Mothercare

A practical guide to keeping moms comfortable in the early weeks

If you don’t feel your best after having a baby, it’s no wonder. Your body is recovering from a birth that was, at the very least, physically taxing. It is turning off the pregnancy changes that have held sway for nine months. And it is turning on your mothering systems — from lactation to that jangly alarm that goes off in your head when your baby cries. Some of these changes are not pretty, but they are pretty impressive.

Vaginal healing
For the first six weeks or so after birth, your uterus sloughs its lining, causing a vaginal discharge called lochia. At first it is like a heavy period, gradually decreasing to a light discharge.

Plain maxi-pads are best, says midwife Kathi Wilson, of Thames Valley Midwives in London, Ont. She advises against products with deodorant or special outer layers, which can irritate or even impede healing. Tampons — which can trigger toxic shock syndrome — are a no-no.

Wilson also tells new moms to play “queen” for the first few days — let others wait on you! “In the first week or so, the bleeding should start to settle down,” she says, but doing too much too soon can delay healing. If your lochia flow suddenly increases, take that as a cue you need to rest a bit more.

Perineal care
If you had a tear or episiotomy during the birth, you will have stitches that can be uncomfortable while they heal. Even without stitches, the area around your vagina (the perineum) may feel bruised and swollen. To speed healing and ease discomfort:

• Keep the area clean with plain soap and water during your regular bath or shower.
• In the first few days, an ice pack can help reduce swelling.
• Allow air to circulate by going without a pad for an hour or so each day. Use old towels to protect your bedding while you lie down for a rest.
• Use a plastic squeeze bottle to gently squirt the perineum with warm water as you urinate. Even a tiny tear may sting when urine touches it.
• Do Kegel exercises (tightening and releasing the vaginal muscles) to speed healing by increasing the flow of blood to the perineum.

A soothing soak
Midwife Kathi Wilson suggests an herbal bath following birth to speed healing. (At the very least, it feels marvellous!)

Her favourite recipe: Take equal parts dried calendula flowers, chamomile, chickweed and plaintain leaves (look in the yellow pages under “Herbal Products” for a retailer near you). Steep in boiling water for 20 to 30 minutes. Add this “tea” to a warm bath with half a cup of sea salt and a cheesecloth bag containing a crushed head of garlic. Mmmm.

Breast discomforts
When your milk “comes in” (usually the second or third day after birth), Mother Nature is often a little overenthusiastic. Many women experience some swelling and tenderness, but the transition will be more comfortable if you feed your baby frequently around the clock, says Gwen Peterek, a nurse and prenatal instructor with Childbirth Educators of London, Ont.

If your breasts become hot and taut, stretching the nipple out of shape and making it hard for the baby to latch on, express a few drops of milk before trying to nurse. (See “Expressing Your Milk” for how-to tips, and “Breastfeeding Basics” for help easing uncomfortably full breasts.) Happily, engorgement is usually short-lived.

If your baby has been asleep for a few hours and your breasts feel full, demand feeding works two ways — Mom can demand, too! If baby’s rooting around in his sleep or sucking on a finger or his fist, there’s a good chance you can get him to latch on and nurse to relieve the pressure of overfull breasts.

In the early weeks, your breasts may also leak when your baby cries, or when you snuggle up to your partner at night. However, this will taper off gradually, and is usually much less noticeable than it feels! Wearing nursing pads and light-coloured tops for the first while should disguise most of the evidence.

Call the doctor if:
• you experience extreme abdominal tenderness, fever or persistent cramping
• your vaginal discharge suddenly becomes bright red and extremely heavy (soaking one large pad in the course of an hour), develops an unpleasant odour or contains clots larger than a 25-cent piece
• you have problems passing urine
• your stitches become extremely tender
• you develop a fever or flu-like symptoms
• you feel dizzy or faint in spite of rest
• you develop a hot, inflamed or red area on your leg that is tender to the touch (sign of a possible blood clot)

Did you know?
Colostrum, the thin liquid your breasts produce before your milk comes in, is low in volume so as not to stress the baby’s kidneys, yet rich in protein, calories, vitamins and minerals, as well as high doses of protective antibodies. It provides everything your baby needs until your milk comes in.
And that’s not all…
Fluid loss: Don’t be surprised if you sweat profusely for a few days, especially at night. You’ll probably need to urinate
frequently during this time, too. Blood volume increases during pregnancy, so now your body needs to rid itself of excess water to get things back to normal.

Toilet time: The first bowel movements after giving birth may not come easily. “Your intestines and stomach have been accustomed to the heavy weight of the uterus. Suddenly that’s gone,” Peterek explains. “So things are going to be a little sluggish for a while.”

Adequate fluids plus high-fibre fruits, vegetables and whole grains are preventative prescriptions against constipation. If the problem persists, try a fibre supplement or prune juice.

These measures are particularly important if you have hemorrhoids (rectal varicose veins). Talk to your caregiver about using a stool softener. After a bowel movement, premoistened hemorrhoid pads clean without irritating, and are easily made with witch hazel and cotton cosmetic pads.

Afterpains: Though it took 38 weeks for your pregnant uterus to grow to the size of a watermelon, it will make the return trip to pear size in only six weeks. It may be a slightly uncomfortable journey, though.

Peterek explains: “A new mom may have afterpains, especially when breastfeeding.” Breastfeeding releases oxytocin, which causes both milk letdown and uterine contractions. These crampy contractions are a sign your body is working properly, and they’re often stronger after second and subsequent births. A pain reliever like acetaminophen can help if you’re very uncomfortable.

Weight loss
For most women the process of toning their tummy muscles and paring off pregnancy pounds takes time. In the early postpartum weeks, concentrate on staying healthy rather than losing weight. Eat nutritious food, get enough rest and gradually return to exercise. Walking with the baby in a sling or stroller is a good way to start.
Fragile feelings
It’s normal to feel a little overwhelmed by the enormity of your new job in the emotional first weeks of parenthood. In fact, all kinds of feelings are normal now: You may be consumed by walk-through-fire love for your baby one minute, and engulfed in despair over never having a moment to call your own the next. Plus there is so much to learn: It’s scary to be in charge of a brand new human being.

Fortunately, babies are resilient little creatures and can thrive despite our inexperience. You and your partner can support each other through this transition with open communication about your feelings and needs. Remember, it takes time to learn how to be a family as well as a couple.

“If this is your first baby, that makes you newborn parents,” says Peterek. Your first steps in this role are bound to feel a little wobbly, and you may need someone to hold your hand at first, but you’ll be up and running soon.
by Wendy Haaf
Survival tips for new moms
• Rest every chance you get. “Really resting for the first week is like money in the bank,” says midwife Kathi Wilson. “If you give yourself time to recover, then you aren’t going to crash and burn six weeks down the road.”

Accept, and ask for, help. Snap up offers of help — and if someone offers help you don’t want, gently suggest an alternative. Most people are pleased to walk the dog or shop for groceries, but may not know what to offer.

Save steps. A “survival kit,” packed with juice boxes, nutritious snacks and other creature comforts stashed near your bed and favourite chair makes it easy to feed yourself while you feed your baby. A change area on every floor of the house, stocked with diapers, wipes and clean clothes will also make life easier.

Find a friend. Other parents can be a great support. If you don’t have a network of friends with babies, find a play group or venture out to a La Leche League meeting or family resource centre.