Friday, April 22, 2011

Answers to Mothers’ Common Questions about the First 3 Days Postpartum

In our previous post, we shared a study reporting postpartum mothers’ most common concerns in the first days and weeks postpartum. Their questions varied from concerns about their own post-operative care to those about feeding and caring for their infant. In today’s post, we’ll provide some answers to mothers’ most common questions about the first 3 days postpartum. For more detailed information on any of the topics below, please see the reference section at the end of this post.

Post-Operative Care

Whether you’ve had a C-Section or an episiotomy, it’s important to know what to expect from the procedure itself and how to care for the stitches and wounds afterwards. It’s important to breastfeed in a position that is most comfortable for you and doesn’t put pressure on your incision.

Cesarean Section
Wound care of your incision is monitored for redness and infection by your healthcare team while you are in the hospital. You will be encouraged to shower and get up to walk within 24 hours. You will also be prescribed pain medication. It is important that you feel comfortable asking for adjustments to the dosage if you are experiencing changes in pain. Pain management is important for healing and being able to comfortably care for your newborn. Once you are home, you may need someone to help you monitor your incision (from experience, it was difficult to see the incision myself). One last piece of advice from my own experience: place a pillow over the incision (on top of your clothing) because the area will be very tender, especially while holding your baby or adjusting your position.

For episiotomies, wound care begins immediately. You will most likely be prescribed pain medication as well as a topical antibacterial cream for the incision itself. An ice pack will help with pain and inflammation. Sitting in a warm bath with Epson salt (“sitz bath”) 2-3 times per day will cleanse the wound and relieve some of the pain.

Uterine Massage
Uterine massage is important to help deliver the placenta and to aid in uterine contractions. This ensures that the uterus expels all of the excess tissue and returns to its normal size. Most nurses will do this for you while you are in the hospital.

Returning to Your ‘Normal’ Figure

I have to admit I was a little surprised to see this was a concern of mothers in the first few days postpartum! There is so much pressure in our society to conform to the ideal body image that we see in the media. Remember, it took you about 40 weeks to carry your baby to term, and most healthcare professionals say that it will take about 40 weeks or up to 1 year to get back to your pre-pregnancy weight. Pregnancy weight gain not only includes weight from your baby but from body fluids and tissues to support the growth of your baby as well. During the first few days postpartum, you should not push yourself too exercise too hard or too soon. Your body needs time to rest, relax, and heal. If you’re jealous of how svelte stars like Angelina Jolie and Reese Witherspoon manage to look red-carpet ready in just a few months after giving birth – consider this – if you had the money to hire a 24/7 personal trainer, nutritionist, chef, nanny, and buy an unlimited supply of Spanx, then you could look like them too!

Physical Activity in the Postpartum Period
How soon you can begin to exercise after giving birth will largely depend on what kind of shape you were in prior to your pregnancy and your fitness during pregnancy. Most people will say that you can resume activity and exercise “when you feel up to it” but moms recovering from a c-section may be asked to wait until their 6-week check-up before restarting an exercise regimen. For all moms, easy walks up to 30 minutes in length can begin a few days postpartum and you can slowly increase exercise intensity as your body regains strength.

Concerns about Your Baby’s 1st 3 Days

Recognizing Infant Illness
Newborn babies will cry, wake, and need to be fed often! Healthy newborns (after they are cleaned up!) will have warm, pink skin and will try to interact with you. If your baby abruptly changes his behavior – i.e. suddenly begins to cry more often than usual and cannot be consoled or becomes lethargic, this may be a sign of illness or injury. Keep in mind that sometimes a baby’s “good” behavior can be misleading. Babies that sleep all of the time, do not wake to feed consistently, or never cry may not be feeding or growing well. Call your pediatrician immediately. If you swaddle your newborn, it is important to un-swaddle them to change diapers and to monitor their skin tone and color. If you are worried that your baby may be sick, call your doctor or advice nurse.

Newborns have very tiny stomachs so they can only eat very small amounts at a time. So if it seems like your baby wants to eat “all the time” – You’re right, he needs to eat frequently! During the first 3 days, babies should be fed whenever they show hunger cues -which can be up to 12 times per day! (Do keep in mind that cues may be unreadable or conflicting in the early newborn period. For more information about newborn behavior in the first 72 hours, click here. Twelve feedings per day may seem like a lot, but remember that feeding takes practice, so the more you do it during those first few days, the better you and your baby will become at breastfeeding! For more information about breastfeeding after a cesarean section, click here.

Note: Days 4 and 5 postpartum usually have the most feeds. Many mothers then think that they do not have enough breast milk. This is not true! This sudden increase in feeds helps prevent engorgement (from the rapid increase in milk supply around this time) and gives mom and baby lots of practice feeding, right when they need it most.

We hope the answers to these questions provide information to those of you who are new or prenatal moms with similar concerns! Next time we’ll address mothers’ most common concerns in the weeks and months after giving birth.

Cesarean Section:

Uterine Massage:


Postpartum Exercise:

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