Postpartum CARe

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Congratulations, you did a great job and you should be very proud of yourself.  Now that your baby is here, it’s time to take care of yourself.  During the first two weeks, it is very important to listen to your body.  Often after a delivery it is not unusual for you to feel either extremely exhausted or full of energy therefore, please listen to your body. Pushing yourself too soon - even if you feel good - can delay your healing and prolong your recover.   Your body is working hard to make milk and establish a good supply and to heal the site on your uterus where the placenta was. Limit visiting hours for your family and friends so that you are sure to get enough rest and are able to conserve energy for baby.  You are in no position to host or entertain people.  If in the event friends and family are coming give them a task to accomplish such as picking up food, do laundry or clean house etc.… Your only activities should be caring for yourself and the baby. If you have a lot of energy, take a short walk or sit outside with the baby. Avoid busy public places. You will find that fatigue arrives suddenly. Sleep when the baby sleeps.

Good nutrition is an essential part of postpartum recovery. You burn plenty of calories while breastfeeding therefore it is extremely important to keep well hydrated and well fed.   You can also continue to take your prenatal vitamins. Eat lots of whole grains, bran and oatmeal cereals, good protein, and plenty of fruits and vegetables. These foods will help keep your bowels moving and to avoid constipation. Drink plenty of water as this will help with your milk supply. A good rule of thumb is to drink a glass of water every time you nurse your baby. To help increase your energy postpartum and to rebuild your blood supply it is important to eat foods high in iron (spinach, kale, red meat, chicken, etc.).

Your breasts are full of colostrum for the first few days after birth. Colostrum is the perfect first food, containing protein, fat, minerals, and vitamins. Put the baby to breast anytime the baby is awake and making mouthing (“rooting”) movements. Your baby will need to nurse at least every one to three hours.   How often your baby wants to nurse is not an indicator of how much milk you’re making. The more often your baby nurses, the sooner your milk will come in. It is normal to have engorgement in your breasts lasting 1-4 days. Frequent nursing will usually give relief. If the fullness makes you too uncomfortable, or makes nursing difficult, try the following:

• Express some milk, by hand or with a pump, to soften the areola before baby nurses. It is unnecessary to pump between feedings (this will just tell your body to make *more* milk, creating more engorgement). You also can try “reverse pressure softening” where you take your two fingers and place the nipple in between them, and place firm pressure down on the breast toward the chest wall. This will also help soften the areola before latching.

• Apply moist heat, a warm shower or a hot water bottle to your breasts before you nurse the baby.

Postpartum bleeding (lochia) is like a heavy period. It should be intermittent rather than steady. The lochia after birth goes through three stages: bright red blood with clots (some clots can be on the larger side, but please call the Dr. Phabby if you pass a clot larger than your fist); pinkish brown; and then cream colored. You should notice your bleeding tapering down and essentially gone by six weeks postpartum. Your bleeding should smell like a period. Do not use tampons and change your pads often. You should not be soaking two pads (front and back) in an hour, if you do that you need to call the Dr. Phabby. Your uterus (found below your bellybutton) should feel firm like a grapefruit. To help keep your uterus firm, nurse your baby “on demand” at least every two to four hours. Empty your bladder frequently (you may not feel a strong urge to go, as the nerve receptors in your bladder are enjoying the extra space). Massage your uterus if it does not feel firm.

Some women, especially after their second or more babies, will experience cramping for the first few days after birth. As your uterus shrinks down to its prepregnant size, you may notice that they feel like menstrual cramps. Here are some options to help alleviate the pain/discomfort:

• Hot water bottle or heating pad

• Extra calcium with magnesium

• After ease Tincture
• Crampbark tincture / tea

• Ibuprofen every four hours

Use your peri bottle during urination and bowel movements to help easy discomfort and clean the area well, and make sure to dry the perineal area well, patting dry is usually most comfortable. It is important to gently keep clean and dry to promote healing. You can utilize frozen pads to help with swelling and discomfort immediately following birth, but remember that after the first 24 hours, warmth helps promote healing better than cold. Squirt witch hazel on a pad or use Tucks pads up against any sutures you may have. Kegels also helps to increase blood flow, ease itching from sutures, and promote healing.

It is best to wait until all bleeding has stopped and you feel physically and psychologically ready and comfortable. The first-time making love can be intimidating after birth so take it slow. Don’t expect to be “back to normal” right away. You may need to use a water-based lubricant or coconut oil (oil only if you’re not using condoms) since your postpartum and breastfeeding hormones may increase vaginal dryness.
It is possible to ovulate within 4-6 weeks after birth - even while breastfeeding - so you may choose to consider some form of birth control. Dr. Phabby will discuss contraceptive options.

The following approach will help you get as much (or almost as much) sleep as you 

• Plan to stay in bed or keep going back to bed until you have slept your allotted number of hours. This means that with exception of meals and trips to the bathroom, you do not get up. You do not brush your teeth, shower or dress in the early morning. Make a mental note of approximately how many hours you have slept since you went to bed (but try not to obsess about it). You may have to stay in bed from 10pm until noon the next day to get eight hours of sleep! If that’s what it takes, do it. Then, brush your teeth, take a shower, dress, and greet the day

• Many parents find it easier to follow this regimen if their baby sleeps with them or nearby
• As your baby grows and begins to sleep for longer stretches, it will take you less time to get enough sleep.
• Consider hiring a postpartum doula