creating a sense of calm and well-being). They are increasing milk volume and altering fat content. They are reducing levels of the stress hormone, cortisol. They are facilitating digestion and the passing of stools. They are hydrating, regulating their temperature, feeling emotionally secure, growing brain connections and trying to get to sleep (which is one of the purposes of breastfeeding.)

To think breastfeeding is just about food and calories (and "quick, measure the gap between breastfeeds!") is to do nature a huge disservice. Measuring all the different reasons a baby comes to the breast is like trying to measure fairy dust. Do you count all the times your partner cuddles you, strokes your arm, kisses you, smiles at you affectionately, communicates with you, has a drink of water, eats a snack or has a meal? You wouldn't find an app for that.

Stop thinking about minutes. No one can tell you a baby should feed for X number of minutes because we all have different physiology and our babies do too. Create your world around you so you can meet your baby's needs in the way they are asking you to. Don't try and mould your baby to fit into a world that has become obsessed with counting and measuring. If you know you are a routine person and you are struggling with a feeling of 'losing control', give yourself a few weeks and see how it feels to trust your baby. Once your milk supply has maximised, you'll have some options. Try and 'control' too early and you'll find things go out of your influence in ways you can't come back from easily.

Get help if things feel wrong - if breastfeeding hurts, if you're not sure about weight gain or nappies, if you can't work out how to meet your own needs for food and sleep. There are lots of people who will help out and we're at the end of a phone or a Twitter account or Facebook page. But don't confuse your baby behaving unexpectedly for something going 'wrong'. Maybe no one told you what normal would be.
If we let normal happen it will make all of our lives easier in the long term. You're creating a little person who enters this world with their needs being met.
This blog was originally featured on the Growing Families conference website.

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Guest blog: "Is this normal?" The first week with a breastfeeding newborn - Baby Friendly Initiative

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The first week with a newborn can be a wonderful and exciting time, but adjusting to a new life can also be overwhelming, especially when parents aren't sure what to expect. In this guest blog, lactation consultant Emma Pickett explores what's "normal" in the first few days, and encourages mums to trust their baby and their own instincts of love, affection and responsive feeding.

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The Fourth Trimester - AKA Why your baby is only happy in your arms

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The Fourth Trimester - AKA Why your baby is only happy in your arms

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Sarah Ockwell-Smith (2012)

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"He sleeps really well but only when he's laying on my chest, he hates his moses basket" "She cries every time we lay her on her play mat" "He hates going in his pram, he cries the second we put him in it".
If I had a pound every time I heard these from a new parent I'd be a very rich lady by now! What amazes me though is that society in general doesn't get it, they don't get why so many babies need to be held by us to settle and what perplexes me even more is that we do spend so long trying to put them down! We spend more than time though, the 'putting babies down' industry is worth millions, rocking cribs, battery swings, vibrating chairs, heartbeat teddies and the list goes on..................having been a first time parent who bought all four of the items listed above I am embarrased to admit now it honestly didn't enter into my head that perhaps the answer was to *not* put my baby down and I certainly didn't consider why these things might help. It took me a long time to understand and empathise with my baby, to see the world through his eyes so to speak.
"Empathy: the intellectual identification with thoughts, or attitudes of another." or vicarious experiencing of the feelings, "Birth suddenly disrupts this organization. During the month following birth, baby tries to regain his sense of organization and fit into life outside the womb. Birth and adaptation to postnatal life bring out the temperament of the baby, so for the first time he must do something to have his needs met. He is forced to act, to "behave." If hungry, cold, or startled, he cries. He must make an effort to get the things he needs from his caregiving environment. If his needs are simple and he can get what he wants easily, he's labeled an "easy baby"; if he does not adapt readily, he is labeled "difficult."" - Dr. William Sears.
To empathise with our newborns feelings we need to put ourselves in their place, to imagine experiencing their world - but which world? The world they have spent most of their life in, their 'womb world' or the world they are in now - our world. To fully understand we must appreciate the enormous transition they have made - a concept known to many as 'The Fourth Trimester' -some make the womb to world transition easily, others less so and it is this latter group in particular "the clingy babies" we can learn so much from through this concept.

So lets quickly compare the two different 'worlds' your baby has lived in:

Pretty different huh? On top of this the big thing to understand is that in utero the baby's world was constant, each day was the same, the stimulation didn't change, but now they are born each day is different - ever changing, ever stimulating!

The concept of the fourth trimester helps us to understand the transition a newborn must make over their first few weeks earthside and once we understand we find so many ways we can help - but to me the most important facet of the fourth trimester is parental understanding and empathy, once that exists everything else will flow naturally.
Movement
Here are some common newborn calming techniques that tend to work quite well, but remember each and every baby is different, if you don't already know, you will soon learn what your baby likes best and that's what matters, that it is unique to *your* baby. Prescriptive 'do this/don't do this' baby calming lists don't help anybody - because they forget they are dealing with individuals - both parents and babies! Some things on this list will be inappropriate for you and your baby, some simply won't work, some you won't like - and that's OK! because really it isn't about these tips it's about you and your baby getting to know each other!
Skin to Skin Contact
The womb is a constantly moving space, Braxton Hicks would squeeze your baby at the end of pregnancy and each time you moves your baby was wobbled around inside. Imagine how walking upstairs feels for a baby in utero! Babies tend to love movement but so often we put them down somewhere completely still. You could try dancing, swaying from side to side, going for an exaggerated quick walk or bumpy car ride.
Bed-Sharing
Such a brilliant baby calmer! Being in contact with your warm, naturally (un)scented, skin is heaven for a baby, it helps to stabilise their body temperature, heart rate and stress hormones and stimulates the release of oxytocin - the love and bonding hormone - in you both. Topless cuddles, shared baths, baby massage and bedsharing are all great skin to skin experiences for your baby and you.

Sharing a bed with your baby is an amazing way of getting more sleep for everyone, babies are generally much calmer and sleep more easily if they sleep with you in your bed, yet it is such a taboo topic and although 60% of parents will share a bed with their baby at some point it's a subject that makes society very uncomfortable, but...it is an *amazing* baby calmer! It's really important that you think about how bedsharing will work and follow some important safety guidelines HERE.
Swaddling
For more on bedsharing and other ways to improve your newborn's sleep, watch my free webinar here:

Imagine how snug your baby was at the very end of your pregnancy inside of you - now imagine how strange it must feel to them after they have been born and have so much space around them! The absolutely best thing you can do is to envelop your baby in your arms, but for times when you don't want to or indeed can't then swaddling is an option. Swaddling is becoming increasingly popular, however there are important safety guidelines to be followed if you choose to swaddle your baby, if you are breastfeeding please make sure feeding is established before swaddling and take care not to miss your baby's hunger cues if you are feeding on demand:
** The American Academy of Paediatrics recommends swaddling for babies 0-14wks. Babywearing

Never swaddle over your baby's head or near his face

Never swaddle your baby if he is ill or has a fever

Make sure your baby does not overheat and only swaddle with a breathable/thin fabric

Only swaddle your baby until he can roll over**

Always place your baby to sleep on his back

Do not swaddle tightly across your baby's chest

Do not swaddle tightly around your baby's hips and legs, his legs should be free to "froggy up" into a typical newborn position.

Lastly start to swaddle as soon as possible, do not swaddle a 3 month old baby if he has not been swaddled before.

Wearing your baby in a sling is one of the ultimate ways to keep them calm and happy. It increases the time a baby spends in a state of "quiet alertness" - a time of contentment when they learn the most. When a baby is in utero they spend 100% of their time in physical contact with us - yet the moment they are born this is estimated to drop to only 40%! Babywearing also means 2 free hands!

Choose your sling carefully. A good sling will be easy to use and will support both yours and your baby's spine whilst not placing any pressure on your baby's growing hips - newborns should always be carried facing inwards with a "frog leg" pose, not a crotch dangle pose so commonly used by commercial baby carriers. Also seek to carry in an 'in arms' position - i.e: how your baby would be held if you were holding them!

Babywearing is a great way for dads to bond with babies!
Position
It is quite common for a baby to cry once placed in a sling, this does not mean that they hate the sling - it just means that you need to move, so get dancing! As with swaddling,babywearing is becoming increasingly popular, however there are important safety guidelines to be followed, the TICKS acronym below neatly sums them all up:

The "tiger in the tree" position below, taken from baby yoga, is often magical, stopping a crying baby in an instant!
Feed
Noise
Babies love sound, but for many not the sound you might think. For many babies a hoover is much more calming to a baby than a lullaby. A special white noise recording, such as , can be played on loop whilst your baby sleeps to help keep them calm.
Deep Bathing
If your baby is hungry nothing will calm him, so watch for his hunger cues. Feeding is always better if it is baby led, not led by a routine - whether you are breast or bottle feeding. Remember as well that your baby may not always be hungry for a full feed, they may want a quick drink, a quick snack or just some comfort sucking. Babies also find sucking the ultimate relaxation and comfort tool. Sucking helps a baby's skull bones to return to their normal position after birth as well as providing them with comfort and security. If you are not breastfeeding you might find your baby will relax when given a dummy/pacifier.
Outside
The womb is a wet, warm place. The world as we know it is dry and cold! Sometimes a nice deep, warm bath can stop a baby's tears in seconds - even better if mummy or daddy goes in the big bath with baby too as skin to skin contact is a wonderful baby calmer.
What have you found calms your newborn? The NEWLY UPDATED Gentle Sleep Book - out now! If you would like to understand and learn how to improve your baby's sleep WITHOUT cry-based conventional sleep training, this is the book for you! p.s: Come and chat with me on Facebook, Twitter and Instagram Or watch my videos on YouTube You can also sign up for my free parenting newsletter HERE.
If all else fails many babies stop crying the minute they hit the open air - I'm not sure if this is because we are usually moving (e.g.: walking over cobbles with the buggy/ bouncing in a sling and the drone and movement of a car) or because of the change in air - but it works!

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The Fourth Trimester - AKA Why Your Newborn Baby is Only Happy in Your Arms

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"My baby is only happy in my arms, the minute I put her down she cries" "He sleeps really well but only when he's laying on my chest, he hates his moses basket" "She cries every time we lay her on ...

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Nancy Mohrbacher (August 2015)

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As it describes, in the beginning, most breastfed newborns bunch their feedings together during wakeful times or "cluster nurse." For this reason, it's not helpful to focus on when baby fed last. Whenever baby shows feeding cues (increased activity, rooting, mouthing), assume it's time to breastfeed again. Yes, even if it's only been 10 minutes. If baby seems hungry again soon after feeding, don't worry about overfeeding and don't consider it a reflection of your milk production. It's just what newborns do. This is how your baby helps you build a healthy milk supply.

There is no value whatsoever in trying to convince your baby to go for longer stretches between feeds. Newborns have no sense of time, and putting your baby off only adds stress to your life. If your baby seems interested in feeding or is fussy, try nursing first, and if that doesn't help, move on to other comfort techniques. As your baby grows and matures (and his stomach grows and can hold more milk), he will naturally become more regular in his feeding patterns. You don't have to do anything to make this happen.
How Long Is It Okay for a Newborn to Sleep?
Beginning on about second night after birth, don't be surprised if your newborn goes into a feeding frenzy just about the time you're thinking about going to bed. Most babies are born with their days and nights mixed up. That's why it's best for the sake of your own rest and recovery to sleep when your baby sleeps so that you're rested and ready for more feedings at night.

It's not uncommon for a brand-new baby to have one 4- to 5-hour sleep stretch, but it is often during the day. As long as your baby fits in at least 8 feedings every 24 hours and is gaining weight well (after Day 4, an average of about 1 oz. or 30 g per day), there's no reason to wake your baby to feed.

It usually takes a few weeks for your baby's body clock to get closer to yours. To speed up this process, try keeping stimulation to a minimum at night (lights low, sounds low, no diaper changes unless baby has a stool). Make daytimes full of light, sound, diaper changes, and before you know it, baby will be taking her longer sleep stretch at night.
Gaining Confidence in your Milk Production
Your baby's feeding patterns are not a reflection of your milk production. But there are other ways you will know that your baby is getting the milk she needs. Her stool color is one sign. If breastfeeding is going well, your baby's stool will turn from black to green by about Day 3 and green to yellow by Day 4 or 5. Weight gain is the best way to gauge your baby's milk intake and your supply. Once baby reaches her low weight on Day 3 or 4, expect a weight gain of about 1 oz. or 30 g per day. Weight gain is the gold standard of healthy milk intake and milk production.

When it comes to breastfeeding and the clock, keep in mind that breastfeeding has been around much longer than clocks. In other words, you don't need a clock to make breastfeeding work. Sometimes too much focus on the clock can even cause problems by shifting your focus away from what really matters.

Your baby will tell you everything you need to know. The American Academy of Pediatrics recommends breastfeeding babies on cue rather than on a schedule. (See its 2012 policy statement HERE). Don't be distracted by the clock. Instead, watch (and trust) your baby.

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The Clock and Early Breastfeeding - Nancy Mohrbacher

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The clock looms large in the lives of many breastfeeding families. When a new baby is born, some parents are told or make assumptions about: How many minutes their baby should breastfeed How long their baby should be satisfied between feedings The longest stretch of time their baby should s

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Top 10 Babymoon tips – AKA How to enjoy the time after your baby is born 

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Top 10 Babymoon tips – AKA How to enjoy the time after your baby is born 

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Sarah Ockwell-Smith (2012)

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I always thought the term babymoon sounded a little bit odd, the sort of thing only hippies would do, locking themselves away from the rest of the world with their babies for days after the birth. I wanted to show my baby off to the world, I wanted to get back to normal and most importantly after the birth of my firstborn I wanted to hit the sales, you see he was born in July the day before most of the summer sales started! So, with my two day old baby in tow we trudged around the high street so I could fill the car with baby bargains. By the time he was seven days old I was hosting a coffee morning for my antenatal group, complete with home baked cake and quiche, a full face of make up and an immaculate house.

I look back now with dismay at what I did. Why? Because those first few days and weeks after your baby is born are precious, you know that old saying "they grow so quickly"? It is irritatingly true. Newborns change literally every day and I missed some of that in my socialising and shopping filled days. More than that though, although my birth was a normal delivery I had still needed stitches and my body needed time to recover. What I really needed was to spend a week or two curled up in bed, a magazine in hand, a baby by my side and good food made for me.

There will be plenty of time for socialising, those first few days are precious and they are also vital for bonding with your baby and getting the hang of breastfeeding. I did things very different with my subsequent babies and these are my top babymoon tips:

1. Don't be afraid to say "no" to visitors. Tell them you are tired and need to sleep and ask if they could perhaps come next week instead.

2. If visitors do come ask them to bring food with them for you or perhaps prepare food for you at your home, under no circumstances should you play the host!

3. Consider limiting the amount of people holding your baby, as I mentioned above physical contact as much as possible with your baby is one of the best ways to bond, recover from the birth and help breastfeeding, not only that when your baby is passed around like a game of pass the parcel it must be scary and over stimulating for them, all of the different smells, touches and noises. Consider holding your baby in a sling when you have visitors, this way your baby can't be passed around and held by everybody!

4. If you are tired when you have visitors tell them! Don't be embarrassed to ask them to leave.

5. Go easy on yourself, even if your birth was natural and straightforward your body has still been through an awful lot and you need time to recover.

6. Try to sleep whenever you can, not just at night

7. Try to eat well balance, nourishing food. Batch cooking and stocking your freezer beforehand is a great idea.

8. Forget the housework, it can wait. So can the washing and supermarket home delivery service is your friend!

9. Don't worry about your hair or make-up. For a midwife it is more alarming seeing a mum in full make-up the day after giving birth than it is one with none on, in fact they positively expect to see you bare faced in your pyjamas.

10. Enjoy every single minute!

Sarah
About SarahOckwell-Smith

Sarah Ockwell-Smith, Parenting author and mother to four.

This entry was posted in Babies, Birth, Mothering and tagged baby expert UK, babymoon, birth expert, bringing baby home, healing after birth, newborn, parenting expert UK, postnatal, recovering after birth, starting to breastfeed, visitors after birth. Bookmark the permalink.

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Top Ten Babymoon Tips - AKA How to Enjoy the Time after Your Baby is born.

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I always thought the term babymoon sounded a little bit odd, the sort of thing only hippies would do, locking themselves away from the rest of the world with their babies for days after the birth. I wanted to show my baby off to the world, I wanted to get back to normal and most...

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NCT

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Kathryn Kelly, NCT antenatal teacher, explains: 'The Fourth Trimester is a way of describing the period after birth when both parents and baby are adjusting to their new lives.

'We think of other trimesters as being three months long, and we can think in terms of roughly another three months after the birth to make the adjustments to being a new family.'

What's the fourth trimester like for babies?

Having been in your warm womb for nine months, your baby has now got to get used to a sensory overload of sights, sounds and smells, as well as a frequently colder environment where they're not constantly supported by your protective amniotic fluid.

Kathryn says: 'Babies have been used to being fed continuously, sleeping when they want to, and being rocked in the cosy embrace of their mum's tummy. When babies are born we introduce gaps between feeds, and put them in a different place to sleep. It's no wonder that they can find this scary, and it's natural that they cry to express their fears.'

Understandably, babies are likely to cry more in this three-month period than any other time in their life. But however logical it might be, it doesn't make this period any easier for new parents. Knowing that other parents are going through the same experience, and thinking of this period as the fourth trimester, might help.

'Parents describe it as a very useful concept, which reminds them that it is OK to find the early days with a baby hard. It is a period of transition, where women become mums, men become dads, and babies adjust to life outside the womb,' Kathryn says.

What can you do to help your baby in the fourth trimester?

Fundamentally, the closer your baby feels to you, the happier they will be. According to Kathryn: 'Anything that mum, dad or other carers can do to replicate the womb-like world will help their baby feel safe. And when we feel safe, we thrive. For your baby, this means holding them close, perhaps in a sling, so they feel the warmth of your body, hear your heartbeat, and are gently rocked as you go about your day (or night).

'Feeding for babies, just like for adults, is about more than just nutrition, it's also social - a way of sharing and being with those we care for. Feeding your baby whenever they they want to will support their emotional development, as well as their physical and intellectual development.

'Your baby will sleep when they're tired, and you will both feel safer if they're close to you. Many parents tell me that in the early days their baby won't sleep in their Moses basket or crib, but only when they're held by a parent. This is perfectly normal and understandable when you think about the baby's point of view. It's important that parents find out about the safer sleep guidelines, and work out a way of sleeping that suits them as a family.'

Can you 'spoil' your baby in the fourth trimester?

No. Despite some people saying that babies need to 'learn' that you won't rush to pick them up every time they cry, in this crucial Fourth Trimester period you can't care for them too much. In fact, the more you look after them when they're upset, the more reassured and confident they'll be.

How might you be feeling?

Even if you're not an international tennis champion, parents who have gone from living busy, independent lives, can find the sudden change to around-the-clock care for a completely dependable infant hard.

Add to that the need to recover from a traumatic or difficult birth, and you can understandably feel like you're the one in need of a little TLC. Kathryn says: 'With the emotional changes in a woman's body, plus the realisation of the enormous responsibility of having a baby, new mums can feel overwhelmed and tearful at times.

'Partners can be dealing with their own response to the birth, their changing identity, and strong feelings about protecting and providing for the family. All of these feelings can also be affected by the way both mum and her partner were parented themselves.'

As with all stages of early parenthood, it's worth remembering that this stage will pass. In what seems no time at all, you might be looking back at the period with fondness at how tiny and attached to you your baby was when they were first born.

However, that is not to downplay how challenging the Fourth Trimester can be for parents. When you're in it, it's all-consuming. You can feel like you don't know what you're doing and you're constantly one step behind.

So, what should I do?

If you think in terms of the first three months of your baby's life being a Fourth Trimester, it can be easier to take the pressure off getting back to 'normal'. You wouldn't have been trying to rush around tidying the house and welcoming endless visitors when you were heavily pregnant, so don't put pressure on yourself to do it now.

'When women are discharged from healthcare some people might think that means they should be able to return to normal life, but there is a long period of adjustment and care needed at home,' says Kathryn. 'Friends and family can support new parents with food, help around the house, and reassurance that they are doing a great job of looking after their baby.'

This is especially important for mums who are raising their baby alone, in which case asking for help from friends and family in advance can help ensure you get the support you need.

Kathryn adds: 'Having very modest aims in the early days - getting outside most days (perhaps a short walk around the block), eating well, resting as much as possible - will change over time to meeting up with friends regularly, getting some exercise every day, and doing the most necessary housework.'

When will the crying settle down?

'As babies grow and change, things that seemed easy one day might feel very difficult another,' Kathryn says. 'A baby's crying tends to peak at around week six, which can mean that parents feel they must be doing something wrong, or that there is a problem with their baby. However, this is normal, and has usually reduced by three months.

'Parents report the excitement and happiness that comes when they see their baby is starting to interact with them, including smiling for the first time.'

Where can I get more help?

'Part of the challenge of this early period is the feeling that there is so much to learn, and to worry about,' explains Kathryn. 'Using safe sources when looking for information about caring for yourself or your baby will reduce anxiety.

'Reputable sources such as NCT practitioners and the website, or NHS health professionals and are a good place to start. Avoid sources of information (including people or media) who make you feel bad about your parenting, and stick with people who you trust and who support you.

'Although things can feel like they're getting harder in the early weeks, most people are feeling much better by around three months after the birth, and some will feel fine before that. If parents are still finding life a real struggle at that point they might consider talking to a health professional, or seeking more support from friends and family, to help them until they are feeling more in control.'

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby. To find out when an NCT nearly new sale is happening near you, search here.

You might find attending one of NCT's New Baby groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

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What is the fourth trimester? | Baby & toddler articles & support | NCT

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Everyone knows that pregnancies last three trimesters - so what exactly is the Fourth Trimester? We explain what this crucial stage is, and what it means for you and baby

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Boundaries and Dealing with unsolicited advice

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Boundaries and Dealing with unsolicited advice

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A long time ago, as a developing parent educator, I found many new moms uncomfortable and frustrated with unsolicited advice - or inadvertently soliciting advice and then feeling uncomfortable with the discussion that followed. Parenting choices should be on a "need to know" basis. Most people don't "need to know". If asked """"Also, don't confuse setting boundaries with trying to convince someone of the rightness of your choices. It's a common and understandable desire to present the same information that lead you to your choices. The problem with that in dealing with a person who has boundary issues is that engaging with content invites discussion. New moms often struggle with this. The boundary is that no one else has an inherent right to tell you how to parent. You set boundaries by doing the above. Where new moms often invite problems is by citing authors, studies and sites to "defend" themselves. Each time you do so, you create more time for discussion and rebuttal and send the message that your decisions are up for debate. Don't defend your choices beyond generalities, and then only once or twice. "Finally, look them in the eye and say simply "

As a result, I developed a summary lesson on boundaries that eventually become known as "The Bean Dip Response", "Pass the Bean Dip" or even used as a verb "Bean dip" someone.

I wrote the summary from the perspective of an attachment or homeschooling parent - but the principles are transferrable to any constellation of parenting choices.

The "Bean Dip Response" is best used when you do not wish to defend or engage with a person over a parenting choice. If you are discussing issues with a person and you welcome their feedback, the Bean Dip Response is not needed.

I've found new moms often confuse boundaries and trying to convince someone of the rightness of their choices.

The best thing is to assert your boundary and not try to defend your choice.

how is the baby sleeping?" Answer: " Great! Thanks for asking! Want some bean dip?"
Are you sure you should be picking her up every time she cries?" Answer: " Yes! Thank you! Want some bean dip?"
Now, with some people you will need to set firm boundaries. The offer of bean dip will not be sufficient to redirect them. They are either not intuitive to gentle redirection or they have emotion tied to the issue and a desire to "go there" more deeply. In such a case, a stronger "Bean Dip" response may be needed. You may be able to anticipate persons for whom this is true, if it's a pattern of intrusion, for example, seen in other circumstances. In these cases, the redirect will need to be backed up with action (like hanging up, leaving the room or even the event, unfriending them). Remember, boundaries are not about forcing another person to comply. You cannot "do" that. Boundaries are about what YOU will do/not do. When do you plan to wean?" Answer: " When she's ready. Thanks! Want some bean dip?"

Practice kind but firm responses:

I know you love us and the baby. We are so glad. Our sleeping choices have been researched and made. I will not discuss it again."

The doctor is in support of our choices. Want some bean dip?"
Finally, an important corollary to the "Bean Dip Response" is reciprocity. The content of the parenting choices should not dictate the interaction. You may be totally convinced that babies should co-sleep, never be left to "cry it out" and that they should be allowed to follow their own weaning path. But if you post those opinions on Facebook (or communicate them in other ways), you invite (and therefore solicit) feedback and advice. You need to give the "other side" the appropriate respect in the same manner you'd like the respect. I want us to have a good relationship. I want you to enjoy the baby. I'll parent the baby - you enjoy them. Let's not discuss this anymore. If you bring it up, I will leave the room."

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“Pass The Bean Dip” - Boundaries and Parenting Choices

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The “Bean Dip Response” is best used when you do not wish to defend or engage with a person over a parenting choice.

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Maddie McMahon

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Pinter & Martin is an independent publishing company specialising in pregnancy, birth, parenting, breastfeeding, yoga and psychology books

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Let's talk about the first year of parenting

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Let's talk about the first year of parenting

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Amy Brown

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Let's talk about the first year of parenting

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Pinter & Martin is an independent publishing company specialising in pregnancy, birth, parenting, breastfeeding, yoga and psychology books

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How men's bodies change when they become Dads

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How men's bodies change when they become Dads

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New York Times

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As an anthropologist who studies human fatherhood at the University of Oxford, I've run up against a widespread and deeply ingrained belief among fathers: that because their bodies haven't undergone the myriad biological changes associated with pregnancy, birth and breastfeeding, they're not as biologically and psychologically "primed" for caretaking as women are.

As a result, they feel less confident and question their abilities to parent: Will they be "good" parents? Will they bond with their babies? How will they know what to do?

As my own personal and professional experiences dictate, the idea that fathers are biologically "less prepared" for parenthood is unlikely to be true. Much of the role of parenting is not instinctual for anyone. (I remember the steep learning curve of those first days of motherhood - learning what each of my baby's cries meant, mastering the quick diaper change and juggling the enormous amount of equipment necessary just to make it out the door.)

And while the biological changes fathers undergo are not as well understood (nor as outwardly dramatic) as those of mothers, scientists are just beginning to find that both men and women undergo hormonal and brain changes that herald this key transition in a parent's life.

In essence, being a dad is as biological a phenomenon as being a mom.

Take testosterone, the stereotypically "male" hormone that plays important roles in male fetal development and puberty. Testosterone is largely responsible for motivating men to find partners and, studies suggest, men with higher levels of testosterone tend to be more attractive to potential mates. But being a successful human father means focusing inward on the family and resisting the drive to seek out another partner. So, experts believe, men have evolved for some of that testosterone to go.

In a pioneering five-year study published in 2011, for instance, Dr. Lee Gettler, Ph.D., an American anthropologist, followed a group of 624 single, childless men in the Philippines from age 21 to 26. Dr. Gettler found that while all men in the study experienced normal, age-related dips in testosterone, the 465 men who became dads during that five-year period experienced a more significant drop - an average 34 percent (when measured at night) - than those who remained single or married.

Globally, study after study - including my own unpublished findings in the United Kingdom - have found similar results, noting that this reduction in testosterone can happen just before and just after the birth of a man's first child. And while it isn't clear exactly what prompts this drop, Dr. Gettler said that his own preliminary results suggest that the more dramatic the drop, the bigger effect it seems to have on a man's caregiving behavior. "We found that if brand-new fathers had lower testosterone the day after their babies were born," said Dr. Gettler, "they did more caregiving and baby-related household tasks months later."

While news of this drop in testosterone is often greeted with groans of resignation from men - choose fatherhood and choose the road to emasculation, they think - some studies have suggested that the lower a man's testosterone, the more likely he is to release key reward and bonding hormones, namely oxytocin and dopamine, when interacting with his child. Caring for your child, therefore, produces not only a strong bond but a neurochemical reward, inducing feelings of happiness, contentment and warmth - a welcome trade-off.

The brain also appears to undergo structural changes to ensure that fathers exhibit the key skills of parenting. In 2014, Dr. Pilyoung Kim, Ph.D., a developmental neuroscientist at The University of Denver, put 16 new dads into an M.R.I. machine: once between the first two to four weeks of their baby's life, and again between 12 and 16 weeks. Dr. Kim found brain changes that mirrored those previously seen in new moms: Certain areas within parts of the brain linked to attachment, nurturing, empathy and the ability to interpret and react appropriately to a baby's behavior had more gray and white matter between 12 and 16 weeks than they did between two and four weeks.

Dr. Kim believes this bulking of the brain reflects a ramping up of the skills associated with parenting - such as nurturing and understanding your baby's needs - and the inevitably steep learning curve that both new moms and new dads have to surmount. In particular, because men do not experience the hormonal surges that accompany pregnancy and childbirth, "learning how to emotionally bond with their own infants may particularly be an important part of becoming a father," Dr. Kim suggested. "The anatomical changes in the brain may support fathers' gradual learning experience over many months."

But while both new mothers and new fathers show activation in the brain regions linked with empathy and understanding their child's emotional state and behavioral intentions, a 2012 study by neuroscientists at Bar-Ilan University in Israel suggested that the parts of the brain that light up the most are startlingly different for each parent. For moms, regions closer to the core of the brain - which enable them to care, nurture and detect risk - were most active. But for dads, the parts that shone most brightly were located on the outer surface of the brain, where higher, more conscious cognitive functions sit, such as thought, goal orientation, planning and problem solving.

Dr. Shir Atzil, Ph.D., a psychologist at The Hebrew University of Jerusalem in Israel and lead author of the study, believes - along with Dr. Kim - that dads' brains have adapted in similar but different ways to ensure that they can bond with and care for their babies, despite not having given birth to them. Meaning both mothers and fathers are primed to "demonstrate similar levels of motivation and attunement to the infant," said Dr. Atzil.

Beyond this, the differing areas of brain activation may reflect a difference in role, and different but equally strong attachments, between mothers and fathers. It is a cliché that children run to Mom for a hug when they're hurt, while Dad is the "fun" parent. But evidence suggests that mothers and fathers get different neurochemical "rewards" after certain parenting behaviors, eliciting these differences in stereotypes.

Dr. Ruth Feldman, Ph.D., a social neuroscientist based in Israel, published a study of 112 mothers and fathers in 2010 which found that peaks in oxytocin (and by association, dopamine) occurred for women when they nurtured their children. In contrast, the peak for men occurred when they took part in rough-and-tumble play. Because young children's brains seem to mimic the same oxytocin levels as their parents' - meaning they'll get a similar blast of feel-good oxytocin when playing with Dad and when being nurtured by Mom - they'll be more likely to engage in that behavior over and over again specifically with that parent, which is critical to their development. Rough-and-tumble play not only cements bonds between father and child, but also plays crucial roles in a child's social development.

There are, of course, many questions still to answer in the relatively new field of the biology of fatherhood. After 10 years of study, we now need to replicate our findings on larger and more diverse groups. But if I get the chance, I tell new fathers that evolution has primed them to parent just as it has primed women. Biology has their back.

Dr. Anna Machin, Ph.D., is an evolutionary anthropologist based at the University of Oxford. She is the author of "The Life of Dad: The Making of the Modern Father."

Read More on Modern Fatherhood

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How Men's Bodies Change When They Become Fathers

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As an anthropologist who studies human fatherhood at the University of Oxford, I've run up against a widespread and deeply ingrained belief among fathers: that because their bodies haven't undergone the myriad biological changes associated with pregnancy, birth and breastfeeding, they're not as biologically and psychologically "primed" for caretaking as women are.

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Your Statutory Maternity Pay (SMP) and Leave - what you get, how to claim, maternity rights and extra help

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When you take time off because your partner's having a baby, adopting a child or having a baby through a surrogacy arrangement you might be eligible for:

You may not get both leave and pay, and there are rules on how to claim and when your leave can start.

Employment rights when on leave

Your employment rights are protected while on paternity leave. This includes your right to:

pay rises

build up (accrue) holiday

return to work

You can get time off to accompany your partner (or the surrogate mother) to 2 antenatal appointments.

If you're adopting a child, you can get time off to attend 2 adoption appointments after you've been matched with a child.

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Your Statutory Paternity Pay and Leave - what you get, how to claim, eligibility

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You and your partner may be able to get Shared Parental Leave ( SPL) and Statutory Shared Parental Pay ( ShPP) if you're:

having a baby

using a surrogate to have a baby

adopting a child

fostering a child who you're planning to adopt

You can share up to 50 weeks of leave and up to 37 weeks of pay between you.

You need to share the pay and leave in the first year after your child is born or placed with your family.

You can use SPL to take leave in blocks separated by periods of work, or take it all in one go. You can also choose to be off work together or to stagger the leave and pay.

To get SPL and ShPP, you and your partner need to:

Giving up maternity and adoption leave and pay

To get SPL and ShPP you or your partner has to:

take less than the 52 weeks of maternity or adoption leave and use the rest as SPL

take less than the 39 weeks of maternity or adoption pay (or Maternity Allowance) and use the rest as ShPP

For example, if you're the mother and you've taken 22 weeks of Maternity Leave and Statutory Maternity Pay, you can share 30 weeks of SPL and 17 weeks of ShPP with your partner.

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You can start Shared Parental Leave (SPL) and Statutory Shared Parental Pay (ShPP) if you're eligible and you or your partner ends your maternity or adoption leave early - eligibility, entitlement, starting SPL and splitting blocks of leave

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Maternity Allowance is paid to pregnant women who do not get Statutory Maternity Pay - rate, eligibility, apply, form MA1

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Skin-to-skin contact between father and baby is vitally important 

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Skin-to-skin contact between father and baby is vitally important 

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Irish Times

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There is an undeniable amount of research on the natural benefits of skin-to-skin contact for mum and baby.

Essentially, skin-to-skin contact is simply that, babies' skin against their parents' skin immediately after birth and continuing later at home. It naturally regulates a new-born's temperature, heart rate and breathing while elevating their blood sugar which is essential for energy. It also encourages breastfeeding and colonises the baby's natural gut bacteria to that of its mother, making their intestinal bacteria more diverse, protecting them from illness and infection.

Skin-to-skin is not just reserved for mum, however. It is vitally important that dad also partakes in this ancient art of snuggling with their new-born. In fact, this close contact with dad brings about many of the same remarkable benefits as it does with mum. Being warm and snug in your arms, is your new-born's favourite place to be. They often cry less, sleep better and are more content when warm against your skin. Be that mum or dads.

The benefits of skin-to-skin with dad are not always advertised as strongly as they are with mum considering an important facet of this connection is establishing breastfeeding. But when a father has the opportunity to hold their baby close, skin-to-skin, we see the love hormone, oxytocin, doing exactly what it needs to - creating the natural bond between parent and child and helping you to fall in love with them. This is the same hormone that makes a woman's uterus contract in labour.

The close bond and connection of skin-to-skin contact is something to cherish in those first days of parenthood

Research has also shown skin-to-skin helps to develop more caring behaviour in dad and also a more sensitive approach to parenting. Furthermore, it has been shown to decrease cortisol levels in new dads which is greatly linked to anxiety. Less stress and less anxiety have a direct positive, correlation on the parent's relationship which naturally affects the family dynamic.

Avril Flynn is a midwife and childbirth educator. She provides birth and baby classes to pregnant couples and single parents but also to families who are growing their families through surrogacy or adoption, including same sex parents. Flynn says, as Mum has carried the baby for nearly 10 months, bonding has already started. For Dad, holding his new-born is the start of that magic process.

Research has shown that men who hold their baby close in the first 24 hours after their baby is born, report better bonding with their new-born. This is one essential and beautiful result from skin-to-skin contact. "Studies have shown that skin-to-skin lowers the heart rate and stress hormones in the baby," Flynn explains. "It is the natural and physiological norm for them to be held close, your skin onto theirs. They can hear the heart, and they know their parents' smell. New-borns will clearly exhibit more calm behaviour while skin-to-skin, releasing oxytocin in both baby and parent. Much like direct contact with mum, it also colonises the baby's skin with the natural flora that exists on dad's skin which helps kick start their immune system."

There is very little reason why skin-to-skin cannot occur. It is possible directly after caesarean section and can also help the premature baby. Once Mum and baby are doing well, the close bond and connection of skin-to-skin contact is something to cherish in those first days of parenthood. Due to naturally beginning breastfeeding, often those initial first few hours are reserved for skin-to-skin with mum, but where possible, dad should take the time to share the connection.

"There is the golden hour after birth where it is recommended mum and baby are left together, skin-to-skin, and undisturbed," says Flynn, "The realities of modern birth sometimes make this an unrealistic possibility, for example, if mum is unwell after the birth. Dad can get involved, and even if all has gone well, it should be encouraged after every baby is born. It also starts to share the load between both parents and includes dad fully in the nurturing beauty that can happen right after their little human is born. It's a very special moment."

We know the benefits of skin-to skin for both parents and baby are huge. So big in fact, that it can influence our brain. "Just a half hour of skin-to-skin for dad essentially rewires their brain," Flynn explains, "by increasing dopamine and oxytocin and lowered testosterone, meaning dad will have an automatic positive association from close contact with their baby. Nils Bergman has written and lectured extensively on its importance."

Thankfully, dads are encouraged to hold their new-born close with direct skin contact while in the maternity ward and advised to continue the practice at home. The method is simple and relaxing allowing for those perfect moments to get to know your baby.

Encouraging skin-to-skin with dads has a strong base on their parenting aims and abilities with many men reporting greater confidence and understanding

Simply find a comfortable chair, prop your arms and back with cushions as you may be sitting or lying a while. Place your baby, wearing only a nappy, on your bare chest and cover them with a blanket to stay warm. Holding your baby upright, support your little one with two hands and enjoy the bonding moment knowing how important it is to both you and your new-born. Let the world slow down. Alternatively, as baby grows, using a sling or wrap to hold your baby close, bare chest to bare chest, singing and talking to your baby, is a perfect way to continue that bond while getting work done around the house.

"It is such a lovely way for dads to feel close and have that connection with their little one," says Flynn, "dads can be very nervous with a small baby so it really builds their confidence when they can see their skin and presence soothes their baby. It will also give mum a break!"

Encouraging skin-to-skin with dads has a strong base on their parenting aims and abilities with many men reporting greater confidence, understanding, and willingness to be greatly involved in the role of dad. It is one of the ways the naturally caring instincts of dads are fortified.
Read: Why skin-to-skin care is best

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Skin-to-skin contact between father and baby is vitally important

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Close contact with dad brings about many of the same remarkable benefits as it does with mum

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Being a new dad: the early days with your new baby

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Being a new dad: the early days with your new baby

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NCT

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In the early days, dads can sometimes feel like the secondary parent. Perhaps taking a back seat and assuming that their partner has everything sussed when it comes to feeding, soothing and caring. In reality, while mums might have a head start with becoming a parent through pregnancy and giving birth, dads can - and do - play an important role (Machin, 2018).
Watch this video for some great tips from dads to dads.
You won't break them

Newborns seem so fragile at this age - with their little heads lolling all over the place. You wouldn't be the first dad to worry you might 'break' them or feel awkward picking them up. But holding them and looking after them is all part of the bondingexperience. And the more you do it, the easier it'll become (Keller et al, 1985). Really.

Gary, dad to nine-month-old twins Arriya and Nieva, says: 'Have confidence and get involved from day one. I think there's a tendency to sit back as a new dad and rely on other people. But I think the quicker you get involved, the quicker you build confidence and also bond with your baby.'

Finding out how your baby likes to be held and soothed will also help you feel close to them. Talk to your partner about your roles and your part in caring for your newborn. We've got lots of tips on ways to bond with your baby.

Family and friends

In the first week, you might be bombarded with requests from family and friends to meet your new baby. While all the attention is lovely, it can be a lot to deal with. Especially when you and your partner are likely to be feeling worn out. If that's the case, try to limit visits and enjoy this special time for your new family.

You can always spread visits over a few weeks. People will generally understand that this is a period of adjustment when you're getting used to caring for your baby. It can also be nice to spend time together as your new family unit. Your partner might find it more helpful to have visitors after you go back to work, at which point she will be on her own.

Accept all offers

This is exactly the time to accept help or ask for it. If somebody offers to do your washing or cook for you, take them up on it.

When people do visit, don't feel that the normal rules of hospitality apply. Say yes if they offer to bring a meal with them. Being able to just heat up some food someone else has prepared when you're shattered and hungry is a lifesaver.

Nobody will expect the house to be spotless, and visitors can easily find the kettle and make their own tea. In fact, they can make you both one too.

Helping your partner recover after the birth

Giving birth is physically and emotionally demanding. Regardless of the type of birth she had, you can support your partner's recovery in lots of ways.

Encourage her to rest when she can and not over-do it. Staying in bed might be the best way to do this for some women. If that's the case for you, your partner will appreciate you bringing her snacks and drinks. And just generally making sure she has what she needs.

If your partner had a caesarean birth or any major medical intervention, she'll need extra time to recover (NCCWCH, 2011). Think about the ways you can help by doing the shopping, helping her move around or driving when needed.

As well as physical support, emotional support is so important too. Tell her that you think she's doing a great job. Right now, she's probably at her most vulnerable so it's important to know that you're with her all the way.

Even if she gets moody or emotional at times, try not to let this affect you negatively. Think about your emotional needs too and seek more support if you need it. Talking through how you're feeling can help.

Likewise, if you feel that your partner's emotions or behaviour doesn't feel right, it could be a sign of postnatal depression. Read our article for more about this.

Lack of sleep

Everybody will have told you how exhausting the early days and weeks can be. Yet nothing can really prepare you for the lack of sleep after becoming a new dad (Beattie et al, 2014). It might not help much to know that sleep deprivation is common among new parents but at least you know you're not alone.

Sleep can be one of the most contentious issues after having a baby, as it can feel like neither you nor your partner are getting enough sleep. Probably neither of you are.

Have an honest conversation about sleep and sleeping arrangements. If your partner is getting up to look after the baby, maybe let her get some rest during the day. Or do your bit at the weekend and be the one to answer that 5am wakeup call from your little one... (Insana et al, 2014).

You've probably also heard the recommendation to 'sleep when the baby sleeps'. OK, so it's a bit of a cliché but it really does work, and it doesn't just apply to mums. If you've been up in the night looking after your baby or just worn out from the non-stop needs of a newborn, it's good advice for dads too.

Tom, dad to Tommy (four months) and Freddie (two years), says: 'Sleep as much as possible, even if its two o'clock in the afternoon. If you can just get your head down for a couple of hours it will help you in the long run.'

Everything seems more manageable when you're rested, so although it might feel a little strange at first, try to sleep or just lie down at every opportunity. When you're exhausted, it'll be easier than you think...

Don't let any visits from family or friends put you off. You don't have to be constantly on show and presentable for visitors. They'll understand if you just need to rest. They could push the buggy round the park while you have a lie down.

Feeding your baby

Babies like to feed frequently which is normal and healthy (NHS, 2016, 2017). This is mainly because they have such small tummies and to also help establish a good breastmilk supply (Peaker and Wilde, 1996; Neville, 2001).

Some new dads find that if their partner is breastfeeding, they're not sure what they can do to help. But you can support your partner in a number of practical ways. You could try fetching drinks (yes, that really is important) and letting her have a break and a rest when she needs to (Ueda et al, 1994; NHS, 2016; Buck et al 2018). Read more in our article ' How to support breastfeeding '.

If your partner is finding breastfeeding challenging, you could help her get support from a breastfeeding counsellor on our Infant Feeding line or in person. It can take some mums and babies about six weeks to get the hang of breastfeeding (NHS, 2017). Once breastfeeding is up and running, you can get stuck in with bottle feeding your breastfed baby expressed milk or a mixture of breast and formula milk, although using formula can reduce breastmilk supply (World Health Organization, 2009).

If you and your partner are feeding your baby formula from the start, you can help with bottle-feeding and making up bottles from the outset. For more tips and information, read our article Tips for bottle-feeding your baby.

Look after yourself

Having a baby can be all-consuming at first, but remember to put aside some time for you to do the things you used to enjoy. Alan, dad to Rocco, says: 'Don't suddenly put the rest of your life on hold. You've got to look after your new son or daughter but you've got to make sure you have a bit of me time as well. Do some of the things you enjoy, find a way to build that in.'

Read more about friendships and changing relationships as a new dad here.
This page was last reviewed in May 2019.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

You might find attending one of NCT's helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what are happening nearby.

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Being a new dad: the early days | Life as a parent articles & support | NCT

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Congratulations, you're a dad. Caring for both a newborn and your partner can be a huge life change. Read our tips for new dads on how to manage.

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NCT

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It goes without saying that becoming a mum is a truly biological experience. Hormones fluctuate, bodies change and brains rewire, all to prime a woman for childbirth and beyond. But we now know that becoming a dad involves some similar overhauls of your brain and body.

We used to say that being a mum was instinctive but dads had to learn how to parent. We now know that both experience some of the same sort of biological changes that help prepare them for parenthood. But as all parents know there is still much to learn.

Here is some of what we know so far about the science behind being a dad.

Hormones

Motherhood can feel like a bit of a hormonal roller coaster but it would appear that dads go on their own ride.

From mating to parenting

Testosterone is the hormone that makes a man a man (Machin, 2018). But research has shown that when a man becomes a father for the first time, his testosterone levels drop and they never return to pre-birth levels (Gettler et al, 2011).

The reason for this change is to motivate men to shift their attention from mating, for which high testosterone is a bonus, to parenting (Gettler et al, 2011; Mascaro et al, 2014).

Studies have shown that men with lower testosterone are more sensitive parents. They're better attuned to their child's needs and quicker to be motivated to respond when they cry (Fleming et al 2002).

Preparing the parenting team

Oxytocin is one of the key bonding hormones as well as being the crucial trigger for contractions to begin and milk production to start (Feldman et al, 2011). But men have oxytocin too, and studies have shown that if a man lives with his pregnant partner then their oxytocin levels synchronise (Feldman et al, 2011; Machin, 2018).

This seems to bring them closer and prime the parenting team to work closely together once their baby is born (Feldman et al, 2011). Also, the more closely bonded you are to your partner the easier having a baby will be on your relationship (Machin, 2018).

Preferred play partners

Speaking of oxytocin, this hormone is released when children interact with their parents. Interestingly though, the activity that produces the most oxytocin for parent and child differs depending on whether the child is interacting with their mum or dad (Feldman et al, 2010).

In dad's case, he and his child get a peak in oxytocin from playing with each other. This is why dads can seem to prefer playing to caretaking, and children preferentially seek them out as play partners (Feldman et al, 2010). So while dad is sometimes labelled as the 'fun' parent, there is a real reason behind his desire to play with his children.

This is not to say that dads don't get a neurochemical reward from caring for their baby. It's just not quite as big a hit as a good bout of rough and tumble play.

Brains

A rewired mind

We know that a woman's brain goes through a rewire when she becomes a mum for the first time. Recent studies have shown that the same is true for dad (Kim et al, 2014). We see increases in grey and white matter, that's the neurons and their connections, in certain key areas. These are linked to affectionate care and threat detection, as well as those responsible for problem solving and planning (Kim et al, 2014). Obviously crucial skills for any parent.

The unique dad brain

There are also some differences between mum and dad in the key areas of activity in the brain when they are interacting with their children. Both parents show similar activity in areas of the brain linked to empathy. That means both parents have the skills to understand their child's emotional and practical needs and to meet these (Atzil et al 2012; Machin 2018).

For mums, the other area of peak activity sits in the centre of the brain and relates to nurturing, affection and threat detection. But for dads their peak is in the outer area, the neocortex, and relates to a set of skills linked to social interaction and pushing boundaries (Atzil et al 2012; Machin 2018).

Experts think these differences represent the splitting of responsibilities between the sexes, meaning their roles are complimentary rather than simply duplications of each other. Each parent has an important and distinct role in their child's development (Atzil et al 2012; Machin 2018).

But what happens when we don't have parents of each sex? Studies looking at primary caretaking gay fathers have shown that the wonderful human brain adapts. So both fathers get peaks in both areas of the brain, mum's and dad's, meaning they are primed to fulfil both roles (Machin, 2018).

Psychology

No more party animal

Becoming a parent is not a moment in time but a period of transition. One aspect of you that will undergo a major change during this period is your psychology, and particularly your identity and personality (Machin, 2018).

Studies have shown that when a man becomes a dad, the part of his personality which is extrovert diminishes (Galdiolo and Roskam, 2014). This means that he is motivated to spend less time away from the home socialising and more time focusing on his family life. Read more about how your friendships and relationships might change in our article here.
Dr Anna Machin is an evolutionary anthropologist based at The University of Oxford, who has studied the experience of dads for over 10 years. She has written The Life of Dad: The Making of the Modern Father (Simon & Schuster, 2018). This page was last reviewed in May 2019.
Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Atzil S, Hendler T, Zagoory-Sharon O, Winetraub Y, Feldman R. (2012). Synchrony and specificity in the maternal and paternal brain: relations to oxytocin and vasopressin. Journal of the American Academy of Adolescent and Child Psychiatry. 51(8):798-811. Available at: https://www.ncbi.nlm.nih.gov/pubmed/22840551

Feldman R, Gordon I, Schneiderman I, Weisman O, Zagoory-Sharon O. (2010). Natural variations in maternal and paternal care associated with systematic changes in oxytocin following parent-infant contact. Psychoneuroendocrinology. 35:1133-1141. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20153585 [Accessed 1st April 2019]

Feldman R, Gordon I, Zagoory-Sharon O. (2011). Maternal and paternal plasma, salivary and urinary oxytocin and parent-infant synchrony: considering stress and affiliation components of human bonding. Developmental Science 14(4):752-761. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21676095 [Accessed 1st April 2019]

Fleming AS, Corter C, Stallings J, Steiner M. (2002). Testosterone and prolactin are associated with emotional responses to infant cries in new fathers. Hormones and Behavior 42(4):399-413. Available at: https://www.ncbi.nlm.nih.gov/pubmed/12488107 [Accessed 1st April 2019]

Galdiolo, S. & Roskam, I. (2014). Development of personality traits in response to childbirth: A longitudinal dyadic perspective. Personality and Individual Differences 69:223-230. Available at: https://www.sciencedirect.com/science/article/pii/S0191886914003304 [Accessed 1st April 2019]

Gettler LT, McDade TW, Feranil AB, Kuzawa CW. (2011). Longitudinal evidence that fatherhood decreases testosterone in human males. Proceedings of the National Academy of the Sciences USA 108:16194-16199. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3182719/ [Accessed 1st April 2019]

Kim P, Rigo P, Mayes LC, Feldman R, Leckman JF, Swain JE. (2014). Neural plasticity in fathers of human infants. Social Neuroscience 9(5):522-535. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4144350/ [Accessed 1st April 2019]

Machin AJ. (2018). The life of dad: the making of the modern father. Simon & Schuster, London.

Mascaro JS, Hackett PD, Rilling JK. (2014) Differential neural response to child and sexual stimuli in human fathers and non-fathers and their hormonal correlates. Psychoneuroendocrinology 46:153-163. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404163/ [Accessed 1st April 2019]

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The science behind dads | Life as a parent articles & support | NCT

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What makes a dad a dad? From changing testosterone levels to brain rewiring, evolutionary anthropologist Dr Anna Machin explains what happens to men's bodies when they become fathers

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Same sex parenting, gap parents | Family Lives

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Same-sex parenting advice for gay and lesbian parents on dealing with everyday family issues

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Fathering Together, A Community of Dads Who Are On a Journey to Become Better Fathers Everyday.

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We offer a variety of resources that highlight the ever-evolving definition of a "good father." Through our podcast, blog, webinars, and books, members of our community help today's fathers navigate work, parenthood, relationships, and play.

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Resources - Fathering Together, A Community of Dads Who Are On a Journey to

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"We feel incredibly lucky to have our children, but each pregnancy and birth has been completely different, and we've faced a lot of barriers as an LGBT+ couple. We have 3 children - our first child is 9 years old, and it took 5 attempts at IUI, including a miscarriage. Our second child is now 5, which took 2 IUI attempts and with our third child, we had 3 failed IUI's, 1 failed IVF and on the 5th attempt, IVF worked. Our fourth child, who is due in October, was conceived through 1 round of IVF.

"After everything we went through, we have felt mesmerised and in disbelief that each of our babies was finally here and safe! The best part of being a parent is waking up knowing you've been given the best gift ever and hearing them call your name!

"But the fear that the world is unkind and that someday they'll come to realise that, is hard to digest. We have to equip them with the understanding that not everyone is accepting of our family unit or who they are, and we are teaching them how to navigate those situations.

"Across the healthcare setting, especially in maternity care, there's a real lack of education about different family pathways and needs. The worst interaction was with the doctor the day after our eldest was born. She refused to deal with me as the non-birthing mother and told the nurse to, "get her out, I don't want her. I want the REAL mum." That sentence and memory lives with me. It definitely tainted our first experience as first-time mothers.

"Being from multiple marginalised minority groups whilst having to overcome a multitude of barriers has been a struggle. Everything from lack of funding, general discrimination, lack of understanding, systems not fit for purpose that exclude our family and our needs, all put us and our communities at risk of poorer outcomes. However, the midwives at our first birth were AMAZING. They didn't know everything, but they were considerate, asked questions, listened and got excited with us - it made us feel like it was an adventure and a memorable experience.

"I'd advise anyone looking to start a family to research every potential family pathway. You don't know where it will lead or how unfortunately, sometimes the path you thought you'd take is unviable due to fertility or finances. Find your support network and organisations to give you guidance about safe spaces around care or treatment.

"Our journey was difficult, and we wanted to create a community and an organisation that supported people down the different paths to parenthood- so people didn't have to experience what we did. LGBT Mummies was founded from this need: a need for a safe haven for women and people like us to come to for guidance, support and to meet others with lived experience- so that their journey felt less isolating and to be understood and celebrated.

"We want equal rights in funding access, access to inclusive care and a system that is trained to support us. How can you support someone if you have no understanding of the struggles and barriers they've had to overcome?"

You can find support and information from LGBT Mummies on their website.

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Experiences of a non-birthing mother | Life as a parent articles & support | NCT

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Laura and her partner have three children aged 9, 5, 3 and a fourth arrival due in October. Here she shares her experience as a non-birthing mother navigating parenthood and the challenges that have come with being an LGBT+ couple going through the maternity system.

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Oscar Duke

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Mixing humorous anecdotes about poo and bottle etiquette with actual proper medical information and advice, Dr Oscar Duke leads expectant dads through the minefield of modern fatherhood. Get to grips with the baffling terminology, bewildering anatomy and unexpected excretions with an expert holding your hand.

- The first doctor-written guide to becoming a dad
- Combines the medical knowledge of a healthcare professional with real-life experience
- Step-by-step - from conception to caring for your newborn baby
- Honest, humorous and engaging, this book answers the questions you've been too afraid to ask

At this crucial life-moment, knowledge is power, but you probably know less than you think: What's a cervix? Can we still have sex? Why's the midwife doing that? How do I make up a bottle and is that poo normal? Dad's role is more important than you might ever have imagined, so what can you do to help?

'I hope that as a doctor and a new dad, I will go some way towards answering those "man questions" that never quite make it to the pub, locker-room, water cooler or any other locations where men might find themselves having meaningful chats with another guy. Think of this as a papery man hug in what is a potentially treacherous world of terminology, hormones, social change, sleep deprivation and finally dirty nappies with tiny feet attached.'

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How to Be a Dad by Oscar Duke | Waterstones

# data[].attributes.attachment_link.description
Mixing humorous anecdotes about poo and bottle etiquette with actual proper medical information and advice, Dr Oscar Duke leads expectant dads through the minefield of modern fatherhood. Get to grips with the baffling terminology, bewildering anatomy and unexpected excretions with an expert holding your hand.

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Pride and Joy: A guide for lesbian, gay, bisexual and trans parents

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Pride and Joy: A guide for lesbian, gay, bisexual and trans parents

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Sarah and Rachel Hagger-Holt

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Pride and Joy: A guide for lesbian, gay, bisexual and trans parents

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Pinter & Martin is an independent publishing company specialising in pregnancy, birth, parenting, breastfeeding, yoga and psychology books