- Non-nursing mothers—To avoid engorgement, wear a tight bra (sports bras work well), and avoid any breast stimulation (especially hot shower water pounding on breasts) for week one.
- If you become engorged, placing ice packs or chilled cabbage leaves in your bra may help.
- Nursing mothers—Avoid soap to keep nipples from drying and cracking.
- Wear a well-fitted supportive bra for comfort, if desired.
- After nursing, express colostrum or breast milk, and rub into nipples, then air dry.
- Use moist wound healing techniques for damaged nipple skin such as a modified lanolin cream.
- Check your breasts frequently for swelling, lumps, or warmth, which are early signs of breast infections. Report these to your doctor.
Constipation & Hemorrhoids
- You should have a bowel movement by 2-3 days after delivery.
- Eat a high-fiber diet, and drink 3-4 quarts of fluid each day.
- Get some exercise every day.
- Use stool softeners as directed by your doctor.
- Tucks (witch hazel) pads may be soothing for hemorrhoids.
- Keep Silverlon dressing in place for 1 week. If it falls off before, it is ok to leave off.
- Remove Silverlon dressing at 1 week. There may be Steri-Strips under the dressing; try to leave those in place for another week.
- Keep incision clean and dry—if it is in a fold of skin, lie down after your shower, and expose it to air or blow dry on low until dry.
- Observe incision daily for signs of infection (redness, warmth, discharge, edges separating, etc.). Notify your doctor immediately if you think your incision is infected.
- Activity as directed by your doctor.
Diet, Drugs, & Fluid Intake
- Breastfeeding moms need approximately 500 more calories per day. Diets containing less than 1800 calories are associated with decreased milk supply.
- Eat a healthy, balanced diet from all food groups: a minimum of 3 cups milk, 2 ½ cups vegetables, 2 cups fruit, 6 ounces grain foods, 6 ounces protein foods and a small amount of fat. (www.choosemyplate.gov/pregnancy-breastfeeding.html)
- If you feel that your baby is bothered by a certain food, stop eating the food for at least 3 days and see if it helps. If so, try the food again when your baby is older.
- Drink approximately 12 cups of caffeine-free drinks per day. (Caffeine may keep your baby awake.) Drink enough to keep from being thirsty and to keep your urine pale and not strong smelling.
- Continue to take a prenatal vitamin and mineral supplement.
- Avoid any medications, including over-the-counter medicine, unless approved by your doctor. Acetaminophen (Tylenol, non-aspirin) or ibuprofen (Motrin) may be taken if needed.
- Do not drive if taking prescription pain medications.
- Expect to be unusually emotional the first 1-2 weeks after your baby is born (“baby blues”).
- Signs that you need to get help from your doctor or a counselor:
- Overwhelming feelings of anxiety, depression, or inability to cope.
- “Baby-Blues” lasting more than a couple of weeks making you feel very sad, hopeless, and depressed.
- Excessive talking, worrying, or crying without being able to stop.
- Extreme loss of appetite lasting more than a couple days.
- Inability to rest or sleep despite trying relaxation skills.
- Inability to care for your baby or worries about harming your baby.
It’s OK to increase your activity daily as you can tolerate—walking is best. Listen to your body, and progress at a comfortable rate.
Questions or concerns regarding diastasis (separation of the abdominal muscles), pelvic ring pain, incontinence issues, or regaining abdominal/pelvic floor strength may be addressed by a physical therapist. Please call Pullman Regional Hospital’s Summit Therapy & Health Services: (509) 332-5106 with further questions.
Laceration, Episiotomy, & Perineal Care
- Use squirt bottle each time you use the toilet until your perineal pain is gone and bleeding has stopped.
- Fill it with warm water and spray it over your bottom from front to back. Pat dry gently from front to back to keep germs from the rectum away from your vagina, and to avoid irritating any stitches.
- Tucks (witch hazel compresses), warm compresses, or sitz baths in a very clean tub may be used several times a day to decrease discomfort.
- Look at your stitches daily using a hand mirror, and make sure the edges are together, and there is no redness or discharge. If they are separating or you have intense, persistent pain from them, call your doctor.
- The stitches will dissolve by 2-3 weeks and do not need to be removed.
Rest & Activity
- Rest frequently—nap when baby naps, if possible.
- Walking is fine, but avoid strenuous activity and lifting over 15 lbs. until OK’d by your doctor.
- Avoid tampons and sexual intercourse until OK’d by your doctor, and only when physically comfortable to do so. (Talk with your doctor about prevention of pregnancy —you could become pregnant the first time you have intercourse after delivery.)
Uterus & Lochia (Bleeding)
- Your bleeding will remain bright red for the first 2-3 days, then turn a watery pinkish color for another 2-3 days and will decrease in amount. By the end of the first week, the discharge is usually brownish-white and will last up to 6 weeks.
- Your flow should never have a foul odor.
- Flow will increase with activity, but if you notice bright red bleeding after the first few days, clots larger than a quarter, or you’re soaking a pad more than every 2 hours after the second day, you should lie down. Check the firmness of your uterus—it should be firm as a coconut and be shrinking by about one finger width per day. If heavy bleeding persists for more than 1-2 hours, call your doctor.
- Uterine cramping is normal, especially after your second, third, and subsequent deliveries, or with nursing. Ibuprofen or Tylenol will usually control the pain.
When to Call for Medical Help
Notify your doctor if you have one or more of the following symptoms:
- Temperature over 100.5 degrees (°F).
- Tender or painful breasts with warm, red areas.
- Painful area (hot, swollen, or red) in calf or thigh.
- Pain and burning on urination, or inability to urinate.
- Heavy bleeding (more than 1 pad soaked every 1-2 hours or passing clots larger than a quarter.)
- Bad smell to lochia (vaginal bleeding).
- Vaginal discharge with pain or itching.
- Increasing tenderness or pain in lower abdomen.
- Intense vaginal or pelvic pain.