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Baby Care After Delivery
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Terminology: Postpartum care (USA) is also known as postnatal care (UK).
What Is The Postpartum Period?
The postpartum period is usually defined as the first 6 weeks after childbirth. At the end of the 6 weeks the mother has a postpartum checkup and then returns home to get on with the rest of her life. In reality of course it takes months (even up to a year), to work through all the issues that arise from having a baby (depending on your physical, emotional and social situation). Not all the issues that crop up are problems. Many women experience the joyous 'glow of motherhood' and take natural pride in their ability to give birth to and nurture a baby. Some feel bonded with other women for the first time in their lives or discover a new love or respect for their own mother. Yet, the arrival of another person in the family always necessitates change in habits, lifestyle and relationships. In the long-term these changes are not necessarily bad, but they do initially create turmoil and throw up issues which need to be worked through.
Postpartum complications are very common. While most are relatively minor, others are cause for concern:
Cramping: You may experience some pain and cramps as the uterus shrinks and returns to normal size. Ask your doctor about taking Ibuprofen or Naprosyn for the pain. To help get your pelvic area back in shape, practice Kegel exercises.
Constipation: If you have not had a bowel movement within 2 or 3 days of labor you may need to use a laxative such as Metamucil or Surfack.
Urination: You will probably urinate a lot in the first few days as you are letting go of the extra fluid needed for pregnancy. This will reduce any swellings in the hands and feet. Continue to drink plenty of fluids.
Hemorrhoids: You may have developed hemorrhoids during pregnancy which hang around after delivery. Tucks cold witch hazel pads may help stop burning and itching.
Vaginal Discharge: You will have a bright red vaginal discharge for the first 3 to 6 weeks. It will gradually become more watery and pink. Use a sanitary pad (not a tampon) until it stops. Avoid douching until at least attending your 6 week checkup. If you are bottle feeding you will have a period within 8 weeks. If you are breastfeeding it could be delayed by a further number of weeks (or even months). See also postpartum bleeding for details.
Episiotomy Soreness: If you had stitching after an episiotomy it should heal quickly. Take a sitz bath 2 or 3 times a day and practice Kegels. See, how do you do pelvic floor exercises? Take painkillers like Tylenol if needed.
Cesarean Incision: It is normal to feel itching and numbness around the incision. Keep it cleaned with plain soap and water, there is no need to cover it.
Washing: If you had a vaginal birth you can have a bath or shower. If you had a C-section you can shower. Do not add soaps, oils or salts to a bath until your 6 week checkup.
Baby Blues: Feeling a little weepy? Don't worry, more than likely it is just a bout of the baby blues and you will feel more like yourself in a few days. If symptoms do not pass and you feel progressively depressed, talk to your doctor about postpartum depression. In the meantime, take our postpartum depression quiz.
Breasts: It normally takes about 3 to 5 days for mature milk to come in, at which point you may suffer engorged breasts. When you start feeding you might experience breastfeeding problems like sore nipples and blocked milk ducts. A lactation consultant can advise you on how to handle these issues.
Hair Loss: It is quite common to experience severe hair loss after pregnancy. It may even fall out in clumps.
When To Call A Doctor
Postpartum symptoms that require a doctor's attention:
• Continual or increasing perineal pain (pain around the vagina opening).
• Fever of 100.8 degrees or more.
• Nausea or vomiting.
• Pain or swelling in the legs.
• Heavy foul smelling vaginal discharge.
• Chest pain or cough.
• Painful or frequent urination.
• Postpartum bleeding: heavy vaginal bleeding, soaking more than 1 pad per hour or passing large clots.
• Painful, red, warm breast may be hard in area and/or flu-like symptoms. This could be mastitis, a breast infection.
The most classic piece of postpartum recovery advice for moms - repeated constantly by doctors and nurses - is to not to neglect your own needs. This means napping when your baby does, eating healthy food without worrying about your figure for a while, asking others to help with the housework, exercising regularly and take relaxing baths. While mothers preach this to each other, in reality they rarely follow their own advice. Mom spending 15 minutes chopping up fresh fruit for her toddlers but surviving on potato chips herself is a typical example. Knowing you are likely to neglect your own needs, it is worth planning your recovery phase carefully.
Postpartum Care: Mom
Sleep And Rest
Getting enough sleep in the weeks following labor is vital for any mother to maintain her physical and emotional health. Consider having a friend or family member stay for the first week to help with other children or household chores. Or if your budget allows, hire the services of a postpartum doula and cleaner. One advantage of hospital births or birthing centers over homebirths is the extra help you have while staying there. As insurance companies push for shorter stays however, this advantage is rapidly dwindling.
Nutrition and Exercise
A healthy diet and exercise are as important in the postpartum period as they are in pregnancy. New mothers should continue to take prenatal vitamins while they are breastfeeding. Weight loss diets (see losing weight after childbirth) are never a good idea in the first few months after delivery, rather it is better to focus on eating well. Postpartum exercises however can help to restore muscle tone and pre-pregnancy shape.
Postpartum sex: Most doctors recommend waiting 4 to 6 weeks before resuming vaginal intercourse. The desire for sex after having a baby varies from woman to woman. Some find the whole experience sensual and are quickly aroused by their partner. For others, plagued with breastfeeding problems or perineal pain, it is the last thing on their mind.
In the first few days, an inexplicable sadness and weepiness is normal (baby blues) as hormone levels crash before settling again. Then, in the weeks and months after having your baby, other issues can raise their head including fears and self-doubt, boredom, loss of self, partner problems, managing older children, work and childcare. See, postpartum emotions for a more detailed discussion.
Postpartum Care: Baby
Learning how to take care of your baby can be both a scary and exhilarating task. "She's so small, I'm afraid of breaking her" is quite a common thought. The first thing to remember is that mothers have been caring for their infants for hundreds of thousands of years before the advent of hospitals, doctors and even websites like this! You have all the natural tools you need to look after your baby - love and a nurturing instinct. That said, a little preparation and knowledge can go a long way to easing nerves and facilitating a smooth homecoming. See our article on postpartum baby care for tips on bathing, skin care, diaper and umbilical cord care.