Podcast

Prepare for birth with a Paediatrician S8 | E215

On this week’s episode of Sense by Meg Faure, Meg sits down with Dr. Nellie Balfour — a paediatrician who is 35 weeks pregnant with her second child — to talk through everything you need to know about what happens the moment your baby is born. This is episode three of their real-time pregnancy series, and it’s one of the most practical and reassuring conversations the show has produced.

Dr. Nellie is having an elective C-section at 38 weeks. She’s packed the bag, she’s thought through the birth plan, and she brings both her medical knowledge and her personal experience as a second-time mum to every part of this conversation.

Sensory Personalities — Who Is This Baby?

Meg and Nellie open with the question every third-trimester parent is really asking: who is this little person? Nellie’s baby has been doing somersaults all pregnancy, and Meg explains what that might mean in terms of sensory personality. She walks through the four sensory types — settled, slow to warm up, social butterfly, and sensitive — and what each means for how you parent in those early months.

Nellie’s firstborn is a slow-to-warm child, and she shares her real concerns about how he’ll adjust to a potentially very different baby brother. Meg offers practical, insight-driven strategies for preparing a slow-to-warm toddler: verbal preparation, room walkthroughs, and co-regulation in the early days when two very different little people are suddenly sharing a space.

The Hospital Bag — What You Actually Need

Nellie unpacks her hospital bag in detail. For a C-section specifically, the focus shifts almost entirely to postnatal comfort rather than labour preparation. Her list covers maternity essentials from the Carrywell range, a front-button nightie over pyjama pants (the elastic irritates the scar), breast pads for when the milk arrives on day two or three, a breastfeeding pillow, flip flops for the shared shower, and the one item people consistently forget: a phone charger.

She also covers the baby bag: two nappy sizes because estimated weights from ultrasounds aren’t always accurate, unscented wipes, cotton wool with surgical spirits for the umbilical stump, swaddles, beanies, and a dummy. Meg adds important context on dummies and breastfeeding — the risk isn’t nipple confusion, it’s skipping feeds. Feed first, then use the dummy for non-nutritive sucking after.

Delayed Cord Clamping, First Baths, and the Delivery Room

Nellie explains delayed cord clamping in plain terms: by waiting 30 to 60 seconds before clamping, blood transfers from mum to baby, reducing the risk of anaemia and jaundice. It happens in elective C-sections and, where safe, in emergency sections too.

On first baths, both Meg and Nellie agree: day three is the right time. The vernix absorbs into the skin, and there’s evidence that babies who aren’t bathed early get their hands to their mouth sooner — because they can still taste something familiar from the womb.

Then Meg asks Nellie to step fully into her paediatrician role and describe exactly what happens the moment your baby is born — what she’s looking for when baby is passed to her in the delivery room. Nellie walks through the full newborn check: why a cry matters (it confirms oxygen is moving through the lungs), why blue skin is normal at first, what a floppy baby signals, and how the head-to-toe examination works. Clear, calm, and genuinely demystifying.

APGAR Scores — What They Actually Mean

Meg and Nellie break down APGAR scores properly. It’s not a score out of 10 — it’s a score at one minute and again at five minutes. A low one-minute score isn’t alarming if the five-minute score is strong. But a score that stays low at five minutes is a signal that baby needs more attention. The five-minute APGAR is the one that matters most.

This episode won’t change what happens in your delivery room, but it will mean you understand it. That’s worth a lot

Guests on this show

Dr. Nellie Balfour is a mom and Specialist Pediatrician with a focus on neonates, newborns, and early childhood development. Originally from South Africa, she now practices in Abu Dhabi. Dr. Nellie is passionate about empowering parents with credible, evidence-based information so they can make the best decisions for their children. You can find her and her popular Q&A sessions on Instagram at @drnelliepaeds

Episode References and Links:

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WEBVTT

00:00:00.000 –> 00:00:15.000
[Meg Faure] You’ve made it to the third trimester.
Your bag’s not packed, the birth plan feels
overwhelming, and your toddler has no idea what’s coming.

00:00:15.000 –> 00:00:30.000
Today I’m joined by Dr. Nellie Balfour.
My name is Meg Faure, and in this episode
we’re tracking what’s happening as Nellie approaches birth.

00:00:30.000 –> 00:00:50.000
We’ve been following Nellie, who’s a paediatrician,
all the way through since the first trimester —
and now she’s almost there.

00:00:50.000 –> 00:01:12.000
In this episode, Nellie and I get into everything
you need to know about birth, and particularly
C-section births, because she’s having an elective C-section.

00:01:13.000 –> 00:01:35.000
We talk about baby sensory personalities —
whether you can actually tell what your baby’s
going to be like from their movements in utero.

00:01:35.000 –> 00:02:00.000
We also talk about the hospital bag,
what you actually need, what you can leave at home —
and those first moments straight after birth.

00:02:00.000 –> 00:02:20.000
What is an APGAR score? Why is cord clamping
timing important? And what is a paediatrician doing
in the room when your baby is born in a C-section?

00:02:22.000 –> 00:02:43.000
Welcome to Sense by Meg Faure, where we make
sense of the science and art of parenting.

00:02:44.000 –> 00:03:10.000
[Meg Faure] This is your space.
You’re not alone. You’re held.

00:03:10.000 –> 00:03:30.000
Right, Nellie, it’s so lovely to have you with us today.
How many weeks are you?

00:03:30.000 –> 00:03:50.000
[Dr. Nellie Balfour] Thanks, Meg. I love being back.
I am 35 weeks and three days.

00:03:50.000 –> 00:04:10.000
[Meg Faure] Oh my goodness, you are right
into that last stretch now. How are you feeling?

00:04:10.000 –> 00:04:35.000
[Dr. Nellie Balfour] I’m feeling good.
I’m feeling ready to meet this little guy.
I’m tired, but weirdly I have enough energy for all the nesting.

00:04:35.000 –> 00:05:05.000
[Meg Faure] So what would you say about this third trimester?
What are you focused on right now?

00:05:05.000 –> 00:05:30.000
[Dr. Nellie Balfour] I’m having an elective caesarean section.
My firstborn was also born by elective C-section.
I don’t think there’s much difference in outcome.

00:05:30.000 –> 00:06:00.000
There are studies about the microbiome
and vaginal delivery, but elective C-section
is safe and it’s the right choice for me.

00:06:00.000 –> 00:06:30.000
And I always say — it doesn’t matter how your
baby comes out, as long as you and your
baby are safe. You’re still a mum at the end of the day.

00:06:30.000 –> 00:07:05.000
[Meg Faure] Let’s talk a bit about his personality.
We already have a few indicators in utero.
How busy has he been compared to your firstborn?

00:07:06.000 –> 00:07:35.000
[Dr. Nellie Balfour] Very busy. My firstborn kicked often,
but this little guy is doing somersaults, tumbling around.
He’s a little acrobat. I think he’s going to be a firecracker.

00:07:35.000 –> 00:08:29.000
[Meg Faure] I love to think about sensory personalities —
how babies engage with their world through their senses.
You get your sensory seekers, the social butterflies.

00:08:30.000 –> 00:09:00.000
Those little ones are very social,
wired for interaction, and they love a lot of sensory input.
They can be quite exhausting babies and toddlers.

00:09:00.000 –> 00:09:30.000
When we understand our baby’s sensory personality,
it helps us with everything from weaning to
sleep in those early days.

00:09:30.000 –> 00:10:00.000
[Dr. Nellie Balfour] I love all your work on sensory personalities.
I watched your webinars with my first one when he was a newborn.
He’s always been slow to warm.

00:10:00.000 –> 00:10:44.000
[Meg Faure] Slow to warm is a very precious personality.
They observe the world before they throw themselves in.
Once they’re comfortable, they’re an utter delight.

00:10:44.000 –> 00:11:15.000
What does happen is that slow to warm little ones’
worlds get disrupted quite significantly
when anything new happens.

00:11:15.000 –> 00:11:45.000
The newness of a new baby — particularly if the baby’s
a busy social butterfly — is potentially going to
be disruptive for your firstborn.

00:11:45.000 –> 00:12:28.000
Talk through what’s coming, prepare the room,
show him the room, and talk about what’s going
to happen each day. Verbal preparation really helps.

00:12:28.000 –> 00:13:00.000
[Dr. Nellie Balfour] He is very observant and watches people
in his environment before he feels comfortable.
But once he does, his personality really comes out.

00:13:00.000 –> 00:13:30.000
I do have concerns about how he’s going to adjust
to his baby brother. I think his brother
might be a social butterfly.

00:13:30.000 –> 00:14:00.000
[Meg Faure] What makes things a lot easier
is when a parent has insight.
You can co-regulate for him.

00:14:00.000 –> 00:14:30.000
Recognise when he’s becoming overstimulated,
take him for a walk while you settle the baby,
and then turn your full attention back to him.

00:14:30.000 –> 00:15:43.000
[Dr. Nellie Balfour] My husband is arriving tomorrow.
He’ll be here for the birth and for a
significant amount of time afterwards.

00:15:44.000 –> 00:16:15.000
[Meg Faure] Let’s talk about the hospital bag.

00:16:15.000 –> 00:16:45.000
For mum: I’m a huge fan of the Carrywell range.
Linen savers for the hospital bed, maternity bras,
maternity pads, maternity underwear.

00:16:45.000 –> 00:17:23.000
People forget a phone charger. Always pack one.
Also a peri bottle — mainly for natural births
to clean and soothe the area after delivery.

00:17:23.000 –> 00:18:00.000
A breastfeeding pillow, slippers, flip flops for the shower,
and a front-button nightie — not pyjama pants,
especially for a C-section. The elastic irritates the scar.

00:18:00.000 –> 00:18:30.000
The buttons are for quick breastfeeding access.
Also a gown, a breast pump, and breast pads —
on day two or three, your milk comes through like a tap.

00:18:30.000 –> 00:20:00.000
I’m not bringing a speaker. I just slept.
When I was awake, I was with my baby.
The C-section itself is 20 to 30 minutes and then you’re back in your room.

00:20:47.000 –> 00:21:30.000
[Meg Faure] And for the baby bag?

00:21:30.000 –> 00:22:00.000
Unscented wet wipes. Cotton wool with surgical spirits
for the umbilical stump — clean with each nappy change
to help it heal and prevent infection.

00:22:00.000 –> 00:22:30.000
Outfits and beanies — babies lose a lot of heat
from their heads. Swaddles help baby feel
contained and comfortable, and they sleep longer.

00:22:30.000 –> 00:23:00.000
And a pacifier. Sometimes when baby can’t be soothed,
that sucking motion really helps them
calm down or drift off.

00:23:00.000 –> 00:23:30.000
[Meg Faure] With premature babies, we actually insist on dummies
because they need to develop their suck reflex
in order to breastfeed.

00:23:30.000 –> 00:24:00.000
The risk with dummies isn’t nipple confusion —
it’s whether a mum is skipping a feed.
Feed regularly, then use the dummy after the feed.

00:24:00.000 –> 00:25:00.000
[Dr. Nellie Balfour] One hundred per cent agree.
Also blankets, a gentle fragrance-free cleanser,
moisturiser, vests, and warm layers for a winter baby.

00:26:33.000 –> 00:27:00.000
[Meg Faure] There’s good research showing that not bathing
early is beneficial — it gives skin time to
absorb the vernix. So not before day three.

00:27:00.000 –> 00:27:30.000
[Dr. Nellie Balfour] That’s exactly what happens now
in private and public hospitals.
At 72 hours, baby gets the first bath.

00:27:30.000 –> 00:28:00.000
[Meg Faure] And speaking of evidence-based practice —
delayed cord clamping. Is that possible
with a C-section?

00:28:00.000 –> 00:28:32.000
[Dr. Nellie Balfour] Yes, we do it with elective C-sections,
and as far as possible with emergency C-sections too,
as long as baby is breathing.

00:28:32.000 –> 00:29:00.000
Delayed cord clamping means not clamping the cord
within 30 to 60 seconds of birth so that blood
can transfer from mum to baby.

00:29:00.000 –> 00:29:30.000
Benefits include lower risk of anaemia
and lower risk of jaundice.
If baby needs resuscitation, we clamp immediately.

00:29:30.000 –> 00:29:59.000
[Meg Faure] In terms of those first moments —
does baby go straight onto your chest
or to the paediatrician?

00:30:00.000 –> 00:30:30.000
[Dr. Nellie Balfour] It depends on the baby and what you request.
If mum requests skin-to-skin and baby is healthy
and pink, that’s completely fine.

00:30:30.000 –> 00:31:00.000
Then baby comes to the paediatrician for examination
and goes right back to mum. If baby needs resuscitation,
baby comes straight to us first.

00:31:00.000 –> 00:31:30.000
[Meg Faure] You as the paediatrician —
what are you looking for when baby is passed to you?
Talk us through it.

00:31:30.000 –> 00:32:00.000
[Dr. Nellie Balfour] We examine baby from head to toe.
We want baby to cry — it doesn’t have to be
a sustained cry, just a whimper, as long as baby is breathing.

00:32:00.000 –> 00:32:30.000
Crying tells us oxygen is going in and out.
The louder and longer the cry,
the more oxygen we know baby is taking in.

00:32:30.000 –> 00:33:00.000
We expect baby to be blue or purplish at first.
After about five to ten minutes, we want to see pink.
A lot of dads get a fright — but it’s completely normal.

00:33:00.000 –> 00:33:30.000
We look at activity — is baby flexed, limbs active?
We don’t want a floppy baby, we don’t want a quiet baby,
we don’t want prolonged blueness.

00:33:30.000 –> 00:34:00.000
Baby is shown to mum and dad briefly first,
then passed to us. We examine head to toe:
heart, lungs, abdomen, limbs, ten fingers, ten toes.

00:34:00.000 –> 00:34:30.000
Once we’re happy with everything,
baby goes right back to mum and dad.

00:34:30.000 –> 00:35:02.000
[Meg Faure] And do you rank the APGAR, or does the nurse?

00:35:02.000 –> 00:35:30.000
The APGAR is a score out of 10.
It covers appearance, breathing, activity,
colour, and heart rate.

00:35:30.000 –> 00:36:00.000
The score tells us whether we’re happy with how baby is doing,
or whether baby needs more attention —
extra oxygen, monitoring, or ICU care.

00:36:00.000 –> 00:36:15.000
[Meg Faure] It’s not “7 out of 10” — it’s 7 at one minute
and 10 at five minutes. A low first score isn’t alarming
if the five-minute score is high.

00:36:15.000 –> 00:36:41.000
[Dr. Nellie Balfour] Exactly. It’s the five-minute APGAR
that counts for more. Your one-minute can be 5,
your five-minute can be 8, and we’re happy.

00:36:41.000 –> 00:36:55.000
[Meg Faure] Thank you for joining me today.
I hope this conversation brought you a little more
clarity, calm, and confidence on your parenting journey.

00:36:55.000 –> 00:37:10.000
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00:37:10.000 –> 00:37:20.000
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Meg faure

Meg Faure

Hi, I’m Meg Faure. I am an Occupational Therapist and the founder of Parent Sense. My ‘why’ is to support parents like you and help you to make the most of your parenting journey. Over the last 25 years, I’ve worked with thousands of babies, and I’ve come to understand that what works for fussy babies works just as well for all babies, worldwide.