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Postpartum Instructions
Activity
When you arrive home, it would be helpful if you limited your activities to taking care of the baby and delegate household chores, cooking, etc., to others for the first week. Limit trips up and down stairs and do so at a leisurely rate. You should not lift anything heavier than the baby the first week. You will require extra rest during the day for the first two weeks or so; therefore, morning and afternoon naps are suggested. You may resume riding in or driving a car when you feel comfortable.

Bathing
Continue taking sitz baths three times a day for at least the first week. Tub bathing is permissible immediately postpartum if vaginal flow is not excessive.

Bleeding
Postpartum bleeding is called lochia and it can last as little as 2-3 weeks and as long as 6-8 weeks. In the hospital your discharge is bright red and heavy, however, by the time you go home it is usually more like your menses. The flow will continue to slow down once home and the color will go from bright red to pink, and eventually yellow-white. If your discharge turns back to red or increases in flow this is a sign that you are doing too much and need to rest. If you are saturating more than a pad in an hour or experiencing a lot of pain, you should call the office.

Bottle Feeding
A certain amount of breast swelling is natural. We recommend an ace wrap bandage wrapped tightly around the breasts for 24 to 48 hours, until comfortable. You also may apply ice packs to breasts for 20 minutes, three to four times per day, for 24 to 48 hours. Avoid unnecessary direct stimulation of your breasts, such as hot showers, loose clothing and manipulation. Avoid excess intake unless advised otherwise.

Breastfeeding
A firm supportive nursing bra should be worn day and night. Avoid using soap directly on your nipples. Following a breastfeeding session, allow your nipple to air dry. The natural oil glands around the areola will keep the nipples soft and supple. Breast creams are not advised. Frequent feedings of 8 to 12 times in 24 hours help to prevent engorgement. Nipple soreness is expected for the first one to two weeks. If you experience any cracking or bleeding of the nipples, please call the office. Consultation with a lactation specialist available through our office.

Clots
Passing clots during the first two weeks postpartum is not uncommon. They can differ in size from the size of a pea to the size of a golf ball. If you are passing clots larger than golf balls or passing clots after two weeks postpartum, please call the office.

Constipation
Try eating natural foods like prunes, prune juice, apple juice, apple cider, bran flakes or raisin bran. Increase your fluids, especially water. Avoid caffeine (colas, tea, coffee and chocolate). If a laxative is needed, take one ounce of Milk of Magnesia at bedtime.

Diet
A well-balanced diet is necessary for the healing process. For a lactating mother, the normal caloric requirement is 2,000 calories or more per day. Your diet should especially include foods high in protein, such as meat, cheese, dairy products and eggs. Drink plenty of liquids, especially if breastfeeding. Increasing your fluid intake can also help to avoid constipation.

Episiotomy
Your stitches will dissolve on their own. Do not be alarmed by a sticking or pulling sensation in the vaginal area during this time; it is entirely normal. Comfort measures include sitz baths and a sensible and gradual increase in activity. You may take aspirin or Tylenol®, two tablets every three to four hours for discomfort.

Exercises
You may begin exercising when the baby is one week old. If there is any pain with activity, you should stop. If you had a C-Section, avoid exercises involving direct use of the stomach muscles, such as sit-ups, etc., until your 4-week checkup. No running, jogging or aerobics until your 4-week exam.

Hemorrhoids
To minimize discomfort, avoid standing or sitting for long periods of time. Take rest periods whenever possible during the day, lying on your left side with legs elevated on two pillows. Knee/chest position is also relieving and helpful. Do not allow yourself to become constipated. Drink plenty of liquids! Sitz baths will help and Preparation H® or Anusol HC® may be used. Support hose are recommended because they improve and increase circulation.

Menstruation
If your baby is bottle fed, you will probably resume menstruation four to ten weeks from the time of delivery. If you are breastfeeding, you may, but probably will not, have a period 3 months or longer after delivery. The first period may be heavier than your normal flow.

Newborn Questions
Please call your pediatrician for all questions regarding your newborn or go to urgent care/Children’s Hospital for any healthcare concerns.

Postpartum Depression
Your postpartum period may be filled with various different emotions and you will probably have 1-3 days of “Baby Blues”. However, if symptoms last longer than a week or are severe, please call for an appointment to discuss postpartum depression. Also see postpartum depression under pregnancy on our website.

Sexual Activity
Intercourse is not advised for the first four weeks after delivery. After this, the healing may be sufficient and discharge lessened enough to permit comfortable sexual relations. K-Y Jelly or Replens, products sold over the counter, are suggested as a lubricant, since the vagina normally tends to be drier following delivery. Vaginal foam along with condoms should be used as a contraceptive until your four-week exam.

Remember: Breastfeeding is not a form of birth control.

Temperature
Take your temperature once daily in the evening for the first week after delivery. Notify the office if it is 100 degrees or higher.

Vitamins
If breastfeeding, continue taking prenatal vitamins for three months after you have weaned the baby. If bottle feeding, continue taking them for three months after delivery.


WHEN TO CALL
  • If you are saturating more than a pad in an hour or experiencing a lot of pain with postpartum bleeding.
  • If you are passing clots larger than golf balls or passing clots after two weeks postpartum.
  • If symptoms of postpartum depression last longer than a week or are severe.
  • If you experience any cracking or bleeding of the nipples.
 
For general information or questions, please email us. Please note: Clinical questions cannot be answered via email due to the current HIPAA Regulations. Notice: All pages and their content are provided as information only. This is not a substitute for medical care or your doctor's attention. Please seek the advice of your doctor.
Copyright © 2014 Professionals for Women‘ Health.