Postpartum Care
in Boca Raton, FL

These tips and practices can contribute to a full and healthy recovery after the birth of your child. When you get home, make an appointment for your postpartum checkup. We’ll discuss birth control during this visit, as well as your schedule for returning to work (if applicable).

• Your rest is important! Rest during the day when your baby sleeps. Limit visitors; taking care of yourself and your baby is a big job. Don’t expect to be “Super Mom.” Ask family members and friends for help.
• Take your prenatal vitamins as directed. You’ll heal faster and have more energy to care for yourself and your baby. If you’re breastfeeding, be aware that some foods may cause your baby to be gassy or colicky. These foods include cow’s milk, cruciferous vegetables (such as broccoli, cauliflower, cabbage and greens), onions, chocolate, peanuts, corn, tomatoes, wheat, citrus fruits, highly spiced or seasoned foods, beans and other legumes, seafood, garlic, caffeinated beverages and strawberries.
  This doesn’t mean you can’t eat these things at all while breastfeeding, but rather that it may be wise to omit them from your diet when you first start breastfeeding. You can then slowly reintroduce them, one at a time. Every baby is different and what may cause problems for one may be perfectly fine for another. If a new addition to your diet causes gas or colic, your baby may have a sensitivity issue with that particular food, so avoiding it in the future would be a good idea. Sometimes you’ll find that offending foods don’t cause problems if you reintroduce them to your diet when your baby is older.
• Drink 6-8 glasses of fluid each day. This is especially important if you’re breastfeeding.
• Your baby needs to eat every 2-3 hours or on demand. For breastfeeding mothers, continue to use the various positions taught by your nursing staff and breastfeeding educators. A good supportive bra should be worn. Manual breast pumps may be used at home if necessary (electric pumps are usually available for rent or purchase from the hospital where you delivered).
  For formula feeding mothers, increase the amount of formula based on your baby’s demand. You’ll usually start with the same formula that was given to your baby in the hospital. Any change in formula should be discussed with your pediatrician. To limit milk production in the first few days, bind the breasts with an Ace™ wrap. Remove the wrap daily to shower. Uncomfortable engorgement usually gets better within three to four days.Do not pump the breasts to relieve discomfort as this will only stimulate milk production. Cold compresses or ice packs can be applied to the breasts for short periods of time and you may also take ibuprofen for relief.
• Continue your perineal care (peri-care) with warm water after using the restroom. Pat dry and change your pad(s) with each trip. You may soak your perineal area in tepid water for 10-20 minutes in the bathtub or use a sitz bath (a small basin that fits into the opening of your toilet — available at most drug stores) 3-4 times daily if stitches or hemorrhoids are painful. The stitches will absorb in three to four weeks (will not require removal).
• Do not douche or use tampons for six weeks after delivery.
• Kegel exercises help promote healing and improve muscle tone. Kegels, or pelvic floor muscle exercises, are done to strengthen the muscles that support the urethra, bladder, uterus and rectum. To identify and isolate the muscles of the pelvic floor, sit on the toilet and start to urinate, then try to stop the flow mid-stream. The muscles you use to stop or slow this flow are the pelvic floor muscles. Kegels are done by squeezing these muscles as if you’re trying to stop the flow of urine. Do the exercises twice a day for five minutes. Try to hold the contraction for five seconds, then rest for five seconds. Gradually increase the time that you hold the contraction.
• Avoid straining to move your bowels. If you do, splint or hold the episiotomy with a clean pad. Be sure to wipe from the front to back (you may also take a stool softener or laxative if desired).
• Avoid sexual intercourse until after your postpartum checkup; you can become pregnant again without a return to your normal menstrual cycle.
• Notify us of fever of 100.4°F or higher (measured orally); burning on urination; excessive bleeding (more than a heavy menstrual flow); swelling, redness and/or tenderness in one or more areas of the breasts or legs; foul-smelling vaginal drainage; redness, swelling and/or drainage from your abdominal incision or episiotomy stitches; or excessive pain anywhere.
• If you delivered via Cesarean, keep your abdominal stitches clean and dry. Shower daily, carefully cleansing your incision with soap and water. Pat dry with a towel. If clips or staples are used, they’ll be removed before you go home or at your first followup visit. Avoid the use of any oil-based or petroleum products on the incision, especially if surgical glue was used.
• Exercise during the first six weeks after delivery should be limited to walking. Do not lift anything heavier than your baby. Be aware that over-activity can cause bleeding.
• We’ll let you know when it’s safe to resume driving. You make take short rides and resume light home activities after delivery, but take care not to overdo it. Your first weeks at home should be devoted exclusively to you and your family.
• Most mothers report feeling very sad and/or tired from time to time during the first few weeks — this is normal. However, if these feelings interfere with caring for yourself or your baby, please call our office.
• Your desire for sexual intimacy will depend on your physical health, emotional state and your feelings (and your partner’s) about adjusting to your new lifestyle. Share your needs and desires, as well as your concerns, with your partner. And again, avoid sexual intercourse until after your postpartum checkup.

Taking your new baby home should be a time of overwhelming joy and excitement. But this time can also be extremely stressful for women as they experience significant lifestyle changes and concern for their baby. Anxiety and nervousness are normal during this period; however, increasing fear and worry, great sadness, or “not feeling normal” may be a sign of more significant problems.

It’s not uncommon for women to experience a roller coaster of emotions during the first days after delivery; “happy one minute; crying and sad the next,” a period often referred to as the “baby blues” (most commonly experienced on the third or fourth day after delivery). Over 50% of new mothers experience the “baby blues.”

Although each woman’s experience is different, these “blues” are often characterized by feelings of disappointment, crying for no known reason, irritability, impatience, anxiety or restlessness. These feelings are likely due to biochemical changes and new mothers should be reassured that the situation is generally transient. Symptoms usually go away without treatment within 2-14 days of onset. However, new mothers with the “blues” should be monitored for development of more severe psychiatric disturbances, such as postpartum depression or postpartum psychosis.

While the exact cause of postpartum depression remains unknown, it’s likely that a number of factors, including the changing of roles (as a spouse and parent), hormonal changes, stress, a personal or family history of depression or other mental illness (especially postpartum depression) and marital strife are involved. Depression can occur during pregnancy or within a year after delivery. The exact number of women with depression during this time is unknown, but research suggests such depression is one of the most common complications during and after pregnancy.

Often, this depression isn’t recognized or treated because certain normal pregnancy changes cause similar symptoms and are happening at the same time. Lethargy, difficulty sleeping, stronger emotional reactions and changes in body weight may occur during and after pregnancy. But these symptoms may also be signs of depression. One difference between “baby blues” and postpartum depression/psychosis is that the “baby blues” can happen in the days right after childbirth and normally go away within a few days to a week. A new mother can have sudden mood swings, sadness, crying spells, loss of appetite, sleeping problems, and feel irritable, restless, anxious and lonely.

Symptoms are not severe and treatment is not needed. But there are things you can do to feel better. Nap when the baby does; ask for help from your spouse, family members, and friends; join a support group for new moms or talk with other moms.

Postpartum depression can happen anytime within the first year after childbirth. A woman may have a number of symptoms, such as sadness, lack of energy, trouble concentrating, anxiety and feelings of guilt or worthlessness. Another difference between postpartum depression and the “baby blues” is that postpartum depression often affects a woman’s well-being and keeps her from functioning for a longer period of time. Postpartum depression needs to be treated. Counseling, support groups and medication are available.

Postpartum psychosis is rare. It occurs in 1-2 of every 1,000 births and usually begins in the first six weeks after delivery. Women who have bipolar disorder or a psychiatric problem called schizoaffective disorder have a higher risk for developing postpartum psychosis. Symptoms may include delusions, hallucinations, sleep disturbances and obsessive thoughts about the baby. A woman may have rapid mood swings, from depression to irritability to euphoria.