The Postpartum Period 

COMMON POSTPARTUM CHANGES

Leaking urine. It's normal to leak a few drops of urine when you cough, sneeze, or laugh. This "stress incontinence" is a temporary nuisance that occurs while your bladder and pelvic organs are rearranging themselves back to their pre-pregnancy positions. Wear a sanitary pad for a few weeks until this annoyance subsides.

Profuse sweating. Another way your body gets rid of the excess fluids accumulated during your pregnancy is by perspiring more, especially at night. For the first night or two wear cotton clothing to absorb the perspiration and cover your sheet and pillow with a towel to absorb the night sweats. Excessive sweating is most prominent during the first week and gradually subsides by the end of the first month.

Painful perineum. Your sensitive perineum has been stretched to the limit and it may possibly have been bruised or torn. If it has been cut into, it's bound to smart. Ask the nurse to instruct you on "peri-care". Heat increases blood flow and promotes healing; cold numbs pain and decreases swelling. Both measures are necessary to heal a traumatized perineum. The nurse will tuck an ice pack up against your perineum as soon as possible (it will feel so good). She will advise you about soaking in a warm bath and show you how to squirt warm or cool water over your perineum, using a "peri-bottle." Try using cool witch hazel pads between your perineum and the sanitary pad.

Constipation. Your bowels may be as reluctant to work as your bladder is, and for similar reasons. The muscles involved in passing a stool may have been traumatized during passage of the baby. Drugs and anesthetics temporarily cause the intestines to be a bit sluggish; and your bowels were probably emptied naturally by the normal "diarrhea" that normally precedes birth. Besides these physical causes for problems with bowel movements, many mothers have a psychological reluctance to do any pushing with their perinea muscles, either for fear of hurting these tissues or because of a desire to rest them. Yet the sooner you get your intestines moving, the better you will feel. (See )

Gas and bloating. The bowel sluggishness that contributes to constipation also may make you feel gassy, especially if you are recovering from a cesarean section. Drinking and eating frequently, but in smaller amounts, and getting your body moving again, will ease these discomforts.

Engorged Breasts

In the first couple of days postpartum you will notice only slight changes in your breasts. You may even wonder where all the milk is supposed to come from, as you produce only small amounts of the first milk, called colostrum. But then, around the third day, you may suddenly awake with breasts the size of a melon, and nearly as hard. You find that you've grown two-cup sizes overnight. This is breast engorgement. Some mothers find that their breasts become suddenly and painfully engorged, while others, especially those whose babies have been nursing frequently and effectively since birth, experience only a gradual increase in breast fullness. Yes, it's hormones at work again; as estrogen and progesterone levels drop in the days after birth, prolactin -- the milk-making hormone -- takes over. As the breasts begin to do their work, the tissues swell, partly with milk and partly with other fluids. These dramatic breast changes may not have been part of the lovely, peaceful breastfeeding experience you envisioned during pregnancy. After your baby learns to latch on properly and your breasts settle into a comfortable balance of milk production where supply equals demand, you will be well on your way to a gratifying, nurturing experience. If your breasts seem too full for baby to latch-on properly, use a breast pump or hand expression to soften your areola enough that your baby can latch onto more than just your nipple. The best remedy for engorgement is frequent breastfeeding. Nothing relieves breast fullness as quickly as a baby who is nursing well. Frequent feedings will also bring your milk supply in line with your baby's demands

Sore nipples. Most sore nipples are the result of a baby who is not latching-on to the breast correctly. When a baby latches and sucks effectively, your nipple goes to the back of his mouth, away from the tongue and gum action that can irritate skin. Sore nipples are not an inevitable part of breastfeeding. If your nipples are starting to get sore, you need to pay some attention to what's going on during feedings. While you may want to call in some helpers (a knowledgeable nurse, a lactation consultant, an experienced friend, or a La Leche League Leader) for expert advice, you are the expert on your baby.

8 TIPS TO RELIEVE NIPPLE SORENESS

1. Be sure to break the suction before removing baby from the breast. Press down on the breast tissue, or slide your index finger inside his mouth between his gums. "Popping" a baby off the breast hurts!
2. Nurse on the least sore side first. Nipple pain usually lessens as the milk begins to flow. Switch to the other side after you notice signs of the milk ejection reflex, i.e., milk dripping from the other nipple, a tingling sensation in your breasts, and a change in the baby's suck and swallow rhythm.
3. Try stimulating the milk ejection reflex before you put your baby to the breast, using warm compresses, massage, or gentle pumping.
4. Breastfeed frequently -- every two hours or so during the day. This will lessen engorgement and make it easier for baby to latch on.
5. Let your nipples air-dry between feedings. Express a few drops of milk and let them dry on the nipple. The immunities in your milk will help heal your skin.
6. Use a purified lanolin product (such as Lansinoh) on your nipples between feedings to keep the skin moist so it will heal more quickly. Avoid using preparations that must be wiped off (ouch!) before feeding the baby.
7. Wear an all-cotton bra that fits well, or go braless under a cotton tee shirt. Avoid bras with plastic or synthetic linings that hold moisture against the skin.
8. Nursing pads with plastic in them can aggravate sore nipples. If a pad sticks to your breast, moisten it with water to release it and avoid skin damage.

4 WAYS TO END POSTPARTUM CONSTIPATION

1. Walk. Moving your body is likely to move your bowels.
2. Drink plenty of fluids.
3. Eat and drink natural laxatives, nectar (prune, pear, apricot), fresh fruits, whole grains, and vegetables. Avoid caffeine-containing foods and beverages, such as chocolate, coffee, and colas.
4. Relax. Don't worry that passing a bowel movement will pop your stitches. While straining may not be friendly to your hemorrhoids, you can start using your perineal muscles as you did before delivery.

5 WAYS TO RECLAIM YOUR PRE-PREGNANCY WEIGHT

1. Figure out your daily basic caloric needs. This means the number of calories of balanced nutrition you can consume to maintain your feeling of well being yet not gain weight. Remember, most breastfeeding mothers will need approximately 500 extra calories for lactation. Most postpartum mothers can eat around 2,000 nutritious calories per day and still expect a gradual weight loss
2. Exercise one hour a day. This could be something as simple as walking briskly while carrying baby in a sling. Brisk walking or swimming for one hour burns off around 400 calories. This exercise plus abstaining from one unnutritious treat each day (one chocolate chip cookie is around 100 calories) means you have a deficit of 500 calories each day or 3,500 calories per week -- enough to lose one pound of body fat. Gradual weight loss is best during breastfeeding. Burning off fat quickly is not safe because the body stores pesticides and other contaminants in fat. Quick weight loss releases these contaminants into your milk.
3. Breastfeeding women often experience their greatest weight loss between three and six months postpartum, when they are producing a lot of milk for their babies. So don't get frustrated if the pounds aren't coming off at first.
4. Chart your weight loss, and tailor your exercise and eating habits to reach the goal you set.
5. Invest in some nice, comfortable clothes that fit your postpartum figure. If you focus only on getting back into the jeans you were wearing nine months ago, you could get very depressed. And no one wants to keep on wearing maternity clothes for weeks after the birth. Some pants or leggings with an elastic waist and a few colorful tops will help you feel better about your still-changing body. Two-piece outfits that are easy to breastfeed in will make it easier for you to get out and around with your baby.