Mother and baby’s care

mother playing with baby

The first six weeks following your baby’s birth is called the postpartum period. These weeks are important as your body recovers after childbirth. Recovery Care Immediately after Delivery During your initial recovery, your blood pressure, heart rate and temperature will be monitored closely for the first two hours. Your fundus, or the top of your uterus, is now found around your belly button and will be checked by your nurse. She will do so by using her hands to feel for the top of your uterus. It is important that your uterus remains firm to decrease the amount of vaginal bleeding during the postpartum period. Sometimes, more medication is needed to keep the uterus firm. Breastfeeding and skin-to-skin contact with your baby also helps the uterus contract and shrink to its pre-pregnancy size. Urinary Catheter If you had a C-section, a urinary catheter will be used to drain your bladder. Typically, it will be removed around 10–12 hours after delivery.

Rest and Activities Adjusting to parenthood takes hard work and all new moms need rest. It takes at least two weeks to recover after delivering a baby vaginally. Recovery will take longer if you had a C-section. Not only is caring for your new baby 24 hours a day emotionally and physically demanding, women do not sleep well late in pregnancy and are further exhausted by the physical work of labor and delivery. Hospital surroundings and routines along with physical discomforts can make it difficult to rest. Excitement and many visitors can also contribute to fatigue. You should try to sleep when your baby sleeps. Ask your nurse about Individualized Quiet Time. When sleep is not possible, relaxation exercises may be helpful. As you recover, let your family and friends help with cooking, laundry and housework. Climb stairs carefully. Do not lift anything heavier than your baby. You may ride in a car in one to two weeks and drive a car in two to three weeks.

Recovery care during the First Four to Six Weeks

After Delivery In the first four to six weeks following your baby’s birth, the changes of pregnancy are gradually reversed as the body begins to return to its non-pregnant state. The amount of time required for this process varies, depending on the type of birth you had and other associated medical conditions. Bathing Showers are usually fine as soon as you are able to walk. Sitz or tub baths are generally safe after the second day. They are soothing to many mothers who have a sore bottom, had an episiotomy or tear or have hemorrhoids. Vaginal douching is not recommended. Discuss this with your doctor at your first postpartum check-up.

The Uterus During pregnancy, the uterus increases approximately 11 times its non-pregnant weight, weighing more than 2 pounds immediately after birth and measuring the size of a grapefruit. It can be felt just below the belly button. During the first six weeks after your baby is born, the uterus will become smaller and return to its normal weight (a mere 2 ounces). As the uterus becomes smaller, “afterbirth pains,” or uterine contractions, usually occur. These pains are more noticeable the first three to four days following birth, particularly for women who have had previous births and during breastfeeding. However, they help shrink the uterus to its pre-pregnant state and reduce blood loss following birth. Relaxing and breathing slowly can help ease the pain. Vaginal Flow / Discharge (Lochia) Whether you deliver your baby vaginally or by C-section, you will have a discharge from your vagina after your baby’s birth. This discharge is called “lochia.” The odor of lochia should not be bad or offensive. Lochia is heavy and bright red for about three days and may contain a few small clots. In a few days, the color will change to a darker color and the amount will decrease. The color gradually changes over the next 10 to 12 days from red to pink; then to brown; and finally to yellow or off-white. The amount of discharge will gradually decrease and then stop over the next two to six weeks. You may experience occasional cramping in the postpartum period. Small clots and brief bleeding may occur. This is normal and should not cause alarm. Lochia is often heavier when you get out of bed. During rest, gravity lets the blood pool in the vagina. However, it is important to notify your healthcare provider if your lochia becomes bright red again; the amount of lochia increases (more than one pad per hour or passing a large clot or several clots); or if there is a foul odor to the discharge.

These may be signs of an underlying problem. Episiotomy Care During delivery, the area around your vagina may have torn or the doctor may have made a small cut to help your baby fit through the birth canal. This tear or cut is called an episiotomy. Your doctor may have placed stitches to help the cut or tear close and heal. If you have stitches, they will dissolve on their own. They do not need to be removed. Your bottom will heal in about four weeks. You may have pain for a longer period of time. To help relieve pain when sitting, sit on a soft pillow or an inflated ring pillow. It is important to keep the area around the episiotomy clean and dry so it does not get infected. Wash your hands before and after caring for your episiotomy and when going to the bathroom. Hemorrhoid Relief To stop hemorrhoids from getting worse, drink a lot of fluid, eat foods that are high in fiber and exercise daily. This will also help you avoid becoming constipated. Sitz baths and/or sitting in a warm bath for 15 to 20 minutes can help relieve hemorrhoids that are sore or swollen. Do this two to three times a day. Likewise, cold compresses can soothe hemorrhoids. Your doctor may also prescribe topical ointments or sprays to help relieve hemorrhoids. A stool softener may also be beneficial at times. Severe pain from hemorrhoids can cause constipation. Be sure to talk to your healthcare provider if this is a concern for you. 5 Breast Changes to Expect Once your baby is born and the placenta is delivered, hormones make the alveoli produce milk. Additional blood and lymph fluid also go to the breasts to help produce milk. Some women will notice drops of fluid on the nipple during pregnancy, called colostrum. This thick, golden fluid is also called the “pre-milk,” “first milk,” or “liquid gold.”

Menstrual Cycle

Following the birth of your baby, your first menstrual period may be delayed if you are breastfeeding. Most women will experience their first period within seven to nine weeks after birth. However, breastfeeding mothers frequently resume menstrual periods by 12 weeks, but some do not until they have completed breastfeeding. Usually, the first period after your baby’s birth will have a heavier flow and last longer than usual. Menstrual periods may not be regular for several months. Avoid tampons for 4-6 weeks or until cleared by doctor.

Bowel Movements

After delivery, many women have trouble having or cannot have a bowel movement. This is called constipation. Hormones, medications, dehydration, perineal pain and decreased physical activity may slow down your bowel function. The first bowel movement usually occurs within two to three days following your delivery. Temporary constipation is not harmful, although it can cause a feeling of fullness and gas. Progressive daily exercise (such as walking) and eating right will help prevent constipation. Your daily diet should include six to eight glasses of fluids (not soft drinks) and dietary fiber — including fresh vegetables, fruits and whole grain breads, cereals and pastas. While in the hospital, you will be given medication to help stool move through the body more easily. You will be instructed to continue the medication at home, as needed.

Sexual Relations

You should not have sexual intercourse until after you receive your doctor’s approval at your checkup in four to six weeks. You may not be as interested in having sex as you were before pregnancy because of fatigue and the demands of caring for your new baby. You may also have concerns about discomfort if you had a tear, episiotomy or a C-section. Discuss your concerns about resuming sex with your partner so there will be minimal frustrations and misunderstandings. You may have pain during sexual intercourse for several weeks. Vaginal dryness and decreased vaginal lubrication may also occur due to hormone changes. If you experience difficulty with sexual intercourse, always discuss it with your partner. Set aside free time for each other a few times each week to become “reacquainted.” If the problem persists, then discuss it with your doctor. Remember, you can become pregnant any time after the birth of your baby, even if your menstrual periods have not returned and you are breastfeeding. You may wish to talk about birth control with your doctor before you begin sexual activity again.

Hormones

It may take a while for your hormones to normalize. Be patient, take good care of yourself, and talk to your doctor if you have any questions about these changes. 8 Muscles and Joints You may feel muscle aches and fatigue — particularly in your shoulders, neck and arms — in the first one to two days following delivery. This is a result of the physical exertion during labor. Many women, expecting the abdominal wall muscles to return to pre-pregnancy condition immediately after birth, are discouraged to find their muscles weak and lacking tone. The abdominal muscles may actually separate with a bulge between them. Ask your doctor about an exercise program that can help and when you can safely begin exercising. Skin Changes Many skin changes that developed during pregnancy are caused by an increase in hormones. The blotchy appearance of the face and “dark line” of the lower abdomen disappear gradually over several months after childbirth. Weight Loss You will likely lose a significant amount of weight immediately after delivery; however, it may take some time to return to your pre-pregnancy weight. As your body’s fluid levels return to normal, more weight loss should occur. Talk to your doctor about healthy exercises and nutrition programs.

Postpartum Check-up

Unless otherwise directed, your doctor will want to see you for a postpartum check-up within two to six weeks. Call your doctor’s office after you get home to make an appointment. Discharge Medications If you have any questions about your medicine after you are discharged, call your doctor. Discuss all medications with your doctor before you take them. This includes any medicine that has been prescribed by any doctor and medicine you buy over the counter. Don’t forget to mention your birth control. Your doctor also needs to know if you take any diet or nutrition supplements, herbs, vitamins or alternative or complementary medicine. This is especially important if you are breastfeeding. Keep taking your prenatal vitamins until your doctor tells you to stop. Discuss any concerns with your doctor so that he may advise you of the safety of taking medications while breastfeeding.

Find your Balance between food and physical activity

General recommendations:

  • Be sure to stay within your recommended daily calorie needs.
  • Eat a well-balanced diet that includes a variety of whole grains, fruits, vegetables, protein and dairy.
  • Drink 8 to 12 (8-ounce) glasses of water every day.
  • Avoid oversized portions.
  • Reduce your daily salt/sodium intake.

This is especially important for African-Americans and anyone with high blood pressure or chronic kidney disease.

  • Limit your intake of simple or refined sugars, such as cakes, pies, candies, table sugars and sugary drinks such as sodas, fruit punch, or cocktails. Water is the best choice.
  • Choose healthy fats and oils such as Omega-3, monounsaturated and polyunsaturated fats.
  • Avoid saturated fats, Tran’s fats and synthetic trans fats. Tran’s fatty acids can be found in vegetable shortenings and partially hydrogenated oils.
  • Engage in 10 to 15 minutes of mild physical activity each day to help get back “in shape”.

Diet and Nutrition

Eat properly to help your body heal. Eating a variety of foods will help you get all of the nutrients your body needs to be healthy and recover after your baby’s birth. To prevent dehydration and promote healing, drink to satisfy your thirst, which should be about 8 to 12 (8-ounce) glasses of water every day. You may lose up to 20 pounds fairly easily in the postpartum period. More weight loss will be easier with moderate exercise and a smart eating program. If you are breastfeeding, refer to the dietary recommendations in the Nutrition for Breastfeeding section of Woman’s Breastfeeding Guide. You may also call Woman’s Food and Nutrition Services at 225-924-8451 for more information. As a general recommendation, breastfeeding mothers need extra fluid, calories, protein and calcium. Calcium and protein can be supplied by milk and other dairy products including yogurt, ice cream, cottage cheese and other cheeses. You should avoid tobacco; alcohol and non-essential medications while breastfeeding

Baby care

Fingernails Babies are born with fingernails that are paper-thin and sharp. Do not cut or bite your baby’s nails. It is very difficult to tell where the nail ends and the skin starts when using baby clippers or scissors. This makes it easy to accidently cut the skin, causing pain and bleeding. You may use an emery board to file the nails about once a week. Your baby’s doctor can instruct you about when it is safe to cut your baby’s nails. Ear Care Use a washcloth, not cotton swabs or Q-tips, to clean your baby’s ears. Never insert a cotton swab into the ear canal. Sneezing Newborns sneeze frequently to clear nasal passages. This is normal. Hiccups during or after eating, your baby may hiccup. This is normal and will soon stop. There is no cause for concern. Bulb Syringe A bulb syringe is used to remove, or suction, fluid (such as milk or mucus) from your baby’s mouth or nose. You may use it when your baby spits up, chokes, sneezes or has a runny nose. For the first few days of life, your baby may have excess mucus that may cause gagging. We suggest you keep a bulb syringe close to your baby, especially during feedings, and use it when necessary. If you need to suction both the nose and the mouth, always suction the mouth first. To help your baby when he gags, turn your baby on his side and firmly pat the back. If gagging continues, you may need to use the bulb syringe.

Protecting Your Baby against Disease: Immunizations

Immunizations are an effective way to produce disease-fighting substances called antibodies. Children are susceptible to nine very dangerous diseases that can be prevented by vaccines. Your child is most vulnerable to diseases when very young, so immunization should start early. Your child should receive immunizations at birth, 2 months, 4 months, 6 months, 12 months, 15 to 18 months, 4 to 6 years, and then as a teen.

Screening Tests

As required by Louisiana state law, a number of screening tests are routinely performed on newborn babies. Some will be done while your baby is in the hospital; others are done in the doctor’s office during a checkup. These tests can give information about certain conditions or diseases. If test results are not normal, your doctor will talk to you about this and discuss what needs to be done. Hearing Screen Hearing loss is the most common congenital disorder in newborns. Therefore, it is recommended that all newborns be screened for hearing. If hearing loss is not caught early, then there will be a lack of stimulation of the brain’s hearing center. This can delay speech and other development in your newborn.

Skin-to-Skin Care Promotes

Nurturing and Bonding

One special benefit of skin-to-skin care is the bonding that takes place between mother and baby. Your baby can feel your warmth and hear your heartbeat and breathing while held skin-to-skin with you. In addition, skin to-skin care fosters frequent eye contact and voice recognition and can be a special time for both your baby and you.

Home Temperature

The American Academy of Pediatrics recommends keeping your home temperature between 68°F and 72°F. Do not place your baby under fans or near drafts. Signs that the house may be too cool and/or your baby is underdressed may be coldness to touch, pale appearance or a mottled-blue appearance of your baby’s hands and feet. Take your baby outdoors for only short periods of time and never leave your baby unprotected in direct sun.

Dressing Your Baby

Dress your baby according to the weather. Comfortable clothing and socks are important. In cool weather:

  • Wrap your baby in a light blanket
  • Cover your baby’s head with a cap or the blanket
  • Leave your baby’s face uncovered and visible Common Infant Conditions A few common conditions are often seen in young babies. These conditions include cradle cap, colds and thrush. Because babies are usually not treated the same as children or adults, talk with your baby’s doctor about ways to treat these common problems.

Toys

Choose toys that are too large to swallow, too tough to break, have no small breakable parts and no sharp points or edges. Toys should be at least 1¼ inches by 2¼ inches around until your baby is 3 years old. Toys should not have buttons, heads or objects on them that can be pulled off. Don’t Forget “Tummy Time” Place babies on their stomachs when they are awake and when someone is watching. This will help your baby gain normal strength in his head, neck and upper body. This also helps prevent flat spots on the back of your baby’s head.

Household  

Plastic bags should not be placed on your baby’s mattress or pillow.

  • Keep plastic bags in a place that your baby cannot reach.
  • Never leave your baby alone with young children or animals.
  • Never place your baby on a waterbed.
  • Do not pour hot liquids when your baby is close by.
  • Do not allow your baby to stay in the sun for more than a few minutes.
  • Do not leave your baby in a parked car.
  • Wash flame-retardant clothing according to the label directions.
  • Do not leave medications within your baby’s reach? Use a medicine box with a safety lock.
  • Store cleaning products out of your baby’s reach.
  • Get rid of any houseplants that could be poisonous.

Further reading

  1. Alexander-Roberts, C. (1994). ADHD Parenting Handbook. Dallas, TX: Taylor Publishing.
  2. Allen, J.V. (1985). What Do I Do When? Impact Publishers: San Luis Obispo, CA.
  3. Barkley, R. A. and Benton, C. M. (1998). Your Defiant Child. The Guilford Press: New York.
  4. Becker, W. C. (1971). Parents Are Teachers. Research Press: Champaign, IL.
  5. Benett, S.R. (1992). 365 TV-Free Activities You Can Do With Your Child. Holbrook, MA: Bob Adams, Inc.
  6. Berne, P.H. and Savary, L.M. (1996) Building Self Esteem in Children. New York, NY: Crossword Publishing Co.
  7. Christophersen, E.R. (1990). Beyond Discipline. Independence, MO: Independent Press
  8. Clark, L. (1985) SOS Help for Parents. Parents Press: Bowling Green, KY.
  9. Davis, L. and Keyser, J. (1997) Becoming the Parent You Want to Be. New York, NY: Broadway Books.
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