Life After Birth: Managing the First Few Days
Read this before your baby is born and get your partner/a loved one to read it to you asap after your baby arrives.
Having a new baby is like learning a new job where you’re expected to work 24/7 on limited amounts of broken sleep, with a boss who doesn’t speak your language. Allow yourself at least 4-6 weeks to recover from the birth, to work out your feeding, to get to know your new baby and to work out your new role with your partner and other children if you have them. Your baby will grow quickly so don’t miss out on this special and unique newborn time by trying to do too much.
You are likely to feel tired / upset / overexcited / pain / aching / frustrated / vulnerable / sensitive / moody / calm / add any emotion you can think of here. This is normal. Be kind to yourself.
Rest as much as possible after the birth and use all your energy on recovering, getting to know your baby and working out how to breastfeed.
Conflicting advice from midwives and other caregivers can be upsetting for new mothers who are tired and vulnerable. If you like the advice, use it. If you don’t, thank them and stick to what you’re doing that works. If you are struggling with your breastfeeding and receiving conflicting advice, ask to see the hospital’s head lactation consultant.
If you are unable to sleep due to noise in the hospital or the hormonal high, have a guided relaxation ready on your phone and use headphones to tune out the noise. Go home when you’re ready.
Managing visitors: When you announce your baby’s arrival, be clear on your visitor’s policy. Other people in the room can be disruptive to learning your baby’s feeding cues and supporting good attachment from your baby. Have a code word or signal to indicate to your partner when you’ve had enough of visitors.
Hospital food is usually very basic and generally not healthy. Ask family or friends to bring you the type of food you usually eat which will help to keep your digestion on track. Doing a poo for the first time after birth can be challenging, so keep up your fibre, drink plenty of water and maybe add some psyllium husk and fruit to your cereal. Some women use a stool softener. Hold a pad over your perineum while you go. Ask your midwife for help if you have haemorrhoids which are very common.
Discomfort from caesarean birth: Follow hospital’s advice for recovery which is likely to include: gentle walks to increase circulation, hold your belly to laugh/cough, roll to your side to get up and down, use as much pain relief as you need as you’ll recover more quickly, limit visitors, ask for advice about positions to hold and feed your baby which don’t hurt your wound. Some women choose homeopathics, herbs or ayurvedic supplements to aid with healing.
- Potential issues: Sore nipples, baby won’t feed, baby wants to feed all the time, baby “losing too much weight”, just can’t work it out, getting stressed about it, midwives giving you conflicting advice. Ask to see the hospital’s lactation consultant or contact a private one (https://transformparenting.com.au/resources), who will come to your house. You need consistent and current information. Don’t wait. If your nipples hurt, call an expert asap.
- Another great resource is the Australian Breastfeeding Association. Call 24/7 1800 686 2 686. Yes, even in the middle of the night!
- Colostrum: From 16 weeks of pregnancy your breasts produce Colostrum which your baby will drink from birth and in the first few days. Colostrum is a thick yellow milk, a laxative to clear baby’s gut, and baby’s first vaccination to protect the gut from the outside world. Ensure that your baby receives colostrum in the first few hours after birth and ensure that your breasts are stimulated in the first 1-3 hours by your baby, or if you’re separated, by pumping, to switch on your milk production.
- A newborn baby’s tummy is tiny (size of a marble) and only drinks drops rather than bottles full, but may spend lots of time at your breast in the first few days learning how to attach and suckle and enjoying your cuddles. Your baby’s suckling stimulates your milk to come in so ensure your breasts feel comfortable and that incorrect attachment doesn’t damage your nipples. When your baby stirs from sleep, place your baby skin to skin and offer the breast as often as you can to encourage your breasts to start producing mature milk.
- During night 2, Babies are often unsettled and feed nearly all night which helps your milk to come in. On day 2, rest as much as possible in preparation for this potentially challenging night.
- “Milk coming in”: From birth your baby will be feeding every 1 to 2 to 3 hours and your milk is changing to “mature” milk. This is designed to happen between 30 and 72 hours/3 days after delivery of the placenta. It may take longer if you’ve had a caesarean, an induction or epidural. Just like your body knows how to grow your baby, your baby knows that by feeding often, they can bring your milk in efficiently. This is perfectly normal but can be exhausting and your nipples may become tender. Try expressing a little colostrum or breast milk and rub it in around the nipple and areola. Breast milk is full of antibodies that will help to heal your nipples and it’s FREE, or you can buy some nipple cream.
- If your nipples are damaged: Grazed or cracked or bleeding, ask for guidance from a lactation consultant. They may recommend resting the breast from baby while expressing, using a nipple shield, correcting your attachment. If your baby is struggling to attach they may suggest a supply line. Try laid-back feeding to help baby attach correctly, rather than hunching over your baby.
- Your breasts will grow in size: Sometimes milk comes in gradually and you can feel your breasts filling slowly, however for others, you may will wake up on the morning of day 3 or 4 and feel like your breasts are about to explode. Feed your baby on demand, wake a sleepy baby (ask the midwife how often – it will probably be every 3 hours) and once your baby lets your body know how much milk he or she needs, your body will adjust and milk production will change accordingly. This can take up to six weeks to stabilise.
- If your breasts are engorged: They may feel swollen and sore/achy. Your nipples may be flat making it hard for baby to attach. You could express a little milk while in the shower or place warm flannels on your breasts then express into the cloth (or a bottle if you want to save it). Or look up reverse pressure softening on the ABA website. After the feed put cool cloths on your breasts or use cold packs (the hospital should have some or you can buy them from a chemist).
- All of this can be challenging, and it often coincides with the typical “baby blues” that many mothers experience as their hormones change.
- Babies exposed to drugs during birth or via c-section may be somewhat drowsy and lethargic. This doesn’t mean that breastfeeding won’t be successful, but it can mean that the milk may take a little longer to come in than it would after a vaginal birth. The baby may need some extra encouragement and stimulation in order to stay alert during feedings (ask for idea on how to wake a sleepy baby) but this period of lethargy generally only lasts a short time. You may like to express colostrum to feed to your baby, keep your baby skin to skin and feed often, and stimulate your breasts by expressing to encourage your milk to come in. If you’re concerned, contact a lactation consultant for consistent, useful guidance early. If formula is suggested make sure you understand there’s no other option and that you’re in agreement.
How to Make this Easier:
- If you are emotional and teary or just want to rest and focus on your baby and breastfeeding, ask for no visitors and let yourself cry. Tell your partner about this now so that if it happens, they can comfort you and not think something’s terribly wrong. It will pass.
- Ask for support with your feeding.
- Stay in bed, take care with your baby’s attachment during every feed, have someone bring your meals, drinks and snacks and trust that these intense few days will pass and become easier as you and your baby get the hang of feeding.
- If your breasts are sore, call a lactation consultant immediately rather than wait as they become damaged. It will be well worth it.
- It’s recommended not to give breastfed babies any other teats such as bottles or dummies for the first 4-6 weeks while you establish feeding, as it can cause confusion for the baby who may then refuse your breast. If you must give baby a teat, use one which mimics your breast as closely as possible.
- Make sure that you learn how to hand express before you leave the hospital as it’s an essential skill to have.
Sore Down Below?
- If your perineum stings when you wee, do it in the shower or bath, or squirt water over the area while you wee.
- If you’ve given birth vaginally, had stitches through tearing or an episiotomy, forceps or vacuum delivery you will feel swollen and tender down below. Swelling can cause the stitches to break down before the wound is healed and it is very painful. Ice packs in the first 48 hours can reduce swelling so ask your midwife for them. Some women wet and freeze sanitary napkins or prepare frozen maternity pads and place in underwear.
- Keep the area clean by taking regular showers or salt baths. Just dab the area dry (don’t rub), wear loose fitting undies and baggy pants to let your perineum breathe and heal. Changing pads regularly and having regular perineal washes helps keep the area clean and it will be less likely to become infected.
- Gentle pelvic floor contractions in the day or two following the birth can also help reduce swelling, increase circulation and improve healing.
- Use a peri spray containing essential oils for healing or use frozen maternity pads. These can be made in the final weeks of pregnancy and kept in the freezer so they are ready when needed:
– 1 part alcohol free witch hazel
– 1 part aloe Vera gel
– 3-5 drops lavender essential oil (optional)
– Mix in a small bowl and spray or spread over pads
– Stack saturated pads placing foil or parchment in between so they don’t freeze together. Place stack in a mixing bowl to help them pre-form to a woman’s body (optional).
- Essential oils for perineal healing: Mix 2 drops cypress and 2 drops lavender with ½ teaspoon salt. Add to warm sitz bath / shallow bath. Soak for 10-15 mins and repeat up to 3 times per day.
- It is important to not get constipated after the birth so a diet high in fibre and drinking at least two litres of water a day will help. When you laugh, cough or sneeze hold onto your perineum. Your first poo after birth can feel very challenging so go easy and “breathe it out”. You could use a stool softener.
Going Home from Hospital:
- If you don’t feel ready to leave, insist on staying an extra night to get your feeding worked out.
- Leave hospital early in the day rather than late afternoon when you’re more likely to be tired.
- Arrange it the day prior and continue to remind the hospital staff.
- Sit in the back seat with baby on the way home if you want.
- Don’t have visitors waiting for you.
- Have someone make dinner for you but not stay to chat.
- Don’t start housekeeping: rest or go to bed with your baby.
- Set up a feeding station on a comfy, supportive chair with everything you need within arm’s reach.
Visitors & Guests (advice from those who’ve experienced the best and worst!):
- Depending on your personality and how social you are to begin with, you’ll have different ideas of how many visitors are too many and how soon you want to invite visitors at all.
- You may want to consider a “babymoon” for the first few days or weeks following birth where you minimise visitors and just focus on bonding, rest and recovery, learning to breastfeed, etc.
- The hours, days and weeks after birth are not a time for you to be worrying about entertaining guests. It’s important for you and your partner to discuss your expectations around visitors ahead of time to help prevent any disagreement later on.
- If visitors ask if they can bring something a good answer is always food. If they ask if they can help, say yes and give them a job – maybe emptying the dishwasher or watching baby so you can have a shower.
- Try to agree an appropriate time for visitors to stay between yourself and your partner before they arrive.
- Your needs may change depending on what kind of night you’ve had with baby. You’ll also be surprised how tiring it is entertaining even with well-meaning helpful relatives.
- If you don’t want visitors to hold your baby, put your baby in a wrap or sling and say they’re sleeping or unsettled.
Your rest and recovery is the MOST IMPORTANT THING right now.
I hope this was helpful.
Love to you all, Tracey
Modified from Birth and Baby Village by Karen Shlegeris: Life after birth: Managing the first few days – www.birthandbabyvillage.com.au