Preparing to go home with your

baby
Discharge information about you and your newborn
Introduction

It will take approximately 30 minutes to complete the following five

sections:
1. Parent Discharge Communication Tool
2. Caring for Yourself
3. Newborn Discharge
4. Caring for Your Baby
5. Additional Resources
All of the topics listed in the Parent Discharge Communication Tool and
during this presentation can be found in the Taking Care: Information
for Mom and Baby book provided to you during your stay at the
hospital. Resources are listed at the back of the book and additional
information can be found in the Postpartum Patient Orientation
presentation on this TV.
1. Parent Discharge
Communication Tool
Parent Discharge Communication Tool

• All parents will receive a Parent Discharge Communication Tool that gives
basic guidelines about what to do over the next several weeks, as well as
important care instructions, warning signs and when to resume normal
activities.

• At the top of the Parent Discharge Communication Tool, it will state your
baby’s date of birth, name of attendant at birth, and type of birth. It also
includes who and when you need to make follow up appointments with for
you and your baby.
Parent Discharge Communication Tool

• The birthing parent will need to make an appointment with their health care
provider 6 weeks postpartum (unless otherwise instructed).

• All babies should be seen by a primary health care provider within 24 to

72 hours of leaving the hospital for checkup (unless otherwise
instructed).

• If you are going home with any equipment from the hospital, it will also be
indicated on this tool (i.e. breast pump, sitz bath, walker).
2. Caring for Yourself
General Information

• Postpartum is the period of time after the birth of your baby, when your body
is changing back to normal.

• It lasts about 6 weeks or until your uterus returns to its normal size.
Breast Care

• Breastfeeding your baby at least every 3 hours

or on cue will help to maintain your breast milk
supply.

• To minimize engorgement, a warm shower,

warm compresses and breast massage will
help the milk to flow.

• After feeding you can use cold compresses to

help soothe the pain of the swelling.
Breast Care

• You can call the Postnatal Ambulatory

Clinic (PNAC) for advice or to book an
appointment to be seen by a lactation
consultant/RN after you have gone
home. PNAC: 416 – 586 – 4800 X
7409

• Seek medical attention if your breasts

are red/warm/shiny or if there is
unusual discharge from the nipple(s).
Perineal Care

• You can expect to have bleeding from your vagina for 2 to 6 weeks. In the
beginning, the bleeding will be heavy and dark red. As the days pass, the
bleeding will become less and the colour will change to brownish pink then to
a yellowish/ white colour.

• In order to prevent infections from occurring, do not use a tampon until your
follow-up appointment in 6 weeks. Keep your perineal area clean with soap
and water at least once a day; and change your pad often.
Perineal Care

• If you had a vaginal birth, you may want to use a sitz bath to promote healing
of the perineum. A sitz bath is a special basin filled with warm water, to soak
your perineal area.

• If you have stitches they will dissolve in about 2 weeks.

• Seek medical attention if you are soaking a pad with bright red blood in less
than 1 hour or passing large clots (size of a plum or larger), having foul
smelling discharge or fever greater than 38 degrees Celsius.
Incisional Care Post C-Section

• When the initial dressing is removed, your incision will be left to air dry.

• You will be able to shower when the incision is left to air dry. Allow the water
and soap to wash over the incision. Gently pat the incision dry.

• Ensure that your incision is kept clean and dry. Wear cotton underwear and
loose clothing for comfort.

• The skin from the incision will heal in several days. The full depth of the
incision takes about 6-8 weeks to heal completely.
Incisional Care Post C-Section

• If you have steri strips, they will fall off on their own, or should be removed
within 5 days from when it was applied.

• If you have staples please ensure you have instruction from your primary
nurse on when to have them removed.

• If you experience fever, increasing abdominal pain, redness, discharge from

the incision site or your incision opens, seek medical assistance immediately.
Bladder Function

• You may not always feel like your bladder is full. This sensation will return in
a few days or when the bladder muscle is exercised and regains tone.

• Empty your bladder every 2 to 3 hours even if you don’t feel like it.

• Pain or burning when urinating, or the urge to urinate frequently, may indicate
a bladder infection and should be reported to your health care provider.

• Practicing kegel exercises will help you regain muscle tone.

Bowel Movement

• Bowel movements can be delayed because of the lack of food during labour
and discomfort due to hemorrhoids or an episiotomy.

• Constipation can be minimized by remaining active and eating foods high in

fibre (whole grains fruits, and vegetables).

• Drink plenty of fluids. Prunes, dates, figs, and bran are helpful remedies as
well. If prescribed by your health care provider, take a stool softener or
laxative as prescribed.
Hemorrhoids

• Hemorrhoids during pregnancy and after giving birth are common.

• Hemorrhoids are varicose veins of the rectum caused by the weight and
pressure of the baby and the force of pushing.

• Using ice packs, sitz bath and medications or Tucks pads will help decrease
the discomfort.

• Avoid becoming constipated or standing for long periods.

Swelling/Fluid Retention

• It is normal to see more swelling in your legs and feet during the first 2 weeks
after birth.

• You may notice an increase in perspiration and urination as your body works
to eliminate the extra fluids from pregnancy.

• Elevate your legs and avoid standing too long in order to minimize and cope
with the swelling.
Pain Management

• It is important to keep pain under control by taking regularly scheduled pain

medication.

• Well managed pain will promote healing and allow you the mobility and ability
to care for your baby.

• Your primary nurse will provide you with regularly scheduled pain
medications. These medications are safe with breastfeeding.
Pain Management

• When you go home please continue to take what you usually take for pain at
home.

• If you were given a prescription, please fill this before you get home, so that if
your regular pain medication is not enough to manage your pain, you have
this for extra pain management.
Resuming Normal Activity

• By the time you are ready for discharge you may be able to go for short
walks and use the stairs. Allow your body to guide your activity. Do not
resume exercise until you meet with your health care provider. Do not carry
anything heavier than your purse or your baby.

• Before resuming sexual activity, please speak to your health care provider
about what method of contraception is best suited for you and your partner.

• If you have had a vaginal delivery you may drive when you feel ready. If you
have had a caesarean section it is recommended to wait 2 to 3 weeks.
Baby Blues, Anxiety and Depression
Postpartum
• You may have many feelings ranging from joy and excitement to guilt and sadness.
These feelings are normal after having a baby.

• The causes of these feelings are not completely understood, however they may
include lack of sleep, hormone changes, stress, and not feeling supported by family or
friends.

• Your primary nurse will discuss and review signs and symptoms of baby blues, anxiety
and depression postpartum with you (and your support person) during your hospital
stay. You are not alone. Support is available to you. Please inform your health care
provider immediately if you are having difficulty coping at home.
Warning Signs

Seek medical attention if:

 You are unable to empty your bladder
 You have a fever (38 degrees Celsius or  You have discharge from an
100.4 degree Fahrenheit) episiotomy/laceration or the incision site
 You have unexplained abdominal or  You have unusual/new/ongoing headache
perineal pain or vision change
 You are soaking a pad in less than 1 hour,  The back of your leg(s) are tender and/or
passing large clots, or having foul smelling red and painful
discharge - consider going to your nearest  You have prolonged and noticeable
Emergency Room (ER) change in mood (feel depressed or feeling
 Your breasts are red, warm, shiny or there blue)
is unusual discharge from the nipple(s)
3. Newborn Discharge
Newborn Discharge Communication Tool

• This is an outline of your baby’s delivery, physical assessment and exams during the
hospital stay. Show this paper to the health care provider you have chosen for your
baby after discharge.

• If there are any issues with results of the Newborn Hearing Screen, Ontario Newborn
Screening (ONS) or Critical Congenital Heart Disease (CCHD) your baby’s health care
provider will be informed.

• All babies should be seen by a primary health care provider within 24 – 72 hours
of leaving the hospital for checkup (unless otherwise instructed).
OHIP and Birth Registration

• The top section of the OHIP form is to be filled out and returned before you
leave the hospital. The bottom slip will be given to you as your baby’s
temporary health card. You should take this slip with you to all of your baby’s
appointments until the card is mailed to you.

• You can fill out your baby’s birth registration and apply for the birth certificate
on the www.serviceontario.ca/newborn website.
4. Caring for Your Baby
Safe Sleeping/SIDS

• Your baby should be sleeping on its back on a firm flat mattress. Do not put
blankets, pillows, bumper pads or stuffed animals in the crib.

• For warmth, layer your baby in fitted clothing.

• Bed sharing is discouraged for the first year of life, as it may increase the risk
of Sudden Infant Death Syndrome (SIDS).

• Smoking in the house is not recommended.

Holding Your Newborn Baby

• Support the head and neck with one hand, and

the bottom and thighs with the other. Hold your
baby close to your body.

• Remember to never shake your baby or toddler.

Crying: Baby’s Communication

• Crying is a baby’s way of communicating. It can

mean “I’m hungry”; “I’m wet”; “I want to be held”,
etc.

• Some babies have crying episodes, especially if

they are overstimulated.

• You can try to calm your baby through skin-to-skin,

talking softly, singing or playing soothing music.

• Evaluate why your baby could be crying and take

action: feed/burp, change the diaper, etc.
Bonding with Your Baby

• Having your baby skin-to-skin with either parent is

a great way to bond with your baby. It is soothing
and calming for parents and baby.

• When you are skin-to-skin with baby, the baby is

naked down to the diaper, and the parent is
naked from the waist up.

• The benefits of skin-to-skin include: baby listening

to your heartbeat, voice and breathing, smell and
feel of your skin, and the ability visualize your
face better.
Feeding Your Baby

• Learning to feed your baby is easier when you cuddle skin-to-skin during and between
feeds.

• If you are exclusively breastfeeding, baby should feed at least 8 to 10 times in 24

hours.

• Babies will go through periods of cluster feeding and sometimes feed more frequently
during the night.

• If you are using breast milk substitute, babies can feed every 3 to 4 hours (be sure to
follow breast milk substitute preparation instructions).
Feeding Your Baby

• Responding to your baby’s earliest feeding cues will make

feeding easier for you and baby.

• Some early cues include: wiggling movements, rooting,

sticking out the tongue, small noises and sucking on
hands/fingers or blankets.

• Crying is a late sign of hunger, try to feed your baby on cue

or every 3 hours.

• Signs that your baby is getting enough milk include: cues

for feeding every 2 to 3 hours, feeds 8 to 10 times in 24
hours, satisfied after feeding and sleeps for 1 to 2 hours,
weight gain and appropriate number of wet and dirty
diapers.
Elimination: Pees and Poops

• You should expect your baby to have 1 pee within the first 24 hours. This
increases with the age of the baby.

• There should be at least one bowel movement (poop) a day for the first
week.

• Your baby’s stool (poop) will be sticky, black and tar like (meconium). Around
day 4 the stool will turn greenish brown and then yellow.
Diapering

• You may need to change your baby’s diaper

every 2 to 3 hours or whenever you feed your
baby.

• Wipe the diaper area with a warm wet

washcloth or non-scented baby wipes. Pat the
area dry or allow to air dry.

• Clean from the front to back. For males, also

wipe under the scrotum. Never pull back the
foreskin when cleaning the penis.

• You can apply a barrier cream to protect the

skin. Never use powders or cornstarch.
Caring for the Umbilical Cord

• Use a wet washcloth to gently clean around the base of the cord. Ensure the
area is dry after cleaning.

• The umbilical stump should be kept dry and above the diaper until it falls off
within 7 to 10 days.

• Continue to gently clean the belly button for a few days after the cord falls off.
Bathing Your Baby

• Ensure you have everything ready and within easy

reach before you start.

• Never leave your baby alone in the bath, always

keep at least one hand on your baby.

• You do not have to bathe your baby every day. Two or

three times a week is sufficient.

• Always test the temperature of the water with your

elbow or wrist.

• After bathing, ensure you pat baby dry with special

attention to the skin folds.
Skin and Nail Care

• To protect baby’s thin and fragile skin: avoid direct sunlight; make sure baby is
wearing a wide brimmed hat in the summer; in the winter, cover up their skin as
much as possible to prevent frostbite.

• You can use a gentle moisturizer after bathing to massage your baby before
bedtime.

• The best time to care for your baby’s nails is when they are relaxed or asleep.

• To care for your baby’s nails you can use emery boards or nail files. Do not clip in
the first 2 weeks, as you could accidentally cause abrasions or bleeding.
Bilirubin (Jaundice)

• Jaundice is very common in newborns. It can

give the skin or the whites of the eyes a yellow
colour and babies can appear overly sleepy.

• Feeding the baby frequently, every 2 to 3

hours, can reduce jaundice.

• Seek medical advice if any of these symptoms

appear.

• A blood test can be done to see if your baby

needs treatment.
Car Seat Safety

• Car seats are only to be used while

traveling in a vehicle (never for sleeping).

• Your primary nurse can give you advice on

putting your baby in the car seat and can
check and see how you did putting the
baby in before you leave the hospital.

• Refer to the photo included in your package

to use as a guide.
Newborn Warning Signs

Seek medical attention immediately:

• If your baby’s skin or whites of the eyes are increasingly yellow
• If your baby is not interested in feeding or is lethargic
• If your baby’s temperature is persistently over >37.5 or <36.5 degrees by
underarm
• If your baby has not passed urine or stool in 24 hours in the first week
• If there is forceful vomiting of a large amount of spit up
• If there is green, brown or fresh red blood in the spit up
• If your baby is gagging or coughing persistently
• If your baby has green foul smelling discharge around cord or circumcision site
5. Additional Resources
Resources for Parents and Families

• Health resources and supports can be found in

the back of the Taking Care booklet.

• Canadian Pediatric Society

www.caringforkids.cps.ca
• Toronto Public Health www.Toronto.ca/health
• Breastfeeding Information
http://breastfeedinginfoforparents.ca
• Postnatal Ambulatory Clinic (PNAC) 416-586-
4800 x 7409
We hope you enjoyed
your stay with us!