Breastfeeding

Ramadan is a very special time of the year, including for pregnant and breastfeeding women. Ramadan is a month in the Islamic calendar when Muslims fast from dawn to dusk. When Ramadan falls in the summer, the fasts are long and many women worry about how they will manage to fast and continue to breastfeed. Even though pregnant and breastfeeding women are not expected to fast, for some women this can be a difficult decision when they are used to fasting alongside family and friends.

Helpful tips for mothers who choose to fast:

• Stay well hydrated by drinking lots of water between Iftar (breaking the fast at sunset) and Suhoor (starting the fast at dawn).
• Eat a nutritious Iftar and Suhoor meal and try to get plenty of rest during the day.
• Consider the age of your baby when making your decision. If your baby is still very young (less than six months) and is completely dependent on breast milk, you may choose not to fast. If your baby is more than a year old, and eating other foods and drinks, you may feel more able to fast.
• Although intermittent fasting is not thought to have an impact on milk supply or affect the main nutrients in breastmilk, you should monitor your baby for signs they are not getting enough milk: Reduced nappy output / Not settling as usual / Lethargic / Feeding much more frequently or not content following feeds / Weight loss or not putting weight on
• For some mothers who are breastfeeding may notice that their baby becomes a bit fussier at the end of the fasting day, as the mother’s body is impacted by the fast. Additionally, the milk let down can slow down due to the stress of the fast. When breastfeeding at this point, breast compression while feeding can help to drain the milk from the breast and you may notice the baby is more satisfied.

Pregnancy

There is conflicting evidence around safety of fasting when pregnant. If you choose to fast, some tips to help you:

• Feeling thirsty or having dark-coloured urine can be early signs of dehydration, other symptoms may include dizziness, headache, tiredness, dry mouth and passing small amounts of urine infrequently (less than three or four times a day).
• Remember that during pregnancy, the amount of fluid you need will increase by an extra one or two glasses a day.
• If you feel dizzy, faint, weak, confused or tired during fasting, even after resting, then you should break your fast with a sweet drink, to replace lost sugar and fluids, and a salty snack, to replace lost salt.
• Make sure you are still taking your supplements (folic acid and vitamin D) and eating a healthy balanced diet during Ramadan so that you are getting all the nutrients you and your baby need.
• Also try to eat foods which release energy slowly such as wholemeal pasta, wholemeal bread, oat and bran-based cereals, beans and unsalted nuts, especially at Suhoor.

If you have decided to fast but begin to feel unwell, it is important to contact the Pregnancy
Assessment Unit on 0191 607 2815

We are currently running our antenatal classes online. You can find out more and book a place here.

From Monday 20 July 2020, women are allowed to bring one person along with them to their 12 and 20 week scan appointments.

To reduce footfall within our sites, please could women attend all other routine and planned antenatal appointments unaccompanied. This includes community and hospital antenatal clinic appointments and any other scans.

Antenatal appointments are important for the health of pregnant women and their babies. We would urge women to continue to attend their planned antenatal visits as long as they do not have a new continuous cough or high temperature. If women are unable to attend their appointment, please contact the hospital or their midwife who will to arrange a telephone consultation.

In future, some routine antenatal and postnatal appointments may be conducted via telephone, rather than face-to-face. If this applies, women will be contacted in advance.

If women need to attend the Pregnancy Assessment Unit, please only bring one support person.

It is understandable that during this challenging situation, women are requesting the use of video calls during scans to try and involve their partners however this is not possible.

Ultrasounds in pregnancy remain clinical investigations and it is important that our sonographer can concentrate on performing these investigations without distraction. Most importantly, the clinical information obtained during the scans must be properly safeguarded by the trust. For these reasons we are unable to accommodate video calls or any other kind of recordings during the scan. This has always been the case and no change to policy is planned.

Due to the exceptional circumstances we are facing we have the following arrangements in place:

• When women attend for their scan we will provide scan images free of charge.
• Should there be any concerns raised during the scan we will ensure that women can involve their partners in these conversations.
• We are happy to accommodate a brief phone call at the end of the scan, on speaker phone, to enable women to share hearing the gender of the baby with their partner. As has always been our policy, we won’t be able to provide the gender in writing for a reveal at a later time.

If women have any concerns about themselves or their baby please contact the maternity unit as usual for advice. Please see here for information regarding the importance of a baby’s movements.

Please could women only bring one designated birthing partner with them when in labour or admitted to hospital. This needs to be the same person throughout labour and they will then accompany them to the postnatal ward.

Please remember to pack your hospital bag and bring it with you. You can find out more information here.

Smoke free

The Northumbria Hospital is a smoke free site and with new babies being delivered every single day, we ask that you refrain from smoking whilst with us. We have worked hard to put safety measures in place to allow birthing partners to remain in our birthing centre throughout delivery right up until post-natal discharge. This involves reducing footfall across the hospital site to protect mums and new babies who are staying with us from infection.

That means that once you and your partner are on the ward, you cannot leave until you are discharged. We are asking people to take extra consideration for their smoking habits, as you will have to refrain from smoking and vaping during your time with us.  

If you choose to leave the Birthing Partner or Postnatal Ward, you will not be able to gain readmission.  Please ensure you bring sufficient supplies of NRT (any form) to last you at least 3 days.   If you would like support in going Smoke Free, please contact your partners midwife for advice or call:

Northumberland Stop Smoking Service:   01670 813 135

North Tyneside Stop Smoking Service:  0191 643 7171

Home births

If women have previously arranged to have a home birth then this is unaffected by the current situation.

Other than the designated birthing partner, there is no visiting on our postnatal ward.

Our single-ensuite rooms on our postnatal ward at our Northumbria hospital enable birthing partners to continue to stay with women throughout the duration of their stay however they must remain in the room at all times.

Birthing partners should be encouraged to bring their own provisions such as bring healthy snacks, noodle pots (hot water will be available) and other non-perishable items as this will not be provided by the ward.  If a birthing partner chooses to leave, they will not be permitted to return and must wear a mask. The on-site restaurant is also for staff only.

After mum and baby leave hospital, the midwife will contact mums before visiting them at home with their babies to ensure everyone in the household is well before attending.

Our birthing centre is based at Northumbria Specialist Emergency Care Hospital and offers you a welcoming, safe environment to have your baby in.

You will have a single en-suite room and your partner is also able to stay overnight in your room. The delivery suite has birthing pools if you would like this as an option.

The centre has a consultant-led obstetric unit and co-located midwifery-led unit. It also has a special care baby unit for those babies who need extra help.

Please get in touch if you would like to look around.

If you choose to deliver your baby here you will still receive your ante-natal care at one of our current hospitals close to home. Depending on the care you need that will be at Hexham, North Tyneside or Wansbeck general hospitals, or Berwick or Alnwick infirmary.

Whether you’ve just found out you are pregnant, or if you are halfway through your journey, our midwives have pulled together a series of videos to support you throughout your pregnancy. From exercise routines to methods of pain relief during labour, we’ve got you covered. Why not check them out here?

In addition to the birthing centre at Northumbria Specialist Emergency Care Hospital, we also have midwifery-led units in Hexham, Berwick and Alnwick. These small units are led by highly skilled experienced midwives who provide one to one personal care and support within a relaxed and friendly environment.

Our midwives provide care to mothers in the units and in the community after the birth of your baby. They cover local and outlying clinics, provide home visits and ensure continuity of antenatal, labour and postnatal care.

We would be delighted to show you around any of our units, please call the units to make an appointment. The contact details are below.

Alnwick Infirmary (Hillcrest)

Hillcrest is a stand alone unit in the grounds of Alnwick Infirmary with nine beds.

As in Berwick, the unit has an overnight on-call system for women deemed to be low-risk who are due to give birth at Hillcrest. This interim measure allows us to continue fully staffing Hillcrest during the day, seven days a week and continue with all local community midwifery services to support local women throughout their pregnancies. The temporary measure means that between 6pm and 8.30am (seven days a week), there will be an on call midwifery service for Alnwick women who are booked to give birth at Hillcrest.

Hillcrest is open seven days a week, from 8.30am until 6pm with antenatal clinics, consultant-led clinics and postnatal drop-in clinics and community midwifery services.

During this interim safety measure, women who give birth at Hillcrest will experience a shortened post natal stay and discharges will be based upon clinical need. As the unit is not be staffed 24/7, there is no inpatient post natal care for Alnwick women who have chosen to deliver at The Northumbria hospital, however extra support with community breastfeeding services are available to support local women at home.

Berwick Infirmary

Women considered to be low-risk women have the choice to give birth in Berwick Maternity Unit.

The unit is open from 9am-6pm Monday to Friday and 9am-2.30pm at weekends, with a 24/7 on-call service for low-risk women who wish to deliver at the unit or at home.

There are regular antenatal and postnatal clinics for both low and high-risk women at the unit with enhanced community postnatal care for women including:

• Daily telephone contact following discharge to give any immediate advice and signpost to relevant services if required
• Home visits arranged to meet needs of individual women.to offer support with feeding and baby care such as bathing, general baby wellbeing
• Drop-in postnatal care at the unit to address any wellbeing concerns for new mothers or babies, including full breastfeeding support. If necessary, new mothers will be able to stay in the unit during opening times to receive feeding support
• Greater links with local organisations such as Sure Start, which provide a range of sessions for new mothers to support breastfeeding and care of the baby.

Hexham General Hospital

This unit is open 24 hours a day. Our delivery suite has four rooms with en-suite facilities, one of which has a birthing pool. The ward area has seven single rooms with en-suite facilities.

During pregnancy most of your contact will be with your community midwife who will see you regularly to ensure that both you and your baby are healthy and to answer any questions you may have.

As soon as you have a positive pregnancy test your GP surgery will provide you with the information you need to access the care of one of our community midwives.

You will be given an opportunity to attend a pre-booking information session with a midwife. During this session you will be given information about where you can have your baby, the screening tests available to you and your baby and information about healthy lifestyle choices will be discussed with you. You will have the opportunity to discuss any concerns you may have with the midwife present. At this stage, you should start to consider additional vitamins and supplements that you can take to keep you and baby healthy throughout your pregnancy. You can find out more information here.

Once you have received this information, you should feel able to make informed decisions about your care and where you would like to have your baby. A booking appointment is then planned to discuss these decisions and your care during your pregnancy and after you have your baby.

You will be offered two ultrasound scans at a hospital of your choice. The first scan, in early pregnancy, is to confirm the expected date of delivery and the second scan is to assess your baby’s development.

You will also be offered parent education classes and given an appointment to attend an infant feeding workshop.

Should you require any extra care (or you are deemed high risk) your midwife will refer you to the hospital to see a consultant. Low risk pregnancies do not generally require a consultant appointment, the midwife is responsible for your care.

Throughout your pregnancy, information and advice is available to you from all the health professionals involved in your care. We have many leaflets readily available which may help you understand, and make decisions on, your care and treatment. The information most appropriate to you will be provided to you throughout your care and you can talk to your midwife or health professional at any point for more advice.

Antenatal clinics are held in a variety of settings, including GP surgeries, children’s centres and in our hospitals to give you a choice of time and location that is most convenient for you. Your community midwife will provide you with the information you need to decide where to have your antenatal care, including those clinics run by our specialist midwives.

We offer a comprehensive screening programme for pregnant women and newborn babies to help identify any increased risk of a disease or condition.

Our screening co-ordinators support pregnant women and their families throughout the process, ensuring that any positive results are received in a timely manner and information provided to promote informed choice and decision making.

Antenatal screening programmes:

• Sickle cell and thalassaemia
• Infectious diseases
• Down’s/Edward’s/Patau’s syndrome and fetal anomaly ultra sound scan

Newborn screening programmes:

• Hearing screening
• Blood spot screening
• Newborn and infant physical examination

The screening programmes will be discussed with you at the appropriate time, either during your pregnancy or after the birth of your baby. You will have time at your appointments to discuss your options and have any queries that you may have answered.

More information about these programmes are available in your ‘screening tests for you and your baby’ leaflet given to you at your early pregnancy session/booking appointment. You can find more information on screening on NHS Choices here.

We have a team of Obstetric Physiotherapists who work across our Trust to keep you healthy and comfortable during your pregnancy and post-delivery.  Below are some downloadable resources that you can access to guide you.

You can still have a telephone consultation with a Physiotherapist at this time, so please ask your Midwife to refer you.

If you are experiencing back and/or pelvic girdle pain during your pregnancy, watch our videos here for advice.

Antenatal Advice Leaflets for pain and discomfort during pregnancy

Fit for Pregnancy

Pregnancy Related Pelvic Girdle Pain For mothers to be and new mothers

Pelvic Floor Muscle Exercises

Antenatal Advice for Labour

Fit for Birth

The Mitchell Method of Simple Relaxation

Post-natal Advice

Exercise and Advice after Pregnancy 

Pelvic Floor Muscle Exercises 

Fit for the Future: Essential Exercises and Advice afte Childbirth

We have a number of specialist midwives who can provide extra care and support with things like diabetes, teenage pregnancy or if you need help with smoking cessation, or drug and alcohol addiction issues. Your community midwife will refer you to these services if you need this extra support.

Our Professional Midwifery Advocates are a group of midwives who work within Northumbria Healthcare Trust who are here to support you with birth choices. They are experienced practicing midwives who have completed further training with the aim to support and facilitate the practices and development of midwives to ensure safety for women and their babies in addition to receiving a high standard of care.

PMAs aim to ensure women and families receive guidance and information about the right type of care, in the right care setting.

They are here to support women and families as well as to give sound professional advice.

They are also here if you have concerns about your care, you and/or your midwife may contact a PMA.

Women are able to talk to a PMA in confidence with any issues relating to practice care provision.

They can meet with you and your midwife and/or one of the consultants in order to help you achieve the birth you want by acting as a resource and to assist in discussing your birth choices. They will provide evidence-based information to help you achieve your goal and ensure all aspects of your planned care are explained thoroughly.

You can contact the PMA team via e-mail at PMA2@northumbria-healthcare.nhs.uk

Our health psychology team support women and couples who are experiencing emotional difficulties related to pregnancy, childbirth or pregnancy loss, or related to a gynaecological condition.

Find out more about the service here.

As a birth partner, there are lots of practical things you can do to support  during labour, whatever kind of birth you and you partner are planning for. This includes:

• keeping your partner company and helping to pass the time during the early stages
• holding her hand, wiping her face and giving sips of water
• massaging her back and shoulders, and helping her move about or change position
• comforting her as labour progresses and contractions get stronger
• reminding her how to use relaxation and breathing techniques – ask the Midwife to show you how if you are unsure
• supporting her decisions, such as pain relief choices, even if they’re different from what’s in the birth plan
• helping to explain to the midwife or doctor what she needs – and help them communicate with your partner – which can help you both feel more in control of the situation
• telling her what’s happening as your baby is being born if she wants you to

Useful link for further information:

• Tommy’s https://www.tommys.org/pregnancy-information/labour-birth/labour-and-birth-faqs/who-can-be-my-birth-partner
• Start4Life https://www.nhs.uk/start4life/pregnancy/advice-for-partners/

Your Feelings

Just because your partner is the one carrying the baby, it does not mean their pregnancy has no impact on you. Whether the pregnancy has been planned for months or years, or is unexpected, you’ll probably feel a range of emotions.

A baby means new responsibilities that you may not feel ready for, whatever your age. You and the mum-to-be may have mixed feelings about the pregnancy. It’s normal for both of you to feel like this.

The first pregnancy will change your life and change can be frightening, even if it’s something you’ve been looking forward to.

A message from our Health Psychology team:

Everyone has different strategies for coping with difficulty. We believe that anyone can encounter emotional distress at any time in their life and that the issues related to fertility, conception, pregnancy and gynaecological difficulties can be especially hard. Our Obstetrics and Gynaecology Health Psychology Service offers psychological assessment and therapy for women and couples who are experiencing emotional difficulties arising in pregnancy or as a result of childbirth, or associated with a gynaecological condition. You can find more information by following this link.

Useful external links for more support:

• National Childbirth Trust https://www.nct.org.uk/life-parent/emotions/postnatal-depression-dads-10-things-you-should-know
• CALM (Campaign Against Living Miserably) https://www.thecalmzone.net/
• MIND https://www.mind.org.uk/information-support/types-of-mental-health-problems/postnatal-depression-and-perinatal-mental-health/partners/
• NHS Mental Health Support https://www.cntw.nhs.uk/need-help-now/

If you need urgent help with your mental health, please call the NHS 24 hr phone line for urgent assistance:  0303 123 1146

COVID-19 support and guidance for partners

We know that this is a worrying time and it will definitely not be how you had planned your parenting journey.  Whilst attending appointments is still restricted, there are other ways which you can bond with your growing baby and support your partner.

• Babies can hear within the womb from around 18 weeks. So, however silly it might feel, take time every day to speak, sing and read to your baby in the womb. This is the beginning of a life long bonding process which promotes brain development even before your baby is born
• Make sure that you get that crucial skin-to-skin contact as soon after birth as you can. Tell the midwife that you’d like to do this so it isn’t forgotten. Skin-to-skin is a great way for dads to continue to get close to their baby in the coming months.
• Skin-to-skin cuddles let your baby hear your heartbeat and learn your smell, just like they do with mum if she’s breastfeeding. Take every opportunity you can to let them snuggle up on your chest. It’s a lovely way to feel close and can help you both relax too. (NCT, 2020)

It is important that when the time comes, you bring a ‘hospital bag’ for yourself and please be aware that if your partner is having labour induced, you should be prepared for a stay of at least 3 days.

Useful items could include:

• Sandwiches and snacks (including pot noodles/pasta pots for which we can provide hot water)
• Treats for you and your partner – chocolate/sweets etc
• Books/puzzles to keep occupied prior to active labour
• iPad/tablet with downloaded films/series
• Toiletries for yourself
• Changes of clothing

Coping with Crying during lockdown

It is hard at the best of times coping with a crying baby. However, it is much more difficult when you are confined to the house and separated from your usual activities and support from family and friends.  Follow this link for tips on coping with crying.

General tips for coping with a new baby, especially during COVID-19.

Smoking

A smoke free environment is recommended for you and your new family.  Your partner’s midwife can refer you to the stop smoking service, which is a free service available to you.  Ask your partner’s midwife to refer you, or your partner can ask on your behalf if you are not able to attend.  Alternatively you can visit here for further support to help you quit and give your baby a healthier start in life.

There is also a new Smoke Free App to support you to give up smoking.

Alcohol

It is advised that women don’t drink alcohol during pregnancy due to the affects this can have on the unborn baby, you can support your partner by also stopping or cutting down.  There’s a strong link between heavy drinking and depression, hangovers can make you feel anxious and low.  If you already feel anxious or sad, drinking can make this worse, so cutting down can make you feel in a better mood.

Drinking can also affect your sleep, it can help you fall to sleep quickly but with a new baby to care for during the night, drinking alcohol could make you less supportive and also poses a danger to your new baby.

For support with cutting down or stopping completely, click here.