Sitting around staring at your adorable, dreamy newborn – responding to your baby's every cue and feeling your bond grow and grow. That's what our ideal vision of the postpartum time is, isn't it? Don't worry – I'm not here to shatter that vision. Chances are you already realized that days and nights with a newborn don't always live up to our ideal. Newborns are infamous for not sleeping at night! But what about you postpartum? Nobody talks about that.
Don't get me wrong – the postpartum time with your newborn is wonderful. I love my new baby so much. I try to treasure every moment, even the hard ones. She's my fifth baby and by now I know the truth of the statement “it goes by so quickly.” It's fleeting and for me it's even more precious. I'm probably not going to have many more babies 😉 The newborn period is a treasure for anyone.
But I do believe that you deserve to know challenges that may occur in the postpartum period. I've written a lot about lying in because I believe it helps make the postpartum time easier, but regardless if you choose to lie in or not, there are still some things to be aware of.
If you're a first time mom you probably won't have afterpains… but it's very likely that you will with your second and subsequent baby. I wouldn't say that they get worse after each baby, at least not in my experience. They're just excruciating. Period.
To me, labor and birth are manageable because there's a real purpose – you're going to hold your baby in your arms! But afterpains, why do they have to hurt so much? In reality, there's a purpose for those too. Your uterus is contracting (strongly) to get back to its normal size and keep things sealed up so you don't bleed a lot. But they feel pretty pointless.
I have never taken anything for afterpains, though you may choose to. There are herbal blends that can help, as well as over-the-counter pain relievers (ask your midwife or doctor for recommendations). I found that using my Pink Kit skills really helped with afterpains, especially breathing and consciously relaxing. Having my baby curled up over that area also seemed to help – the gentle weight and warmth of a baby is nice. A heating pad can also be used some.
My midwife with Cassidy, Asher, and Brennan told me that the afterpains are bad for three days… then they're done. I have found this to be true. It's almost like a switch is turned, and after three days they go from being very painful to being slight, and then you don't even notice them. I've always told myself “just three days, just three days.”
Having your milk come in is a wonderful thing – but it can also bring with it something that's not quite so wonderful. Engorgement is when your breasts get so full of milk they feel tight, hard, and uncomfortable. This is most common in the early days when your milk has just come in and your supply hasn't adjusted to your baby. Newborns often have trouble clearing the milk fast enough. If you're still nursing an older child you're lucky – you probably won't have to worry about engorgement because you can just ask them to nurse and clear the milk!
If you don't have an older nursling I would recommend you have at least a simple hand pump around. You can use the pump to remove enough milk to soften your breasts and get some relief, plus it will be easier for your baby to latch on to slightly softer breasts. I really like the Avent breastpump – this newer model is BPA free and has a greatly improved valve system. It's comfortable and effective for me and has provided a lot of relief 🙂
You're going to leak milk – and probably a lot if. Leaking milk is most noticeable in the early days, but will likely continue for several weeks or months. It doesn't sound too bad, and you know that you have a plentiful milk supply. But, well, always leaking milk everywhere gets tiring. You'll probably leak from one side every time your baby nurses on the other. You may also leak if your baby goes awhile without nursing, stops nursing before a breast is emptied, or if anything (such as baby cries) cause your milk to let down.
There are a few things you can do to help with this:
- Nursing pads in your nursing bra or tank can soak up excess milk.
- Put something absorbent up to the side you're not nursing on while you nurse your baby (I recommend a thick prefold diaper!)
- Put a “chux pad” (large disposable waterproof pad) or a washable waterproof mat on your side of the bed. I put mine on top of the sheet so I only have to wash the mat.
- Bring an extra shirt when you go out – this is good in case you leak a lot or in case baby spits up everywhere!
This is another one you may not notice with your first baby, and it tends to become a bigger problem with subsequent babies. This is pain around your stomach muscles/abdominal muscles/belly button area (trying to describe it is hard – but basically around your “six pack” muscles). The pain is caused by weakened and possibly separated muscles. There's a strong band of connective tissue that holds the two sides of your abdominal muscles together, and pregnancy stretches and weakens this. This condition is called diastasis recti. The gap left by pregnancy, or the diastasis, can cause you pain (note that other things, such as obesity can cause this condition, and many common exercises, like crunches/sit-ups aggravate it).
I was surprised by this pain after Honor was born because I never noticed it before. My belly button was tender to the touch and my stomach just felt very weak. If you experience this, have your midwife or doctor check it for you. First, you want to be sure it's not pain caused by your uterus failing to contract properly. Secondly, a knowledgeable midwife or doctor can probably measure the diastasis for you (it's measured in finger-widths).
I found that wearing one of Scott's back support belts helped a lot, because it went all the way around my body and cinched tightly around my tummy. It was bulky, but the bulk was better than the pain. After a couple of days I was able to take it off and my muscles felt stronger… but it was hard to deal with.
I've been doing the Tupler Technique exercises from Julie Tupler's Lose Your Mummy Tummy program since Honor was born to help close my diastasis. You can do the Tupler Technique while you nurse your baby and it makes a big difference in resolving the pain and in shrinking that “mummy tummy!”
You're probably aware that bleeding comes postpartum. This is actually one of the least annoying things about being postpartum, in my opinion… at least in the first few days. It gets old after awhile. Usually postpartum bleeding lasts anywhere from 2-4 weeks. Your bleeding will be shorter if you take it easy and avoid physical and emotional stress.
In the early days remember to take it easy and change your pad frequently. I also found that using cloth pads (often called “mama cloth”) after Honor was born was far, far more comfortable than using disposable pads. Scott helped with the laundry in the first couple of weeks, keeping them washed for me. I'll write more about that experience, including how I made my own mama cloth, in an upcoming post.
A peri-bottle or irrigation bottle really helps in the postpartum time. Fill it with warm water to gently rinse the perineal area each time you go to the bathroom. This will help rinse away blood and urine gently and keep you feeling fresher.
After the first few days the bleeding will taper off dramatically, eventually turning to just pink/brown discharge and then clear 🙂
Using the bathroom can be a challenging experience postpartum. Some women have trouble urinating during and just after birthing, and some women find the first postpartum bowel movement to be challenging. Be sure you're getting plenty of fluids in the first few days – this will help both problems dramatically.
Your body is going to start moving a lot of the extra fluids you needed during pregnancy out as soon as your baby is born, so expect to need to pee frequently and a lot each time for a couple of days. Then you'll find yourself returning (finally!) to your normal pre-pregnancy bathroom trip frequency.
If you're having trouble with constipation again, drink lots of water. Consider a good probiotic supplement as well, and eat foods that you know are easy for you to digest.
You're going to be very, very hungry for the first week or so. You have just done a major job – birthing a baby – and your body is gearing up for another major job – producing breastmilk and nourishing your baby! You will probably feel ravenous and will want to eat larger portions than usual. Of course, having the stomach-squishing baby on the outside also helps your appetite!
I'm six weeks postpartum now and have found that my appetite is just now starting to level off. I still want frequent snacks and big meals, and start to get really grumpy if I get too hungry. Plan to have snacks on hand while you nurse your baby, and eat generous meals that help you feel full. Try not to worry too much about the baby weight right now – you can focus on that once your milk supply is established and you're through these early weeks.
You're going to be tired. You birthed a baby, you're nursing a baby. Your baby needs you around the clock. Do yourself a favor and sleep when your baby sleeps! Get the help you need to be able to do this if at all possible. You will do much, much better and enjoy this time more if you sleep when your baby does, at least in the early weeks. And try to keep up with taking an afternoon nap with your baby even after you're feeling better and are up and about doing more!
Remember that the time really flies in the early weeks, and sometimes they go by in a complete blur. Recognizing some of the things that will happen during this time, and taking the time to make yourself more comfortable (and remembering to take it easy on yourself) really helps. This is a time to treasure and enjoy – accept the challenges and relish the time snuggling your sweet newborn!