Are you going to be a grandparent?

Wednesday 21 May 2014

Congratulations on this exciting period in your life as you look forward to becoming a grandparent, whether this is your first grandchild, or one of many.

Given you’ve already survived parenthood, we don’t intend to tell you how to be a grandparent but we have put together some up-to-date information which new parents receive which may differ to the advice and information you received when your children were born.

This may help you to have a better understanding of your children’s parenting perspectives and enable you to support their choices.

Family-centred maternity care

Today, hospitals have a family-centred approach to maternity care, recognising the importance of an evolving togetherness between expectant parents. This partnership is an important stage for them; as they prepare for the role of parent and learn to make joint decisions about how they will care for, and parent, their child. Fathers are encouraged to take a major supportive role in birth suite, at antenatal classes and in the postnatal wards. Children and extended family are welcome in maternity units as the arrival of a new baby is the creation of a new family.

Current baby care trends

Skin-to-skin contact: Mater encourages skin-to-skin contact between mothers and babies immediately after birth; baby should be naked against their mother’s skin, with a warm blanket placed over baby’s back. This early contact allows the mother to share her own immunity with her baby. It is important for this skin-to-skin contact to continue uninterrupted until after the first breastfeed so we ask you to save your cuddles until this has occurred. Weighing baby should also occur after the first breastfeed. Mothers who have a caesarean birth are also able to have skin-to-skin contact with their baby in the operating theatre; however, fathers are able to do this if the mother is unwell or unable. Other benefits of skin-to skin contact include facilitation of breastfeeding and stabilisation of baby’s temperature.

Rooming-in: the practice of mother and baby rooming-in 24 hours a day is now common in maternity facilities and practiced at Mater; night nurseries are a thing of the past. Mothers need to learn to care for, and respond to, their baby’s cues. Current research indicates that mothers get more, and better quality, sleep when their baby is close to them. Rooming-in also supports mothers and babies when learning to breastfeed, facilitates bonding, decreases the risk of babies picking up infections and increases security and safety.

Bathing: can be flexible; in winter it is appropriate to bath baby less frequently; in summer perhaps more often if baby is hot and sweaty. Bath oils, infant soaps or even plain water are acceptable for bathing. Babies love to float in deep warm water or may even enjoy sharing a shower with mum or dad.

Soft spots (fontanels): are no longer an area treated with great care as the area below this skin is actually quite tough. Parents are encouraged to wash and massage the head firmly with either hand or towel as this helps to prevent a build-up of oils on the scalp which cause cradle cap.

Cord care: current research supports leaving the cord stump alone to dry out and detach; water only is used for cleaning if required; never alcohol. In the days before it drops off, the cord may become a little sticky, smelly and might ooze a tiny amount of blood. This is all normal.

Dummies or pacifiers: using a pacifier is very much a parental choice. We recommend that pacifiers are not used while breastfeeding is being established in the initial four to six weeks. Pacifiers are associated with a decreased milk supply as they tend to reduce feeding opportunities at the breast. Pacifiers can be washed in warm soapy water, rinsed, air-dried and kept in a clean container.

Sterilising: current research no longer supports routine sterilising of baby’s feeding equipment (especially when breastfeeding or using breast milk). Breast pumps, bottles and teats can be rinsed in cool water, washed thoroughly in warm soapy water, rinsed and air dried on a clean surface and kept in an airtight container. If formula feeding, bottles and teats may be washed, as above, and sterilised once each 24 hours. Steam sterilising is effective and practical; although, a dishwasher may be used if it has a final high temperature rinse program. Then air dry and store as above.

Crying babies: traditionally, it was believed that baby’s needed to learn to self-settle as soon as possible or they would become spoilt and difficult. Attachment theories and research into infant brain development encourage demand feeding and responsive care and no longer support the use of controlled crying methods or practices allowing the baby to cry for extended periods of time.

Colic: all babies will cry at some stage, some more than others. Most infants will experience an unsettled period once a day lasting at least one feed period to the next, and perhaps one day a week, which is normal. Colic is no longer viewed as an illness but rather a label for an extremely unsettled baby. There are a number of causes for this and while most are normal, it is advisable to check with a doctor or child health professional.

Laundering clothing: there are no specific laundering methods for infant clothing. Babies’ clothes can be washed, with the rest of the family’s, with normal washing powders or liquids. If clothing has been stored in naphthalene (moth balls) it is important to air and wash the clothes thoroughly before baby wears them, as exposure to naphthalene can cause a dangerous form of jaundice (yellow skin).

Infant feeding

The choice of how to feed their baby is perhaps the first major decision that new parents make. It is vitally important to support the mother’s choice, whatever she has decided upon.

Breastfeeding

As with any new activity, it can take some time to feel comfortable with breastfeeding. It is common for mums to feel unsure about the various elements of breastfeeding such as timing, frequency, techniques and milk production.

A new mother requires a lot of support, both practical and emotional, in the early days so it is important to be familiar with the latest breastfeeding information.

We encourage mothers to breastfeed their baby on demand, rather than to a schedule, as this supports a better milk supply, minimises risk of engorgement and mastitis and encourages better growth in their baby. Baby is usually offered both breasts at a feed and encouraged to feed as long as they want at the breast; until they are full and disinterested and the breast has softened. Feeds do not need to be timed.

Babies have very small stomachs and breast milk is easily digested, so they need to feed frequently, including at night. In the early days, they will breastfeed eight to10 times in each 24 hour period. Parents are taught to assess adequate intake by recognising full and empty breasts as well as assessing baby’s output by the number of wet and dirty nappies in a day (six wet nappies and one to two poos is normal). Parents are easily discouraged by remarks such as “are you sure he is getting enough” or “he’s starving”.

Growth spurts: babies experience periods of rapid growth, will become very unsettled and demand frequent feeds. This encourages the breast to increase supply. It is normal that they feed hourly or so for a 24–48 hour period which will settle as the milk supply increases. Breast milk is a living, changing fluid which alters to meet each baby’s requirements at any given time i.e. if a baby is sick or the weather is especially hot. Babies in the first six months do not require anything other than breast milk; neither water, vitamins, juice or formula.

Breastfeeding mothers do not need to observe special diets or avoid particular foods. A healthy diet will ensure that mum feels well and can provide for her baby. Exposure to a variety of flavours in the mother’s diet helps prevent fussy eaters later.

For more information on breastfeeding please see our brochure on breastfeeding and your new baby

Formula feeding

Mothers may choose to formula feed and should be supported in this decision. A plain cow’s milk starter formula is recommended unless otherwise prescribed by a doctor.

Sterilisation of equipment has been discussed above. Bottles should be made up individually rather than in bulk to prevent contamination with bacteria that have been found in formula. To prepare formula safely, the water should be boiled and then allowed to cool to 70 degrees Celsius (about 30 minutes), the powdered infant formula added as per instructions on the can and mixed through. Then quickly cool in cold or iced water before use.

If stored in a fridge, store in the central part of the fridge which is coldest. Prepared milk should be transported in a cooler bag with an ice brick. Boiled water, cooled to be mixed with formula powder later is not recommended as it risks contamination. Never heat formula in a microwave as it destroys the vitamins in the milk and hot spots risk the baby’s mouth being burnt.

For more information on breastfeeding please see our brochur on formula feeding

Introduction of solid foods

The current recommendations are to introduce solid foods at around six months; this is purely educational and not nutritional and the baby still gets all their nutritional requirements from their milk feeds until 12 months. Introduction of solid foods does not promote sleeping through the night and early exposure can increase the risk of allergy.

Safe sleeping

The safe sleeping guidelines are recommended by SIDS and Kids to reduce the risk of sudden infant death (May 2012). You need to be familiar with these guidelines when settling your grandchild to sleep.

1. Sleep baby on their back from birth, not on tummy or side.
2. Sleep baby with head and face uncovered.
3. Keep baby smoke free before birth and after
4. Provide a safe sleeping environment.
5. Sleep baby in their own safe sleeping place in the same room as an adult care-giver for the first six to twelve months.
6. Breastfeed baby.

A safe sleeping environment includes:

• a cot that meets Australian standards
• a firm, clean well-fitting mattress
• removing all quilts, doonas, pillows, loose bedding, cot bumpers, sheepskins and soft toys.

For additional, comprehensive information about safe sleeping and providing a safe sleeping environment please visit the Sids and Kids website and select the safe sleeping tab or read the following SIDS and Kids brochures:

• Safe sleeping
• Making up baby’s cot
• Safe wrapping

Car seats

Queensland legislation requires that all children up to seven years of age are to be secured in an Australian standards approved child restraint that is installed according to the manufacturers’ instructions.

• Birth to six months (less than 8 kilograms) rearward facing baby capsule or infant restraint
• Six months to one year (8 to 12 kilograms) rearward or forward facing infant restraint
• Six months to four years (8 to 18 kilograms) forward facing restraint with built in harness
• Four to seven years (14 to 26 kilograms) booster seat with H-harness or a booster seat with a secured adult seatbelt

If you have a second-hand restraint, you need to be assured of its history and that it has not been in an accident. If you do not have this information, the manufacture’s fitting instructions, or the restraint is more than 10 years old you should not use it.

Safety in the home

Be aware of issues in your home and start thinking about when your grandchild will be crawling and walking. Other tips include:

• Never leave your grandchild unattended on a high surface or in the bath.
• Do not handle hot drinks or food when holding your grandchild.
• Make sure all baby furniture meets the Australian standards.
• Use placemats instead of table cloths.
• Place child proof caps on electricity sockets.
• Adjust dangling cords on blinds or curtains so they are not accessible
• Put away items which are small enough to put into a baby’s mouth.
• Lock up dangerous liquids and poisons.
• Any medications should be stored in a safe (preferably high) place away from curious fingers.They may look like lollies to small children.
• Reversing your car—know where your grandchildren are at all times.