Drs. Sarah and Alicia review the immediate post partum period and what to expect after childbirth. They review normal and abnormal post partum bleeding, …
hey guys dr. alicia and dr. sarah here
welcome to our labor and delivery video
series today we are talking about
postpartum expectations and what to
expect for you and your newborn in the
first few days after delivery check out
the rest of our video series we will
Link all the other videos in the show
notes below also hit subscribe if you
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notes that would be fabulous anything
that we mentioned in the show notes will
link down below as well so postpartum
and what to expect
so generally if you've had a vaginal
birth you'll spend about two days in the
hospital and if you've had a cesarean
section usually on average it's about
three days and this time is spent
resting you know just being skin-to-skin
with that new babe and establishing
feeding whether that be breastfeeding or
bottle feeding and these first few hours
today's are so important for bonding and
if you are breastfeeding for
establishing your milk supply so a
really great website we like to direct
our patients to is www.firstdroplets.com
and again I'll link that down below
it is done by a lactation consultant in
the States and she is so passionate
about breastfeeding that she created
this free website that talks about skin
to skin how to latch your baby how to
work on a latch if it's a bit hard and
how to express milk in those first days
two hours which is really important
perks for getting your milk supply well
established so really great website
check down below
we also suggest for those early days you
know it's not a bad idea to limit
visitors at this time you know you'll be
exhausted and and all those people
coming in and out can be really
disruptive for you for for trying to
rest and also spending time with your
baby there's no harm in having visitors
but if you're planning on doing that
maybe you know give it a defined time to
make sure that you and your partner have
enough time to rest and bond with that
new babe and just keep in mind a lot of
your time is gonna be doing skin-to-skin
and work on breastfeeding your baby like
every hour or two and so if you have
visitors coming out if you're not really
comfortable I mean I'm not that shy so I
probably wouldn't care but you're gonna
have your breasts exposed a lot so it's
hard to really establish that latch if
you're not comfortable and you have
people coming in and out wanting to
snuggle the baby and hold the baby also
keeping in mind that everybody has girls
germs on them and so your baby is very
vulnerable at this point as are you and
so just being really cautious of who you
invite save it for later when you're
home they can come visit you but make
sure that you get them to do something
useful for you when you're at home clean
your kitchen bring some meals snuggle
your baby while you have a shower useful
guests are the best kind of guests yeah
I agree
so like Alicia said your
babies generally gonna feed every 1 to 2
hours during those first few days to
week because what they're getting is
really tiny but really powerful amounts
of what we call colostrum as well as
your early milk their bellies are tiny
and they really need to be frequently
fed during this time you won't feel like
you're producing much but that's ok
because they don't need much at that
time they just need to feed really
frequently on average your milk will
start to come in anywhere between day 2
and day 4 and this can be super dramatic
it could lead to
significant engorgement and also leaking
so it's good to be prepared for that to
have some you know good supportive bras
to have some breast pads
and you know be prepared to be managing
painful breasts yeah for sure
and to help deal with that leaking
because that milk in those first few
days is so valuable often women use
something called milkies they're kind
of like a milk capture device that you
can put on the breast that you're not
feeding out if to capture that extra
milk or some
called the hakaa and they again will link
it down below or if you're finding that
you're leaking and you don't have those
devices you can just press on the nipple
that's leaking and that should slow the
flow down so that your baby then has the
opportunity to drink that milk and I
personally use both of those the milk I
used to walk around with male keys home
in the early days and then I used to
hakaa that would feed on one side and
I'd collect collect breast milk on the
other and like Alicia said if you don't
have them that's okay and if your your
baby's having difficulty gaining weight
or you're having difficulty
breastfeeding we don't recommend using
those because we want to make sure that
we're saving that milk too because
that's easy milk for that baby to drink
yeah or if you are using them and you
can use that to top-up right after the
release so just making sure that as long
as your baby is gaining weight those are
great products if they're a little bit
slow if you're using those products make
sure you use that milk right after the
feed to top them up and that can be a
really useful way of using those
products so we mentioned babies need to
eat frequently during those first few
days and you know for the first couple
days it'll be literally every one to two
hours once you get home sometimes that
space is out but we really recommend
feeding that baby at least every two
hours at night sometimes you can stretch
that to as much as three hours and
that's from start to start so start of a
feed to the start of the next feet we're
counting that time and we we do
recommend waking your baby up at night
for that feeding sometimes you can
stretch it to four hours but that's
something that you need to chat with
your care provider about and we
generally recommend that that waking
baby to feed until your baby's well
established in its weight gain and often
times once it's above its birth weight
then we're more confident that it's got
a good feeding habit have it established
and that it's gonna continue to go on
and gain weight in those early weeks and
so we want to see you in the office to
do a weight check at about five to seven
days after delivery so if you're on hold
if you're in hospital for a couple of
days we'll go home for a couple of days
and then come back in to see us and
that's because we want to make sure that
you're doing well because it's a big
transition and that your baby is gaining
well so how do you know your baby's
hydrated well they're gonna have as many
peas as they are a day old so on day one
they should have one pee on day 1
on day two they should have a two pees etc etc up
until about five to seven days they
should be having five to seven point wet
diapers a day normally so that's how you
know that your baby is getting enough
milk in and then we know because we
weigh them and so we expect babies to
gain about an ounce a day except for
Sunday's I say or 30 milliliters a day
six out of the seven days so that's kind
of what we would hope for most day
babies dip down to their lowest weight
at about day five and that's often when
babies jaundice is the worst – and then
they start to kind of gain after that so
very normal to have a dip in weight we
expect that but we just want to make
sure that that weight is coming up so
day five to seven is when we want to see
you guys in the office at grow health we
have amazing lactation consultants who
work with us and so they'll see the
babies do a weight check if they have
any and support the breastfeeding or
infant feeding if you choose not to
breastfeed and then they'll grab us docs
if they have any concerns but that's how
we kind of help support that early
breastfeeding here at Grow Health
so you know talking about
breastfeeding and infant feeding there's
there's so much going on in those first
few weeks and they're amazing but they
certainly can be exhausting and
overwhelming you know you're you're
trying to navigate caring for this new
beautiful human that you love like
you've never experienced love before and
you're just you're recovering from like
a super crazy intense labor and delivery
experience so what we have learned is
experienced mums between the two of us
we've got five kids so we've had five
deliveries and five postpartum times um
it's ask for help when you need it
delegate housework and cooking and
cleaning to others as much as you can
and don't stress about getting these
things done
let the laundry pile up yeah let the
dishes pile up someone else can take
care of them you know most of that stuff
can wait talk to your partner and be
really explicit about what what you need
and respect the same this can be a
really challenging time for partners too
and they didn't go through all the
hormonal changes leading up so it's a
bit more sudden for partners so you know
be sure you have open honest
conversations between the two of you to
figure out what's going to work in those
a few weeks at home as you adjust to you
know your new life as a family and if
you're watching this video before you've
had a baby which we're assuming you are
now's a great time to start making
those plans so start making meals and
putting them in the freezer or asking
your parents or friends to kind of come
over and help with cleaning and cooking
and that type of stuff
after baby's delivered because there
it's a lot of stuff and and we want you
to take care of yourself and take care
of your baby and take care of your
family unit including your partner and
the only way to do that is to come up
with a good plan between your family you
know how to do that. okay so the
other thing that we need to talk about
which we have tons of questions of
postpartum women is of what kind of
bleeding do I expect so generally in the
first couple of days you're gonna have
bleeding that's like a heavy period
you'll be soaking a pad every couple of
hours so get those big postpartum pads
or those depend underwears super-useful
and that's normal you're gonna have some
clots and that's all fine as your uterus
is cramping down to to get back to its
normal size then the bleeding should
settle down so I usually say it kind of
like does like this so it should be
trending downwards and depending on how
busy your day was the day before you
might have a little bit heavier bleeding
again if you've been lying down for a
while and you get up to go to the
bathroom you're gonna have some clots
most likely and that's fine that's just
because the blood isn't pooling in the
back of the back of your vagina as you
were lying down as long as that bleeding
doesn't continue to be heavy afterwards
we're fine with that so when do when
what is too heavy well when you're
soaking up at an hour every hour for
four hours in a row or if you have big
clots and continued heavy bleeding after
it we want to know about that and when I
say big clots
I don't mean loonie or toonie like we
mean like sort of lemon-lime sized clots
because the loony toony size clots are
normal so some women are told in the
hospital to watch out for those clots
well that's okay but they're normal so
it's big honkin clots that we want to
know about and continued bleeding
afterwards you have a big clot and then
you have no bleeding afterwards that's
usually okay something else we we want
women to start thinking about pretty
early on maybe not the first few days
but as as a physician whose first two
children were 14 months apart we start
talking about contraception pretty early
on if you are not exclusively
breastfeeding your your period can
return within the first month yeah and
that means you're ovulating two to three
weeks after you've had that baby or even
if you are exclusively breastfeeding oh
yeah same oh my gosh you guys it happens
okay so talk to your care providers
about contraception early and often I
had a good plan for contraception I was
okay I didn't know what can you do he's
a beautiful baby and the other option is
if you know that you want an IUD after
delivery we can put those in immediately
after delivery if we don't put them in
right away we have to wait about ten
weeks so if that is something that you
know you want a Mirena IUD then talk to
a care provider before you deliver
because you can set that up if it's a
nice normal safe delivery and we can
certainly put that in right away which
is a great option for some women yeah
for sure
the there's one more thing women often
talk about or are afraid to talk about
and that is their bowels so when you are
exhausted from just having had a labor
and a delivery you're breastfeeding you
can be dehydrated and your stools can
slow down and that combined with women
who often have had a type of vaginal
tear can be really scary for women so
it's important to drink tons of fluid
and don't be hesitant to take a stool
softener the one we recommend is called
PEG it has many different Lax-a-day
the most common one brand here
is anyways and I'll link it below in the
show notes yeah but it's safe to take in
breastfeeding and it doesn't cause any
dependence or anything like that and
it's just really important to keep your
stool soft and in flowing you know
basically we want you to have a urge to
have a bowel movement sit down on the
toilet and be able to pass it easily
without having to strain too much
and another tip I tell women who are a
bit afraid to have that first bowel
movement is to get a face cloth with
some warm water and just protect your
perineum so if you've had stitches or an
episiotomy just put a little bit of
pressure on your perineum you are not
going to tear anything from having a
bowel movement but just gives people a
little bit more confidence in that so I
think that about wraps it up thanks for
watching we hope you found it useful if
you did please hit subscribe below we'll
link a couple of other great videos for
you to watch and then check out our show
notes have a great day thanks guys

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