Care & Standards

Nine decisionsNine standards

After birth everything has two versions: the way a family has always done it, and the way medicine recommends. Casa does not tell anyone they are wrong. We say which we follow, and why.

Nine things, decided before you arrive
Nurse measuring a newborn's jaundice with a handheld meter
Jaundice
A mother resting under a thick blanket in a warm, well-aired room
The charcoal fire
A mother after her first warm shower, a nurse beside her
Not washing
A nurse checking a newborn's umbilical cord, left dry to the air
The cord
Casa's lactation specialist guiding a mother's feeding hold
Clearing the ducts
A newborn sleeping on his back in an empty cot beside the bed
How the baby sleeps
A mother feeding her newborn, a glass of water within her reach
Giving water
A nurse soothing a swaddled newborn held in her arms
Held too much
A mother with a mood questionnaire, a psychologist seated opposite
Crying after birth
care-back-sleep
American Academy of Pediatrics, 2022

Jaundice

The way it has always been done

Morning sun, herbal water, then a few days of waiting to see if it fades.

At Casa

Casa measures jaundice through the skin every day and writes it down, never judging by eye. When the reading nears the line, the paediatrician sees him and a hospital check is arranged that same day.

The AAP finds eight feeds a day help clear it. Sunlight and herbal water do not, and can do harm.
A mother resting under a thick blanket in a warm room with fresh air, no charcoal fire
CDC carbon monoxide guidance

The charcoal fire

The way it has always been done

Embers under the bed for warmth, the room shut tight against the wind.

At Casa

Casa burns nothing indoors. Warmth comes from a room held at a steady temperature, blankets that are enough, and air that keeps moving.

Charcoal in a closed room makes carbon monoxide: no colour, no smell. It poisons the blood.
A mother in a robe after her first warm shower, a nurse beside her in the bathroom
NHS postnatal guidance

Not washing

The way it has always been done

A month without water, for fear of aching bones and headaches in later years.

At Casa

She showers in warm water as soon as she is steady on her feet, with a nurse in the room the first time. The wound is cleaned and dried every day.

A clean, dry wound lowers the risk of infection. Not washing only hides the signs.
A nurse checking a newborn's umbilical cord, left dry and open to the air
The WHO dry cord care method

The cord

The way it has always been done

Powder, a poultice, or a tight dressing, so that the cord drops sooner.

At Casa

The cord is left to dry in the open, with nothing applied. Each day a nurse looks closely at its base, so nothing is missed.

Redness, swelling or odour: the doctor sees him that day. With fever or poor feeding: at once.
Casa's lactation specialist guiding a mother's feeding hold at eye level
ABM Mastitis Spectrum Protocol #36, 2022

Clearing the ducts

The way it has always been done

Hard kneading of the breast, with pain taken as proof that it is working.

At Casa

The baby feeds on demand, with a correct latch. We never pump to empty and never knead: taking more milk out only tells the body to make more, and the swelling worsens. Between feeds, a cold pack and a feather-light sweep along the lymph path.

Pain is the signal to stop, not to press harder. Fever lasting beyond a day: a doctor sees her.
A newborn sleeping on his back in an empty cot beside his mother's bed
AAP safe sleep guidance

How the baby sleeps

The way it has always been done

On the side to stop the spit-up, a wedge under the head, cushions all round.

At Casa

He sleeps on his back, on a firm flat mattress, in an empty cot. The cot stands in his mother's room, beside her bed, but never in it.

Back-sleeping on a flat surface does not cause choking, even with reflux. No wedge.
A mother feeding her newborn on a hot afternoon, a glass of water within her own reach
WHO infant feeding recommendations

Giving water

The way it has always been done

A few spoons of water to rinse the mouth, liquorice water, or a touch of honey.

At Casa

An exclusively breastfed baby needs no water before six months, not even in the hottest weather: when it is hot, he feeds more often, and that is his water.

Honey, never: not in water, not on the tongue. Before one year it carries a risk of botulism.
A nurse soothing a swaddled, awake newborn held on his side along her forearm
American Academy of Pediatrics

Held too much

The way it has always been done

Let him cry, it opens the lungs. Carry him too much and he will never settle.

At Casa

A newborn cannot manipulate anyone, he can only signal. Answer him early and he cries less overall, not more, and he is not spoilt by it.

Swaddled, held on his side in our arms, white noise, a gentle sway, something to suck. Laid down to sleep, he is always on his back.
A mother with a questionnaire on her lap, a psychologist seated opposite at a respectful distance
WHO 2022 and ACOG 2023

Crying after birth

The way it has always been done

The house says a baby is a blessing, do not overthink, it will pass in days.

At Casa

Casa checks in regularly on how she feels after birth, rather than waiting for her to speak first.

The score is not a diagnosis. When it rises, she is seen the same day.

Two ways to ease engorgement

The most contested task in the house, and the one a mother pays for in pain if it is done wrongly.

Traditional milk masseuseCasa's lactation specialist
BasisPassed down by trade, no common standardFollows ABM Protocol #36, 2022
MethodKneading and pressing hard into the tissueFix the latch, feed on demand, cold packs
PainTaken as the sign that it is workingTaken as the sign to stop
RiskBruised tissue, oedema, risk of abscessWatched for fever and inflammation, doctor if needed
Written downNothing is left behindInto the file the family reads at night
A cold pack wrapped in linen on a tray, a specialist's hand resting lightly, never pressing

Every standard here has a name behind it

Casa's obstetrician reading a patient file by a window
ObstetricianExamines her at Casa and recommends the next step when needed
Casa's paediatrician listening to a newborn's chest with a stethoscope
PaediatricianExamines the baby at Casa, and comes at once at any warning sign
Casa's head nurse at shift handover, the ward book in her hands
Head nurseManages shifts, handovers and the daily record
Casa's lactation specialist demonstrating a feeding hold
Lactation specialistThe latch, the feeds, pain nobody need endure
Casa's psychologist listening, leaning slightly forward
PsychologistThe mood scale, and a private conversation when she needs one
The day's handwritten care notes in a plum folder, handed back to the family in the evening

What is written, and who reads it

A promise no one can check is only advertising. Each evening, the family receives the day's record, to follow along and rest easy.

  • Feeds, volumes, and wet nappies
  • The baby's weight and the measured bilirubin
  • The baby's sleep, and the mother's sleep
  • The incision or the stitches, and her pain
  • Meals, fluids and any medication given
  • The mood score, when it is due

Clarity for every concern

When advice differs, Casa helps your family understand each option through thoughtful listening and trusted guidance, so you can confidently choose what best suits mother and baby.