The first few post natal days
A new mother may not know how to feed her baby. Though it is a natural process, it will help to have some knowledge beforehand. Watch videos and get help from the nurses and lactation consultants at the hospital.
The conventional method of feeding is by holding the baby on the lap (cross cradle hold). Try this with a nursing pillow so you don't hurt your back leaning over. If this doesn't work, try other feeding positions such as the football hold to fix any latching problems. You never know which way your baby prefers to be held!
Empty one breast completely before shifting to the other side. Breasts should feel light after feeding/pumping.
A few hours after the delivery, the epidural begins to wear off. If you had an episiotomy, you will feel the pain of the stitches setting in. You might also have trouble passing urine and stools. The hospital staff will help empty your bladder. Your doctor will prescribe capsules for external use to induce a bowel movement if you haven't had one a couple of days after delivery.
You will stay in the hospital for 3 days if you had a normal delivery, and for 5 days if you had a C-section. Your temperature and blood pressure will be monitored during your stay and pain killers provided.
The day after your delivery, the hospital offers to help you with getting the birth certificate. Fill in all the information and apply, but wait for the original to arrive in the mail so you can check and order copies after verifying the information is correct. Its better than paying for multiple copies and finding out that all of them are wrong.
Ok, you are back from the hospital, and still tired and recovering.
If your baby is recovering from jaundice, he will need additional tests and pediatrician visits to make sure the jaundice is coming down.
When the milk supply is just beginning to set in on the third day, engorgement can happen. Your breasts could feel hard and painful. Do not press or squeeze the breasts to relieve pain. Use warm compresses (towel dipped in warm water), a hot pack, or a warm diaper carefully to relieve pain and ease milk flow. The pain should subside in a couple of days when the colostrum gives way to milk. During this time, feeding and pumping will be difficult. Try to squeeze some milk out of the aereola to soften it and try latching the baby on and/or pumping.
This too will pass!
Tip: Try to introduce the bottle around the 8th week if you are planning to go back to work soon. Some babies take many months to accept the bottle, if they have been exclusively breastfed.
Post natal care
If you had a long labor, it is very possible that you will have extreme fatigue up to a month after the delivery.
If you had an episiotomy, sit in a tub of warm water mixed with Epsom salt. At frequent intervals, spray warm water on the stitches to relieve the stinging and pain. Change napkins often and keep the area clean and dry to prevent infections.
At your 6th week appointment after delivery, your OB will advise you to do Kegel and abdominal exercises few times a day to strengthen your muscles. Avoid lifting weights for at least 8 weeks after the baby is born. Wait for a couple of months before you resume intercourse.
If you have back problems after delivery (possible if you took an epidural and/or had a long labor), be careful about doing abdominal crunches. Try doing stretches with your hands up instead, or do the plank pose with your knees down. Wearing an abdominal/post-partum belt might help. You can stick an ice pack inside the belt so it won't fall off.
Scary as it may be, sometimes, the epidural needle may break in the spine and cause pain. Get medical help.
It is possible that your back bone alignment has changed due to the pushing during labor; try a good chiropractor to help, and be religious about the exercises he suggests.
General tips: Wear shoes with arch support, bend your knees when you lift something or when you hold your baby, sit straight at right angled poses instead of slouching over, make sure your feet touch the ground when sitting and are not dangling.
Post-natal diet
Eating well (balanced diet) is just as important when breastfeeding as it was during your pregnancy. It is important to stay well hydrated so that the body has enough liquid to make milk and help avoid constipation.
Doctors recommend continuing the multi-vitamin and iron supplements after pregnancy if you are breastfeeding. If you are a vegetarian/vegan, explore options (try other cuisines, you might like it!) for a wealth of healthy recipes.
Try to avoid gas-producing foods such as cabbage, broccoli, cauliflower, etc. If you must include these in your diet, use thymol seeds in your diet as a tea to reduce gas. This will also help the baby have lesser gas through your milk.
Post partum anxiety
There is a sudden drop of hormones after the baby is born as the body tries to get back to normalcy. Mood shifts and sudden crying spells (for no obvious reason) are possible. If this lasts longer and interferes with your ability to function normally or interact with the baby, get professional help.
To handle the emotional roller coaster, try walking, relaxing, taking some time for yourself, sleeping, and resting well. Talk to your friends and family for support.
Your hospital can provide professional counseling help if needed.
Newborn care and the first few months
You are settling down into motherhood. You are not scared of holding the baby anymore and have even mastered the craft of changing diapers! Onto more fun stuff!
Why do babies cry?
Babies cry for three main reasons. The top one being...you guessed it right! Hunger. Check for signs of hunger such as restlessness, pushing the lip out, hand sucking (older kids). Crying is often the last sign.
If the baby is breastfed, she will let go after she has had her fill and sleep in the warmth of her mother's body. If the baby is bottle fed, it is tempting to force her to finish the bottle. Try not to. It might help in preventing obesity, now and later in life.
The second reason why babies cry is when they wet or dirty their diapers. Most babies can't stand the wet feeling. Check and change diapers once every few hours so that the baby doesn't get diaper rashes (you can also apply some diaper rash cream). Try to give the baby some diaper-free time every day. Apply baby moisturizing cream (not lotion, because lotion has water and can dry the skin) to keep the skin moist and prevent eczema.
Babies might cry because the temperature may be too hot or too cold. The general guideline is to dress the baby in as many layers as adults dress. Room temperature shouldn't be too high or too low. Babies might need extra warmth during the first few days after birth. So swaddle them for comfort, or even better, hold them skin-to-skin.
Cover them from head to toe (cap that covers the head and ears, full-handed shirt and pants/onesies, socks).
(Tip: A newborn can be delicate. Open the onesie's neck wide and slide it down the baby's face gently)
Remember, if you were cold, you would just pull over a blanket, or ask your partner to throw over the blanket. Your baby still can't do that. So if your baby won't stop crying in the middle of the night, it is important to be patient and rule out these possibilities.
If the crying still doesn't stop, it could be colic. If the baby is bottle-fed, there are some bottles on the market that claim to reduce colic. Talk to your ped and get help.
If your baby is spitting up, don't worry. Spit ups and hiccups are normal (In many cultures, they are believed to help the baby's lungs grow).
Some bottles help reducing spit-ups. Also, change bottle nipples once every 6 weeks.
There is medication available for spit-ups. If your baby is over four months old, your doctor might suggest mixing rice cereal with milk to help hold the food down. Talk to your ped.
Traveling with baby
From now on, its not, "Honey, I'm hungry. Let's go on a drive and grab something to eat." You have to pack the diaper bag. Make sure you have everything the baby might need. That includes diapers, wipes, baby food or mom :-), spare clothes, bibs, caps, towels, bottles. A pacifier might help calm a baby if other methods don't work. Some believe that prolonged use might lead to protruded teeth. But your baby might just learn to suck her fingers and throw away the pacifier a few months later.
Personally, I wouldn't want to take a newborn to a place with lots of people, especially if the baby hasn't received all the shots, just to reduce the risk of infection. But its a personal choice.
Baby food
In the US, doctors advise parents to not give water to babies as BM contains > 80% water. But in other cultures, it is believed that drinking water expands the stomach, promotes digestion, and creates hunger.
Newborns also need vitamin D supplements as the amount available in mother's milk or formula is not enough. As the baby gets older, you would shift to iron and multi-vitamin supplements.
If your baby is not gaining enough weight, and you are not breastfeeding, talk to your ped about adding formula in mother's milk to squeeze in more calories.
When introducing solids, it is better to avoid cereals with sugar additives and those made from cow's milk. If the child is allergic to cow's milk, these could cause bleeding in the gut. That said, a lot of babies in other cultures are fed cow's milk before one year of age. Note that newborn formula contains soy and is made from an easily digestible, safe version of cow's milk.
Your ped will keep track of the vaccines and shots that your baby should receive. The polio vaccine is made from passive viruses; the body produces antibodies to fight the viruses and these antibodies stay throughout the baby's life, but the virus itself is not capable of causing any harm. Save the vaccination card, it is a very important document.
Baby hygiene
Brush baby's teeth (or gums/tongue) everyday with a clean finger, or with a soft special brush that you can slip on your finger, and no-fluoride toothpaste. This will help prevent yeast infection from leftover milk/formula in mouth. Yeast is normally present wherever moisture and warmth are present. But an infection can be recognized as white patches on the lips/tongue/inside of the mouth that won't go away on wiping. But if the infection is pronounced, the ped might prescribe topical medicine, or in severe cases, antibiotics.
Some babies just don't like taking a bath. Some are too busy to sit in the tub. Make bath time fun using toys.
Give the baby a massage before bath. It is believed that kids grow taller if they are massaged in oil or ghee and if safely hot to warm water is used for bathing.
Often, an elderly lady sits on an elevated surface with her legs stretched out, and the baby is placed on the legs and given a massage and bath. This is believed to prevent any bone deformities.
Bottle-fed babies also tend to be more gassy because of the air in the bottle they inhale (also possible in cases where a nipple shield is used in breastfeeding). Burp them often and feed them after each burp.
Most kids learn to handle the flow of the bottle by the second month. Some don't. It might take longer. Until the baby is ready for a rapid flow nipple, try slow-flow nipples.
Most doctors don't mind parents calling them at off-work hours. If anything worries you, or if you think your baby is sick (stool smells funny, baby throws up, etc.), call your doctor immediately.
Baby Care
There are some things that you will learn in baby care classes. But a lot of it is 'learning-on-the-job'. Small things such as how to hold the baby till she is able to hold her neck, how to bathe the baby (wait till umbilical stub falls off), etc. may be scary to a new mother. If at all possible, try to get family to help or hire a nurse to help with the baby the first couple of weeks after delivery.
Infant CPR
Hopefully, this is a skill we learn to never have to use.
If the baby is in trouble, and the paramedics are on their way, infant CPR can be used to help the baby till assistance arrives. Take these classes at your hospital or any school nearby.
