Your first days at home – settling in at home after birth at the hospital

The day after

The day after the birth, a midwife will call you to check in and see how you are doing. If needed, the midwife can come for a visit.

If you have questions before the midwife contacts you, you can call the Post-Natal Ward at 97 66 20 01 (between 7.00 AM – 3.00 PM) or at 97 66 29 86 (between 3.00 PM – 7.00 AM).

Home visits for first-time mothers

If you are a first-time mother and have given birth at the hospital, you can choose to have a home visit from a staff member from the Post-Natal Ward. This visit takes place about 24-36 hours after the birth. Before you leave the labor ward, we can arrange a time for the visit if you wish.

During the visit, we will talk about how you are doing as a family, both physically and mentally. We will also discuss nutrition for your newborn and your baby’s well-being.

Contacting your public health nurse

We suggest reaching out to your public health nurse on the first working day after arriving home after the birth. You must call your local municipal office and ask to speak with the public health nurse assigned to your area. The public health nurse's phone hours are usually from 8:00 AM to 9:00 AM.

Care and responsibility declaration

Unmarried parents must submit a care and responsibility declaration within 2 weeks after the birth, in order to obtain joint custody of your child. You can find the form at https://statsforvaltningen.dk under the paternity section.

Physical examination

Before you leave the labor ward, a midwife will examine your baby. The next check-up will be with your own doctor when your baby is 5 weeks old.

PKU blood test

Your baby will be offered a blood test 48 to 72 hours after birth. This blood test checks for several disorders, among others Folling's disease (PKU) and myxedema. If the test results are normal, you won’t receive any notification. If the test shows any signs of illness, you will be contacted within 1 to 2 weeks.

You can find more information about these conditions in the blood test form and the brochures you received at the maternity ward.

Hearing examination

All newborns are offered a hearing examination. This is done to identify the few children who are born with hearing impairment. The hearing examination can be done at the earliest when your baby is 2 days old. For more details about the test, you can check the brochure called 'Hearing Examination of Newborns' on our website.

You will receive an appointment for the PKU test and the hearing exam before you leave the maternity ward.

Breastfeeding

Our guidance and recommendations regarding breastfeeding is based on guidelines from the Danish Health Authority. Their guidelines indicate that breast milk is the best nutrition for your child during his or her first 6 months. Breast milk has many benefits and contains, among other things, antibodies that protect against infections and can delay the potential development of allergies.

Getting off to a good start with breastfeeding is very important. Trying out different breastfeeding positions can help stimulate your breasts in various ways. At night, lying down to breastfeed can be a great idea. It allows you to relax and rest while feeding your baby.

In the beginning, it’s normal for your baby to want to nurse often, which might lead to sore nipples. You might feel some pain during the first few minutes of each feeding, but it shouldn’t hurt the entire meal. After each feeding, let your breast air dry. When your baby finishes nursing, saliva and breast milk will be left on your nipple, which is great for the sensitive skin. Also, remember to change your nursing pads often to keep the area around your nipple dry and comfortable.

Skin-to-skin

Skin-to-skin contact is very important in the first 3 days after your baby is born. During this time, your baby goes from getting food continuously (through the umbilical cord) to eating at different intervals. You can help your baby during this transition and help them save energy by:

• bringing baby the breast often/at the first sign of hunger
• letting baby lie skin-to-skin.

Holding your baby skin-to-skin, helps them keep warm and helps them feel calmer and more relaxed.

In the first few days after your baby is born, they will want to nurse frequently for prolonged durations and often without any set schedule. During this time, your baby receives colostrum, which is particularly rich in antibodies. Around the third to fifth day, your milk will come in, and this is when your milk changes from colostrum to regular milk, also known as whole milk. In this phase, which lasts 1 to 2 days, you might notice that your breasts feel full, firm, and a bit tender; this is known as breast engorgement. This can make it tricky for your baby to latch and nurse properly. To help with this, you could try taking a warm bath or using a heating pad on your breast for about 5 minutes before nursing. This can make your breast a bit softer and easier for your baby to latch on to. You can also express a little milk to soften the area around your nipple, which can also make it easier for your little one to feed.

When the milk comes in, the amount of milk increases significantly. Breastfeeding starts to feel more like a meal, and over the course of a few weeks, a pattern may develop for when your baby is hungry. However, most babies will still need a comfort or soothing feed between the actual meals. Your baby should have a minimum of eight feeds a day. Once your milk comes in, some babies can manage with just one breast per feeding, while others may need to feed from both.

Every breastfeeding experience is unique, so it's a good idea to let your health nurse guide you based on your current needs. You can also reach out to ‘Forældre og Fødsel’s breastfeeding counsellors.

If you cannot or do not wish to breastfeed

If you have decided not to breastfeed, then your baby should be given formula milk. During the first few days, it can be challenging to determine the right amount of milk. We recommend that you contact your health nurse for guidance.

When you come home with a newborn, it can be beneficial to understand the baby's development during the early days.

Baby's reaction patterns

First day:

• Your baby sleeps a lot.
• Your baby has a need to nurse but may not be very hungry.
• Your baby has natural reserves of fluid and glucose to rely on.
• Your baby passes meconium (the black, sticky stool) and urinates.

Second day:

• Your baby gradually becomes more alert.
• Your baby nurses for both pleasure and nourishment.
• Your baby has less frequent bowel movements and urination.

Third day:

• Your baby's natural reserves are depleted.
• Your baby feels hunger and sucks more vigorously.
• The milk supply does not yet meet your baby's needs, so your baby will want to stay at the breast constantly.
• Your baby has a strong need for contact and wants to be with mom at all times.
• Your baby does not sleep very much.
• Your baby has infrequent urination and greenish stools.

Fourth and fifth day:

• The milk supply meets your baby's needs.
• Your baby sucks strongly.
• Your baby does not nurse as long at each feeding as before and is hungry again after about two hours.
• Your baby may spit up.
• Your baby's stools are now thinner and yellow/greenish.
• Your baby may have stomach cramps.

From the fifth to sixth day:

• Your baby should have frequent urination.
• Your baby should have thin, yellow stools daily.

If your child does not have frequent urination and thin, yellow stools daily from the 5th to 6th day, it may be a sign that your baby is not getting enough milk. Please contact the health nurse, your doctor, or the out-of-hours Medical helpline. If your child is on formula, they should have daily stools.

Vernix caseosa

If your baby is born with vernix on their skin, it's a good idea to gently spread it out every time the baby is changed during the first day. If there is still some left after the first day, you should wash it off. Keeping vernix on the skin for too long can cause irritation because it prevents the skin from breathing. This is especially important in all the baby's 'folds,' such as the backs of the knees and elbows, where it can be a breeding ground for bacteria and cause deep cracks in the skin.

If your baby has any blood on them after birth, it should also be washed off.

Hormonal bumps – heat rash

Approximately one in every three newborns develop what is commonly referred to as hormonal bumps or heat rash in the first few days after birth. These are one to two millimeter large whitish-yellow bumps surrounded by red rash. The bumps and rash have no significance for the baby and disappear on their own within a short period. There is no evidence to suggest that the rash is linked to allergies, heat, or hormones.

The umbilical cord

The umbilical stump falls off after five to ten days. It is normal for it to bleed a little as it gradually loosens from the skin. Some greenish, foul-smelling fluid may come from it.

Try to keep the umbilical area clean and dry. The baby can take a bath before the stump falls off.

Be aware of infection in the umbilical area. A red circle about one centimeter from the edge of the umbilical cord, with red discoloration shaped like a triangle pointing towards the chest, is a sign of infection. In this case, you should contact your doctor.

Urination

During the first diaper changes, it is important to pay attention to whether the baby has urinated. It can take up to 24 hours before the baby urinates for the first time. In the first few days, the baby has sparse, concentrated urine. By the third or fourth day, you should notice that the amount of urine increases, and it becomes less concentrated.

When the milk comes in, and no later than six to seven days after birth, the baby should have at least six well-soaked diapers each day.

If you notice that your baby does not urinate large amounts of clear urine, it may be a sign that the baby is not getting enough milk.

In the first few days, you may observe an orange-red uric salt in your baby’s diaper. This is a waste product from the kidneys that gets excreted in the baby's urine. It is a normal phenomenon that should disappear as the baby begins to urinate more. It can sometimes be mistaken for blood in the urine.

Stool

The baby's first stool is black and sticky, known as meconium. During the first few days, as the baby starts to receive more milk, the stool changes in color and consistency. Initially, it becomes a greenish-brown, less sticky stool, and when the milk comes in, it changes to a yellow, grainy stool.

By the fifth day at the latest, the stool should have changed in color and consistency. From the sixth day and in the following weeks, the baby should also have a bowel movement at least once a day. During this time, the stool will have a yellow, grainy, and watery consistency. If the baby does not follow this pattern of stool, it may indicate that they are not getting enough milk. In such cases, it is advisable to contact your health nurse or doctor.

Jaundice

Jaundice is a common condition in newborns that usually starts one to two days after birth. At birth, babies have a higher number of red blood cells. When these cells break down, they produce a yellow pigment called bilirubin. The baby's liver, which is still developing, may not be able to process this bilirubin quickly enough, leading to a buildup in the blood and causing the skin to take on a yellow appearance.

If you notice that your baby's skin looks slightly yellow, it's important to keep an eye on it. If the yellowing gets worse, you should reach out to your health nurse or doctor for an assessment. If the baby has jaundice, they may become lethargic, refuse to eat, and it can be difficult to interact with them. In this case, you should contact your doctor or the out-of-hours Medical helpline promptly.

A blood test can determine the level of bilirubin in your baby’s blood. If the bilirubin level is too high, the baby may need to be admitted for treatment. Severe jaundice that goes untreated can lead to serious complications, including brain damage. The standard treatment is phototherapy, where the baby is placed in a crib under special lamps that emit ultraviolet light. This light helps break down the bilirubin in the skin. The phototherapy is safe and not painful for the baby.

Genitalia

In newborn girls, there may be a little mucus from the vagina, and sometimes there can also be a bit of blood in the mucus. This is completely natural and is due to hormonal influence from the mother.

In some boys, the scrotum may be swollen at birth and in the weeks that follow. This is entirely normal and is caused by fluid accumulation. The swelling will go away on its own.

In both girls and boys, the breast glands may be slightly swollen in the first weeks after birth. There may also be a little fluid discharge, known as witch's milk. This is due to hormonal influence from the mother, and it will disappear on its own.

Pacifier

To ensure the best start to breastfeeding, we recommend waiting with the use of a pacifier until breastfeeding is well established. If the baby's suckling needs are met with a pacifier, there is a risk of:

• the baby not receiving enough colostrum in the first few days
• a delay in milk production, resulting in a quantity that may be less than what the baby needs thereafter.

Crying

One of the ways the baby communicates is by crying. Over time, you will gradually learn to interpret the different types of cries. For example, your baby may cry to indicate that it is hungry, has a wet diaper, wants contact, or is tired.

Many parents feel helpless at first when the baby cries. However, as you learn to interpret your baby's signals and become able to comfort and meet its needs, you will feel a great sense of satisfaction.

Some babies cry more than others, and this is influenced by the baby's temperament. Some babies scream intensely as soon as a need arises, while others are more patient and can be distracted with talk or similar activities. Don't compare your baby to others. Just as children are different later on, so are infants.

Sleep

Infants' sleep patterns and needs vary greatly. Some children quickly fall into a regular rhythm, sleeping and eating at consistent intervals. Others may take longer to establish this. Immediately after birth, most babies will need to eat every two to three hours. Once breastfeeding is established, the baby will typically eat every three to four hours, possibly with one longer sleep period once a day. In the early days, many babies will sleep between feedings. However, some babies may already have periods where they are awake for a few hours at a time, during which they expect company. Over time, you will learn to interpret your baby's signals that say, "That's enough now – I want to sleep again." Overtired babies may have difficulty falling asleep.

Sleep positions

The Danish Health Authority recommends that infants be placed to sleep on their backs. Since the early 1990s, it has been recommended that infants sleep on their backs, and since then, the number of children who die from unexplained sudden infant death syndrome (SIDS) has significantly decreased.

Some babies may tend to always turn their heads to the same side while sleeping. This can lead to the baby's skull becoming misshapen. Talk to the health nurse about how you can change your baby’s habit.

When your baby is awake, it is important to not always lay them on their back. They should be placed on their stomach, you should sit with them, and you should carry them in various ways to stimulate and strengthen the baby's motor skills and muscles.

Bleeding and discharge

In the first week after giving birth, you will experience fresh bleeding similar to a heavy menstrual period. In the first few days, there may be clots in the bleeding. This is completely normal but should not occur after the first week. As the fresh bleeding decreases, you will still have bloody, slimy discharge, which can last up to six to eight weeks after giving birth. You should seek medical attention:

• if the discharge becomes foul-smelling
• with increasing bleeding that does not decrease after rest and relaxation
• if you experience pain
• if you get a fever.

Contractions

After giving birth, the uterus begins to contract immediately. These contractions are sometimes called afterpains. In the first few days after birth, there may be strong contractions. These may be experienced by some as menstrual cramps and by others – especially by multiparas – as labor-like pains. Sometimes, frequent urination or lying on your stomach can help relieve these afterpains. Talk to the medical staff if you need pain relief medication.

Vaginal tearing and repair

If you have sustained a vaginal tear during labor and have received stitches, the thread used will dissolve on its own. This means that the threads do not need to be removed. If you are swollen and sore in your perineal area, you can relieve this by occasionally using an ice pack. Ask the medical staff for advice. You can also take over-the-counter pain relief medication if you experience any discomfort.

Pelvic floor exercises – Kegels

It is important that after giving birth, you retrain your pelvic floor muscles to avoid involuntary urination and a prolapsed uterus. Check out good exercises for training the pelvic floor at https://gynzone.dk

In the beginning, you may not fully sense that you are doing Kegel exercises, but over time, your pelvic floor will become strong again. As you practice, you'll be able to feel the tightening of the perineal muscles more effectively. It's a good idea to perform Kegels when you cough, sneeze, or lift something heavy. Regular practice can help improve your pelvic floor strength and overall bladder control.

Many find it beneficial to attend postnatal gymnastics. Here, you meet other new mothers and their babies while doing exercises that retrain and strengthen your body after pregnancy and childbirth.

Intercourse

After giving birth, you may have intercourse when you feel ready. It varies greatly when the desire comes. Some may become afraid of having sex due to pain. The woman may be afraid of whether it will hurt – especially if she has sustained any tearing. The man may be afraid of causing harm and inflicting pain on the woman. Talk about the thoughts that occupy you, and try to explore gently. The woman may initially experience vaginal dryness, which is due to hormonal changes. You may want to use a lubricant.

Breastfeeding cannot be used as a contraceptive. If you don't want to get pregnant again, always use reliable birth control. Use a condom while there is postpartum discharge, and otherwise, speak with your doctor about a suitable contraceptive method.

Birth debriefing

There isn’t a clear answer to what makes a birth experience "good," and others may not fully understand how you felt during yours. For some people, certain aspects of their birth can linger heavily on their minds – things that are hard to come to terms with. If that resonates with you, having a birth debriefing could be beneficial. The midwife who was present during your birth will be there to help guide the discussion, as she knows the process well.

In the debriefing, we’ll focus on what was most significant for you during the birth. We’ll talk about both the positive moments and the challenges you faced. The goal is to help you better understand and accept how your birth experience unfolded. You don’t need to pinpoint exactly what’s bothering you; sometimes, that’s what the debriefing is meant to assist with.

If you’d like to learn more about birth debriefing, you can find additional information under "Activities and Offers" on the Aalborg Midwifery Center website: https://aalborguh.RN.dk/aalborg-jordemodercenter

If you feel the need for a birth debriefing, please contact Aalborg Midwifery Center at tel. 97 66 28 28.

If you have questions, you are welcome to contact the Post-Natal Ward or your health nurse.