Congratulations

Congratulations on the birth of your child. There are many things new parents have to deal with just after the birth of their baby. We have put together this pamphlet to help answer many of the questions you may have. You are also welcome to give us a call during the first seven days after birth. After the seven days, contact your health visitor or your general practitioner if you are in doubt or if you have any problems.

Practicalities

If you gave birth at home, or if you return home soon after giving birth

If you gave birth at home, or if you left the maternity ward very soon after the birth, we will call you over the next days to check how things are going.
We will also visit you within 48-72 hours after birth. For primiparas/first timers, we make two home visits, the first within 24 hours from birth and the second between 48-72 hours. For multiparas there is no home visit on the first day, we ring instead, and we make the home visit between 48-72 hours after birth. These appointments will be booked before leaving the hospital for the postnatal period.

Hearing screening and heel prick test (blood spot screening)

You will be given an appointment for a hearing and blood spot screening no later than 72 hours after the birth. We will carry out the tests in the hospital or in your home.

Visit by a health visitor

A health visitor will visit you during the first week. They will call or send you a text message to arrange an appointment. The health visitor will advise you about the period after birth, the child's development, breastfeeding or other nutrition, and your new role as parents, etc.

Registering the birth and custody

The midwife will make sure the birth is registered electronically and that the child is given a civil registration number.
If you are married, you and your partner will automatically share joint custody of the child.
If you are not married, you will have to fill out a form (Declaration of care and responsibility for paternity) within 14 days of the child’s birth. The form can be found at www.lifeindenmark.dk. The form must be completed and signed with MitID by both parents. If you are a single parent of the child, you will automatically have custody.

Post birth consultation

You will be offered a post birth consultation with a midwife. If you need another consultation later on, you are welcome to contact the maternity ward secretary. The telephone number for the secretary can be found under the contact information.

Visit to your general practitioner five and eight weeks after the birth

Mother and child will be offered a check-up by their general practitioner after the birth. Five weeks after birth, your general practitioner will examine the child and weigh it.

Eight weeks after birth, the general practitioner will conduct a gynaecological examination of the mother. The general practitioner will check the pelvic floor muscles and any cuts from tearing or a caesarean section. Your general practitioner will also ask about how you are both doing and discuss birth control with you. You will need to book both appointments yourself.

The child

Check whether you child is urinating

Your child should pee within the first 24 hours of birth. This is a sign that the kidneys are working correctly. Once you have started producing milk, your child should have five to six wet nappies a day.
Small orange or red spots in the nappy are normal at the beginning. This is caused by waste from the kidneys, called urates. The small spots should disappear within the first five days. If they do not disappear, your child should be weighed. If they do not disappear, your child should be weighed to ensure that the reason for excretion of urates is not caused by dehydration/too little milk. Your child will be control weighed by the first visit of the health visitor.

Contact us if your child has not peed within 24 hours after birth.

Keep an eye on your child’s bowel movements

Your child will have their first bowel movement within 24 hours of being born. At first, the stool will be sticky and almost black, and then turn green over the course of a few days. Five to six days later, the stool will turn yellow, grainy and soft. This is a sign that your child is eating well. In general, your child should have a bowel movement every day during the first 14 days.

Contact our hotline if your child has not had a bowel movement two days after birth.

Be aware of jaundice

Some children develop a yellow tint on their skin a few days after birth. This is normal and will often disappear once you start producing milk and your child begins to eat a little more.

Contact us immediately if your child’s skin or eyes become more yellow, if your child does not wake for feedings or if your child becomes listless or hard to wake. This may be a sign of jaundice. We will check to see whether your child needs treatment. When a child looks jaundiced/yellow, it is important to prevent dehydration. It may be necessary to wake the child regularly, every 2-3 hours, to ensure enough milk is given and to check the digestion for urine and feces/stools.

Keep an eye on your child’s temperature

A newborn’s temperature is easily affected by the surroundings. Your child’s temperature can go up and down very quickly. Check whether your child’s body temperature is OK by touching the chest or neck. If the skin is neither damp nor cool, then your child’s temperature is OK. Your child's hands and feet can feel cold and be a little bluish even if their overall temperature is alright. This is normal and usually changes after a couple of weeks.

Your child should be dressed, except during skin-to-skin contact with you. Your child does not need to wear a head covering indoors.

The normal temperature for a child is between 36.5 and 37.5 degrees centigrade. If your child has a temperature above 37.5 degrees centigrade measured in the rectum, try to take off some of their clothes and check the temperature again after 30-60 minutes.

Contact our hotline (during the first seven days after birth), your general practitioner or dial 1813 for the medical hotline if you child’s temperature does not go down, or if the child seems limp, is crying a lot or not eating.

Genital organs

Newborn girls may bleed slightly from the vagina, and there may be a small amount of slimy discharge. The labia may also be slightly swollen. This is normal and it is caused by the mother’s hormones.

Newborn boys may have a red and swollen scrotum at birth and for a brief period after. This is normal and caused by fluids. These symptoms will go away on their own.

Both newborn boys and girls may have swollen breasts and a little liquid may leak out. This is caused by the mother’s hormones and will go away on its own.

Eye care

Your child’s eyelids may be a bit swollen during the first few days after birth. If your child has a little pus in their eyes, remove it with clean, lukewarm water. Swipe from the inner corner of the eye and away using a piece of cotton wool. Use a new piece of cotton wool for each eye, so the pus is not transferred from one eye to the other.

If the white of your child’s eyes is a bit red, or you see some yellowish pus that returns within the hour, contact your general practitioner.

Skincare

Many children have dry, flaky skin after birth. This is normal and is caused by the skin reacting to the air after spending the pregnancy in amniotic fluid. This does not usually require treatment.

If your child has vernix caseosa, a white, cheese-like coating on the body, it is best to leave it for the first 24 hours. Afterwards, you can smear it evenly onto dry areas of your child’s body. If there is still a high amount of vernix caseosa after a couple of days, you can wash it off.

Your child may also develop a variety of spots on the skin. Contact your health visitor or general practitioner if the spots contain yellow pus and do not disappear after a couple of days.

Changing nappies

There are a couple of things to remember when changing your child’s nappy:

• Make sure your child does not get too cold. Have everything ready beforehand and place a piece of cloth on your child’s chest to keep them warm.
• Never leave your child alone on the changing table. Children are born with a crawling and catching reflex and they may move about and fall off.
• Only use tepid water to wash your child. Soap can dry out the skin.
• Always wash from front to back to avoid getting stool or grime near the genitals.
• Do not wash males under their foreskin.
• Let the skin air-dry for a bit before putting on a new nappy. Gently dry between every skinfold to avoid irritated skin.
• If your child’s bottom is red, change the nappy more frequently. If skin redness persists, ask your health visitor for advice.

Bathtime

It is not necessary to bathe your child in the first few days after birth as the skin is protected by vernix caseosa. We recommend waiting at least 48 hours after the birth before bathing your child. During the first weeks we recommend bathing your child only once or twice a week. Bath your child more frequently afterwards:

• The child must be awake, full and calm before a bath. Do not wake your child up for a bath.
• Make sure that everything you need is ready beforehand.
• The temperature of the bathwater should be 37 degrees centigrade. Use your elbow to see if the temperature of the water feels comfortable or use a thermometer.
• Do not put soap or oil in the water.
• Wrap your child in a piece of cloth before slowly lowering them into the water.
• Rest the child's neck on your wrist and keep a firm hold of the child’s upper arm.
• Start by washing the face. If the naval cord is still attached, use fresh tap water to wash your child’s face. Do not use the bathwater.
• Then wash all the skinfolds, behind the ears and neck.
• The bath should not last too long as your child can quickly become chilled.
• Dry the hair and body first and the bottom last. Make sure to gently dry between all skin folds and around the naval. 

Sleep and sudden infant death syndrome (SIDS)

A newborn baby sleeps approximately 10 to 22 hours a day. Some children do not sleep much, and others sleep a lot.

Your child should always sleep on its back. Only let your child sleep on their stomach when lying on an adult who is awake. Once your child can turn over, you can allow the child to sleep on its stomach.

The safest place for an infant to sleep is in its own bed in the same room as the parents. If you want your child to sleep in your bed, never place the child between you and your partner. The child should sleep on one side of the bed with its own duvet. There is a slightly greater risk of SIDS if your child sleeps in your bed.

The risk of SIDS also increases if you, your partner or both are overweight, smoke or if you have drunk alcohol or taken medicine that makes you drowsy. If this is the case, we do not recommend letting your child sleep in bed with you.

SIDS can also be prevented by making sure your child is not too hot when sleeping. Therefore, do not dress your child too warmly. The neck or chest area should not feel damp/sweaty. The temperature in the room should preferably be around 18-20 degrees.

You can take your baby for walks in a pram as soon as you wish. However, we recommend waiting with letting your child sleep in the pram outside until it has started gaining weight and is otherwise thriving. Make sure your child is dressed warmly enough and check their temperature regularly. Your child should not sleep outside if the temperature is below -10 degrees centigrade, or if it is foggy or misty. A child does not need a pillow during the first year.

Head position

Make sure your child’s head is not always turned to the same side when sleeping, resting, being changed or carried. This will help prevent the development of an uneven head or tight neck muscles. We recommend placing your child on its stomach when it is awake to help train the neck and back muscles.

Navel

Keep your child's navel clean and dry. The umbilical cord stump will shrink after a few days and eventually fall off, usually within a week. Once the stump becomes loose, it may discharge blood or fluid. It is also normal for the stump to smell. If redness appears around the navel, clean it with mild soap. Contact your general practitioner if this does not help or if your child develops a fever.

Nails

In the initial period after birth, your child’s nails will be so soft that you can use your fingers to gently rub them down. Once that is no longer possible, you can begin to use nail clippers. Do not put mittens on your child, even if their nails seem sharp. It is important for your child's sensory perception that they can use their hands to feel things.

Vitamin D

Your child should be given vitamin D from the age of 14 days to 4 years.

A thriving child

Your child should be content most of the time. A thriving child:

• eats at least eight times a day
• is awake and attentive while eating or during a nappy change
• has wet nappies and a bowel movement every day
• has normal skin colour
• begins to gain weight once the mother starts producing milk.

A child that is not thriving will often seem listless and despondent, cry a lot or lack appetite.

Mother

Bleeding after birth

After giving birth, it is normal to experience vaginal bleeding corresponding to a heavy menstrual flow or stronger. The bleeding will decrease gradually during the first week. You will then experience a bloody or brown discharge for six to eight weeks.

To prevent infection, we recommend that you wash yourself with lukewarm water after visiting the toilet during the first week or for as long as you are bleeding heavily. Make sure to replace pads often. Avoid using tampons or menstrual cups, swimming at public pools or in the sea, or taking baths while you are bleeding or have bloody discharge.

Contact our hotline during the first seven days after birth, if:

• your bleeding increases or becomes lumpy
• your discharge develops an unpleasant smell
• you experience severe pain
• you develop a fever.

If you detect signs of infection after the first seven days, contact your general practitioner or dial 1813 for the medical helpline.

After-pains

The uterus will shrink back to its usual size after the birth. The contractions can be painful and are referred to as after-pains. You may notice them more while breastfeeding, and the pain may last for up to a week. You can use a heat pad or pain-relieving medicine to alleviate the pain.

If you need pain-relieving medicine, we recommend that you take 2 x 500 mg paracetamol, possibly combined with 2 x 200 mg ibuprofen, no more than four times a day. You can breastfeed while taking pain-relieving medicine. When you begin to gradually stop using pain-relieving medicine, begin with the ibuprofen.

After tearing

If you received stitches after the birth, keep them clean by changing your pad often and washing yourself with water after visiting the toilet. Reduce swelling and soreness by sitting on a soft pillow or by using a postpartum ice pack. Postpartum ice packs can be purchased at the pharmacy or you can make them yourself by wetting normal pads and freezing them individually in freezer bags. Make sure your skin does not come in direct contact with the ice by wrapping the ice pack in a clean piece of cloth or by putting it in a sock. Place the ice pack on the stitches for 15 minutes at a time, several times a day.

We recommend that you use a mirror to keep an eye on how the tear is healing. The stiches will dissolve within 10 to 14 days. The scar may feel a bit tight for some time after.

Remember to urinate

It may be difficult to tell whether you need to urinate. You should urinate by no later than four hours after birth and then approximately every three hours for the first few days, even if you don’t feel like you need to urinate. This will help the uterus shrink to its normal size. You may experience a burning sensation when urinating, especially if you received stitches or a caesarean section. It sometimes helps to rinse yourself with water while you are urinating. Make sure to drink about 2 litres of fluid every day.

Contact your general practitioner if you have ongoing issues with a burning sensation, emptying your bladder or incontinence.

Constipation

It is normal for a few days to pass before you have a bowel movement. To help your stomach get back on track and prevent constipation, we recommend moving about, eating high-fibre foods and drinking lots of fluids. If you still haven’t had a bowel movement after four to five days, take medicine to treat constipation. Laxatives are available over-the-counter at the pharmacy.

If you received stitches or have haemorrhoids/piles after the birth, it may be a good idea to support the perineum with a piece of cloth during your first bowel movement. Stitches can take the pressure from bowel movement.

Haemorrhoids/piles

Haemorrhoids/piles are lumps inside and around the anus. They are often caused by constipation during pregnancy or pressure on blood vessels during birth.

Haemorrhoids usually disappear within a few days of giving birth, but some women will need to be treated with either creams or suppositories. Contact your general practitioner if you are in doubt.

Exercise and pelvic floor exercises

Exercising your body, particularly your pelvic floor, is important to avoid a prolapsed uterus, weak stomach and back muscles, as well as bladder and bowel dysfunction. We recommend that you begin doing pelvic floor exercises as soon as possible after giving birth.

You should do the exercise every day, repeating 5-10 times. There should be no pain when you do the exercise.

You can also make pelvic floor exercise a regular part of your day, for example, by doing the exercise each time you get up or sit down. Do short squeezes to start with, and then gradually increase the time you hold the squeeze. The interval between squeezes should last as long as the squeeze itself.

Lie on your back or on your side with your legs slightly bent when doing the exercise:

• Squeeze the muscles in your anus. Try to relax your stomach, buttocks and thighs when squeezing.
• Relax your entire body for the duration of the squeeze.

Getting your pelvic floor back in shape can take many weeks, and you should not begin doing exercises that involve jumping until your pelvic floor is back to normal.

If you have had a caesarean section, begin with low-impact exercise like walking or cycling. Within three to six weeks you can gradually start doing more physical activities. Avoid activities that do not feel good.

Sex

You and your partner can resume your sex life when you want and when you feel ready. However, if you have had a caesarean section we recommend waiting 3-6 weeks. Many women have a lower sex drive just after giving birth. This can be due to pain, and the vagina can be sore and dry due to hormonal changes. We recommend using a silicone-based lubricant, possibly combined with a numbing cream, for as long as necessary. Lubricants and numbing creams can be purchased over the counter at a pharmacy. Start slowly and remember to communicate with each other.

Contact your general practitioner if you continue to experience pain during intercourse.

Breastfeeding does not prevent pregnancy, so you should use contraception. Use a condom if you are still bleeding or have discharge. You can speak to your general practitioner about contraception.

Reactions after birth

Becoming parents can be daunting, and you may cry a lot at times or feel restless, anxious or irritable. This is caused by hormonal changes and can be exacerbated by a lack of sleep or problems with breastfeeding. Up to 80% of all new mothers feel emotionally overwhelmed during the first week.

If this reaction lasts more than 14 days, we recommend speaking to your health visitor or your general practitioner about it, as it may be a sign of postpartum depression. Your partner can also experience postpartum depression.

Breastfeeding

Skin-to-skin contact

We recommend that both you and your partner have as much skin-to-skin contact with your child as you can. Your child should only be wearing a nappy. Lay your child on your naked upper body and cover them with a light duvet.

Skin-to-skin contact increases attachment between the parent and child, stimulates milk production, and helps the child regulate its body temperature, pulse, blood sugar and breathing.

If the child is placed on the mother’s chest immediately after birth, it will usually begin to seek the breast and self-attach. Give child unlimited access to the breast and keep the surroundings calm, making sure there are not too many disruptions. The first milk is called colostrum milk. There will not be much of it, but colostrum milk is very concentrated and full of nutrients, so your child will get what it needs.

Breast milk

You will begin producing milk within two to five days. Your breasts may feel tight and sore, and it can be difficult for your child to latch on. Any soreness can be relieved by a warm bath, a heat pad or warm towels, or by massaging the breasts, possibly while the child feeds. You can also try using your hands to express milk. Let your child nurse often.

You can also read the pamphlet ‘Udmalkning med hånden’ (only in Danish).

How often to breastfeed

Your child may sleep a lot in the first 24 hours but should have as much skin-to-skin contact as possible and should be nursed as much as possible, at least four to five times. After the first 24 hours, we recommend nursing the child at least eight times a day, preferably more. Contact our hotline or your health visitor if your child will not nurse eight times a day.

Breastfeeding and latching

Find a good position for breastfeeding: either sitting or lying down. Make sure you are comfortable. Place your child so their belly touches yours with the nose aligned with your nipple.

When nursing, your child should have the whole nipple and part of the dark area around the nipple in its mouth. If your child only latches onto the top of the nipple, you increase the risk of tears and cuts. Your child’s head should be tilted back so the nose is not blocked. The mouth should be open wide, and the lips should be slightly rolled back and covering a portion of the brown area around the breast.

It can be hard to determine whether your child has latched on correctly, but you will know if it feels right. If your child does not latch on correctly, try moving the child a little and helping them open their mouth wider. If this does not help, remove your child from the breast and start again. Slowly place your finger in the corner of your child’s mouth to help it detach.  

When your child begins to feed, the lower jaw and the muscles along the ear will move and you will hear your child swallow. Your nipples may feel a bit sore at the start. It can be painful when your child latches on, but you should not experience continuous pain while breastfeeding. Vary how you sit when breastfeeding and squeeze out some breast milk and let it dry on the nipple.

If you have a nipple piercing, always remove it before nursing. It can hurt your child’s mouth or your child might choke on the jewellery if it comes loose.  

Do not offer a pacifier right away

Your child should not be given a pacifier or bottle until your breast milk has come and breastfeeding is going well. Your child should concentrate on your breast. A pacifier may give your child the illusion of feeling full, causing it to skip a feeding.

Keep an eye out for breast infection (Mastitis)

Hard areas in your breast can be caused by an accumulation of milk. Make sure to change your nursing position regularly and try to place your child’s chin on the hard area while breastfeeding. This will help “empty” your breast of milk, and your child’s chin will massage the hardened area. Always try to empty your breast of milk if you experience discomfort.

Contact our hotline if these suggestions do not help and you begin to develop symptoms of breast infection:

• Hard areas in one or both breasts that do not disappear after nursing.
• Pain in your breast(s)
• Red and warm breasts
• A fever over 38 degrees for more than 24 hours.

Vitamins and iron

We recommend that you continue taking your pregnancy vitamins until the packet/bottle is empty. If you have a low blood count after giving birth, you may need to take iron supplements.

If you do not eat or drink milk products, take a calcium supplements while you are breastfeeding or milking out.

Eat a healthy and varied diet, drink plenty of fluids

Remember to eat a healthy and varied diet and drink a lot of fluids while breastfeeding. There is nothing you cannot eat when you are breastfeeding. We recommend following the seven official dietary recommendations:

• Eat plant-rich, varied and not too much.
• Eat more vegetables and fruit.
• Eat less meat - choose legumes and fish.
• Eat whole grain.
• Choose vegetable oils and low-fat dairy products.
• Eat less sweet, salty and fatty foods.
• Quench your thirst with water.

Limit your intake of carnivorous fish as they contain high levels of mercury that can accumulate in breast milk. We recommend limiting your intake of fish to 100 grams per week (e.g. tuna steaks). Canned tuna usually uses smaller tuna and therefore typically has a low mercury content.

You should not go on a diet while you are breastfeeding, as this may affect how much milk you produce. However, you should not eat more than usual either, even though your body uses more energy to produce milk.

You should drink approximately 2 litres of fluids every day. If your urine is dark, or if you become constipated, you may need to increase your fluid intake.

It is quite normal to feel thirsty when breastfeeding. It is therefore a good idea to keep a glass of water next to you while nursing.

Avoid smoking, alcohol and unnecessary medication

Nicotine and alcohol will find their way into your breast milk. We therefore recommend that you do not smoke and only occasionally drink alcohol so long as you are breastfeeding or milking out. If you cannot stop smoking entirely, you should only smoke after nursing or milking out, so your breast milk contains as little nicotine as possible when you nurse.

If you drink alcohol, wait two to three hours before nursing your child, as your breast milk will have the same alcohol percent as your blood. The alcohol content of your milk is highest around one to one-and-a-half hours after drinking. Both smoking and alcohol can reduce the amount of milk you produce.

Medicine can also appear in your breast milk, and certain types of medicine can affect the child. Therefore, avoid unnecessary medicine while breastfeeding. Contact your general practitioner if you have started, or are going to start, medical treatment for an illness.

Take enough rest

Breastfeeding requires patience, time, calm, and peace of mind. Rest during the day, for example when your child is asleep. Agree with friends and family when they can visit and for how long.

Get help if you have problems breastfeeding

Contact our hotline if you have problems breastfeeding. For example, if your child does not nurse often enough, if you develop cuts and tearing in your nipples, if you develop a breast infection or if you want to stop breastfeeding.

Worth knowing

Future pregnancies

If you had your child via caesarean section this time, this does not necessarily mean you will need to have a caesarean section next time. During your next pregnancy, discuss how you want to deliver with your obstetrician.

If you want a vaginal birth during your next pregnancy, there must be at least 12 months between this delivery and your next one.

We will notify your doctor

We will send information about your delivery to your general practitioner. Let us know if you do not want your general practitioner to be notified about your delivery at the hospital.

Check your medical journal and test results

You can check your medical journal, health data and any test results at www.minsundhedsplatform.dk and www.sundhed.dk. They are both available as apps: MinSP and MinSundhed. Log on to the apps with your MitID.

Tell us about your experience

We would very much like to receive your feedback. If you are considering lodging a complaint, please contact the hospital’s impartial patient advisors. Read more about your rights here (in Danish): www.regionh.dk/patientrettigheder

For more information

The Danish Health Authority's website, www.sst.dk has more information about the period after birth and advice about your child’s health. Search for “Børnesundhed” and then click “Børn og unge” (only in Danish).