Postpartum Discharge Instructions for Mom and Baby Newborn | from Palm Beach Midwife

In this blog post I share Gentle Birth Center’s Midwife Erika Piagetti Postpartum Instructions for moms and newborn babies from natural births.

Video Transcript:

Congratulations, you did it and I'm so proud of you. So as you begin to start getting ready to go home, we're gonna have to go over a couple of things so that this postpartum time will be the healthiest and safest for you and your baby.

Let's start with you Mom.

First get plenty of rest, eat lots of protein, take your prenatals, keep drinking water, get household help with things like laundry and meal preparation.

Also, make sure you limit your visitors. No one should be holding your baby for more than 10 minutes. That way you can make sure that you and your baby are having the easiest transition time.

Next thing, I want you to focus on your bleeding. Your bleeding is going to be like a heavy period for the first few days. You can also pass some clots even ones the size of your fist, but it only should be one a day. Now, you should not be bleeding more than two pads in an hour. That's too much. And if you start to bleed too much, make sure you void, you nurse your baby, and you massage your uterus until it feels really hard and tight like the size of a grapefruit. It's also very important to prevent infection.

Wash your hands often. Change your pad often. You do not want to have a temperature above 100.4F.

Be aware of some signs of infection: fever, body aches, foul smelling, discharge, sore tender breasts. Keep drinking water. We want you and baby to be super healthy.

We also want you to really pay attention to your perineum. It's been through a lot. We want you to make sure you keep yourself clean and dry. Get your Perry bottle. You can put some witch hazel, a few drops, hydrogen peroxide or some tea tree oil and gently spray clean. Pat dry. Never rub. You might have some difficulty having your first few bowel movements and that's okay. It could take up to two to three days post birth for you to have your first. But we want it to go easy. So make sure you keep drinking water, things like prune juice or even Colace can help soften your stool to make that time a little bit easier.

Remember when I said rest, well you have to do that, but your activity level will gradually increase as time goes by. But for the first 48 hours, you should have someone take you to the bathroom and never go holding your baby. Be very careful. If you feel dizzy or have tunnel vision or hear ringing in your ears. Those could be signs that you will faint so immediately sit down or lay down and rest.

Nursing: very important not just for baby, but also for you. It should be done every two to three hours now nursing for you helps clamp down your uterus. So make sure that as you're nursing you're also rubbing your uterus to make sure that bleeding is under control. A good latch is very important for baby and also for you. It helps prevent sore nipples. We will help you get a good latch before you get to go home nursing is very important for your baby, too. Remember every two to three hours. Now, for the first day, a four to five hour rest period is normal. Both you and your baby have gone through a lot. You have colostrum. It's the first milk and it is exactly what the baby needs. It might be small in quantity, but it is protein-packed and full of all the nutrients for baby's first few days.

Now, let's talk about baby's breathing. It should never be labored or high-pitched but it is normal to be irregular. It should be between 30 and 60 breaths a minute, never showing the baby's ribs or what we call retraction. Mucus can come out, coughing and sneezing is normal. So if you have any questions regarding your baby's breathing feel free to call us and we'll go over what is normal and what it isn't.

It's all so important to monitor baby's temperature at least for the first 48 hours. Every 46 hours is good. Baby's temperature should be between 97F and 99F axillary. It's always one degree less when taken under the arm or temporal.

Your baby has the umbilical cord stump and it does fall off between 4 to 10 days. You really don't have to do much. Just keep it dry. Make sure that when you put on the diaper the urine cannot go through it and wet the umbilical cord stump. It should never be foul smelling, ooze or bleed. If you feel it's taken too long to dry and fall off, you can get a cotton tip swab, and put alcohol on it, and go around the base of the cord trying to avoid the baby skin.

Baby should pee and poop within the first 24 hours. Baby's first poo is called meconium. It is dark, tarry, and pretty sticky. But as the baby nurses and your milk comes in, it should turn from greenish to yellow, and that's completely normal. After your milk comes in, baby should have six to eight wet diapers a day and two bowel movements. And that's the way you make sure baby is getting enough nutrition.

Jaundice. It is a yellowing of the skin and at the whites of the eyes in the baby, and can happen between two and seven days of life. Within the first 24 hours of life, it is a warning sign that something might not be right. To avoid the buildup of Bilirubin in the baby's blood you want to take the baby out into the sun, with just a diaper before 10am and after 4pm when the sun isn't so hot. Five minutes on one side, flipping the baby over, five minutes on the other side, helps baby break down that bilirubin and get rid of that yellowing.

There's lots of information on your postpartum's sheets, like for follow-up care of the infant and the birth certificate. So make sure you read over that, if you have any questions. One of the sheets you're going to be sent home with is following and monitoring the baby for the first three days of life.

You're going to want to check baby's temperature, bowel movements, voiding, skin color, and activity level. And also make sure baby is nursing every 2 to 3 hours.

So now that we've talked about some of the things you should expect in the postpartum period, let's talk about some of the things that are not normal. Warning signs that are indicators you should call your midwife.

Mom, call the midwife immediately, if you have any of the following:

• Fever greater than 100.4F.

• Any sign of localized swelling or tenderness in your breasts, especially if accompanied by body aches or fevers, tender or sore nipples when nursing. These are signs of a poor latch that can be fixed very quickly in order to avoid nursing problems.

• Any sign of swelling or infection around the vagina, especially if you have had a tear.

• Discomfort or burning when you urinate. Having difficulty in urinating or being unable to completely empty your bladder.

• Sharp pains in your abdomen, chest, or breast.

• Blurred vision or dizziness, with or without a headache.

• Headaches.

• Pain in your legs, especially the calf muscles.

• A foul smell or unexpected change in your bleeding.

• Bleeding lasting more than 6 weeks.

• Any strong sense that something is wrong with you or your baby.

• Crying spells or mood swings that feel out of control and do not get better with more sleep, rest, and nutrition.

• Thoughts of harming yourself or your baby.

Now, for your baby. Call the midwife immediately if your baby has any of the following:

• Temperature over 99.5F or under 97.5F axillary.

• Respiratory difficulty: noisy grunting on the exhale, flaring nostrils with each breath, ribs sticking out when inhaling, or becomes blue or gray in the torso and head.

• Becomes yellow or orange in the skin or eyes in the first 24hours.

• Seizures or lethargy.

• If you cannot stimulate baby to wake up and it is very tired and it won't nurse.

• Develops a high-pitched cry.

• Baby will not nurse.

• Skin bruising or unusual bleeding, especially any bleeding from either a circumcision or the cord.

• Failure to thrive.

Again, congratulations! You did amazing! Now go home and enjoy your new family.

If you’re reading this while pregnant - check out some of my Palm Beach Newborn Films and Photos as you prepare for the arrival of you new baby!