Postpartum Instructions

1. You should not soak more than one pad in 30 min., or 2 pads in 1 hour.  If you do, empty your bladder, massage your uterus so that it remains firm and contracted, then nurse your baby.  These steps should help stop your bleeding.  If not, call me right away.  If you pass a clot larger than a lemon let me know.  
2. If blood starts to pour out continuously and is not containable, go to the hospital immediately and have someone call me to let me know to meet you there.
3. Check your uterus for firmness every hour for the first 24 hours and several times a day for three days thereafter.  It should feel about the size of a grapefruit and be no higher than your navel.  
4. Change your pad with each trip to the bathroom and rinse your perineum with warm water in a peri bottle with a few drops of lavender oil.  If needed, you can pat dry from front to back.  
5. During the first 12-24 hours, someone should be with you when you get up, to make sure that you don’t become dizzy or faint.  Walk the length of the house twice a day to help with circulation.  
6. Wait to shower until you do not feel weak or lightheaded. You may take a bath as long as the tub is cleaned thoroughly.  Do not use too hot of water for too long as it can cause dizziness and increase bleeding.
7. If you have a tear, keep your legs together as much as possible to encourage healing.  Sit and swivel onto your bed or into the car.  Do not climb stairs.  
8. Notice, if your flow has a bad odor (it should smell like your menses), if your flow does have a bad odor, report to your midwife.
9. Take your temperature twice daily for at least 4 days.  If your temperature is above 101.0 contact your midwife.  This could be a sign of a uterine or breast infection.
10. Your flow should turn from red to pink in a few days, and gradually turn brownish and then clear.  If it should turn red again, or increase, you are doing too much, and need to slow down!  Your main job is to take care of yourself and your baby.
11. Do your Kegal exercises as soon as possible after delivery to strengthen your tissues and muscles.  This also helps prevent prolapse of the uterus.
12. Drink plenty of fluids (about three quarts daily to establish milk flow), avoid coffee, caffeinated drinks, tea, soda and chocolate while nursing.  Also, red raspberry and peppermint tea can reduce your milk supply.
13. If you tore, you can soak in a seitz bath with comfrey, goldenseal, and ginger tea three or four times daily.  Air dry your perineum in the sunlight, if possible.  Report any pain.  Witch hazel and/or cold compresses are good for hemorrhoids
14. Try to get help around the house and to do the cooking for the first two weeks.  Add activity slowly as you feel able.  
15. Afterbirth pains can increase with each birth.  Drink a cup of postpartum tea, (hops, chamomile, arnica, and shepherd’s purse), or hops tea alone, one half hour before nursing to greatly relieve discomfort.  Cheated Calcium/Magnesium (500 mg/250 mg) and Homeopathic Avena Sativa, by Weleda, (10-15 drops under the tongue or mixed with warm water) can help relieve cramps as well.  Be sure to place drops under the tongue and let them dissolve slowly. Avoid heating pads as these tend to dilate blood vessels and increase bleeding.
16. Abstain from any sexual activity until your bleeding has stopped completely and any stitches are healed.  It is a good idea to wait until after your 6 week check up before resuming intimacy.  If you chose to go ahead, be gentle and use plenty of lubrication.
17. Get plenty of rest, sleep when the baby sleeps, eats lots of good healthy nutrient dense foods, with plenty of protein, and iron to replenish blood loss. Continue to take your vitamins while you are nursing.
18. Let friends and family help with dishes, laundry, watching children, making meals, etc.  Put a note on your door, and a message on your answering machine, so that you can be undisturbed and rest.  It is important to rest and recover for the first couple of weeks and work into activity slowly.
19. Don’t lift anything heavier than the baby for the first three weeks.
20. Try to take parenting one day at a time.  If you feel sad, or depressed, please call.

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Newborn Instructions

21. Be sure to fold down the top of the diaper and let your baby’s cord stump air dry as much as possible.  No alcohol is necessary.  If needed, you can clean it with a little coconut oil and a drop of lavender oil on a Q-tip.
22. Nurse your baby every 2-3 hours or as often as the baby wants.  Do not go more than 4 hours without nursing your baby.  During the first 36-48 hours, the breasts produce colostrum.  This is the perfect food for baby.  Do not offer the baby water or other fluids.
23. If the baby looks yellow within the first 24 hours, call us immediately.  
24. If baby looks yellow around the 3rd day, this is normal physiological jaundice. (Normal physiological jaundice peaks around 72 hours).  Keep baby in the sunlight as much as possible.  Remove baby’s clothes and sun baby on the front (with eye’s covered) and then on back; 10-15 minutes on each side, twice a day.  Be careful that the baby does not get sunburned.  You can sun your baby through a sunny window.  Nursing your baby frequently can also help move your baby’s bowels and decrease jaundice.  
25. Your baby should urinate and have a bowel movement at least once, within 24 hours, after birth.  Once your milk has come in, your baby should wet at least six diapers a day, and your baby’s bowels should turn to a liquid, mustard yellow, cottage cheese consistency.
26. Nurse your baby skin to skin as often as (s)he wants to nurse until your milk flow is established.  This will probably be at least every two hours, sometimes more frequently at first.  It is necessary for your baby to nurse frequently to build up your milk supply.  This first milk, or colostrum, is full of antibodies, protein, and vitamins; it is very important for your baby’s health.  Alternate breasts, nursing about 10 minutes on each side every two hours.  Air dry your nipples several times a day.  To keep them from cracking, use nipple balm, lanolin, vitamin E oil, or rub a drop of breastmilk on each breast after each feeding (none of these need to be washed off before the next nursing).
27. Baby should not become overheated or chilled.  Babies can become overheated from too much clothing or chilled from too little.  If, after correcting any environmental factors, the baby’s temperature is still abnormal, call immediately.
28. After cleaning your baby’s bottom, apply some olive oil for the first few days, or until all dark stools are gone.  This prevents scrubbing baby’s tender bottom and makes them easier to clean up.
29. Watch what you eat.  Sometimes milk, onion, garlic, chocolate, caffeine, peanut butter,                                                  beans, and vegetables like cabbage, broccoli, tomato, pepper, corn, peas, and cauliflower can make your baby colicky.  Eliminate these foods if your baby has an upset stomach.
30. When resting, lie baby on his side with his head a little lower than the rest of the body.  This way the mucus can drain more easily without choking him.  Roll a blanket or towel behind his back so he can’t turn over. Review your “When my baby is not breathing” sheet.
31. Do not use furry sheets and blankets for baby or overdress them as these things can lead to oxygen deprivation.  Dress your baby in cotton clothing so your baby’s skin can breath.
32. Do not use pacifiers and bottles for the first 3-4 weeks.  These can confuse your baby’s sucking and latch which can make breastfeeding difficult.
33. Don’t hesitate to call us if the baby seems disinterested in nursing, listless, or irritable.
34. Enjoy your baby and relax!  Take things one day at a time.
35. Call me immediately, day or night, if you have questions or concerns.