Postpartum Instructions

For You

Rest. Spend your first week in bed or on the couch. If you have to climb stairs, do so only once a day in the first week.
You will bleed like a heavy period and you may pass clots smaller than a golfball. Your uterus should feel like a firm ball about the size of a grapefruit, and should be below your belly button.
If you notice heavier bleeding, massage your belly, empty your bladder, and nurse your baby. If you soak a pad in under an hour or if you are gushing blood, call 911.
For the first 24 hours, always have someone close by when you get up to use the bathroom or shower.
Drink water and herbal teas such as red raspberry leaf, nettles, alfalfa, ginger, turmeric). Have your people always keep your glass full, and empty your bladder every 2-3 hours.
Nourish with warming foods. Soups and stews are easy for your body to digest. Here’s a link to my Pinterest board of postpartum meals.
Afterpains increase with each child. Keeping your bladder empty will help relieve this. “AfterEase” or cramp bark tincture will help with this. You may also take 800mg Ibuprofen every 6 hours, with food.

Keep your baby on your body, skin to skin, covered with a blanket. You can tell if your baby is too cold if their hands and feet are cool to the touch.
Nurse frequently, at least every 2-3 hours, until your milk is in.
Take your baby’s temperature in their armpit once daily. Because you’re taking it in their armpit, you add 1 degree for their accurate temperature (ie. 97.1 + 1 degree = 98.1). Temperature is affected by clothing and environment. It should be between 96.6 and 98.6*F. Call immediately if it is abnormal after adjusting clothing or room temperature.
Your baby should urinate and have a bowel movement within the first 24 hours. Your baby will pass tarry meconium, which will transition to a seedy mustard yellow poop once your milk comes in.
Cord care - keep it dry and exposed to air. Swelling, constant wetness, leaking of blood or meconium is not normal.
Breaths can be irregular as your baby learns to breathe. Quick breaths may be followed by pauses. Most important is to watch for chest retraction or blueness around the mouth. Report these immediately.
Babies may spit up mucous, typically for the first 24 hours.

A low fever is normal when your milk comes in. Call immediately if you have a fever of 100.4 or higher, if you have flu-like symptoms, foul-smelling bleeding (it should smell earthy, like menstrual blood), or pain in your abdomen.

If you soak a heavy pad in under an hour and are continuing to bleed. If at any point you are continuously gushing blood, call 911 and call me once you’re on your way or at the hospital.
If you pass a clot the size of your fist or larger.
If you feel heat, tenderness or pain, redness, or swelling in your legs.
If you feel suddenly short of breath and anxious.
If you develop pain beneath your right rib cage, have vision changes, experience swelling in your face, hands, feet, or legs, a headache, or if you just feel really awful.
If you have pain, swelling, or redness in your breast. Once established, a blocked duct can become mastitis, symptoms of which include fever and chills, achiness, malaise, and fatigue.
If you are having thoughts about harming yourself or your baby.

If your baby is lethargic and will not wake to nurse, or is disinterested in nursing despite not having eaten in several hours.
If your baby is jaundiced (yellow) within the first 24 hours postpartum, or if the jaundice extends below the nipples (it is not unusual for babies to become jaundiced after 24 hours postpartum).
If your baby has a continuous, high pitched cry.
If your baby has a fever higher than 100.4
If your baby has not urinated or had a bowel movement within the first 24 hours.