Post-Partum Instructions/Office VisitCongratulations on the birth of your new baby! We at Grand Rapid's Women's Health would like to provide you with some information that may prove helpful once you have been discharged from the hospital. Activity: Don't be surprised if you are not feeling 100% on your first day home. You will gradually notice an increase in your stamina with each passing day. It usually takes around six weeks after delivery for your body to return to normal. You should increase your activity gradually each day. You should be able to resume a light exercise schedule within two to three weeks. Avoid abdominal exercises until you have been seen for your six week postpartum visit. Diet: Now that you are no longer pregnant, you can be a little more liberal with your dietary choices. Nursing mothers must remember that nursing is more of a nutritional demand than pregnancy and as such, you must be careful not to skip meals. You should also increase the amount of fluids in your diet to ensure an adequate milk supply. You should try to drink 8-10 glasses of water a day. Keep in mind that foods that you eat will end up in the breastmilk usually within two to four hours. This way you can keep track of foods in your diet that may affect either the taste of your breast milk or that tend to make your baby colicky. A good rule of thumb is foods that tend to give you gas will also do the same to your baby. We recommend you continue the prenatal vitamins while nursing. Medications: You may take Tylenol or Ibuprofen as needed for pain. Occasionally, over the counter medications may not be sufficient for pain relief. You may ask your physician to provide you with a written prescription for stronger medication. Perineal Care / Stitches: It is very common to feel sore and bruised in the vaginal, perineal, and rectal areas after delivery. If you have had stitches, these will dissolve gradually and do not need to be removed. It is important to keep the perineal area as clean as possible. After either urination or bowel movement, the area should be rinsed with warm water and gently dried. You may use sitz baths for relief from discomfort (sit in a bath of 6-8 inches of warm water for 15-20 minutes, may repeat 2-3 times a day, may add Epsom salts to the water). You may use a topical anesthetic spray such as Dermoplast for additional relief. Always change peri-pad after using the restroom. Incisional Care After Cesarean: If you had staples placed after the cesarean section, the staples will be removed prior to your discharge from the hospital. If you had stitches placed at the incision site instead, the stitches will dissolve and do not have to be removed. You may remove the steri-strips (small adhesive strips placed on the skin) in a week if they have not fallen off on their own. You may shower with steri-strips in place. Keep the incision site clean and dry. Call the office if you notice any increased redness, increased pain, or pus-like drainage from the incision site. Breast Care for Nursing Mothers: Wear a good supportive bra. Discuss with your pediatrician issues such as adequacy of the newborn's intake, supplementing with formula, or use of medications while breastfeeding. Call us if you have any problems with breastfeeding such as cracked or bleeding nipples. Localized breast tenderness or localized breast induration or redness associated with a fever may be a sign of mastitis. Please inform your physician. Breast Care for Non-Nursing Mothers: If you are not breastfeeding, we recommend wearing a firm bra and avoiding any stimulation to your breasts. Call us if you have any localized tenderness, redness, or fever. Vaginal Bleeding: You will have vaginal bleeding for two to six weeks. The flow will gradually decrease in amount and darken in color. You should use nothing in the vagina for six weeks. Please use pads instead of tampons, do not douche and please abstain from intercourse until the bleeding stops. Constipation / Gas Pain: Try increasing your fluid intake and your intake of fresh fruits and vegetables. Mild laxatives such as Metamucil, Dulcolax, and Pericolace may be taken as directed. For gas, you make take Gas X (Simethicone 40-80 mg.) three or four times a day with meals and at bedtime. For hemorrhoids, you may use Preparation H or Anusol as directed. If you're breastfeeding you may use Colace for constipation. Post Partum Blues: Anxiety, irritability, fatigue are common after delivery. The postpartum period may be a time of uncertainty and anxiety for new parents, and when coupled with hormonal changes and lack of sleep, transient mild depression known as "baby blues" is not unusual. Please call us if the blues last longer than a few weeks, if it seems severe, or if you are unable to take care of yourself or the baby. Post Partum Office Visit: Call the office to schedule your postpartum appointment. You should be seen in the office six weeks after your delivery. You should however contact us promptly if any of the following occur:
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