Creating a postnatal plan for the health of mom and baby

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This is an article from our “Doctor’s Corner” series, brought to you by Samitivej Hospital. Dr. Yaowaluk Rapeepattana is an obstetrician and gynecologist at Samitivej Sukhumvit hospital. Make sure to read the entire series!

Having a plan for your postnatal care is essential for the health of the mother and baby. Here are some tips for mothers to take care of themselves during the postnatal period while also looking out for any abnormalities that may occur.

Postnatal Plan

1st day after a natural delivery

Daily Routine
If you feel a little dizzy, do not make sudden movements such as when sitting down or standing up. You may also need a helping hand when going to the bathroom. However, if you do not feel dizzy or faint, you can maintain your daily routine as normal.

Relaxation
Spend as much time resting as possible, and try to sleep when the baby is asleep.
Diet: eat easily-digestible, plain food with an emphasis on protein, vitamins, and minerals, and drink plenty of water
Toilet: Try to urinate within 6 hours after the delivery to help the shrinkage of the uterus and to prevent post-delivery hemorrhage. However, there may be no stool to pass today.

Amniotic Fluids
The amniotic fluids will be bright red and come in large amounts. You may need to wear sanitary napkin and change very frequently.

Uterus and Perineum
After the delivery, the uterus is compressed as it returns to normal. This makes the abdomen stiff and causes pain in the abdomen, especially when breastfeeding. To clean the perineum, clean it as you would normally do after going to the bathroom, and dry it before applying a sanitary napkin. If you feel pain in the perineum or it swells, an ice pack may help alleviate the pain or the swelling.

Breast Milk
In most cases, mothers may not be able to produce breast milk on the first day and, in some cases, mothers may produce as little as 25 cc of colostrums per day. The volume of breast milk generally increases with regular feeding. On the first day, the baby will be sleeping most of the time. Breast feeding helps stimulate the production of breast milk and it will continue to be produced as long as it is stimulated. Start breastfeeding the baby as soon as possible. Keep stimulating the production of milk every 2–3 hours to expedite the production of breast milk. Have the baby stay in the same room with you so that the breastfeeding is more convenient.

2nd day after a natural delivery

Daily Routine
You can maintain your daily routine.

Relaxation
Spend as much time resting as possible, and try to sleep when the baby is asleep.

Diet
Eat all five food groups with an emphasis on vegetables and fruits. Drink plenty of water, ginger ale, soybean milk, and soup.

Toilet
Maintain your usual urination habits. The perineum may hurt during bowel movements, but drinking plenty of water, eating fruit and vegetables, doing some exercise can help.

Amniotic Fluids
The amniotic fluids will be red and come in large amounts. You may need to wear sanitary napkin and change very frequently.

Uterus and Perineum
The pain caused by the compression of the uterus will be less and can be assuaged by paracetamol. Clean the perineum as you did on the 1st day. Some mothers may choose the heat lamp for faster recovery of perineum.

Breast Milk
The amount of colostrums produced will increase on the 2nd day. It is important to hold the newborn close the mother’s abdomen, with the chin of the baby close to the mother’s breast. Make sure that the baby’s mouth can cover the base of the breast. Breastfeeding frequently, quickly, and in a proper manner will ensure that you have sufficient milk for the baby and this will prevent you from feeling any pain in the nipple. Holding the baby in skin-to-skin contact will keep the baby awake and ready for feeding.

3rd day after a natural delivery

Daily Routine
You can maintain your daily routine. However, do not lift heavy objects during the first few months. Light and frequent exercise is good for the new mother, but do not swim or immerse yourself in water until your wounds have been healed.

Relaxation
Try to find some free time to rest or nap in the afternoon. Sleep when the baby sleeps because the baby will wake up for breastfeeding 3–4 times at night.

Diet
Avoid strong-tasting and preserved food, alcohol, tea, coffee and carbonated caffeinate beverages. It is advisable to drink malt, water, fruit juice or herbal drinks to freshen yourself up and recover from a state of exhaustion.

Toilet
Maintain your usual urination habits. If your bowels do not move, you may need to take laxatives.

Amniotic Fluids
The amniotic fluids will be bright red, but now in smaller amounts (the color and the amount of the amniotic fluids will become lighter and less in the following days and will stop altogether during the 2nd or 3rd week). You need to wear sanitary napkin and change frequently.

Uterus and Perineum
The uterus will become smaller in size. You may experience flatulence. The perineum will be significantly improved.

Breast Milk
The color of the milk will become white and the amount will increase. If you feel discomfort at the breast, breastfeed more frequently will prevent the breast engorgement. Pumping can potentially increase milk production. Breastfeeding until the last drop is used up will produce even more milk and the baby will take the full fat from the milk, making him or her full and sleep longer. Every time you breastfeed, you should breastfeed from both sides. Breastfeed on each side until your breast feels soft. It takes about 20-30 minutes for each breast.

Looking for a doctor for your postnatal health questions? We recommend:
Yaowaluk RapeepattanaYaowaluk Rapeepattana, M.D.
Obstetrics – Gynecology, Samitivej Hospital
Questions about your pregnancy, child birth or life with an infant? Ask the Doctor!

Care After a C –Section

General Daily Care
In the recovery room after a C-Section, turn yourself over frequently in order to speed up the recovery of the intestine and prevent flatulence. The nurse will measure your blood pressure every 30 minutes for the first few hours. Tell the nurse if you feel queasy or pain from the operation wound so that she will provide you with prescribed medication. You can breastfeed the newborn baby immediately if you are ready.

1st Day after a C-Section
It is recommended to start to move your body as soon as possible by sitting up and standing next to the bed. If you feel dizzy, lay on your bed. You may need help to walk around the room. This is to prevent flatulence, make the intestine start functioning properly again, and speed up your recovery.

2nd Day Onwards
You may be able to sit and stand by yourself. However, you may feel piercing pain from the operation wound. This is very normal. If you cough, use your hand or a pillow to hold the wound. Take a deep breath and hold it, and then cough heavily two–three times to release the phlegm.

Relaxation
Try to get some sleep when the baby falls asleep because you will still be very exhausted as a result of the C-Section and breastfeeding at night.

Diet
You should abstain from eating and drinking. After that, you may have a sip of water and some liquid, clear food (boiled milk-like water and soup) and then full fluid food or congee (served by the hospital). Then you may try easily digestible food or plain food. Avoid milk or carbonated beverages as they will cause flatulence. You should also avoid strong-tasting and preserved food, alcohol, tea, coffer, and carbonated caffeinated beverages.

Toilet
During the 1st and 2nd days, you can urinate through a urinary catheterization. After the urinary catheterization has been removed, you need to urinate within six hours. When you can urinate by yourself, always keep yourself clean. You may not have a bowel movement during the 1st and 2nd days because a rectum enema was performed before the C-Section. If you still do not have a bowel movement on the next day, you are advised to take laxatives.

Amniotic Fluids
You will have amniotic fluids, even though you have undergone a C-Section. The amniotic fluids will be bright red and come in large amounts in the early days of postnatal care. The color will become lighter and the amount smaller. (The amniotic fluids will stop altogether during the 2nd or 3rd week). You may need to wear sanitary napkin and change very frequently.

Uterus and Operation Wound
You will feel pain in the uterus from time to time because of its contraction. The severity of the pain will increase while breastfeeding. The wound will be covered and you need to make sure that it will not be exposed to water. Look out for any abnormalities that may occur, for instance, swelling, turning red, heat, blood leakage or fever.

Breast Milk
As a result of the C-Section and medication, there may be a delay in the production of breast milk. However, this is not a big problem. Here are some useful tips. Start breastfeeding as soon as possible – breastfeeding the baby while still on the operating table will speed up the production of milk. You are advised to breastfeed frequently, every 2-3 hours during the daytime and every 3-4 hours at nighttime in order to speed up the production of milk. After this stage, you can breastfeed the baby as often as the baby needs. The chin of the baby should be close to the mother’s breast and the baby’s mouth should be able to cover the base of the breast. You will hear the sound of the baby swallowing.

Breastfeeding Posture

1st Day after Operation
You can breastfeed while lying on your side. The head of the baby should be at the same level as the breast. Your abdomen should be close to the baby’s stomach, while the chin of the baby should be close to the breast.

The Following days
After you feel able to move comfortably, you may breastfeed in a sitting posture. Hold the baby to your body with his head at your breast and supported by your hand and his back resting on your forearm. This is sometimes called the football hold as your arm will be in a position similar to if it were holding a football under your arm. You may also need a pillow to support your arm. This posture not only helps you breastfeed the baby but also helps avoid contact with the wound.

The Role of the Father in Breastfeeding
The father can give moral support and encourage the mother to breastfeed. The father’s moral support is very valuable as it can encourage the mother to breastfeed as long as the baby needs his or her mother’s milk.

Samitivej, We Care!

For further information, please contact:

Child Health Institute
Samitivej Sukhumvit Hospital
2st Floor, Building 2
Tel: 66 (0) 2711-8236-7
Call Center: 66 (0) 2711-8181
E-mail: info@samitivej.co.th
Facebook: www.facebook.com/samitivej

Photo Credit: f.svehla via Compfight cc

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