Postpartum Health: A Guide for New Parents

Feeling tired after having a baby is normal. Get as much rest as possible and try napping when your baby sleeps. Gradually increase your activities as you feel up to it. If you have had a cesarean birth, you have also had major surgery. Limit your activity to caring for your baby and giving your body time to recover.

• Do not pick up anything that causes strain or discomfort in your stomach.
• Limit your daily activities to caring for the baby and light housework.
• You may go up stairs.
• Do not strain your stomach. Your skin will heal quickly, but the muscle underneath takes longer.
• Avoid swimming pools until vaginal bleeding has stopped.
• You can resume driving about a week after a vaginal birth or three weeks after a cesarean birth.

If you have received stitches as part of an episiotomy, that area may be uncomfortable. For comfort and healing:

• Apply ice packs in the first 24 hours.
• Sit in a sitz bath for 20 minutes, three times a day.
• Take pain medication as recommended by your physician or midwife.Each time you urinate, make a bowel movement, or change your sanitary pad, use a peribottle to squirt warm water from front to back and pat dry.

You can get pregnant after delivery even if you are not having regular periods and if you are breastfeeding. You should think about a birth control plan before you go home from the hospital.

It is recommended that you use condoms with foam. You can buy both at a pharmacy. If your doctor has ordered birth control pills for you, you should use another form of birth control (such as foam and condoms) for the first month until your menstrual periods become regular.

After your six-week checkup, you may return to your choice of birth control. Keep in mind that some forms of birth control affect breastfeeding. Discuss the options for ongoing birth control with your doctor or nurse midwife.

Mothers of Preemies

Family planning is also important for moms of preemies. Many women feel overwhelmed after preterm birth. While it can be hard to think about yourself, it is important to take control of your reproductive life. This includes using appropriate birth control methods and getting pregnant again only when you are ready to get pregnant.

Whether you are feeding your baby at the breast or with a bottle, your body will naturally produce milk. As your milk supply increases, your breasts may become very tender and/or swollen. This is called engorgement and begins on the second or third day after your baby's birth. It will last about 24 to 48 hours.

If Your Breasts Become Engorged When Breastfeeding

• Wear a bra with good support 24 hours a day.
• Take a warm shower or apply a warm face cloth to your breasts. The heat may help milk flow.
• Pump or hand express milk before nursing to soften the breast if your baby is having trouble latching on because your breasts are engorged.
• Apply a cold compress after feeding. It may help relieve swelling.
• Take Tylenol or Motrin for discomfort.
• Nurse your baby frequently to help your milk supply and reduce engorgement.

If Your Breasts Become Engorged When Bottle Feeding

• Wear a bra with good support 24 hours a day.
• Avoid handling your breasts.
• Do not pump or hand express milk. This will only increase the engorgement.
• Take Tylenol or Motrin for discomfort.

Call the Warm Line at 1-800-711-7011 if you have any questions or concerns.

After your six-week checkup is a good time to start exercising again, but talk with your doctor before you start a formal exercise program. Your body will return to its pre-pregnant state naturally, except for muscle tone. Exercise will help you regain this tone.

You can try Kegel exercises to help tighten the muscles around the vagina. You can begin these shortly after delivery. Tighten the muscles that surround the opening of the vagina and rectum as if you are trying not to urinate. Hold for several seconds and then slowly relax. Repeat five to 10 times, several times a day.

In addition, you can help your body return to normal by using good body mechanics. Sit, stand, and walk with proper postural alignment. Bend at your knees to pick things up. Avoid bending from the waist, which strains and pulls the back muscles.

Eating Well After Your Baby is Born

Your body needs time and a balanced diet to recover from pregnancy and adjust to meeting the needs of your new baby.

Things to Keep in Mind

• While you are breastfeeding continue to eat a well-balanced intake of food from the basic food groups and drink adequate fluids. The basic food groups include:
• • Dairy.
  • Protein (animal and plant-based sources).
  • Colorful fruits and vegetables.
  • Starches and whole grains.
  • Other foods including good fats.
• Stay hydrated with appropriate fluids. Special diets may be needed only for nutrition-related medical conditions, otherwise, eat regularly. Your body uses energy stored during your pregnancy weight gain for milk production for your baby. If you are not breastfeeding, lower calorie intake will help you lose any desired weight.
• You should drink eight to 10 glasses of fluids (water, juice, milk) every day. Limit caffeine, including soda, tea, coffee and chocolate, and highly sweetened beverages.
• A well-balanced intake includes:
  • Protein from meat.
  • Eggs and cheese.
  • Plant-based proteins such as peanut butter and soy.
  • Ancient grains like quinoa.
• Including high fiber foods and adequate water intake may help with regular bowel movements. High fiber foods include:
• • Fresh fruits.
  • Vegetables.
  • Bran and bran products.
  • Other whole grain products.
  • Fresh fruits.
• Dairy which includes low- fat milk products, such as cheeses and yogurt or lactose free products, should be included in your daily diet. Keeping your intake of high fat and sugary foods and snacks low and smaller portions will help reduce your calorie intake for weight reduction.
• Finish taking your prenatal vitamins and iron pills as prescribed. If you are breastfeeding, take them the entire time you are nursing. Your doctor can renew your prenatal vitamin prescription if you run out.

For any significant problems such as severe constipation, please contact your health care provider for a laxative or stool softener or other medical advice. If you would like a nutrition consult, have your health care provider make a referral to the Women & Infants Outpatient Nutrition Services Department at (401) 274-1122, ext. 42749.

Bleeding from the vagina is normal in both vaginal and cesarean births. It usually lasts 10 days to three weeks. The color of the bleeding will change from bright red to brownish to tan, and will become less in amount and then disappear. You can take showers and baths at any time, but do not douche before your six-week checkup.

Warning Signs

Some new mothers develop complications following their delivery whether it was a vaginal or cesarean birth. Call your doctor if you have any of the following signs or symptoms:

• Fever of 100.4 degrees or higher.
• Increased bleeding without an increase in activity. If you have increased your activity, try resting for an hour. If your flow does not decrease, call your doctor.
• Passing large clots (the size of a quarter or larger).
• Severe pain in your abdomen, chest or legs.
• Tender, painful or reddened breasts.
• Painful or frequent urination.
• Severe headache or vision problems.
• Shortness of breath.
• Swelling of hands or face.
• Severe pain, tenderness, redness or yellow drainage from the incision if you had had a cesarean birth (a small amount of clear, sticky fluid may ooze from the incision, and this is normal).

Your emotional health is just as important as your physical health. As the number one medical complication of pregnancy and childbirth, one in five women suffers from a mood disorder during their pregnancy and postpartum period. Know that you are not alone. Seeking help is the best thing you can do for yourself and your family.