A god friend of mine gave birth in the States recently and was
concerned she wasn't getting the best care from her prenatal team. To help, I
typed up the postpartum counseling I usually do with moms before they go home
with their babies. This is meant as a guide and is not a replacement for visits
or advice from your prenatal care provider.
On to the postpartum part…
Congratulations! You’ve accomplished one of the most intense
amazing things in life – you’ve given birth! Maybe it was exactly the way you
planned, most likely your labor followed it’s own plan, but you made it and
you’re parents! Things to keep in mind in the days and weeks ahead.
The first week
Stay in your jammies. Your job is to snuggle baby, drink plenty of
water, and get good at breast feeding. In pregnancy, many babies are up and
active at night time when mama is trying to sleep. This continues into the
first couple of months! They can’t get on our schedule, so we have to get on
their schedule. Many babies like to eat at night, sometimes they just want to
be near you and stare at you. Try to nap when they do and consider limiting
visitors if you feel like you
aren’t getting any time to rest without visitors around.
Bleeding
Your bleeding should get lighter instead of heavier. You can
expect to have bleeding like a period for 3-6 weeks. Initially, when you get up
to pee, you’ll see the toilet totally red with blood. This will lighten over the
next couple of days. Then, use your bleeding as a guide to activity. If you’re
up and about and your bleeding is getting heavier, take it easy. The general
trend is, it gets lighter over the days and weeks ahead. If it’s suddenly
getting heavier and you’re soaking more than one pad and hour or after the
first day you have clots greater than the size of your fist, call your clinic.
Your discharge should change from bright red like a period to brownish, then
light pink, then just white over the course of the first couple of weeks.
Activity
First week, it’s okay to be up and about the house. Second week,
up and about the neighborhood. If you’re schlepping yourself to Target or
Trader Joe’s those first few days, expect your bleeding to increase and to feel
unusually tired. Instead, order in food, rent some movies, and snuggle.
Breastfeeding
I’m definitely biased toward breastfeeding. While all women are
different, I have cared for moms who have had breast surgeries who have been
able to either partially breastfeed or even fully breastfeed. Those milk ducts
are incredible at regenerating. You just don’t know until you try. So, if you
plan to try…when baby is born, your breasts are not gushing with milk. It is
the early milk, the colostrum that is in there. It is yellow like honey, packed
with sugar and antibodies for baby. There isn’t a lot of it though. If you
squeeze your nipple, you may see a little drop come out. Babies are very
effective at getting the colostrum out. Remember, their tummies are very tiny,
the size of a marble, so they don’t need to be chugging bottles the first
couple of days. If they do, be prepared for baby barf blow-out. Breastfeeding
also causes your body to make the hormone oxytocin AKA the “love hormone”.
Oxytocin is released after orgasm and gives us that afterglow feeling. It also
causes the uterus to contract and decrease bleeding. So, there’s lots of
reasons to try breastfeeding, if nothing else, to get that love potion high.
Typically, after baby drinks the colostrum for about 3 days, your body makes
the white colored milk. There is more volume to this milk (more than just a few
sips). How do you know baby is getting enough to eat? Day one he should poo
once. Day 2 - 2 times, Day 3 – 3 times, and by Day 4, he should poo at least 4
times a day. Also, pay attention to his body language. Often when they start
nursing, their fists are all balled up and they seem frantic at times. As he
eats watch his hands relax, his body slow, his eyes will get this drunken stare
and they usually go to sleep after a good feeding. The first couple of days
babies usually have an erratic feeding schedule. Sometimes they’re not that
interested. They are tired from the birth, they’ve swallowed amniotic fluid and
can have a tummy ache. Typically 24-48hrs after birth they wake up very hungry
and want to eat often. I tell moms you don’t need to wake a sleeping baby to
eat. They will wake you when they are ready. The “feed them every 2 hours” thing
is no longer recommended. If baby goes more than 5 or 6 hours the first week
without eating, unwrap him from his blankets, take off his hat, sit him up so
his eyes are open and he’s looking at you, then try to feed him. Please enlist
the help of a lactation consultant if you need help. You can find one in your
area on lalecheleague.org
Mood changes
After giving birth, your hormones are going to nose dive like PMS
on acid. Combine that with lack of sleep, breastfeeding, body aches, and you
and your partner taking in your role as parents and you’re ripe for some
serious mood changes. Feeling down, teary, and overwhelmed IS NORMAL in the
first 2 weeks of baby’s life. If baby is screaming and you can’t settle him,
just hold him, tell him “mommy loves you, you are okay, I am okay. You’re just
a baby so you’re crying.” Tell your partner to climb in to bed and he/she may
be crying with you: Mom, Dad, Baby, all in tears because you’re all tired and
trying to figure each other out.
There will also be many moments of total awe as you and baby stare
at each other and you realize you love him like nothing else in the world. You
may feel weird being away from him, even if he’s in the other room. Sleeping
with him is fine, most mom’s have a hard time sleeping if baby isn’t right next
to them.
*If at any time during baby’s first year beyond the first 2 weeks,
you start to feel down, blue, depressed, or not like yourself, get seen ASAP
because there are safe medications (safe for breastfeeding moms) to help with
post partum depression. It is easier to treat mild depression than severe
depression.
Vagina what?
Your vagina may be swollen and tender the first few days. If you
had stitches placed, they will dissolve on their own in the first 10days to 2
weeks. You don’t have to do anything special down there. Consider rinsing with
cool water after peeing and in the shower. No need for soaps, creams, or
anything else. It may sting the first few times you pee but should get better.
Your butt will not spit open the first time you poo. Many moms are very afraid
to poo after baby is born. You may feel more comfortable wrapping toilet paper
around your hand and splinting your vagina with your hand as you poo but for
most moms they are worried about it and then they poo and realize it wasn’t so
bad. Make sure you’re eating plenty of fruits, veggies, and drinking tons of
water. This will all help. You can also use over the counter Metamucil 3 times
daily or Colace, a gentle stool softener tablet taken by mouth. You’ll probably
notice that you’re peeing more than usual and even sweating buckets. Your body
is processing all of the extra fluids. The swelling will usually go away as
your body pees and sweats out all that fluid.
Your period: if you’re breastfeeding your period may not return for 4-6 months. If you’re
mixfeeding, your period may return 6-8 weeks after baby comes. It is possible
to become pregnant once you’re period has returned so talk to your midwife or
doctor at your postpartum visit about birth control. If you have Medicaid, you
may be able to get an intrauterine device (IUD). I like these because (I’ve
used two different ones for the past 7 years myself) but the paraguard IUD has
no hormones so it doesn't affect moms who are sensitive to hormones in birth
control pills and the depo provera shot.
Oh yes, the baby
As I alluded to earlier, babies are monsters. The first 3 months
most parents are in survival mode. Mark on your calendar 3 months from when
baby was born, get to there and you’ll be fine. Those first 3 months are like
the fourth trimester. The babies aren’t really full people yet. They eat, the
poop, they pee, the sleep, but they often have kind of a blank stare in their
eyes and they’re just not neurologically developed enough to interact with us
in meaningful ways. Wow, it sounds like I hate babies. I don’t but many parents
have expectations that their baby will be born and they’ll be best friends and
love every moment together when in reality, you, Dad and baby are trying to
figure each other out. There is no “right” way to care for a baby, beyond the
basics. So, Dad will do things his way, you’ll do things your way and the baby
will be happy as long as he’s loved and snuggled. You can’t spoil a baby. But
if he’s ever wailing away and gets that high pitched scream that strikes a
nerve in the crazy-center of your brain it is perfectly fine to put him down in
a safe place and leave the room. You may take a shower, sit in the tub, step
out side, go call a friend, or your mom, or go have a cry. Sometimes everyone needs
a break.
In order to prevent jaundice, try to get the baby in a sunny
window or sitting outside (if it’s warm) for 20 mins a day. If baby is in a
sunny window, as long as its warm inside he can be in his diaper with the light
hitting his skin. This should prevent him from turning yellow and being
re-admitted to the hospital.
Anything else?
You have many days, nights, weeks, and months ahead of incredible
awe, love, and learning. I may sound like I know what I’m talking about, but
you know I don’t yet have kids. Much of the above info comes from mom’s that
I’ve cared for. You will get tons of advice on all topics from breastfeeding to
swaddling, sleeping schedules, to diapering. Take it all in, file it away, some
of it you may call on and find surprisingly useful, some you may never use. Be
confident in your ability to care for baby. Babies need love, that’s about it.
Enjoy the journey. It will be intense, funny, overwhelming with love and fear,
but know in your heart that you and your partner have everything you need to
provide this very lucky baby a great start.
Love,
Jessie
Warning signs
·
Call your clinic if you have a
fever >100.4 on 2 occasions one hour apart
·
If you are soaking more than one
pad an hour for more than one hour
·
If you feel so awful and sad that
you can’t get out of bed or you don’t want to care for baby.
·
If baby has a temperature >100.4
·
If baby appears very yellow
·
If baby is lethargic and you are
unable to fully waken him
Further reading
·
I LOVE LOVE LOVE this book. It is a
memoir that is hilarious, honest, and short. Consider reading it before baby
comes just because you likely won’t have time or energy after: Operating Instructions, A journal of my
son’s first year by Anne Lamott
·
The Baby Book by
Sears and Sears
·
Happiest Baby on the Block by Dr Harvey Karp. You can visit their website at
happiestbaby.com Great tips for soothing cranky babies. If you need the tips,
email me or call me, I can explain some over the phone. I use these on cranky
newborns and the parents look at me like I’m a baby whisperer, they settle so
quickly.
·
Youtube has great videos on
breatfeeding. Search “Breastfeeding latch-on” and prepare for lots of babies
and boobies.
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