Routine postnatal care given to all babies

In 2004 there were over 600 000 live births in England and Wales. Most babies were healthy, without any significant medical problems and were born to healthy mothers.

In July 2006 the National Institute for Health and Clinical Excellence (NICE) published a clinical guideline on the care that should be delivered to all healthy mothers and babies.1 Developed by the National Collaborating Centre for Primary Care, it covers the expected care given to all mothers and their babies up to around 6–8 weeks after birth. The guideline development group of 14 people included a community paediatrician, with an additional co-opted neonatologist to advise on neonatal examination and other aspects of infant health. Although its scope does not cover management of identified problems, guidance is given on the treatment of common breastfeeding problems such as mastitis.

It stresses the importance of developing an individualised postnatal care plan with each woman, ideally in the antenatal period or as soon as possible after birth, and of empowering women to take care of their own health and that of their baby. Many recommendations relate to the prevention and early recognition of maternal health problems such as postpartum haemorrhage, puerperal sepsis, pre-eclampsia, thromboembolism, postnatal depression and constipation, as well as common symptoms such as dyspareunia, headache and backache. Infant feeding is discussed in detail, with 45 recommendations on breastfeeding, some of which are included in this review.

There are a number of aspects of baby care covered in the guideline, and this review highlights selected recommendations. There is also guidance on skin care, thrush and nappy rash, diarrhoea and constipation, colic and fever, as well as immunisation and screening programmes.

Throughout this guideline, recommendations with a grade A are based on directly relevant evidence from high quality systematic reviews, randomised controlled trials (RCTs) and …