You’ve just delivered a tiny human that you have been growing for the last 40 weeks (hopefully). You are overjoyed but nervous. What comes next? Postpartum comes next. Our friends always talk about all the beautiful, wonderful things about having a baby and the days after, but what about the things no one really tells you about? To breastfeed or not to breastfeed?Why do my nipples hurt? Where did all this bleeding come from? WHY does my bottom hurt? Will it hurt the first time I have to poop? WHY won’t baby sleep? So. Many. Questions. Hopefully I can help with some of them. Please remember I am not a doctor and I am not offering medical advice. These are my thoughts and my experiences from my postpartum journeys. Your journey will look different and you should ALWAYS consult with your physician when it comes to medications-prescription, over the counter, herbal, etc. This includes medicated sprays for your tush as well as anything you will be putting down there.
Immediately after delivering baby you will likely be encouraged to do skin-to-skin contact. This means baby will have nothing (no diaper, NOTHING) on and will be placed on your bare chest. Typically he only receives a quick wipe but nothing in depth. Baby will still be covered in vernix. Baby may pee and poop on you (my first 2 both pooped on me). Your body heat will help baby regulate his temperature. It can be such a beautiful time. It can also be a little awkward especially if you aren’t prepared for it or don’t even know it’s coming. Ideally, baby will start his first breastfeeding in the first hour if you have chosen to breastfeed. With my 3rd babe I didn’t get to do much skin-to-skin because of breathing issues. I was pretty upset. Little did I know it would be the start of very little skin-to-skin contact. He didn’t end up in the NICU (Neonatal Intensive Care Unit), but he did have to go under what is called triple bank phototherapy due to high bilirubin at 4 hours old. I was devastated, but also knew it was necessary. I had sneaking suspicions that he would end up under phototherapy because he resembled a pumpkin when he was born. Anyway…skin-to-skin contact-Dad can do it too. It is a good way for Dad and baby to bond. I LOVE skin-to-skin and continue it even when I go home with baby. If you have a C-section, a lot of hospitals offer what is called a gently c-section and they still offer skin-to-skin with Mom immediately as long as Mom and baby are safe and doing okay. Check with your hospital on their policies.
If you are in Texas, erythromycin for baby’s eyes is required by the state and vitamin K is highly recommended. Both are typically given within the first hour to 2 hours of birth. Most hospitals in Texas also offer the hepatitis B vaccination. Sometimes it is given with the other medications and sometimes it is given at a later time prior to leaving the hospital. You will need to research and talk with your pediatrician to see if that is something you want baby to have. At 24 hours of life baby should get a newborn screen and bilirubin check. Keep in mind that a newborn screen does require a heel stick. Baby will likely cry, but baby will be okay. I don’t like getting stuck with anything and neither will baby. If the nurse has done a skin check for baby’s bilirubin level and it is elevated, baby will also need to blood drawn for a more accurate check.
If you plan to breastfeed and your hospital has lactation consultants you will likely be on their list to see but I would always ask. Even if you think breastfeeding is going well it’s never a bad idea to have a second set of eyes just to check baby’s latch and to help make sure you are comfortable when breastfeeding. While we are on breastfeeding, your nipples will be a bit tender. This is normal. When feeding baby, there shouldn’t be a constant pinchy feeling or a ton of pain. When baby unlatches, your nipple shouldn’t look like a brand new tube of lipstick, your nipple should still be nice and rounded. If you experience either of the above problems, it is likely that baby isn’t getting a deep enough latch. A lactation consultant can help with this. Depending on your hospital, your nurse may have fairly extensive breastfeeding training and may be a great resource as well. Don’t be afraid to ask. No I am not a lactation consultant. I did mention in a previous post that I was a postpartum nurse. On our unit we did go through in depth training to help our Mamas with breastfeeding and I chose to do a more in depth course because breastfeeding can be so hard for Moms. If you feel like you are struggling with breastfeeding you are not alone! I will move on from breastfeeding although I could probably write 5 million pages on breastfeeding! But one more thing about baby and breastfeeding! As baby gets closer to 24 hours of age, he will likely start to do what is called cluster feeding. This means you will finish feeding baby and he will almost immediately want to go right back to the breast. This does NOT mean you are not producing enough for baby. This is what baby will do. Daily weights while in the hospital will help find how baby is doing on feedings. If weight loss is too much, you may be asked to supplement, but there are different guidelines for breastfed babies vs formula fed babies. Where I deliver, lactation consultants can do a weight prior to breastfeeding and again after baby has fed to get a better idea of how much baby is getting. DON’T rely on what you get from a pump as a way to see how much you are producing. Pumps are not as efficient as baby at getting milk out. Some babies may have a tongue or lip tie that may interfere with breastfeeding. This is something you will need to discuss with the pediatrician as he/she will be able to diagnose that if it is an issue. Keep in mind that while you are feeding baby you may have some very strong cramping. Breastfeeding helps to shrink the uterus back down to size and helps keep it toned. However, it is always best to talk with your nurse and doctor if you are concerned about what you are feeling. While I was a postpartum nurse, I do not give medical advice. Please remember this is just a post about things I found helpful while in the postpartum unit. Okay, really moving on now!
I was lucky enough to have a few friends that were just open and honest with me about pooping after having baby. They each told me that the first time after baby can be scary and painful. I didn’t even think about that! They were not wrong. My doctor and many other doctors offer a stool softener after baby and recommend continuing when you go home. Discuss this with your doctor. The stool softener made things so much better. No it won’t make you poop, it will just make it easier when you need to. With my first baby I didn’t keep up with my stool softener and I thought my EVERYTHING was going to fall out when it was time to go. Y’all it was not fun. With my 2nd and 3rd I kept up with my stool softener. Again, speak with your physician about whether a stool softener is right for you.
My doctor also wrote orders that I was allowed to use witch hazel pads and a special cooling spray for my…lady bits. These were magical! I would do an ice pack with some witch hazel pads on it and spray my bits with the spray, pull up the underwear with ice pack and..ahhh..some of the pain was eased. Again, these were things my doctor ordered for me. This is something you will need to speak with your doctor about to see if it is right for you. I think most hospitals do the ice pack for you, but I don’t guarantee it.
Your doctor may prescribe pain medicine for you. Talk with your doctor about what you feel comfortable with and what he/she thinks is in your best interest. Your doctor knows your medical history and your allergies and can help make the best decision for you and your pain control.
If you didn’t know, after baby you will bleed. It doesn’t go away overnight. You shouldn’t pass large clots. Talk with your nurse and/or doctor on size of clot to be concerned about. Bleeding can last at least 6 weeks but the color should change. Again talk with your nurse and doctor about what is normal.
Another thing to mention is postpartum depression. Everyone talks about how wonderful it is to have a baby. Moms should be happy. Yes having a baby is wonderful but for some women, postpartum depression occurs. It doesn’t mean you have done something wrong or that you should be ashamed. Instead, seek help. Contact your doctor immediately. If you have thoughts of harming yourself, baby, or others, you should always seek help immediately and call 911. Postpartum depression is different from “baby blues” but it is always best to contact your doctor or other qualified healthcare professional to help determine what is going on and what help/options you may need. Keep in mind fathers go through some adjustments as well. While not as common, fathers can also suffer from postpartum depression.
I’m sure I will think of more later and wonder why I didn’t mention it in this post, but for now that’s all I can think of!
