Hesperian Health Guides
Caring for the Mother and Baby after Birth
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More InformationHIV medicines and childbirth
Caring for the mother just after the birth
Encourage the mother to breastfeed her baby, which will help her to stop bleeding sooner. Also:
- Feel the top of the mother's womb. It should be hard and rounded, at about the level of her navel. If the womb feels soft, ask the mother to pass urine, then rub her womb until it gets hard. Keep checking the womb to see if it gets soft again. Check for bleeding. Teach the mother how to feel her womb and rub it if it gets soft.
- Look at the mother's vagina. If she has a long, deep tear, or a tear that will not stop bleeding, she should have it stitched by someone who knows how.
- Give her plenty to drink and eat if she is hungry.
Make sure the mother knows that breastfeeding is the best food for her baby. Keep the baby with the mother so it can suck the breast and stay warm. Encourage the mother to keep the baby warm and clean and to let it suckle as often as it likes.
Babies often have a little yellowish mucus coming from their eyes in the first weeks after birth. You can wash out the eyes with breast milk or cool, boiled water and a clean cloth. If the baby's eyes get red, swollen, and have a lot of pus in them, see a health worker.
If the mother has HIV, giving HIV medicines to the baby after birth can protect the baby from becoming infected.
Care of the cord
Keep the cord stump on the baby clean and dry. If possible, clean it with alcohol and a clean cloth with every diaper (nappy) change. It will turn black and fall off during the first week. You do not need to cover it with anything unless there are flies or dust. Then you can use a very clean piece of gauze or cloth to cover it loosely.
If you notice redness or pus around the cord, the baby may have an infection. The baby should be seen by a health worker and be given antibiotics right away.
Tetanus of the newborn
What to do:
Take the baby to a health center or hospital right away.
If the hospital is more than 2 hours away and you know how, first inject the baby with 100,000 Units of benzylpenicillin.
In the First Weeks After Birth
Caring for a New Mother
Mothers need care after birth just as the baby does. People are often so busy looking after the baby that the mother's needs may be forgotten.
- To prevent infection the mother should not have sex or put anything in her vagina
until her bleeding stops.
- She should get a lot of rest for at least 6 weeks.
- She should try to stay clean. It is good for her to wash and to keep her genitals very clean. While bathing, do not sit in water until 1 week after the birth.
- A new mother needs to eat more food than usual. She can eat any kind of food: fish, meat, beans, grains, vegetables, and fruit will all help her heal from the birth and have energy to be a good mother.
- She should drink plenty of fluids.
- If she is breastfeeding her baby and giving no other milk, the breastfeeding can protect her from getting pregnant again too soon. For full protection, see the directions in the chapter on family planning.
- If she has a tear at the opening of her vagina, she should keep it clean. She can apply a hot, damp cloth and honey to the tear to help it feel better and to heal more quickly. If the tear causes burning, she can pour water over her genitals while she passes urine.
Any plant medicines used to help her genitals heal should be clean (boiled is best). Do not put plant medicines inside the vagina.
- She should start a family planning method soon, especially if she ever feeds her baby something other than breast milk. For her good health, she should start using a family planning method before she has sex again, or she could become pregnant too soon.
If the mother complains that she does not feel well, watch her carefully for signs of infection.
Danger Signs in the First Few Days After Birth
Bleeding that starts more than a day after the birth is usually caused by pieces of the placenta that have been left in the womb.
What to do:
- Firmly rub the top of her womb until it gets very hard and the bleeding stops. Have the baby suck on her breasts, or have someone roll her nipples.
- Give medicines to stop the bleeding.
- If the bleeding will not stop, get medical help. Continue to rub her womb as you take her to the hospital.
- If she has signs of infection, give the same antibiotics as for womb infection described below.
Infection of the womb is very dangerous. It must be treated or the woman can become infertile or die.
|1. Give one of these combinations of medicines:|
|ampicillin||2 g (2000 mg) IV or IM the first time only,
then 1 g (1000 mg) IV or IM each other time
|4 times a day|
|and gentamicin||80 mg IV or IM||3 times a day|
|and metronidazole||500 mg by mouth or by IV||3 times a day|
|ceftriaxone||250 mg IM||1 time only|
(avoid using doxycycline
if you are breastfeeding)
|100 mg by mouth||2 times a day|
|and metronidazole||500 mg by mouth or IV||3 times a day|
|Give all 3 medicines until 2 days after signs of infection have stopped. If the woman is allergic to penicillins, give 500 mg erythromycin, by mouth, 4 times a day instead of ampicillin.|
|2. If she does not start to feel better within 24 hours, take her to the nearest hospital. Encourage her to drink a lot of fluids if she is taking medicines by mouth.|