Key recommendations include:
• That each woman has her own personalised care plan which takes into account her and her baby 's individual needs.
• All maternity care providers should implement an externally evaluated structured programme that encourages breastfeeding, using the Baby Friendly Initiative (www.babyfriendly.org.uk) as a minimum standard.
• At each postnatal contact, parents should be offered information and advice to enable them to:
• assess their baby 's general condition
• identify signs and symptoms of common health problems seen in babies
• contact a healthcare professional or emergency service if required
Prof. Rona McCandlish, Chair of the guideline development group said: "In the past postnatal care has often been considered the 'Cinderella service ' of maternity care. This guideline recognises that women, babies and families deserve highest quality care after birth. It establishes clear, much needed national standards for healthcare professionals to help them offer women the support they need in the hours, days and weeks following birth."
At each postnatal contact, women should be asked about their emotional well-being, what family and social support they have and their usual coping strategies for dealing with day-to-day matters. Women and their families/partners should be encouraged to tell their healthcare professional about any changes in mood, emotional state and behaviour that are outside of the woman 's normal pattern.
The guideline is underpinned by a core principle of good communication with new mothers and between healthcare providers. It promotes respect for the wishes and cultural beliefs of the woman and her family, and encourages healthcare professionals to provide information in an accessible format.
The guideline also sets out what advice women should be given regarding aspects of their own and their baby 's care. For example, advising women:
• How to breastfeed successfully and what the signs are that a baby is getting sufficient milk during breastfeeding.
• How to overcome breastfeeding concerns such as mastitis and sore or cracked nipples, so they can continue to breastfeed.
• How to deal with common problems such as jaundice, excessive crying, colic and nappy rash.
• That sleeping with a baby, in a bed, a chair or sofa is not recommended as this can increase the risks of sudden infant death syndrome (cot death).
• What support networks are available to them in their area
•How to prepare, store and warm formula, and how to clean and sterilize bottles and teats, should they choose to bottle feed.
NICE have produced an easy to use "quick reference guide" for healthcare professionals that presents the guideline in a straightforward format. This recognises that midwives and health visitors need an easy document to refer to when offering post natal care. The guide details what should happen at each postnatal contact, from the first hours after birth through to 8 weeks outlining what healthcare professionals should do for the woman and for the baby. There is also a section detailing the signs and symptoms of potentially serious and life threatening conditions for both the mother and her baby.
Mustary Parkar, lay member of the guideline development group said: "Good quality post natal care can have a big impact on successful breastfeeding which we know gives babies the best start in life. Recommending that NHS organisations use the Baby Friendly Initiative as a minimum standard means that healthcare professionals will be trained to support women to breastfeed following internationally recognised standards. Women often feel they gave up breastfeeding sooner than they wished because of concerns or problems that with the right advice and support may never have arisen or could easily have been overcome. The guideline will help healthcare professionals to support women to breastfeed for as long as they wish."
Dr. David Elliman, Consultant in Community Child Health, said: "New babies require huge amounts of care and attention, and this can be daunting, particularly for first time parents. Helping mothers to know what signs and symptoms could indicate something serious so they know what to worry about and what is normal gives them reassurance and confidence. Giving babies the best start in life through good quality post natal care means they are less likely to have health problems during childhood and into adulthood."
Cheryll Adams, Health Visitor Advisor, said: "The role health visitors and community midwives play in supporting mothers and taking care of new babies is invaluable. Because they get to know mums and babies well and often see them in their own homes, they are able to spot when things aren 't right and offer the most appropriate support. Whether it 's something as simple as nappy rash or something more serious like the signs of post natal depression health visitors and community midwives are often the ones to spot it and to know what to do. These guidelines, particularly presented in the quick reference guide format, will really support my colleagues to deliver the best care at such an important time."
July 26 2006
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