POSTPARTUM CHANGES VI: POSTPARTUM NUTRITION TIPS

	EAT MORE OF THIS:	AND LESS OF THIS:
DRINKS	Drink more fresh fruit juice, milk, water, herbal teas.	Drink fewer juice drinks with added sugar, and less soda, coffee and tea, and any alcoholic drinks.
FRESH VS. FROZEN	Fresh or dried vegetables, fresh tomatoes, fresh oranges, avocados, corn on the cob, baked potatoes, bananas, pineapples, raisins, dates, and nuts like walnuts and peanuts are all good as meals and snacks.	Fresh foods lose vitamins fast the longer they are canned, cooked, or frozen. If you want to stock up, though, frozen foods are your best choice because vitamins last a little longer frozen than canned.
UNPROCESSED FIBER	Try more whole-wheat, or corn bread; brown or wild rice; pasta without heavy sauces; whole-grain and high-fibre foods like oatmeal, rice, beans, and bran muffins.	Try less white bread, white rice, croissants, sugared cereal, graham crackers, doughnuts, pancakes, and waffles; bleached and processed grain loose vitamins and isn’t as good for your digestion.
COOKING STYLES	Baked, grilled, or steamed foods are better; raw or very lightly cooked fruits and vegetables can be tastiest and are definitely most nutritious!	Fried foods, food cooked in heavy sauce or lots of fat or oil, and boiled foods have lost lots of vitamins.
PROTEIN	Chicken or turkey, fish, lean red meat, dried beans and peas, and peanut butter are good ways to get protein!	Avoid fatty meat like bacon, sausage, and pepperoni. Red meat (lean or not) and fried meat (like burgers) are okay only once in a while.
CALCIUM	Try more whole, low-fat, or skim milk, cheddar or cottage cheese, plain yogurt, dark leafy greens, mackerel or sardines.	Try less flavoured milk, milkshakes, ice cream or frozen yogurt, flavoured yogurt, flavoured pudding or custard, cheesecake, and creamed soup.
SWEETS	Instead of refined sugar, try more honey, brown sugar, or maple syrup (just a little); carob bean (if you can get some around here) is a healthier chocolate taste-alike! Fresh fruit makes the best snack.	Avoid white, or refined, sugar; candy and chocolate; ice cream; cakes, pastry, and cookies; and fruit in heavy syrup.
FATS	Try vegetable oil (like corn oil or olive oil), oil-and-vinegar dressing, and margarine in small amounts.	Avoid butter, cream cheese, lard, cream sauce, and gravy in large amounts.

FOOD SAFETY

It is very important that your meals or snacks are prepared carefully to ensure that no harmful germs get into the food. New mothers recovering from childbirth may become ill more easily, and newborn infants do not have resistance to germs or food poisoning. Avoid food poisoning by:

·         cooking all meats and eggs completely, and avoiding raw eggs and meat

·         keeping all refrigerated foods cold enough to prevent the growth of bacteria

·         washing your hands well before preparing a meal and in between touching cooked and raw foods, and keeping preparation surfaces (countertops, cutting boards, etc.) clean

POSTPARTUM CHANGES VI: DIET AND NUTRIENTS

It is important to make sure that you’re getting the nutrition you need after childbirth, especially if you are breastfeeding your baby. If you are concerned about losing weight and gaining muscle as soon as possible, keep these points in mind:

·         You lost about ten pounds during delivery: the baby, the placenta, and amniotic fluids.

·         Much of the swelling and weight on your body for the first week or two is made up of the remaining fluid and tissue in your uterus, which is coming out gradually as lochia. Most of the extra water your body stored during pregnancy will leave your body through urination and sweating.

·         Producing breast milk uses many calories. This means that you must try to eat the most nutritious foods you can to keep your energy up and to pass important vitamins and minerals to your baby. As long as you try not to eat more than you need, and make sure the food you eat is high in nutrition, you will lose extra fat naturally as you breastfeed.

·         Dieting is not recommended until six weeks after childbirth if you aren’t breastfeeding. Dieting is not recommended at all while you are breastfeeding.

·         If you diet, talk to a health care provider about getting the nutrition you need and making sure you won’t be losing much more than a half pound every month. Don’t forget to include an exercise program to build strength while you lose fat you don’t need.

The nutrients that are most important to breastfeeding mothers and babies are generally those that are important to everyone. If you are breastfeeding, you may need to eat more of certain foods to take in enough for two, and you may also feel thirstier than usual. It is important to eat and drink frequently when you breastfeed—you can probably trust your body to crave the foods you need the most. Here is a list of foods containing the nutrients your body needs:

WATER: Clear water, juices, soups

FAT: Dairy products (milk, yogurt, cheese, butter, etc.), lean meats, nuts, oils, eggs

CARBOHYDRATES: Whole grains (not bleached or processed), rice and pasta, nuts, fruits, vegetables

PROTEIN: Dried beans, nuts and peanut butter, eggs, dairy products, lean meats

VITAMIN A: Carrots, sweet potatoes, and dark leafy greens like spinach, ugu

VITAMIN C: Citrus fruits like oranges and lemons, berries, potato skins

CALCIUM: Dairy products, greens, dried beans, some fish

IRON: Spinach (ewedu), whole-grain foods, lean red meat, dried fruit

Products That Pass Into Breast Milk

Certain common products pass into your breast milk and may affect your baby’s health as

well as yours. Some of these products are caffeine (coffee, tea, chocolate, colas), tobacco, artificial sweeteners, alcohol (beer, wine, liquor), aspirin and ibuprofen (acetaminophen is usually not harmful in small amounts), cold medications, and weight-loss medications. Call your health care provider to ask questions before using these products. Do not use illegal drugs (marijuana, cocaine or crack, heroin or methadone, PCP, LSD, amphetamines, ecstasy, hashish, and so on). Prescription drugs should be taken only on the advice of your health care provider.

POSTPARTUM CHANGES V: EXERCISE

Exercise is an important part of your body’s return to normal after pregnancy and childbirth. Moving around soon after delivery will not only make you feel better, it will also keep blood clots from forming in your legs or pelvis. Very light exercise, such as gentle leg or tummy lifts, is a good way to stimulate healing and get you on the road to regaining your pre-pregnant strength. Try to keep good posture while walking, standing, or sitting. This will stretch your muscles and help you feel better. Movement may be difficult at first, but keep trying. The results will be worth it!

Consider the following:

·         Walk and move around a little as soon as you are able.

·         Practice good posture: stand up straight; gently contract your tummy as you move to take pressure off your back muscles; and concentrate on relaxing your neck and shoulder muscles—good posture shouldn’t make you stiff!

·         Be conscious of how you place your legs when sitting or in bed. To keep your blood flowing, try not to cross your legs, flex them too tightly, or position them with pressure against the back of the knees.

·         You can try leg exercises in bed. Bend and straighten your knees, pressing the back of your knees into the bed and then relaxing in gentle rhythm.

·          Performing Kegel exercises will help return muscle tone to an area stretched during childbirth. Try to squeeze the muscles you use to control the flow of urine. Simply tighten and relax ten times, for about ten seconds each time, and then rest. You will improve bladder control and help your perineum heal faster by increasing blood and oxygen flow to the tissue. You may even improve sexual intercourse with this muscle control, since you are also exercising your vaginal muscles!

If you gave birth vaginally, you may be recovered enough after two weeks or so to be able to exercise a little more. You will probably need more time to rest and recover after a caesarean birth or after a labour and birth with complications.

·         Continue, and maybe increase, your Kegel exercises.

·         Exercise your pelvic muscles. Lie on your back and tighten your lower belly while supporting your lower back. Gently lift your hips for five seconds, release for two seconds, and repeat. This exercise will help to firm your loosened abdominal muscles.

·         Exercise your legs: first, tuck your hips forward and firm your abdominal muscles and buttocks. Keeping your back straight and your arms stretched in front for balance, slowly and smoothly bend your knees and squat until your thighs are parallel to the floor, hold for two to five seconds, and then slowly and smoothly stand up. Be careful not to lock your knees or bend them too far.

·         Have your health care provider help you plan a light exercise program as you recover. Plan to increase your activities once you’re able. Swimming (six or more weeks after childbirth) and walking are good choices for getting back in shape after a pregnancy, since they put less strain on joints.

·          Don’t forget the three most important companions to exercise: warm-up, stretching, and cool-down!

POSTPARTUM CHANGES IV

POSTPARTUM WARNING SIGNS

As time passes, be aware of the changes that are happening in your body. They are a good way to tell how you are healing. You will probably heal with few, if any, problems. But in order to take good care of yourself, you should be able to identify any changes that are not normal. Contact your health care provider if any of the following symptoms appear:

·         fever higher than 100.4°F (38°C)

·         sharp pains in your abdomen, breast, or chest

·         blurred vision or dizziness

·         headache that does not go away

·         severe pain or burning sensation in your legs (this pain could be a sign of phlebitis)

·         foul smell or an unexpected change in your lochia; you should not see bright-red bleeding or clots after the first postpartum week

·          localized swelling or tenderness in your breasts

·         burning or urgency when you urinate; being unable to urinate

·         crying spells or mood swings that feel out of control

·         thoughts of harming yourself or your baby

SLEEP AND REST

In the days and weeks after your delivery, you’ll be constantly reminded to rest. Why? Because resting helps you heal and gives you the energy you need to be a mother. You may have so much to do every day—feeding and caring for your baby, getting used to this new stage in your family life—that you may ignore your own needs. It’s no surprise that the most common complaint heard from new mothers is that they just can’t shake off that tired feeling. How much rest is enough? It depends on how much energy you have day by day. If you need more rest, try making time for sleep and relaxation by:

·         scheduling periods of rest along with your other activities; for example, try to nap  when your baby naps

·          avoiding noise and distractions, including many visitors and phone calls

·          if you are having trouble resting, thinking of ways you used to relax before or during your pregnancy—take a warm bath, ask someone for a back rub, listen to music, go for a walk

·         viewing feeding your baby as a time for you to enjoy each other’s company, and making feeding time a restful and calming time for yourself and the baby

POSTPARTUM CHANGES III: AFTER CAESAREAN BIRTH

If the delivery of your infant required a caesarean incision, or “c-section,” you’ll have some extra concerns to keep in mind while you heal. Remember, you’re healing from major abdominal surgery as well as from childbirth!

·         If you are asked to stay in bed, or if the effects of anaesthesia leave you too weak or nauseated to walk comfortably the first day, you can begin some simple leg exercises. Bend and stretch your knees, or press the back of your knees into the bed and then relax your legs in gentle rhythm. These exercises will help prevent blood clots from forming in your legs.

·          Your staples will probably be removed after four to six days. Your internal stitches will dissolve on their own.

·          Because the caesarean involved surgery to your abdomen, you may not be able to start eating solid foods right away. If you’re unsure, ask your health care provider.

·         Many new mothers have constipation and gas pains at first. Walking, light exercise, drinking plenty of water, and eating high-fibre vegetables, fruits, and grains will help. If constipation becomes a problem, contact your care provider.

·         As you heal, you will need to make sure your incision is healing normally. Contact your care provider if you have a fever or if the incision becomes red or swollen or oozes pus.

·         It will take four to six weeks to feel fully recovered from surgery. Allow yourself enough time to rest and to heal! Don’t expect to recover as quickly as you would if your baby were born vaginally.

·         Remember, if can’t stop feeling emotionally down or you have thoughts that are quite disturbing, do not keep it a secret. Talk to someone about it especially your healthcare provider

POSTPARTUM CHANGES II: MAKING YOURSELF COMFORTABLE AND PREVENTING INFECTION

The perineum is the area between the vagina and rectum. This area may be swollen and painful after stretching to allow your baby to be born. Your doctor or midwife may have made a surgical incision, called an episiotomy, to enlarge the vaginal opening. This area may also be painful. During the time that the lining of the uterus and the episiotomy are healing, you will want to be extra-careful to prevent infection. It is important to keep your perineum very clean. Each time you use the bathroom or change your pad, be sure to remove the pad from front to back and clean the area from front to back (from your vagina to your rectum). After going to the bathroom, you can squirt yourself off with warm water, using a squirt bottle, and then pat yourself dry with clean tissue. You may feel discomfort or pain in this area for two or three weeks. There are several different ways to relieve the soreness and keep down swelling:

·         Place an ice pack on the perineum continually for the first 24 hours to minimize swelling.

·        Have your nurse show you how to use a sitz bath. A sitz bath is a small tub you place on the toilet. It can be filled with warm or cool water, whichever is more comfortable. As you sit on the toilet, the water washes over your perineum, relieving pain and speeding healing. Many women find this bath very relaxing and soothing. Women who are extremely uncomfortable may find it soothing to use cold water and add ice to the tub. When you are at home you can clean your bathtub well and sit in there if your perineum is still uncomfortable. If your doctor or midwife placed stitches, they will dissolve over time. Be sure that the water you sit in is not extremely hot, since this could dissolve the stitches prematurely.

·         If your health care provider suggests a spray or ointment for your perineum to relieve pain, read the instructions on the container. Most can be used three or four times a day. There are also small pads containing witch hazel that can be placed on the sanitary napkin and placed against your perineum to relieve pain. Talk to your health care provider about these options if not suggested.

·          Your doctor or midwife may also prescribe an analgesic for the pain.

Lochia

Your body will begin to expel the blood and mucus built up in your uterus. This flow is called lochia, and it will last about four to six weeks. For the first three days, your lochia is dark-red and made up of blood and some small clots. From the third to the tenth days, the fluid is pink or light-brown. Finally, the discharge will turn to a yellowish-white mucus and lasts for another two to eight weeks. Lochia should have a clean smell, like fresh blood or mucus. The amount of lochia may increase slightly when you first get out of bed in the morning, when you breastfeed, or when you stand up after lying down for a period of time. Contact your health care provider if:

·         your flow suddenly becomes heavier than it has been,

·          if it is bright-red beyond the first three or four days,

·          or if you notice large clots or a foul odor at any time.

 If your lochia suddenly becomes bright-red or contains clots after it has turned paler, this should also be reported to your health care provider.

Uterus

Your uterus will gradually shrink over the next six weeks, though it will probably never be as small as before your pregnancy (Mums, please believe me on this one!!).

For the first week or two, you can make sure your uterus is shrinking normally by gently pressing down and feeling it through your belly. PLEASE DO NOT PRESS HOT WATER AGAINST YOU TUMMY, IT IS AN ARK AGED TECHNIQUE THAT HAS BEEN PROVEN UNSAFE!!Have your nurse or doctor show you how to do this correctly. Your uterus should feel firm and round. The top of your uterus is normally just below your bellybutton on the first day or two after birth. It should descend one or two finger-widths every 24 hours. After the second week, you should no longer be able to feel your uterus, since it has grown much smaller. You can also wear a post pregnancy girdle to help with the uterus shrinking. Its also a great idea to have that girdle on while you excersice!!

POSTPARTUM CHANGES: TAKING CARE OF YOURSELF

The moment you’ve waited and planned for—your child’s birth—has arrived. The first days and weeks with your newborn will be a very busy time. One of your greatest challenges will probably be to find time to take care of yourself. Fortunately, there’s much you can do to help yourself to heal and to adjust more easily to the changes in your life.

During the first few hours or even days after giving birth, you can expect to feel both very excited and very tired. You may feel very happy or you may feel sad immediately after birth; you may want to gather friends and relatives around you to celebrate the birth, or you may want private time to start breastfeeding as soon as your baby is ready. It can be helpful to talk about how the labour and birth went with your nurse or doctor. Just don’t forget that both you and your baby need and deserve a good, long rest after the exercise of childbirth!

The period during which your uterus repairs itself and returns to normal size and during which most of your physical recovery takes place—the first three months or so after childbirth—is called postpartum(don’t be confused-the word postpartum has many definitions; this is just one of the many). Understanding the changes that affect your body during this time will help you know that you are recovering well.

Let’s take a look at a few body changes you may encounter.

	THE FIRST HOURS AFTER BIRTH	THE FIRST WEEK AFTER BIRTH	THE SECOND WEEK AFTER BIRTH	THE THIRD WEEK TO THE THIRD MONTH AFTER BIRTH
Lochia	The placenta separates from the uterus and is pushed out over the first 30 minutes after birth. If you breastfeed immediately after birth, that separation will often happen more quickly.	You will experience a vaginal discharge called lochia over the next few weeks, as your uterus heals. For the first one to three days after giving birth, your lochial flow will look much like your period. It should be dark-red or brownish. It may contain clots that should not be larger than quarters, and it should smell like blood. From days 3 to 10, this flow turns pink.	Lochial flow at this time is made up of a small amount of blood, mucus, and white blood cells. The colour is pink or brown-tinged. It usually continues until about day 10. Call your caregiver if you notice a fishy odour, or if you notice a bright red colour or clots after your lochia has turned pink. After day 10, your flow should become white or pale yellow.	White or pale yellow lochial flow lasts from two to eight weeks. It should not contain any blood or clots and should not have an odour. If you are breastfeeding, your period will usually start again one to three months after weaning. If you are not breastfeeding, your period can return anywhere from one to four months after the birth.
Uterus	Your uterus stretched to hold your infant and now needs to shrink back into a tight ball of muscle. Your nurse or doctor may gently massage the area over your uterus to feel for this tightness. Right after birth, you will be able to feel the top of your uterus just below your bellybutton.	Your uterus shrinks a little every day. By the end of the first week, you should be able to tell that it has grown smaller. Your nurse or doctor may want to teach you how to locate your uterus and feel for firmness to make sure it shrinks about one finger-width a day. Some women will notice “afterbirth pains” that feel like menstrual cramps. These cramps are the result of the muscle of the uterus contracting back to its pre-pregnant size. These pains are usually felt more strongly by women when they start to breastfeed or by those who have given birth to other children.	By the end of the second week, you should no longer be able to feel the top of your uterus through your belly. The “afterbirth pains” you may have felt should be over.	Your uterus should return close to its pre-pregnant size by the sixth week.
Perineum	The area between your vagina and rectum is called the perineum. After giving birth, this area is often swollen and may have torn. Your health care provider may have made a surgical incision here called an episiotomy.	Your perineum will probably still be swollen, and it may be uncomfortable for the first week.	Swelling should be mostly gone by the end of the second week. If you had an episiotomy, the area may still be uncomfortable.	If you have an episiotomy wound, it should heal by the end of the third week.