Reception: Mothers post natal form

Congratulations on the birth of your baby. 

This can be a wonderful but also tricky time and there is a lot of support available.

We hope you have already been seen (and possibly discharged) by your midwife and have been in contact with your health visiting team.

We look forward to seeing you at the surgery for your 6-8 week check.

This 'six-week check' is part of the NHS Newborn and Infant Physical Examination (NIPE) programme. Along with the newborn examination, it is an essential part of the 'Healthy Child Programme', the Department of Health guideline for promotion of child health.

It is an important opportunity for us to examine your baby but also to make sure that you feel well and are recovering properly.  We recommend you read this information to know what to expect during your 6-8 week check: What happens at your 6-8 week check?

To help us complete this check we ask if you could complete this form online a week or two before the appointment.

Please bring your red book to your appointment. 

And if you have had twins please complete a form for EACH baby.

 

Please do not write any clinical queries on this form. Any clinical queries or request for appointments via this form will be discarded. To make an appointment either book online via the NHS app/Patient access or by calling reception 01926 331401. On receipt of your form we will update your clinical records. If you are NOT a registered patient then your form will be discarded. This service is only for patients registered at the surgery aged 16 and over; and for parents or legal guardians of children. Forms must be completed in the UK due to GDPR regulations.
Reception: Mothers post natal form
For example were you under shared care with a hospital consultant during your pregnancy? Please give as many details as you can
For example where you induced? Did you have a vaginal delivery or a caesarean section? Was this a planned c-section or an emergency?
Feeding methods
For example breast feeding, bottle feeding or mixed feeding? Have you any problems (such as breast engorgement) or concerns about your babies feeding or weight? How often are they feeding during the day and night? And how much milk are they having (if known)?
Baby's development
If yes, were there any problems identified?
This test is normally done when your baby is around 5 days old and is a quick blood test taken from their heel
Risk of SIDS

Adjusting to having a new baby can be very difficult. Especially if they want to party all night!

The Lullaby Trust has lots of information about safe sleep and how to reduce the risk of Sudden Infant Death Syndrome.

Please see their website for more information: https://www.lullabytrust.org.uk/safer-sleep-advice/

Sleeping your baby on their back (known as the supine position) every night is one of the most protective actions you can take to ensure your baby is sleeping as safely as possible.
Smoking can increase the risk of SIDS. If someone in the household does smoke and would like support to stop please contact the surgery and arrange a smoking cessation appointment with one of our nurses who would be pleased to help
Mother's information

Having a new baby can be a very challenging time and it is important to also look after your own health.

Please complete this information as best you can so we can discuss it in your appointment.

If your blood pressure has been high it is useful to measure it at home. If you have a home blood pressure monitor please could you take it at home and record the result here
It can be completely normal to feel upset or emotional following birth. Sometimes instead of getting better these feelings can worsen. If this is the case we want to be able to offer support. Please seek help from us or your midwife/health visitor as soon as possible
Family and friends are very important, especially in the post natal period. Do you live with anyone? Have you friends or family locally who are able to offer support?
These can be very easy to forget but are very important to do!
Contraception post partum is very important. This might be condoms, the pill or a longer acting method such as a coil or implant. Are they any methods you would like to discuss?
This is crucially important. If you do not feel safe please contact the surgery urgently. The IRIS website also has lots of information and support services: https://irisi.org/
Other information

Thank you for completing this form.

We look forward to meeting you and your baby at your appointment.

If you do have any concerns and would like to speak with a GP or nurse in the meantime please contact the surgery.


Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

Information submitted through all secure forms, with the exception of the Leamington Primary Care Network Coil insertion/replacement form and Implant insertion/replacement/removal form, is secured with a private key and is accessed over a secure connection by nominated staff. Information submitted through the Leamington Primary Care Network Coil insertion/replacement form and Implant insertion/replacement/removal form is sent to The Leamington Primary Care Network via secure email.

We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 365 days.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.