Your child birth and first 6 weeks

Bottle Feeding From Birth to 6 Weeks

If you are not breast feeding, our doctors and nurses may prescribe a medication to suppress (or stop) lactation. You can expect some discomfort from your milk 'coming in' on the second or third day. To minimize this discomfort:

• Wear a supportive bra or compression binder if prescribed.
• Apply ice packs to your breasts (crushed ice in a plastic bag works well).
• Minimize stimulation to your breasts (shower spray or sexual activity) as it will only worsen the problem.
• Take a mild pain reliever as prescribed by our doctors and nurses.

Note: The most uncomfortable period usually lasts only about 36 hours.

Contraception Following Your Baby`s Birth Discussion - From Birth to 6 Weeks

There are many myths about pregnancy following childbirth. You may have heard, for example, that new mothers can`t conceive as long as they are breast feeding. Or that you can`t get pregnant until you begin to menstruate. Neither of the myths is true.

There is no set time following your baby`s birth for you to begin ovulating again. You may ovulate as soon as one month after delivery and you could become pregnant as quickly as that first ovulation.

Remember, no woman, including nursing mothers, is naturally protected from becoming pregnant. Some form of contraception must be used from the first time you have sex after the birth of your child, until you are ready to get pregnant again.

The only method of preventing pregnancy that is 100% effective is sexual abstinence (no sexual activity). But, if you choose to be sexually active, many birth control methods are available. Each method works in one or more ways to prevent pregnancy. Either it keeps eggs from being released from the woman`s ovaries each month, it kills the sperm or blocks it from reaching the egg, or it keeps the lining of the uterus from developing fully so the egg cannot implant.

There are a number of things to consider when deciding on the right method for you. How does the method work? How is it used? What are the potential side effects and risks of using it? What is its effectiveness in preventing pregnancy? Are there any additional benefits using it? What is the cost?

If you were satisfied with the method you used before you became pregnant, check with our doctors and nurses to make sure it is still suitable for you. If you weren`t using any contraception previously or you`d like to explore other options, discuss this with your partner and our doctors and nurses. You`ll need to include your partner in the selection of a method and in the responsibility for using it. If one of you is uncomfortable with a particular method, your chances of using it consistently and effectively are reduced.

Both birth control pills and contraceptive implants use hormones similar to those a woman`s body naturally produces. The hormones prevent ovulation so that no egg is released from the ovary each month. Some birth control pills should not be taken while breast feeding, so check with our doctors and nurses.

An IUD is any of a variety of small devices inserted into the uterus by our doctors and nurses. The IUD remains in the uterus preventing fertilization of the egg and/or implantation in the lining of the uterus.

There are a number of ways to prevent sperm from reaching eggs. The diaphragm and condom (rubber) create physical barriers that prevent sperm from travelling into the uterus. Spermicidal creams, gels and foams, and vaginal sponges create a chemical barrier that kills the sperm. If you prefer to use a diaphragm or IUD, our doctors and nurses can fit one for you at your postpartum check-up. If you used a diaphragm before your pregnancy, it may no longer fit properly and you may need a new one.

Natural methods of family planning, also called the rhythm method, rely on periodic abstinence to prevent conception. A woman estimates when she will ovulate by counting days during her cycle and watching for bodily changes such as change in temperature and vaginal discharge, and then avoids having sex around that time. Body changes may be hard to determine for some women. This method cannot be used until you have re-established a regular menstrual period.

Women and men who have completed their family and do not need an easily reversible birth control method may prefer sterilization for preventing pregnancy. Tubal ligation for women and vasectomy for men are surgical procedures and should be considered permanent.

Contraceptive methods vary in effectiveness, from about 80% effectiveness for periodic abstinence and spermicides alone, to approximately 98% effectiveness for IUDs and 99% for the birth control pill when taken as directed. You may, of course, combine methods to improve their overall protection.

Some contraceptives require a prescription from our doctors and nurses. Even methods that do not require a prescription will be more effective if our doctors and nurses help you learn how to use them properly.

Whatever your choice in birth control is, remember there is no one ideal method. There is only the most effective method for you: the one you are able to use exactly as directed and every time you have sex.

Emotional Changes From Birth to 6 Weeks

From the moment you bring your baby home from the hospital, you begin to undergo more life changes than probably ever before. As your baby's life begins, a new life also begins for you. As countless others have told you, 'your life will never be the same again'. As you recover from the physical stress that you have undergone, you will also experience many emotional changes and stresses. It may take several weeks, or even months, to meet the new demands being placed on you. To help you through this time, try to set realistic goals and expectations for yourself.

Postpartum blues may occur a few days or even a few weeks or months after delivery and last anywhere from a few hours to several weeks. As recent as a few years ago, this condition was thought to be a figment of a woman's imagination. But today, health care providers accept the fact that postpartum blues are real. Even though there is varying opinion as to the cause and treatment of postpartum blues, this condition is taken seriously.

Postpartum blues range from a mild form of feeling 'down', to being easily upset and unexplainably sad, to frequent bouts of crying for reasons you may be unable to explain. Other symptoms might include a significant lack of energy, anxiety attacks, headaches, lack of appetite, insomnia, confusion, worrying about your physical appearance and attractiveness, and a totally negative attitude toward your husband or partner. If you experience any of these signs, discuss them with our doctors and nurses.

Some women who sense a loss after birth, and 'empty' feeling and the perception of no longer being the 'centre of attention' experience most serious postpartum depression. You may also feel as if you are actually in mourning for your old self, the confident and carefree way you used to be. This grief is joined by feelings of insecurity and inadequacy in the new role of mother. If the blues are profound and interfere persistently with sleep and appetite, this may be an indication that professional help and counselling is needed.

As you acquire confidence in your new role, learning to manage your time and juggle daily activities, everything will fall into perspective and you will return to your former self. For almost all women, postpartum blues are short lived.

Nursing Positions From Birth to 6 Weeks

This position can be used when you're sitting in bed or in a chair. When sitting up in bed, be sure to prop pillows behind your back for support. If you decide to use a chair, choose one that has a back high enough to support you comfortably. A footstool may be helpful to raise a leg in a supportive position. You don't want to hunch over to feed or look at your baby. Cradle your baby's body in one arm, head resting in the bend of your elbow. The arm that is holding your baby should be supporting your baby's back and buttocks. A pillow across your lap may also be helpful to support your arm and baby.

For this position, you'll need pillow. After you're comfortably seated in a chair or sitting up in bed, place the pillow along your side under your arm on the side you plan to nurse. Place the baby on the pillow with his/her legs toward your back and the head toward your midline. Cradling the head in your hand, bring the baby close to the breast. Your arm should support the upper back. With your other hand, support your breast, fingers below the nipple and thumb above. After the baby has begun rooting, firmly pull the baby close to latch on.

If you're more comfortable lying down while breast feeding, lie on your side using a pillow for support. Place your baby in a side lying position with the mouth parallel to your nipple. And feet toward the foot of the bed. With the baby's head near your breast, lift your breast upward with your fingers and lift it to your baby's mouth. This position works best when you need to rest or when you need to stay in bed after a Caesarean delivery.

Remember: A newborn can only breathe through their nose so be sure not to block the airway. As you breast feed, your baby's nose will be close to or just touching your breast. If the nostrils are blocked, reposition your baby. You may even need to support your breasts during feedings for the first several weeks until your baby is stronger and more efficient at sucking.

Nutrition From Birth to 6 Weeks

Many women do not get enough calcium and iron during pregnancy, as well as throughout their life cycle. Continue to include sources of these nutrients in your diet each day. Calcium can be found in low fat dairy products and dark green vegetables, and iron in lean red meat and enriched breads and grains.

Be sure to get enough vitamin C and protein, these nutrients are involved in the promotion of healing. Vitamin C can be found in citrus fruits, strawberries, cantaloupe, and broccoli. Protein can be found in meat, shellfish, tofu and peanut butter.

You will require additional nutrients if you are breast feeding, including a daily food intake of approximately 500 calories more than you were eating before you became pregnant. Recommended daily servings include the following:

• Protein - 3 to 4 servings.
• Milk and milk products - 4 to 6 servings.
• Vegetables and fruits - 5 to 6 servings.
• Grain products - 6 to 8 servings.
• Fluids - at least six glasses daily.

Physical Facts and Comfort Measures From Birth to 6 Weeks

The first 6 weeks following your delivery is still part of the childbearing cycle. Called the postpartum period, it brings many changes as your body adjusts to a non-pregnant state.

Lochia is the bloody vaginal flow during the first few weeks after delivery. Lochia usually disappears or is just a slight, brownish discharge at about three weeks after delivery. It should not have an offensive odour. Notify our doctors and nurses if:

• There is any increase in the amount of vaginal discharge.
• The discharge changes from brown back to red.
• You have vaginal odour or discomfort.

Following the birth of your baby, your uterus returns to a size close to its pre-pregnancy size through the process of involution. This process takes about six weeks to complete. In the beginning you may experience cramping, or 'after birth pains'. These are usually more severe if you had twins or triplets, if it is your second or third baby, or if you are breast feeding. For relief:

• Keep your bladder empty.
• Take a mild pain reliever as prescribed by our doctors and nurses.
• Perform breathing and relaxation exercises.

If you experience excess perspiration, which is common in the postpartum period:

• Shower often to keep clean and dry.
• Stay well hydrated by drinking water and other fluids.

To relieve perineal discomfort and vulvar / vaginal hematoma (blood filled tissue):

• Take a sit bath and regular warm baths as prescribed by our doctors and nurses.
• Sit on a foam mattress, cushion, or pillow or lie on your side whenever possible.
• Apply an ice pack.
• Use medication as prescribed by our doctors and nurses.

For relief of itching and soreness of haemorrhoids:

• Use a pain relief ointment as prescribed by our doctors and nurses.
• Eat high fibre foods such as fresh fruits, vegetables, and whole grains to prevent constipation.
• Drink plenty of fluids (at least six 8-ounce glasses daily).

For vaginal discharge:

• Change pads every one to three hours and/or each time you empty your bladder.
• Practice good personal hygiene (wipe from front to back after urinating).
• Shower daily.

For relief and prevention of oedema (swelling):

• Wear support hose.
• Avoid crossing your legs when sitting.
• Drink plenty of fluids (at least six 8-ounce glasses daily).
• Elevate your legs when possible.

To prevent or relieve constipation:

• Drink plenty of fluids (at least six 8-ounce glasses daily).
• Eat recommended daily amounts of fresh fruits, raw vegetables, and whole brain or whole grain cereal.
• Use a stool softener or laxative only as prescribed by our doctors and nurses.
• Exercise regularly, after checking with our doctors and nurses.

It is common for newly delivered mothers not to have a bowel movement in the first few days postpartum. If this becomes a problem, notify our doctors and nurses.

Stretch marks (striae) may never go away completely, but they usually change to fine silvery white lines.

Women lose an average of 12 pounds at the time of delivery, representing the weight of the baby, placenta, and amniotic fluid. You may return to your pre-pregnancy weight by the end of your postpartum period or soon thereafter. Appropriate exercise and a healthy diet will play a large part in your weight loss. Do not become overly concerned if it takes you longer to lose the weight gained during your pregnancy.

To avoid fatigue:

• Take naps while your baby is sleeping.
• Establish an early bedtime hour to make up for sleep missed during night time feeding.
• Limit visitors, especially during the first few weeks after delivery.
• Do only light household chores.
• Accept offers for help with cooking, cleaning, and errands.
• Practice relaxation techniques.
• Take time for yourself.

Exercise and other activity.

• Daily activities and household chores can be resumed gradually. For a vaginal delivery perform only very light household chores during the first two weeks, and avoid lifting heavy objects for about six weeks. Talk with our doctors and nurses about activity levels after a Caesarean birth. If you attempt to do too much too early, you may experience an increase in vaginal discharge.
• Unless otherwise recommended by our doctors and nurses, you can usually begin driving within one week if you have delivered vaginally. If you had a Caesarean birth, ask our doctors and nurses for their recommendations.
• If you had a Caesarean birth, shower rather than take a tub bath until there is no risk of infection. Always ask our doctors and nurses for recommendations.
• Resume or initiate exercise gradually. If you had a Caesarean birth, don`t begin exercise until our doctors and nurses recommend it.
• Use an exercise program that promotes muscle tone of your abdomen and pelvic muscles. The pelvic tilt and Kegel exercises you did before delivery work well afterward, too.
• Many hospitals and community centres offer special postpartum exercise classes.

If you are breast feeding, your breasts will become full and tender within two or three days after delivery, as they naturally prepare to supply milk, or lactate. As the colostrum turns to milk, the breasts become larger and fuller. For many women, the condition is noticeable but not bothersome. For others, it may be very uncomfortable and even painful. It is common for the breasts to become swollen and tender, with some women complaining of throbbing and hardening. If your engorgement is severe enough, the nipple may flatten, making it hard for your baby to latch on. The swelling and tenderness will usually start to disappear in one or two days. It`s important to nurse your baby often during this time, in order to relieve the pressure and fullness. Otherwise, the condition may worsen. Breast feeding experts suggest several possible measures to relive the symptoms of breast engorgement and to make you feel more comfortable. You may need to try more than one to see which works best for you:

• Wear a well fitting supportive nursing bra, even during the night.
• Wear cotton nursing pads to protect your clothing from leakage.
• Take warm showers or apply washcloths for soothing relief.
• Nurse frequently, every two or three hours, even if you have to wake your baby. Be sure to use both breasts at each feeding.
• Gently massage your breasts while nursing to encourage the milk to flow and to speed emptying.
• Just before nursing, express a small amount of milk prior to feeding to relieve pressure. This will help your baby to 'latch on'.
• Ice packs may be used to reduce discomfort and internal swelling, apply cold packs to the breast after nursing.

Prolonged engorgement may lead to breast infection (mastitis). The most common symptoms are high fever, chills, fatigue, increasing breast soreness, swelling, warmth, and redness. Prompt medical attention is necessary. If you have any of these symptoms, report them to our doctors and nurses.

Soreness or tenderness of the nipples can occur at any time during the breast feeding period, especially during the first week. If soreness continues, they may become irritated or cracked. There are several comfort measures that may be helpful:

• Apply ice to the nipple just before the baby latches on.
• Begin nursing on the side that is less sore (if there is one), since babies usually nurse more vigorously at the start of a feeding when they are most hungry.
• Restrict nursing time to about ten minutes per side if you are sore during the entire feeding, as shorter, more frequent feedings are easier on the nipples.
• Release the baby`s suction hold carefully before removing the baby from the breast.
• Air-dry the nipples after each feeding. Leave the nipples exposed to the air as much as possible between feedings (especially if your nipples are cracked).
• Use ointments sparingly. Avoid putting any preparation on the tip of the nipple unless cracking is severe. Your nipples are naturally protected and lubricated by sweat glands and skin oils; so let nature do its job.
• Change nursing pads after each nursing and when they become wet.
• Vary your nursing position so a different part of the nipple will be compressed at each feeding.
• Alternate the breast on which your baby nurses first at each feeding. One way to remember this is to pin a safety pin to your bra to remind you which breast to start with at the next feeding.

Sexuality From Birth to 6 Weeks

Our doctors and nurses will provide you with specific guidelines for resuming sexual activity after delivery. For some couples, sexual intimacy returns to its pre-pregnancy level as early as 6 weeks postpartum. It can also return when interest and desire occurs because of an increased sense of femininity or womanliness as a result of the birthing experience. For other couples, fatigue, anxiety, and preoccupation with the baby may affect their relationship for a longer period of time.

Discomfort during sexual activity may result because levels of oestrogen drop after delivery, causing decreased lubrication and a tighter, more sensitive vagina. Vulvar and vaginal tissues may be more sensitive or sore during intercourse or genital manipulation. A water-soluble lubricant can be very helpful with this problem.

Your Postpartum Visit From Birth to 6 Weeks

This visit with our doctors and nurses is usually scheduled within approximately 6 week after a vaginal birth. If you had a Caesarean birth, tubal ligation, or any complication, your first postpartum visit may be scheduled 4 to 6 weeks after delivery. A complete physical exam will be done that will include measurement of blood pressure and weight, urine analysis, breast exam, and pelvic exam. Talk to our doctors and nurses about any emotional changes you may be experiencing, about your contraception options and any other concerns you may have.

Your Body's Change From Birth to 6 Weeks

Your baby has arrived! Your baby has a large head in comparison to his/her body. It may be temporarily misshapen due to the labour and delivery process. The baby usually remains in a curled up position as in your uterus. The skin is dark red to pinkish-red except for hand and feet, which may be slightly blue. Your newborn baby will have strong startle, grasping, and sucking reflexes. As you baby adjusts to its new environment, you may notice quivering, increasing activity during sleep, and gagging at times. Within several days most babies will have good colour and muscle tone, a strong cry, and will sleep and eat well.

The time from delivery of your baby through the next 6 weeks is the 'postpartum period'. Many body changes will continue. You will notice that your abdomen is still enlarged. Your uterus is returning to it pre-pregnancy size (involution), and you may experience cramping (after pains) as it contracts. You will have a vaginal flow (lochia) that decreases over the next few weeks. Your breasts will become full and tender (engorgement) as they prepare to supply milk (lactate). You will experience many emotions during this time due to the many adjustments. Mild depression (postpartum blues) is not uncommon.