Monday, May 27, 2013

What to expect after your baby is born

A Postpartum Survival Guide

Let's talk about how to survive and thrive in the postpartum period. For me, postpartum life has always been blissful and magical. Nursing...cuddly newborn making little squeaks and grunts...being able to lie on my back and stomach...more nursing = bliss. It's my favorite stage by far.

nursing Inga a few days postpartum

But I know that many women struggle to adjust to life with a newborn baby. It can be a terrible shock after all that planning and preparation for the birth. You have a baby in your arms, and WHAT ON EARTH DO YOU DO NOW?

So today, let's talk about all the postpartum stuff that you wish you'd known, or that you figured out, or that surprised you, or that blindsided you. Let's talk about what to really expect postpartum for yourself, your baby, and the rest of your family. Let's share our tips and tricks for an easier postpartum adjustment.

Here are some things I've figured out:

Make a list of your postpartum responsibilities. Keep it short. 
*Everything else* other people should be doing for you. My postpartum responsibilities are:
1. Nurse the baby
2. Stay in bed and snuggle with the baby
3. Take pictures of the baby
4. Read books and putz around on the internet
5. Eat dark chocolate

I'm quite serious about #5 (but it has to be at least 70% and preferably 85% cocoa). That's really all I do for the first few weeks. I don't look after the other kids. I don't prepare meals. I don't do laundry. I don't really do anything except hole up in my room and admire my baby. Now, sometimes I feel a bit stir crazy and I have to *make* myself stay in bed.

The first recovery is probably the hardest and longest
I was really, really sore for weeks on end after I had Zari. It hurt to sit and walk for a long time. But after my other three children were born, I hardly felt like I'd had a baby. Give me a day or two, and I was almost totally recovered except for the postpartum bleeding.There's just something about having had a baby before that makes subsequent recoveries so much easier (unless, of course, you have something unusual happen like a c-section or shoulder dystocia or vacuum extraction or whatever).

Learn how to nurse lying down ASAP
This was a lifesaver. It took me about a month to master after Zari and Dio were born. But with Inga and Ivy, we nursed lying down from day one. It is seriously one of the BEST THINGS EVER.

I don't care how you do it: in the bed, with a co-sleeper, or even with a crib or bassinet in the same room. The more you can stay in bed at night, the better you'll sleep. I usually get out of bed once at night--and that's to use the bathroom and get a drink of water. Otherwise I get to stay cozy and warm under the blankets all night long. I think I would DIE if I didn't co-sleep. I can't imagine having to get out of bed multiple times per night, sit in a rocking chair and nurse the baby, put the baby down and settle it to sleep, then walk back into my bed and go back to sleep. That sounds positively horrific.

Size matters
Get a king-size bed if at all possible. I feel way too crowded co-sleeping on a queen bed.

Learn about breastfeeding before the baby is born. Get help ASAP if a problem arises. 
Nursing has gone very smoothly with all four of my babies. Some of it was luck (no tongue-ties, no routine practices that undermined breastfeeding, etc.), while some came from learning as much as I could before my first baby was born. I felt really well-prepared and knew how to get help if I needed it. If you can, spend some time with nursing mothers. Watch them latch their babies on. Ask them questions. Watch them some more. It's so helpful to see breastfeeding up-close and in person.

Wait to buy nursing bras
You don't know what size you'll end up after the baby is born. Wait at least a week or two to buy your nursing bras, because you'll change sizes so much in those first weeks. You'll have crazy huge porn boobs once your mature milk comes in around days 3-4-5. Then they'll settle down to a more manageable size. You can buy your sleep bras in advance, since they're stretchy and less supportive.

Towels are very handy
I put a bath towel underneath me and the baby when we're in bed at night. It catches the inevitable fluids (leaking milk, blood, spit up, pee, poop...) and saves me from having to change the sheets every day. Because leaks happen. All the time. I also put a crib-sized mattress protector underneath the fitted sheet. If we have a big leak and need to change the sheets, this protects the large mattress pad.

Double up
So, I finally figured out how to avoid bleeding all over the bed every night. Before I go to bed, I put an extra pad in the back of my underwear. Do this maybe the first week or two, or until your flow lightens up.

Learn how to ask for help
When someone says, "If there's anything I can do, just let me know," I've become really good about saying, "Yes, actually, I really need help with ________." Don't be polite and turn down help.

Get a sling
(Or a Moby wrap, or an Ergo, or a mei tai...) I don't know how I'd survive postpartum without one, especially when my help leaves and I'm on my own with a newborn and several other little children.

Now for some crowdsourcing...

Time to share your postpartum stories (the good, the bad, and the ugly). Tell us all about what it's really like to have a new baby. Share any tips or tricks you've learned. What do you wish you'd done differently, or known beforehand?


  1. Such great advice, Rixa; my baby is 27 so it's been years since I had a newborn of my own but I am a nanny and have a little teeny one now. Your list of suggestions is comprehensive and contains very good stuff.

  2. This is also a great time to obsessively watch TV series. Watch one episode after the other, nurse your baby, and eat what people bring you. It almost makes the sleep deprivation and constant nursing worth it.

    I also have to suggest, since I am one, that hiring a postpartum doula can be a great option!

  3. Rixa, this is making me LOL because it's so far removed from my experiences. It sounds idyllic this way, though. I had to resume teaching two weeks after my first was born (and one day after getting the worst case of mastitis ever), and my husband never had more than a few days to take off, and my other kids needed my attention more than the baby (although all I wanted to do was snuggle the baby).

    The worst was when my fourth was born two months early. He was in the hospital, and all I wanted was to stay there all day, but I had three little children at home who'd been missing me for weeks while I'd been in the hospital. I've never felt so torn between two all-powerful forces.

    1. Wow, I can't even imagine going back to work so soon. My husband has only taken a day or two off each time. He's a professor, so he is able to be home a bit more after the baby is born. But I've been so fortunate to have my mom (or MIL after Inga) come each time and help out, usually for a week and a half or so. I'd go nuts trying to entertain the other kids and take care of the newborn if I didn't have my mom helping at first.

      I recognize how fortunate I am to have the help each time. I know so many people don't have a mom or sister or whoever to come stay and help out for a week or 2 or 3.

    2. I'm with Amy on this. I didn't have to go back to work as soon but I never had anyone stay with me. I was driving carpool again at two weeks post cesarean.

      Its really nice for those who can have the kind of help you did but that is not the case for a lot of people. i always ask about help when I am doing a lactation consult or teaching a class and the majority of people have someone coming for a few days to help but that is generally all.

  4. Line up the lactation consultant to come to your house whether you think you're having problems or not. It won't hurt and might help.

    Fill up your DVR before the birth for those marathon tv nursing sessions. Don't read your favorite blogs for a few weeks so you have lots of reading material that isn't too taxing.

    Based on my first birth, I'd say get up and moving and leave the house every day as soon as you can. I was so out of shape after lounging around for six weeks it was awful. Take walks as soon as possible.

    Keep up with iron supplements if they're recommended. I was so anemic after birth, but when I got home I spaced out on the iron and so stayed anemic for a really long time and that made things harder than necessary.

    If you have a baby who screamed all night like mine did wrapping her in the moby and walking on a treadmill work wonders!

    1. Oh - I never thought to use the treadmill - what a great idea!! I did so many laps around my house with my son in the K'tan as it was the only way to get him to sleep - he craved the motion. Luckily I had him in the summer so during the day I could go for long walks outside. I lost weight so fast because I was always walking (bouncing, etc) with him in carrier for the first few months!

  5. My big life saver was to have expressed colostrum from about 37 weeks and frozen it. I know not everyone can, but even those few drops were a lifesaver when I had big problems just after the birth (peripartum cardiomyopathy) and needed to buy some time to find milk donors to help me while I was on medication and having tests.

    Also, print out a list of breastfeeding help sources and pin it by the phone. Find 3x more and varied sources than you think you'll need because the haze of those first few days of newborn chaos is not the time to be finding contacts if everyone you thought you could rely on mysteriously stops answering their phone (as has happened to me!)

    Finally, if you are using washable nappies, maybe consider using something "throwaway" over the first few days because meconium staining? DAMN!!

  6. With my first I had mastitis several times. It was like hitting a brick wall for me for days. Something about the bacteria in my baby's mouth just didn't sit well with me. I even got help from a specialist to make sure the latch, unlatching, etc was done properly to try and minimize it. Before the second baby I had a plan in place so that if/when I got it, the infection wouldn't knock me and my family on our butts. I had raw cabbage in the fridge at all times, I had hot and cold compressions waiting, and if it those didn't work in the first few hours then I had already talked with my practitioner and had a prescription in place. I think because of my pro-activeness the second time around I was able to catch and stop it before it spread like wildfire and I'd have to take the medication.

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  8. Love this post, great advice.

    In addition to towels, I used Chux pads for the first few weeks - put them underneath myself and also on the floor of bathroom outside the shower. I got them on Amazon. The best gift I received was an Amazon Prime membership. They have EVERYTHING (bath herbs, breastfeeding tea, vitamins, etc) and knowing it will be delivered to your door in two days is an amazing feeling (warning: the iphone/ipad app can be addicting when lying in bed with a newborn...) With an .edu email address you get a year free.

    I also agree that having as much breastfeeding info and support prior to giving birth is a lifesaver - and making sure to have multiple lactation consultant contacts, because all LC's are not created equal (and you don't necessarily know who will be helpful until after the baby comes).

    In addition to nursing bras - I also recommend nursing tanks (camis) - I wore them for the first few weeks instead of bras and they were so comfortable and I like having the belly support even while in bed.

  9. I wish I had realized how much "easier" it was to take care of myself with a baby than a toddler. I really miss the days of being able to set the baby in her swing or Boppy in the bathroom with me while I took a shower--I was so afraid to be apart from her that I barely kept up with hygiene AT ALL. Now that she's mobile and I actually want a break to bathe, it's nearly impossible!

  10. I found eating tons of a variety of fruits in the first weeks to be wonderful. If you can, have someone cut it up into bite-sized pieces and bring it to wherever you are nursing/dozing at the moment. Fruit smoothies work great too. Keeping well hydrated is essential for breastfeeding, and I got so tired of gulping down plain water. It's also an easy thing to ask a potential helper to do for you.

  11. Communicate with your partner! You may think that what you want or need is obvious but it might not be for them. Plan your postpartum. Have caregivers in place for you and for older children. Know who is going to do what. Have lists in place for if someone offers to help (there's a great sign in the tear sheet toolkit section of The Womanly Art of Breastfeeding). Have meals in the freezer made a head of time. HIRE A POSTPARTUM DOULA!

  12. I had the baby blues with all three of my children. It caught me off guard the first time, but I was prepared the next two times. For me, a place to retreat to for privacy was absolutely necessary. Help from family & friends was welcome and yea, helpful. But I felt my crying was going to be taken the wrong way. I cried because my baby was so beautiful. I cried because my older children were so gentle with her. There didn't ever seem to be a 'good' reason for the tears, but they would inevitably flow. And for the most part, it felt good when they did. My blues gradually lifted within two weeks with all three. So my tip is to be aware (expect? I don't know what the rates are) of baby blues. And not to be a Debbie downer, but to also be aware of signs of PPD.

  13. Your circumstances are what i wish for all new Moms. It's just not possible for many of us, though.

    My husband has never had a day home after a baby is born. This is his own failing and has hurt me tremendously, but it's a fact of my life. Now, expecting #5 very soon, i'm stocking my deep freezer with snacks and meals and having my eldest (9year old) pack it so she knows where things are so SHE can get to what she wants. She will be my saving grace this time. This is the first time, though, that i'll have ANY kind of help (as limited as a 9 year old's help is... it's still far more than i've regularly had before).

    i've had help from RS, but that's more stressful than helpful at times because it's time visiting not actually HELP (at least in my experience). And i would accept help if it was offered (and have the few times it has been). i DEFINITELY have been grateful for the meals brought in, but can't count on that this time with the food restrictions we have now. *sigh*

    anyway, i'm so glad you've had such blessed idyllic post-partum days! i can only imagine that my bouts with PPD may have been MUCH reduced if i'd had that kind of support... even just more support from the husband. ahwell. such is life!

  14. I love this!

    My midwives showed me the 'doubling up' trick with my current baby (#6). You'd think I'd have known that by now, but it had not occurred to me. ;)

    I think meal and/or snack planning ahead of time is helpful, even (especially) if you're not planning to make the food yourself. This might just be us, but at our house, thinking of what to cook is as much work as making the food! So if we have a list of foods I would want to eat, it's much easier for someone else to whip them up.

  15. For me, having my healing lotions and potions ready was important - arnica, rescue remedy, comfrey root (on pads in the freezer, in peri bottles and in cheese cloth "pads"), iron supplements, lanolin, lactation teas and tintures and healing foods (bone broth, livers, dark leafy greens, and oatmeal).

    My husband took lots of parental leave with both babies - 35 weeks with #1 and 12 weeks with #2 while I took the rest of the leave. It was so important especially because I had killer PPD after my first but, thankfully, not after my second. My husband does everything the first few weeks - cooking, cleaning, laundry, childcare, grocery shopping, diaper changes and making sure I am well fed and watered. Once I am feeling more myself, I start to slowly pick up chores here and there, as baby allows.

    A wrap is important for me for babywearing. I love my woven wraps more than any other type of carrier but it's important to try lots of different ones to see what mum and baby prefer. Once I figured out how to babywear and nurse at the same time, the whole world seems to open up for me.

    And I so agree about the side-lying nursing and co-sleeping. Such life-savers! Also having a "nursing basket" that has all of your nursing essentials in it so they can be easily portable wherever you happen to be nursing (I liked to move my nest around so I felt less trapped). Some nursing basket essentials were a water bottle, lanolin, breast pads, a few good books, some granola bars and fruit, medication (if needed), lip balm, my phone and charger plus a few receiving blankets just in case.

  16. For postpartum bleeding: Depends!!! (Adult-sized diapers.) I had my daughter in July, and lived in a short, pretty, comfortable, cotton summer sundress-style nightgown + Depends as underwear for eight days. My bleeding was heavy, and I didn't have a single leak. And oh my goodness, I could not believe how comfortable they were. It is the single best thing I did for self-care post-birth.

    I didn't even purchase them originally for that purpose...I purchased them in case my water broke first, to allow myself the freedom to move around without leaking amniotic fluid everywhere. But they were there, so I thought: hmm, I'll try one of these. And I never looked back.

  17. I finally learned with baby #3 that you don't have to get painfully engorged when your milk comes in. Nurse really frequently--like every 90 minutes, whether baby asks or not. I had lots of leakage (wore a towel for a few days, LOL), but no pain or unmanageable swelling.
    I also found that while the first week is surprisingly awesome, I was shocked with how crappy I felt by week 6. So very, very, very tired (esp. with 1 and 2 who were in a separate room!). For two of my kids, that also happened to be right at Christmas. But then it gradually got better. Living away from family, with no friends, husband got ONE day off with first baby (and he worked at a large company considered to be a great place to work, with other great benefits, but not birth leave!). I really wish I could have done less other "stuff" in the first few weeks, but that just wasn't a possibility in my life.
    Sign language!
    Agree about the babywearing--"real" babywearing, not a Snugli or Bjorn that seems a major undertaking just to put on. Didn't learn about pouches, etc, until #3, and what a lifesaver. Also never figured out side lying and nursing until #3.
    Gee....wouldn't it be great if baby #3 could have come first!!

  18. Great advice, Rixa! I just had #4 at the end of March, and this was the first time I'd had help--it made a HUGE difference. My mom and mil came out the weekend that I was due at stayed around watching the kids and doing housework while I waited around to have the baby (she was THREE WEEKS "late!") After she was born, my mom stayed an extra week, and it, was, like, the best pp period ever.

    My secret weapon during the first few weeks is this: I know (by now) that six weeks is my sweet spot; for six weeks, the house goes to hell, my kids run around like untamed ruffians, we eat TV dinners, and I go nuts. At six weeks, the waters recede and suddenly, I can get the laundry washed, dried, folded AND PUT AWAY all in the same day, get a home-cooked meal on the table, get the house organized again, and have a sit-down talk with the kids, during which I inform them that the day-long Pixar marathons are over, and it's back to the normal routine in which mama can enforce the rules and responsibilities again. It gets me through those first few crazy weeks with surprising amounts of zen.

    Oh, and nursing in the sling--after four kids, I've finally figured that out at the nb level (I'd only done it with my toddlers before). It's made a WORLD of difference!

    1. 'Day long Pixar marathons...' Laughing to myself :)

  19. This list is fantastic! I was fortunate enough to be a student and had the summer off so could basically just blissfully spend time with the baby. I wish someone had told me how bad I'd feel for awhile though -- soooo sore everywhere, my breasts blew up every evening and would just make me feel awful, and I'd get really nauseated every time my milk would let down early on. I'd redo the birth in a second (all 30 hours of it!), but that postpartum period is enough to make me reconsider wanting to have another child.

    I'll admit, I was not one of those people who was for co-sleeping in bed. We had a side car co-sleeper, but even that would be so hard for me to maneuver my daughter into without waking her up, especially with being so sore. But then about a week later, my husband says, "my advisor (he's also a student) says you should just bring her into bed with you," and so I did. And that was that. I can't believe how much better sleep I got after that!

    The only things I'd add to the list are:
    1) Cloth diapers (the prefold kind) are great in addition to the towels. I was so leaky at first, I slept with one tucked in my shirt so I didn't wake up drenched with milk.
    2) If giving birth outside of the home, ask for ice packs to take home. Boy, I needed them! I also got good advice that you can run a little water on a maternity pad and stick it in the freezer.
    3) In addition to learning to nurse lying down (a lifesaver for sure!), knowing that you can change your nursing position to help with plugged ducts to make the milk flow toward the nipple. I had so many early on. I'm sure I looked ridiculous, but I have memories of dangling my breasts over my daughter, while she was essentially upside down in relation to me. It worked though!

  20. LOVE this post. And totally living it right now.

    I make the mistake of overdoing it in the first week or two, and then feel like crap later on when I should be starting to feel back to normal. So that's where I'm at....

    Love the list of responsibilities. I'm totally adopting that for a week or so.

  21. We bought a fitted water-proof mattress pad that covers our entire king-sized mattress. It's a fabric-ish type material, so it isn't crunchy when you move or anything. We've had one covering the bed for years now, ever since our son was born. It has saved our mattress many times over from all types of bodily fluids, like when one of the kid's diaper's would leak, or when they would wake up in the middle of the night and vomit all over the bed.

    My husband had a lot of time off, but he can't even cook a frozen pizza, so I made sure to freeze lots of meals that he could just heat up in the microwave. I left detailed instructions for him about how to heat up meals, how to make things like hard boiled eggs, and ideas for what to feed our son. For the first couple weeks he brought me all my meals in bed. We bought a bed tray with slots in the sides for magazines and books, which worked out really well.

    I taped a list of names and phone numbers on the fridge, including our midwives, a chiropractor, a craniosacral therapist, names of postpartum doulas (if needed), mental health professionals (in case of a postpartum mood disorder), people I thought might be willing to babysit our son, etc. I listed anyone I thought might possibly be needed and I wanted their numbers handy so my husband could just make the call and we wouldn't have to go digging for someone.

    I can not concentrate for anything postpartum, so I had lots of magazines around instead of books, and we loaded our Netflix with short sitcoms. I couldn't handle anything sad or scary at all either. I went online some, but stayed far away from anything that would pull me into any kind of heavy discussion.

    My bedroom became my sanctuary. After a couple weeks I spent more and more time in the rest of the house, but I would still often retreat to my bedroom with the baby whenever things got to be too much.

    These are all tips from my second postpartum experience. The first was not like this at all, I just thought I was supposed to jump back into life, which didn't go very well. I wish that everyone could have an experience like this because I really do think it goes a long way in preventing PPD or other PP mood disorders.

  22. I wish I had done what you did, especially after Henry and Harmony were born. After both of them were born, I went back to work after two weeks. I was too stir crazy in our house! So yes, savor the time.

  23. I never have help(except hubby) after having a baby. After our second was born my husband went to work the next day and I was left with our 2.5 year old and a new baby and I was really sore. It is alittle too much, especially when you are still trying to recover yourself from the birth. If you have help available use it, and keep your responsibilities to a minimum. I let alot of thing slide the first couple weeks(laundry, dishes, cooking) just worked on caring for toddler, baby & myself and trying to get some sleep. I had a friend take my older child for a few hours a couple times so I could nap with baby and that was a huge lifesaver. You don't want to push yourself into depression or something by not allowing for recovery and getting overwhelmed.

  24. Wear Depends for the first few days (under a nightgown so you don't have to take off your pj bottoms to change it).

    Some of those chux pads (usually sold next to the Depends) are great to put by the bathtub or on the bed.

    Salt water baths--you feel so light in the water it helps all those tired achy sore parts feel better. My midwives also had a bag of herbs that you would steep in a pot of boiling water to add to the tub. The herbs supposedly helped with the healing too, but all I know is that they smelled wonderful and made me feel great getting a couple of special baths.

    With my first, I was blindsided by the firehose of emotions that I had. I knew about PPD and stuff, but I never knew the opposite could happen too. I was high as a kite for two months solid, had a hard time going to sleep because I couldn't stop thinking about that awesome birth experience. When I woke up in the middle of the night because my breasts were engorged, I didn't recognize that as painful and would try and go back to sleep until my baby woke up!

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  26. We had family come in to help after 1 and 2. 3 we had help from our church family and my husband (the pastor) was able to do a lot of working from home. #4... UGH! Hubby just got a new part-time job (he's a worker-priest... part-time pastor looking for part-time work for almost 3 years - you don't pass it up) a couple days before my EDD. The morning the baby was born, he called in. The next day we all got up for me to go claim the big kids from one friend (where they spend the night) to drop them at another friend (where they'd stay while I brought my UC baby in for her PKU) and drop hubby off at work. He's running a few minutes late and calls in to find out the boss came in - thinking hubby would want to spend the day with his family. Would have been nice to know before we got up at the butt-crack of dawn to get ready. Got to the doctor's office - and they wouldn't see the baby because she was a liability since she hadn't seen a doctor (why were we there?) - they wanted us to take her to the ER (no). So we drove 90 minutes in the opposite direction to the chiropractor to get her weighed and measured and adjusted - and me adjusted. By the time we got the big kids and went home, it was about 2PM. We were all tired, got a nap, ate some dinner, went to bed.

    That was it for my babymoon. The next day I started single parenting until my husband left that job when the baby was 4 months old. He worked the second job Tuesday through Saturday, the church job Tuesday through Sunday and Mondays we frantically tried to get everything done that didn't happen the other 6 days. And we homeschool. This transition period has sucked - that's all I can say about it. My first crawl in bed "all day" with the baby day happened at around 6 weeks, and I had to change the sheets and do laundry before that happened. Had we known he was getting this job, we would have had help lined up. All volunteers from church had to cancel after that first day for various (valid) reasons (work, illness, family issues). My in-laws still haven't met the baby after 6 months of life (my mom is deceased). It's real life and %^&$ happens - but I'm still very angry and bitter about it.

    1. Oh my, that does sound incredibly difficult. I'm really sorry that you didn't get a babymoon this last time.


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