The family way

By Lisa Salmon

Giving birth can be a harrowing experience, but for many new mums, looking after a tiny baby in the early months can be almost as hard.

Being responsible for a new life for the first time can be overwhelming, with many first-time mums unsure if they're doing the right thing, and sometimes feeling isolated, depressed or anxious, with concerns about their baby's health and development.

But postnatal experts are keen to stress that there's plenty of help available for new mums, both through NHS postnatal services, and organisations such as the NCT, which points out that increasing amounts of research links maternal wellbeing with both short-term and long-term benefits for babies.

Louise Silverton, deputy general secretary of the Royal College of Midwives, stresses that good postnatal care is vital, for example to help and support women to establish breastfeeding, learn to care for their baby, and ensure women are in good health after their pregnancy.

"Women should rightly be expecting the NHS to provide this," she says.

"However, we know anecdotally that the number of postnatal visits are being cut across the country, and I have real concerns about the impact of this."

She says the Government's Healthy Child Programme highlights the importance of good care throughout and after pregnancy for the health and wellbeing of mother and baby, but stresses that officials need to ensure there are enough NHS midwives so postnatal care doesn't suffer.

"There can only be benefits for the health of the mother through good and comprehensive NHS-provided postnatal care," she says.

"This will also ultimately reap benefits for the NHS because it will lead to better long-term health for the mother and baby."

As well as NHS services, postnatal support is available through the NCT, which runs Early Days courses where parents can discuss topics ranging from baby's feeding and sleeping, to relationships, returning to work, and different styles of parenting.

NCT postnatal leader Alex Bollen says sleep and tiredness tend to be the most talked-about issues on the courses, but points out: "It's not just lack of sleep that causes parents' exhaustion, it's the very steep learning curve they're on.

"It's 24/7 and mums are exhausted - it's a big shock."

She says mums are scared of doing anything that might harm their child, and simply want to be the best mum they can, which makes baby's crying and unpredictability in the first six to eight weeks extra tough.

"Mums can be surprised at how hard they find it when their baby cries, particularly if they have a colicky baby," she says.

Bollen says the wealth of information available for new mums creates a great deal of pressure, as parents don't know what advice to follow for the best.

"There are different philosophies on parenting and that can be very confusing for new mums.

"But it's trial and error, getting to know your baby, and understanding what makes your baby tick, and that often doesn't fit in with books that say 'you must do it this way'."

She says support is vital in the early months, as is putting parents in touch with others who are going through the same thing.

"Early Days courses provide a safe environment where parents can talk about the challenges and what they're finding tough. They can share their experiences and emotions, which is valuable.

"As the courses progress, mums become more confident at trusting their common sense and knowing what's right for their baby."

NCT postnatal leader Caroline Smith says worries about a baby's development are normal, and gives the following tips:

:: It's normal for new babies to cry a lot. It's a developmental stage that peaks around six weeks and then will gradually tail off without the need for any intervention.

:: It's normal for new babies to be very awake during the day from around three weeks old - babies don't know how to fall asleep alone and need a lot of help in the first few months.

:: New babies want to be held all the time - they still think they're in the womb and find separation very frightening. Around the three-month stage they will suddenly become more interested in their surroundings and be happy to be left for short periods of time.

"With these things in mind, I always ask new parents whether they feel able to put their lives on hold for the first 12-14 weeks after their baby's born, so they can help baby adjust to being out in the world," says Smith.

"I promise them it's just a phase and it will get better."

She says new parents sometimes feel guilty about the amount of time they think they should spend interacting with their babies. But she gives these reassuring tips:

:: Babies are born primed to develop and only need a 'good enough' amount of interaction to allow the process to occur.

:: Babies don't really need toys at all for the first few months - their favourite toy is their parent. Simply looking at each other, touching and talking to one another is more than enough.

:: Up to the age of six weeks babies can only cope with a few minutes of sensory stimulation before they may need a break. A baby signals overstimulation in quite subtle ways, and parents may not be able to pick up on these signs. However, babies then start to give more obvious signals such as crying. By this point it can be hard to calm baby down, so some people suggest reducing stimulation beforehand.

:: Many baby books suggest using a routine to schedule baby's downtime, and while all babies are different, some parents like to try this, rather than trying to read baby's signals.

Smith also stresses that parents should remember that they have needs too, and not lose sight of the person they were before they had a baby and how they enjoyed relaxing and socialising.

She says: "The first few months are undoubtedly the most intense, but it's important for parents to acknowledge that they have needs too - you are still 'you' even though you've had a baby."

She adds: "It really is only a short period of time in your life, so try not to wish it away - you'll never have these days and weeks back again."

:: To find a local Early Days postnatal course, visit www.nct.org.uk/courses/postnatal. The NCT helpline is on 0300 330 0700.

Ask the expert

Q: "I'm six months pregnant and work long hours, mostly on my feet. Is working likely to harm my unborn baby?"

A: Professor Alex Burdorf of the Erasmus Medical Centre in Rotterdam, Holland, has just led a study into whether a pregnant woman's working conditions affect her baby's size.

He says: "We showed that women exposed to long periods of standing had lower fetal growth rates for fetal head circumference, resulting in a reduction in the average head circumference at birth of approximately 1cm.

"Furthermore, compared to women working less than 25 hours per week, women working 25-39 hours, and more than 40 hours had lower growth rates for both fetal weight and head circumference, resulting in a difference of approximately 1cm in head circumference at birth and a difference of 148g-198g in birth weight.

"However, there were no consistent findings between long periods of standing and long working hours in relation to major adverse birth outcomes, such as small for gestation age, low birth weight or preterm delivery.

"This means that women exposed to long periods of standing and women working long hours, when compared to women who do not, have a slightly higher risk of lower fetal growth rates during pregnancy."

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