Routine postnatal care
of women and their
babies
July, 2006
Changing clinical practice
NICE guidelines are based on the best available
evidence
The Department of Health asks NHS organisations to
work towards implementing guidelines
Compliance will be monitored by the Healthcare
Commission
Changes should be linked with other NICE guidance
and relevant national policies
The postnatal period
The guideline covers maternal and infant care in the
period after transfer from intrapartum care until the end
of the postnatal period. This is usually 6–8 weeks after
the birth
Need for the guideline
Common health problems in the postnatal period
Dissatisfaction of those receiving care
Creating services which are woman and family centred
Aim of the guideline
Appropriate objectives, purpose,
content and timing
Best practices and competencies
for assessment
Information, education and
support
Planning
Good practice in communication
Essential principles of care
Kindness, respect and dignity
Views, beliefs and values
Women’s full involvement
All actions and interventions
fully explained
Supporting informed decisions
This guideline covers
Planning the content and delivery of care for
woman and baby
Maintaining maternal health
Infant feeding
Maintaining infant health
Planning content and
delivery of care
Documented, individualised care plan
Written communication
Relevant and timely information
Suggested actions
Local care planning
documentation and use
Local protocols about written
communication
Quality of local information
provision for effectiveness and
relevance to local community
Identifying the named postnatal
coordinator within the care plan
Maintaining maternal health
Signs and symptoms of potentially life-threatening
conditions:
•
•
•
•
postpartum haemorrhage
infection
pre-eclampsia/eclampsia
Thromboembolism
Emotional wellbeing
Suggested actions
Local protocols within
primary and secondary care
Continuous professional
development programmes
Maternity and Care of the
Newborn Competence
Frameworks
Clinical Negligence Scheme
for Trusts (CNST) standards
Infant feeding
Programme to encourage breastfeeding,
using an externally evaluated structured
programme using the Baby Friendly
Initiative as a minimum standard
Support of breastfeeding initiation and
continuation
Suggested actions
Look at the UNICEF UK Baby
Friendly Initiative which provides
one possible framework for
implementing an externally
evaluated, structured programme
which supports breastfeeding.
This can be used by NHS trusts,
other healthcare facilities and higher
education institutions
www.babyfriendly.org.uk
Maintaining infant health
Information and guidance offered to enable parents to:
• assess their baby’s general condition
• identify signs and symptoms of common health
problems seen in babies
• contact a healthcare professional or emergency
service if required
Suggested actions
Distribution of ‘Birth to five’
Quality of local information
Named postnatal
coordinator within the care plan
Maternity and Care of the
Newborn Competence
Frameworks
Costs and savings
Use NICE costing tools to identify recommendations with
the greatest impact on resources
• savings
– savings are linked to the reduction in the
incidence of certain childhood disease
because of the protective effects of
breastfeeding
• costs
– structured programme that encourages
breastfeeding including training
NICE into practice guides
Access tools online
Costing tools
• costing report
• costing template
Audit criteria
Available from: www.nice.org.uk/cg037
Access the guideline online
quick reference guide – a summary
NICE guideline – all of the recommendations
full guideline – all of the evidence and rationale
‘Information for the public’ – a version for people using
the NHS in England and Whales
All found at: http://guidance.nice.org.uk/CG37
Care pathway
Key components – maintaining maternal health, infant
feeding, and maintaining infant health
Time bands – first 24 hours, first week and first 2–8
weeks after birth
Action levels – emergency, urgent and non-urgent
Includes – core information, core care and areas for
concern
Area for concern:
unilateral calf pain and
redness or swelling
Example: signs of
thromboembolism
Time band 24 hours
Maintaining maternal health
Emergency action
Example: routine
immunisations
Core care
Time band
2–6 weeks
Offer routine baby
immunisations