Kurth et al. BMC Pregnancy and Childbirth 2010, 10:21 http://www.biomedcentral.com/1471-2393/10/21 Open Access RESEARCH ARTICLE BioMed Central © 2010 Kurth et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Research article Crying babies, tired mothers - challenges of the postnatal hospital stay: an interpretive phenomenological study Elisabeth Kurth* 1,2 , Elisabeth Spichiger 1 , Elisabeth Zemp Stutz 2 , Johanna Biedermann 3 , Irene Hösli 3 and Holly P Kennedy 4 Abstract Background: According to an old Swiss proverb, "a new mother lazing in childbed is a blessing to her family". Today mothers rarely enjoy restful days after birth, but enter directly into the challenge of combining baby- and self-care. They often face a combination of infant crying and personal tiredness. Yet, routine postnatal care often lacks effective strategies to alleviate these challenges which can adversely affect family health. We explored how new mothers experience and handle postnatal infant crying and their own tiredness in the context of changing hospital care practices in Switzerland. Methods: Purposeful sampling was used to enroll 15 mothers of diverse parity and educational backgrounds, all of who had given birth to a full term healthy neonate. Using interpretive phenomenology, we analyzed interview and participant observation data collected during the postnatal hospital stay and at 6 and 12 weeks post birth. This paper reports on the postnatal hospital experience. Results: Women's personal beliefs about beneficial childcare practices shaped how they cared for their newborn's and their own needs during the early postnatal period in the hospital. These beliefs ranged from an infant-centered approach focused on the infant's development of a basic sense of trust to an approach that balanced the infants' demands with the mother's personal needs. Getting adequate rest was particularly difficult for mothers striving to provide infant-centered care for an unsettled neonate. These mothers suffered from sleep deprivation and severe tiredness unless they were able to leave the baby with health professionals for several hours during the night. Conclusion: New mothers often need permission to attend to their own needs, as well as practical support with childcare to recover from birth especially when neonates are fussy. To strengthen family health from the earliest stage, postnatal care should establish conditions which enable new mothers to balance the care of their infant with their own needs. Background Comforting a crying baby while coping with personal tiredness can challenge mothers after birth. As many as 46%-87% of new mothers report problems with tiredness or fatigue [1,2], and disquieting infant crying is the most commonly reported reason parents consult health profes- sionals [3]. Not surprising, the occurrence of postnatal tiredness is associated with the amount of infant crying [4,5]. In the worst case, infant crying and increasing exhaustion can cumulate into a vicious circle and nega- tively affect family health. Maternal exhaustion has been identified as a predictor of postpartum depression [6,7], and persistently crying infants are at a higher risk for shaken baby syndrome or other forms of child abuse [8,9]. To date, little is known about how mothers confront these challenges during their postnatal hospital stay. Both postpartum maternal tiredness and fatigue are defined as an imbalance between activity and rest [10]. Milligan and colleagues [11] differentiate between tired- ness and fatigue, defining tiredness as a physiological * Correspondence: elisabeth.kurth@unibas.ch 1 University of Basel, Institute of Nursing Science, Bernoullistr. 28, 4056 Basel, Switzerland Full list of author information is available at the end of the article