Comfort Measures

Positioning:

• Lying on abdomen helps uterus contract.
• Pulling buttocks together before sitting/standing helps episiotomy pain.
• Splint c-section incision when coughing, laughing,moving about.

Squirt bottle:

• Helps improve circulation and promotes healing.
• Will continue using at home.
• Spray perineum with warm water for cleansing and comfort.
• Use for first couple of weeks at home.

Postpartum Changes
The effects of pregnancy usually last up to 6 weeks.

• Uterus - Large muscular organ, which will be contracting, and slowly moving down in pelvis. By 10th day you will no longer be able to feel it.
• Lochia - Vaginal discharge that changes from reddish brown to pinkish to white/yellow.  May last 4-6 weeks. No douching or tampons.
• Afterbirth pains - Uterine contractions that may be more frequent and stronger while breastfeeding or for mothers with more than one child.  Normal part of postpartum, which lasts 3-4 days.
• Episiotomy - Report excessive swelling, redness or abnormal discharge to physician.
• Bladder function - Drink plenty of fluids. Report burning on urination or urinating small amounts frequently to physician.
• Menstruation - Begins 4-12 weeks postpartum for bottle-feeding mothers. May not reoccur until after breastfeeding ceases.
• Hormonal - Major hormonal changes that occur after delivery may cause frequently changing moods and some depression or frustration. Do not hesitate to get help with difficult adjustment to parenthood if more than 5 days. Report to provider.

Bathing
Tub baths are not recommended until your physician is consulted. Showering is permissible at any time. Hair washing is also acceptable.

Physical Activity

Exercise:

• You will tire easily with the decreased demands on your energy and time.
• Plan naps the same time your baby sleeps.
• Usually permissible with physician approval - Kegels, low impact walking.
• Strenuous exercise to be avoided until after first postpartum visit.

Sex:

• Pelvic rest for 6 weeks. 
• Discuss with physician. 

Nutrition
Eat well-balanced meals, emphasizing four food groups (meat, milk products, fruits and vegetables)

Breast care
Wear good support bra to help support heavy tissue and limit engorgement.

Nipple care:

• Do not wash nipples between feedings.
• Daily shower is adequate for cleaning.
• May use pure lanolin as discussed with physician.
• Keep nipples dry between feedings.
• Wear breast pads to help catch leaking and keep moisture off nipple.

Engorgement:

• Bottle feeding mother use tight bra or binder with ice packs as tolerated.
• Bottle-feeding mothers - Do not use breast pump.
• Breast feeding mother use warm, wet towels to breast or hot showers followed by gentle massage and manual expression. May be done as needed for comfort but especially useful prior to breastfeeding.

Should you decide to stop breast feeding at home, there are 3 things for you to do to minimize the discomfort:

• Wear a bra night and day. 
• Limit fluid intake to thirst only.
• Use ice bags to the breast for 15‑20 minutes 4 times a day.

If you do breast feed, continue to take your prenatal vitamins and increase fluid levels.

Situations to report to your physician:

• Temperature elevation of 100.6 or over.
• Heavy, bright red bleeding. 
• Passage of large clots.
• Painful urination.
• Abnormally painful breastfeeding.
• Discharge from abdominal incision.