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New Mom at Home

Mom at home breastfeedingAfter 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 over 100.4 degrees Fahrenheit (38 degrees Celsius), 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 breastfeeding. 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 if you are breastfeeding. Apply cold compresses if not breastfeeding.
  • Wear a well-fitting bra for support.
  • If breastfeeding, make sure the baby feeds from each breast, alternately.
  • Although a low-grade fever is normal, see your doctor if your temperature rises above 100.4 degrees Fahrenheit (38 degrees Celsius). This could indicate mastitis, an infection in the breast tissue.

After vaginal delivery
Whether you have stitches 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 100.4 degrees Fahreinheit (38 degrees Celsius), 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.

Postpartum depression
Sudden and frequent mood swings are to be expected in the first days after you give birth. New mothers not only experience rapid hormonal changes, they are also adjusting to the challenge of motherhood while coping with physical discomforts and lack of sleep. Your spirits should lift as you gain confidence in your ability to care for your new baby.

In rare cases, postpartum depression is more serious. 
  • Try to avoid overtiring yourself. Your moods should stabilize when you are feeling more energetic.
  • Before the delivery, arrange for help from family or friends.
  • If you have suicidal thoughts, or if your depression persists beyond a week, contact your doctor.

Weight loss and dieting
During delivery, you lose the weight of the baby, placenta, and amniotic fluid. Some women lose most of their additional weight in the first two weeks after pregnancy with little effort. Others may need to work at losing the weight. Either way, weight loss should not be an immediate concern.

Maintain a diet (with adequate calories and that is high in nutrition). Your body needs to be well nourished during this transition from pregnancy. If you are breastfeeding, you especially need to eat well to maintain your milk supply.

The cardinal rule for new mothers: Always rest when the baby is sleeping. Take advantage of these opportunities for naps because when the baby is awake, you will be busy feeding and diapering.

Listen to your body's cues about how much activity you can handle. If you feel pain, or if your bleeding increases, slow down.
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Touro Infirmary, 1401 Foucher Street, New Orleans, Louisiana 70115
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