Resources for New Mothers

Postpartum Instructions

Schedule your postpartum visit six weeks after your delivery, or if you have any questions or concerns after delivery. Call your physician if you have any of the following symptoms, which could mean you have an infection and require immediate treatment:

• A flu-like feeling, fever >100.4 F or chills
• Foul-smelling discharge or unusual abdominal tenderness
• Red or tender breasts
• Extreme tenderness in the area of your stitches or vagina
• Tenderness of your pubic bone accompanied by frequency, urgency and burning with urination

Postpartum recovery

The following guidelines will help both you and your baby have a healthy and happy postpartum recovery.

Vaginal bleeding

Your bleeding after delivery will resemble a period but will be heavier at times, especially the first one to two weeks. Use pads instead of tampons during this time and do not have sexual intercourse. Activity or breastfeeding/pumping may increase bleeding at times. You may notice small clots, but they should never be larger than an egg. The color of the bleeding will change from red to brown and then from yellow to clear. You may continue to bleed for the full six weeks, but it should decrease over time. Call your physician immediately if you are saturating a pad hourly or heavy bleeding suddenly restarts after weeks of slowing.

Urination

Listen to your body. Increase activity as tolerated, and rest or modify activity as needed for pain/fatigue. After vaginal delivery, you may get back to exercise after 3-4 weeks but discuss with your doctor when you feel ready. If you had a C-section, you may need to wait 6 weeks before exercising but light exercise such as walking and stretching is encouraged when able. You may drive once you are off narcotic painkillers and feel able to slam on breaks in an emergency. This is usually 1-2 weeks postpartum, maybe longer if you had a C-section.trouble urinating, use the peri bottle to spray the area with warm water. Call your physician if you are unable to empty your bladder.

Bowel movements

It may take up to a week to resume normal bowel activity. Eat foods that promote a soft stool, such as raw fruits, vegetables, bran and plenty of fluids. Call your physician if you have not passed a bowel movement by the fourth day.

Pain management

Over the counter Ibuprofen (do not exceed 800 mg every 8 hours) or Tylenol^® (do not exceed 1000 mg every 8 hours) are usually enough for pain management. You should wean off the medication when you are able. Prescription pain medication may be given on an individual basis and you may discuss dosing with your physician.

Rest

Focus on self and baby during this time. Do not expect too much of yourself. You will not be able to “jump” back in to your usual routine. Get plenty of rest for the first few weeks. Take naps when your baby is sleeping. Get help with general household duties if possible. Limit visitors to family and close friends, and make sure hand washing occurs before visits with baby.

Activity

Listen to your body. Increase activity as tolerated, and rest or modify activity as needed for pain/fatigue. After vaginal delivery, you may get back to exercise after three to four weeks but discuss with your doctor when you feel ready. If you had a C-section, you may need to wait six weeks before exercising but light exercise such as walking and stretching is encouraged when able. You may drive once you are off narcotic painkillers and feel able to slam on breaks in an emergency. This is usually one to two weeks postpartum, maybe longer if you had a C-section.

Nutrition

A good diet is the best way to help your body recover. Eat a balanced diet with plenty of fruits, vegetables, protein, healthy fats and whole grains. Minimize processed foods and added sugars. Drink plenty of water daily as it is essential for healing and maintaining an adequate supply of breast milk.

Bathing

You may take baths but do not use any bubble baths, soaps, salts or oils. If you have had a cesarean section, it is important to keep your incision site clean. You should pat the area gently and keep it dry after showering.

Breast care

Ensure that baby has a good latch with feedings and get as much of the areola in the baby’s mouth as possible. Loosen the suction from your breast with your finger when stopping a feeding to avoid undue traction on the breast. It will take a few weeks for you and baby to adjust to each other. Your breasts may feel very full at these times. This is called engorgement and can be relieved with warm packs or a warm shower followed by feeding your baby or pumping. Cold cabbage leaves in your bra may also relieve this sensation. If you feel a lump, massage it towards the nipple during feedings. If a breast lump persists, hurts, becomes red or your nipples become sore or cracked, call your physician.

Stitches and hemorrhoids

Soothe stitches or relieve hemorrhoids with a warm bath in plain water several times a day. You can also use cold packs or make your own with a damp wash cloth in a freezer bag that you refrigerate throughout the day. Spray analgesics and Tucks pads can also be helpful. Try refrigerating the Tucks pads for extra comfort. Use Preparation H cream or suppositories as needed for hemorrhoids. Avoid constipation and straining by following a healthy diet. Don’t be alarmed if you see loose stitches on your pad or in the toilet. Stitches are normally absorbed or loosen as you heal. Your stitches will dissolve and do not need to be removed in the office.

Intercourse

We encourage you to wait until after your six-week postpartum visit before you have sex. Most women may resume intercourse when the vaginal area feels comfortable and the stitches have healed. Gentleness and additional lubrication may be needed for comfort initially. Please contact your physician if you have persistent pain or problems.

Birth control

Breastfeeding does not prevent you from ovulating. A new mother can become pregnant again soon after giving birth, even if she's breastfeeding. Use birth control to prevent pregnancy any time after delivery. Oral contraceptives must be used consistently for one week to protect you from pregnancy. Use condoms if you have not completed at least two weeks of pills before resuming intercourse. We encourage you to wait one year between pregnancies to allow your body to recuperate and replenish vitamin stores.

Postpartum depression support

Being a new mother is a time of major change, and many new moms experience a wide range of emotions during the first several weeks after childbirth. In fact, up to 20 percent of women (and even some men) will experience a more intense case of baby blues, known as postpartum depression. Symptoms can surface between three weeks and one year after delivery. Symptoms can include sadness, anxiety, irritability, insomnia, difficulty bonding with baby, unwanted thoughts, loss of appetite and more. Learn more about postpartum depression.

If you feel overwhelmed by negative feelings during this time, please talk to a healthcare professional. Treatment may include medication, counseling and increased social support through hospital and community groups.

Postpartum depression is not a lifelong condition. It's a short-term, serious condition that your physician can help you manage.

Care of baby

Taking your baby home is exciting, but sometimes a bit overwhelming. The following is a list of helpful information for mothers to care for their newborn.

Umbilical cord

Letting the cord air dry will encourage it to fall off sooner. Fold diapers down to expose the area to air and avoid contamination from wet diapers. The cord site may bleed slightly when it falls off. Call your pediatrician if there is substantial bleeding or redness on the skin or around the base of the cord.

Feedings

Feeding your baby on demand is a wonderful way to help your baby learn to regulate food intake. When breastfeeding, keep in mind that the more frequently the baby sucks, the more your milk supply will be stimulated. Feedings should occur two to three hours apart with no more than one four-hour stretch between feedings in a 24-hour period. Ideally, nursing or feeding sessions should take 20 to 30 minutes.

Burping

Generally, the best position for burping is to hold your baby in an upright position while he or she sits on your lap or on your chest. Rubbing or gently tapping the back may produce a burp. Some babies are more comfortable after burping, others don’t seem to mind not burping. Get to know your baby’s preferences. Newborns often spit up one ounce or less after feedings. Call your pediatrician if baby is vomiting large amounts or has projectile vomiting.

Elimination

Wet diapers are a good indicator that your baby is hydrated and getting enough breast milk or formula. Once baby is eating adequately, six to eight wet diapers per day is normal. The first stool has a sticky black tar appearance and is called meconium. Stools will then change to green and then yellow. Stools are looser and more frequent with breastfed babies. They will look yellow and seedy. Formula-fed infants will have more formed yellow stools. Initially, baby will have three to five bowel movements each day. As your baby gets older, their bowel routines will vary.

Sleeping

Place your newborn on his or her back on a firm sleeping surface. This position is advised to prevent Sudden Infant Death Syndrome (SIDS). Newborns generally sleep in two- to three-hour intervals. Many infants will begin to sleep through the night by eight weeks of age.