Taking Care of Yourself After Childbirth

By Wilkerson, Marciana

After you've had your baby and returned home from the hospital, you are not yet finished with the physical transitions that pregnancy brings. Your body continues to change after delivery. Your breasts fill with milk and your uterus shrinks back to its regular size.

Coping with these changes while you adjust to caring for a new baby can present a challenge. To stay in good health, you need to recognize which symptoms are normal and which require medical attention.

The following are some health issues that you may encounter in the first weeks after childbirth and some suggestions on how to deal with them. Call your doctor if you experience a high fever, severe pain, or any other unusual symptoms.

Breast engorgement

About three to five days after delivery, when your breast milk arrives, you may notice your breasts are hard, sore, and warm. This is a normal part of early lactation and should end in about 24 hours if you are breast-feeding. If you are not, the engorgement may last up to 48 hours, until the body recognizes that it does not need to continue producing breast milk.

  • Apply warm compresses to the breasts to stimulate milk flow.

  • Wear a well-fitting bra for support.

  • If breast-feeding, make sure the baby feeds from each breast, alternately.

  • Although a low-grade fever is normal, see your doctor if your temperature rises above 101 degrees. This could indicate mastitis an infection in the breast tissue.

Breast-feeding

Well-meaning family and friends, aware of the many benefits of breast-feeding, sometimes pressure new mothers to breast-feed. But this may not be the right choice for everyone. Mothers who choose not to breast-feed, or find that they can't, shouldn't feel a sense of guilt or failure. A balanced formula will provide your baby with all the nutrients he or she needs.

If you do breast-feed, it may take a while for both you and the baby to adjust. If you experience feeding problems or are concerned about how well your baby is feeding, do not delay in alerting your pediatrician. The baby could become dehydrated if he or she is not able to get enough milk.

  • If your baby is a slow feeder, rub his or her back, abdomen, and legs to stimulate the rooting reflex.

  • Push aside the part of your breast that covers the baby's nose to make room for him or her to breathe comfortably.

  • To get the baby to turn toward your breast, place your nipple against the baby's cheek.

Mastitis

Mastitis, a bacterial infection that can occur in one or both breasts during breast-feeding, causes pain, tenderness, and swelling. Other symptoms include a temperature above 101 degrees and breasts that are warm and reddish. This occurs most frequently during the first month of breast-feeding.

See your obstetrician if you suspect that you have mastitis. Your doctor may prescribe antibiotics to clear up the infection and will advise you as to whether you can continue breast-feeding. If untreated, mastitis can result in a breast abscess that may require surgical drainage.

Sore nipples

Allowing the baby to begin sucking on the end of the nipple rather than a full latch on the nipple and areola, or pulling the baby away from the nipple while he or she is still sucking, can harm the nipples.

If soreness does not subside as you grow accustomed to breast-feeding, check with your doctor. Cracked nipples can lead to mastitis.

  • Be sure to air dry your nipples after each feeding.

  • If deep cracks develop in the nipples, or if they bleed, see your doctor.

After vaginal delivery

Whether you have an incision or not, the vagina and the perineum (the tissue between the vagina and the anus) will be sore after delivery. Swelling and bruising also are common.

  • In the first 24 hours after delivery, use ice packs to reduce swelling and relieve pain. Then switch to warm compresses.

  • To relieve soreness and promote healing, use a bidet or sitz bath--a small plastic basin that sits atop the toilet--two to three times a day. (The hospital may provide you with a portable sitz bath.) Or, if you have a gooseneck shower attachment, use it to rinse with a low-pressure stream of water.

  • Cleanse after each time you use the toilet. A bidet, sitz bath, or showerhead can serve this purpose.

  • Examine the vagina and perineal area for hematomas, collections of blood caused by bleeding from a ruptured blood vessel. If you detect a discolored bluish or reddish mass under the skin, see your doctor. The hematoma may need to be drained to relieve pressure on surrounding tissues.

  • If you develop a fever above 101.4 degrees, you could have an infection. Call your doctor.

  • Avoid heavy lifting and climbing stairs for the first two weeks after delivery.

  • Avoid sexual intercourse, douching, and tampons until after your postnatal examination six weeks after delivery.

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