I love to talk about birth plans, write about birth plans, and help people make birth plans. You’ve probably heard about birth plans. What a lot of people don’t often hear about are postpartum plans. As much as I love birth plans, I might argue that postpartum planning is equally, if not more, important.

What is Postpartum Planning?

To simplify, it’s just the process of thinking about and planning what your postpartum recovery time will be like. What happens AFTER birth? In the recorded interview below with postpartum doula, Amy Tucker, she describes a postpartum plan as a continuation of the birth plan. She recommends going through a similar process in making this plan as you would a birth plan. It takes a lot of thought and many conversations with loved ones and partners. You want to spend some real time and energy on this. It might sound like an unpleasant homework assignment, but it might be as bad as you think, and will likely save you so much frustration and stress later on. You want to prepare yourself to have the most peaceful and restorative postpartum experience possible. This can help set you up for a lifetime of better health and parenting.

Why is it Important?

When you are pregnant, you usually get to be the center of attention. Your needs and your health become top priority. You get parties and gifts, and people hold the door open for you more often. People might tell you you’re beautiful and “glowing”, and you might even feel like that! After the baby comes, things change. Most of the attention shifts to the baby. Your attention has to shift a lot, but it’s likely true for the people around you too. You might not have much support or encouragement at a time you need it the most. I like to suggest that your most important job is taking care of your baby, but everyone else should be taking care of you! Instead of offering to hold the baby for you, a friend or family member could offer to bring you a cup of tea or fold a load of laundry.

Your body is doing some BIG healing from pregnancy and birth, and it’s important to rest and support that healing. In some other cultures, there are specific recommendations and rituals related to postpartum healing. Communities are set up to provide care and feeding for the postpartum parent. They continue to be top priority. Unfortunately, in our modern Western culture, the expectation is that we hurry up and get back to our bodies and life as usual… only new and improved and WITH a new baby. This is not real. Even if you can fit into your jeans and get things done, you might not be truly healed on the inside. I mean your organs and soft tissues, AND your emotional state.

After birth, most people do experience some big changes in their mental health. Even when things are “normal”, postpartum emotions can be hard to manage. You might not feel like yourself for at least a few weeks. Most people feel overwhelmed, weepy, irritable, tired, or foggy at least some of the time. This is normal, but it can also become something more difficult to manage especially when you don’t get proper care or if you have some risk factors. You need help from others, and you also need to learn how to take care of yourself.

Like Amy says in the interview, a family is a system. When one part of the system is not functioning well, the whole system suffers. Your baby is an important part of that system, and so are you. Postpartum planning can help you be a healthy part of that system.

How to Make a Postpartum Plan

You can just sit down and make a list. You might get everything covered, or you might not. To make the most of your efforts, Amy recommends following some guidelines when you’re creating a postpartum plan. If you want even more guidance, the Life with Baby Workbook is a great tool!

• Talk about it. You’ll want to have some conversations with the people who will be supporting you and your family. Find out how they intend to help, or ask for what you think you’ll need. It’s important to figure out what your resources are before you make a plan.
• Write it down. Once you have a better idea of what is available to you, write out many paragraphs, or an outline, or a list. You might organize it or just rough it. The point is to get everything down on paper. You can refine it later.
• Get feedback. Once you have your document, you might want to go over it with people who can offer encouragement or helpful suggestions. Your sister might notice that you didn’t ask for help with meals on your plan and might be able to give you some suggestions for that.
• Share it. Once you feel good about the document, you can share it with all the people who might be supporting you in the postpartum period. This can include medical professionals and doulas, but also your partner and any family or friends who might be spending time with you after you get home with your baby.
• Remember that this is a living document. This is not a POSTPARTUM PLAN. (period) This is a postpartum plan… You can and should change your mind about some things. It’s so important to be flexible. When you’re actually in the postpartum period, you might notice that you need more than you thought, or just different things. Change it! People can change a lot from pregnancy to postpartum. Your expectations about what it would be like to have a new baby might be completely different from your reality. That’s OK. I would even say that it’s a great character asset to be able to say, “This is not what I thought I would do. Oh well, I guess I need to adjust!” You might have planned to use cloth diapers, but then feel like you want to switch to disposable. Or maybe you thought you’d want your baby in their own room right away, and now you want your baby right next to your bed, or even in your bed. This happens to all parents. No one has it all figured out at the beginning. Parenting is a journey of learning. We never stop learning new things about our kids and about ourselves. It’s part of the beauty.
• Remember that this is just a guideline. So many of us enter pregnancy with the desire to control our experiences and our lives. We can even start to feel some sense of control when things go well. At some point, we all have to come to realize that control is an illusion. If you think you have it, it’s just luck. But luck runs out at some point, and you have to recognize that you can’t actually control everything. Having children can expedite this understanding for a lot of parents! These little people have their own ideas about life and how they want to do things. Postpartum recovery is the same. It’s impossible to predict what might happen during birth and during our recovery. A postpartum plan can’t give you absolute control, but it can give you a framework and something to refer to for options and help when things don’t go exactly as planned. It can’t offer you total control, but it can offer you direction.

What to Include on a Postpartum Plan

If you’d like to be very organized with your document, you might divide your list into sections, categories, or buckets as Amy calls them. It can be helpful to start with this framework even when you’re just having conversations or organizing your thoughts.

• Your emotional health/support: Consider what you might go through emotionally after giving birth. Do you have a history of or any risk factors for a mood disorder? How do you handle difficult emotions? What do you need to support your mental health?
• Everyday basics: Think about the stuff you do on a daily or weekly basis. Do you wash dishes, do laundry, walk the dogs, eat, sleep, stretch, take medicine, make and keep appointments, etc, etc, etc. What about during postpartum recovery? Remembering that you’ll want to take care of your baby and let other people take care of you and the rest, who can you enlist to help with some or all of these things?
• Transitional preferences: If you have a co-parent/partner, it’s really important to figure out these things together on a postpartum plan. Do you plan to stay home with the baby for some amount of time? What about your partner? What happens when you or your partner go back to work? What does this mean for your planning, breastfeeding, childcare, etc.?
• Communication/relationships: It can be so hard to ask for help, but a postpartum plan is a great way to organize your needs and then communicate them. It can also be a lot easier to do this before the baby arrives when you’re not so overwhelmed that it’s much harder to ask for help. Since you’ll share that plan with your support system ahead of time, hopefully, they can step up and provide the help and support you need when the time comes. You might also need to ask for more, or remind people. You might have very strong emotions that make communication difficult. Your postpartum plan can provide some direction for you in this way too. You might set up some time for you and your partner to meet and talk or connect on a regular basis. You might include some information about how you would best like to communicate needs or frustrations with your partner during this time. Maybe you’ll write things down instead of speaking. Maybe you choose a “safe word” to use when you’re feeling very overwhelmed so your partner can understand that they might not be doing something especially wrong, but that you’re feeling especially bad. Then they can be prepared to be extra compassionate. You might plan for your partner to handle the logistics of other people’s involvement in your care (asking for help and setting it up). Your partner might help by communicating and holding boundaries with family members or friends. Setting these boundaries in a postpartum plan is also a really important thing to do! You might love to have visitors, or you might not. In that case, you might communicate something like, “Thank you so much for bringing us a meal. In the first couple of weeks, we plan to lay low and recover and minimize visits, so please drop it on the front porch and send a quick text. We’ll follow up with you soon so you can meet the baby!”
• Resources: This last section of a postpartum plan is where you put all the phone numbers and information for resources you think you might need. I love to recommend having a lactation consultant’s phone number readily available in case you need some help with breastfeeding. Breastfeeding Success has a 24/7 hotline that you can use for some quick help or to schedule an appointment! 512-808-0237. You might have some names and phone numbers for a therapist, the pediatrician, your acupuncturist, a postpartum doula, neighbors, etc.

Self-care for You

First, I encourage you to lower your expectations related to self-care. I don’t mean that you shouldn’t do anything, just change what you expect to do and how much. You’re not likely going to want to take vacations or go to a spa or lots of your favorite fitness classes. You might not be going to happy hours with friends or co-workers for a while. You might not even get to church or take nice long walks or baths. If these sorts of things were part of your self-care routine before, it’s ok to let those go temporarily. Or you might even find that some of those things can change forever! You are not “giving up” when you modify your life to work better as a new parent.

Second, it’s important to have some self-compassion. It will help you to learn to be OK with doing “less”. The fact is that it might look like doing less, but you’re actually doing as much or more. It just looks different. When you are recovering from pregnancy and birth, your body is making a heroic effort to heal. Your uterus needs to shrink and move back into its proper position. Your other organs need to shift back into place. Muscles, ligaments, and tendons need to shorten and heal. Your skin and bones need to readjust, and your hormones will need time to rebalance. On top of all of that, you’re learning how to do something huge… parenting. A newborn is a very special little human with high needs and a high level of dependency on YOU. It might look like doing “less” when you’re lying in bed holding your baby skin-to-skin, but you’re actually encouraging your milk supply to stabilize, your uterus to shrink, bleeding to lessen, hormones to rebalance, and your baby to adjust their bodily functions like body temperature and blood sugar levels, to being outside the womb. When you can put it that way to yourself, you might recognize that you’re doing pretty big things “just lying there”. When you’re able to be compassionate with yourself, you will likely feel better and heal better. Remind yourself that “productivity” will look different temporarily, and when you can allow this time to fully heal, you’ll be better off in the long run.

Here are some good examples of postpartum self-care, but this might look a little different for every person. Just do what works for you. Whatever you choose, integrate the practices into your daily routines so they become automatic, and you don’t forget or skip it.

• Check in with how you’re feeling. You might do this each time you feed your baby, or after every diaper change. You might also set recurring alarms on your phone to do this every 2-3 hours. Do you need to use the bathroom? Are you hungry? Then make sure to meet those needs!
• Make yourself a cup of tea or a special drink before you sit down to feed your baby.
• Rinse your face and put on some lotion after you feed your baby.
• Do a few simple stretches or some diaphragmatic breathing exercises at every diaper change.
• Eat really nutritious but delicious meals. This is best when you can let other people make them for you! And don’t skip meals.
• Take 10 minutes to lie down and listen to some alpha and theta frequency binaural sounds for relaxation.
• Take 10 minutes to lie down and meditate or pray.
• Try to accept help with your baby so you can sleep. Listen to your body and take the opportunity to do this whenever it feels like you might be able to fall asleep.
• Have a conversation with your partner or support person about setting up a regular time each day for you to have a break from baby care. It might be just 30 minutes or an hour. Use that time to do something that supports your mental health. You might read a book, take a short walk (if you’re at that point in your healing), take a bath, have a cup of coffee with your neighbor, etc.
• It’s also OK to ask someone else to take care of your baby for a little while because you really want to fold a basket of laundry or do some dishes. If that makes you feel good, that’s ok! When I was recovering, I had helpers to do those things, and I let them most of the time. But every once in a while, I just wanted to do a simple household chore. It made me feel a little more grounded. As long as you’re not doing so much of this to be holding up your recovery, that can be self-care too.

Final Takeaway

In the recorded interview, Amy makes sure to emphasize something really important for ALL parents. She reminds us that EVERYONE has to learn to be a parent. I’ll even add to that and say that we have to learn how to be a parent again for every child we have. It might not be as much of a struggle, but every child is different. Every new child is a learning experience. It WILL feel like a struggle and an adjustment at times. This is absolutely normal. No one has this all figured out when they become a parent. We are all learning at all times along the way.

The perinatal period starts around the time you become pregnant and continues through the first year postpartum. A person’s mental health can definitely experience some ups and downs during this time. Some of that is caused by hormone fluctuations and the physical stress that conception, pregnancy, and birth can put on the body. But it’s also affected by the special circumstances in a person’s life during this time.

Before Pregnancy

Just deciding that it’s time to start a family is a big deal. It might be a huge decision that you don’t come to lightly. It might also be something that is unplanned. Either way, it can definitely cause some stress and emotional upheaval.

If you’re making the decision to start a family, conception is another big hurdle for some people. It might be easy to become pregnant, but it can also be a long and very difficult process.

Pregnancy Changes & Stressful Decisions

Once you are pregnant, the hormones and physical changes can cause a lot of emotional ups and downs. Sometimes people become forgetful, irritable, or easily overwhelmed. It’s very normal to experience mental and emotional changes. This isn’t necessarily healthy or unhealthy, it’s just part of the process.

In addition to all of that, there are the logistics of being pregnant, giving birth, and starting a family. You might have a job or career that will need to change or adjust. It can be intimidating to think about actually having a baby in your home. Will you know how to take care of a tiny baby? What about child care? What about toddlers and teenagers?! Those kinds of thoughts and planning can feel very overwhelming. You might have concerns about your other relationships. How will becoming parents affect you and your partner? Will you still find time for each other? Will you agree on parenting issues and be able to figure out a work/life balance that works for you both? You might have other family members or friends to think about too.

Having a child can definitely bring out the best or the worst in our loved ones. You might be getting a lot of unwanted advice or judgment. You might be having to choose who to ask to be at your birth or who you will visit first when the baby comes. You might worry about finances. You’ve probably heard that diapers and daycare are expensive! What about your home? Will it work with a new baby? A lot of people move or remodel when they’re expecting a baby. That alone is a big deal. There is just a lot to think about when starting a family.

It’s very normal to feel overwhelmed or a lot of stress during the perinatal period. Most of the time, this is just a normal part of this big life transition. This can be managed well with some awareness that you are normal, with some good talking and planning, good health care, and with some support. It’s also possible to have some more concerning issues during this period, so it’s important to recognize that you can get help if things start to feel like too much during this time.

Postpartum Mental Health

The postpartum period is what most people recognize as a time of high sensitivity and vulnerability to mental health issues. Postpartum means after birth. It’s true that postpartum depression is common, and a lot of people worry about this. The postpartum time is really just a part of the whole perinatal picture, although it does deserve some special attention.

What is normal?

First of all, it’s important to recognize that it’s normal to have some emotional changes, especially during the first couple of weeks after having a baby. Some people call this “The Baby Blues”.

You can expect to have some tearfulness, sadness, feel overwhelmed and exhausted. BUT you should still be able to do things you need to do. This time period should not be all bad. You might also have some moments of bliss and feel very positive and excited too.

The Baby Blues are a result of all of the things that are going on that were mentioned above. Your hormones, your physical state, and all of the new circumstances caused by having a new baby in your life. You’ll probably start noticing these ups and downs by day three postpartum, and it typically gets better after a couple of weeks.

Some people will describe feeling out of control or confused. “I just start crying all of a sudden for no good reason!” I always respond by saying, “You have PLENTY of good reasons!” It’s just hard to pinpoint only one right at that moment. I call all of the reasons for the emotional upheaval The Perfect Storm. There is a lot of change and physical healing going on, and when you add sleep deprivation to that, no one could be expected to feel perfectly stable and normal. After a couple of weeks of that though, you should gradually start to feel more normal and have fewer of the mood fluctuations.

Transition and Transformation

I like to think of this as a time of transition and transformation. You are not just growing and birthing a baby. You are becoming a parent. That is the butterfly that will emerge from the cocoon. You were a beautiful caterpillar, then you got really hungry and started to change. You formed a chrysalis. I love using this analogy. Scientists have discovered that what happens inside a chrysalis is a complete dismantling of the caterpillar. It stops being a caterpillar and becomes some kind of goo. The DNA is the same, but the form completely changes. From that goo, a new form is created. It’s completely unrecognizable, but is also the same at the most fundamental and cellular level. And it may be even more beautiful when it emerges. When a butterfly emerges, it needs some time to figure out its new form. Their wings are wet, so they can’t fly quite yet. They are a little weak and wobbly and need some time to rest, recover, and heal before they can safely fly.
So remember the butterfly, and give yourself the time to let your wings dry. It’s normal to need this, and healthy to take it. It’s also normal to feel like you’re not quite sure who you are. Are you the caterpillar anymore? Are you really ready to be a butterfly? I like to think that we get to be neither and both. The caterpillar is still there, but now it’s even bigger and has wings.

Some things you can do to support your recovery and help you ease through more gracefully:

• Recognize that you need this time and rest. Don’t push yourself.
• Accept or ask for help from others. You might ask family and friends, or hire help whenever you can.
• Get more sleep. Especially when you can let others help you, you might find more time for naps and better sleep. This can make a HUGE difference in how you feel.
• Breastfeeding and skin-to-skin time with your baby can also help. These are oxytocin making activities. Oxytocin is a feel-good hormone that also supports good bonding and breastfeeding.
• Take care of your physical needs. Get good nutrition, hydrate well, sleep, do some deep breathing, take your vitamins and supplements. Your body needs all the resources it can get for best healing.
• Practice mindfulness. When you’re holding your baby, just hold your baby and look carefully. Try not to think about anything else. To-do lists and planning can wait. Dwelling on the past is unnecessary. Try to be fully present and aware of what is happening RIGHT NOW.

Postpartum Mood Disorders

Mood disorders are different. In general, the feelings are more intense. The ups and downs are more dramatic, and the really good moments are harder to come by. You feel bad emotionally, and you may also feel physically worse. Postpartum mood disorders are not just a response to the normal circumstances following birth and pregnancy. There is definitely more going on, and it’s important to get specialized help.

Postpartum mood disorders are hard to predict, although there are some things that can put you into a higher risk category including a previous history of depression, anxiety, bipolar disorder or other mental illness. The good news is that even if you are at higher risk, nothing guarantees that you will experience a postpartum mood disorder. And if you do, you’ll likely have the resources ready to help you sooner.

The more common mood disorders are postpartum depression and postpartum anxiety. A lot of times, the symptoms of mood disorders can look similar to The Baby Blues. Something that can help you recognize that you might be experiencing a mood disorder and not just The Baby Blues is the timeline. Mood disorders don’t usually start until later, even months later. They also do not tend to get better on their own after just a couple of weeks. Also, mood disorders are a lot more intense, and it’s harder to find the good moments.

Depression

Although postpartum depression is the one we hear most about, it might actually be less common than postpartum anxiety. It looks very different though, and it’s easier to recognize, so it’s more likely that people will be diagnosed and get help with postpartum depression. This condition can cause a lot of the same symptoms of The Baby Blues, only more intense. It may also make it hard to bond with your baby and others. You might feel like just basic functioning is all you can handle, and even that feels very difficult. You might feel like you’re constantly in survival mode.

Anxiety

Postpartum anxiety looks very different because people tend to get a lot done. You might be putting a lot of energy into other people and tasks. This might look good on the outside, but true anxiety doesn’t feel good on the inside. It might feel like you HAVE to do these things or something terrible will happen. It’s stressful. People usually feel very restless, have trouble sleeping for very long, have a lot of distracting and even disturbing thoughts.

One of the more common disturbing thoughts postpartum is a recurring thought and fear that the baby will fall down the stairs. People worry that they will be the cause. This kind of disturbing thought might be normal if it just happens a few times and doesn’t change your behavior. All parents have worrying thoughts sometimes. But if your disturbing thoughts become obsessive, and you decide you can’t be trusted to hold your baby on the stairs and make someone else do that for you, that could be caused by anxiety.

How to Know the Difference Between Normal and Not Normal

The severity of the symptoms can be a clue if it’s a normal mood swing or not. Also, if the symptoms are negatively impacting you for more than two weeks, it’s probably more than The Baby Blues. And if the symptoms start later than just a few days postpartum, it’s probably more serious.

In some cases, you should absolutely trust your instincts. If you’re sure that you’re not feeling normal, and suspect a mood disorder, please seek help. You are probably right!

In other cases, the person who is depressed or experiencing anxiety does not recognize that something is wrong. Instead, it might be other people who bring it to their attention. If this is happening, it’s a very good idea to accept what your loved ones are seeing and telling you. At least get a second opinion with a professional. If they assess that you do not have a mood disorder, they may still be able to help you feel a little better, so there’s no loss in seeking the help. Doulas can be particularly helpful in noticing some of the signs of mood disorders and tend to be very good at giving gentle recommendations.

Friends and family members can be helpful by helping point out things that don’t seem normal, but this can be done in a better or worse way. It probably won’t go well if someone says, “What’s wrong with you?” or “You’re not acting right, you need therapy.” Here are some suggestions that might be helpful if you suspect a mood disorder in someone else:

Start from a place of love. “I care about you so much and want this to be a special time for you, but it seems like you’re really struggling.”
Let them lead the conversation. “Are you feeling ok? Is there anything I can do to help?”
Have a conversation before the baby comes. This is a great idea offered by Cheryl Reeley MS, LCSW-S, PMH-C. Talk about postpartum mood disorders with loved ones and discuss ways that they can help if something comes up. Maybe you could even set up a code word they can use playfully if they suspect you’re struggling too much.

When to Get Help

It’s best to get help right away. I recommend consenting to any assessments offered to screen for mood disorders. As soon as you suspect a mood disorder, you can reach out for help. Therapists don’t see people usually until 3-6 months postpartum, and often those people were feeling bad for a long time before seeking help.

I’ve known many people who have experienced a postpartum mood disorder. No one regrets getting help, but many people regret not getting help sooner. Some people just honestly don’t recognize that it’s happening until it’s gone on long enough. Other times, people think they’ll get through it without help and want to muscle through. It’s not shameful to have a mood disorder or to ask for help. It’s just something that happens sometimes, and the good news is that there are interventions that can make a big difference in how you feel and how you’re able to thrive and enjoy your time as a new parent.

How to Get Help

It’s very important to talk to your care provider if you suspect you have a mood disorder, or if you’re just not feeling quite right. If you’re under OB care, you may not have an appointment scheduled until six weeks postpartum. I would recommend calling to see about referrals before your scheduled appointment. If you see other providers such as a pediatrician or lactation consultant, they may also be able to give you an assessment and make a referral for you.

Our outpatient clinics provide a postpartum depression assessment when people come in for a lactation consultation, because we understand that many people need it before their next doctor visit and that early intervention is important. Many pediatricians will do the same. If you have a therapist or other care provider like a physical therapist, chiropractor, or acupuncturist, it’s also a great idea to contact them for help. Any of these practitioners should be able to offer you good referrals so you can get help.

What kind of help is available?

There are a couple of different ways to tackle this problem.

1. Behavioral/Talk Therapy: This can be individual or group therapy, or even support groups. The goal is that you are thinking about and talking about how the mood disorder is affecting you the most, how it affects your daily life. You can learn about strategies to take care of yourself while you’re dealing with the issue. You might get help coping with intrusive and disturbing thoughts, or trauma related to infertility, pregnancy, or birth.
2. Medication: Not everyone wants or needs medication, but many people benefit from it. It’s important to recognize that there are many medications that are very safe to use, even when you’re pregnant or breastfeeding. It’s also important to remember that the benefits of using a particular medication can sometimes outweigh the risks. You need to get all the information so you can make an informed choice. A therapist will usually refer to a perinatal psychiatrist for medication options. They are specialists working with people who are pregnant or postpartum, and have the knowledge and expertise to keep you safe.

For most people, a combination of the behavioral and medical help have the most impact and quickest results.

Postpartum Support International is an excellent online resource. They have a helpline, local resources, online groups to join, and more.

The Postpartum Health Alliance (PPHA) is an organization local to my area of Central Texas and is an excellent resource. Kristi’s List is their directory of local providers related to postpartum mental health.

The National Maternal Health Hotline is another great resource for getting phone support and help finding resources in your area. You can text or call 24/7 to 1-833-TLC-MAMA.

Prevention

Although there aren’t any guaranteed ways to prevent postpartum mood disorders, there are some things you can do to minimize your risk. Most of these things are basic self-care strategies and probably things you already know about. Prioritizing this kind of self-care is the hard part for a lot of people, but also the best way to keep you healthy and happy.

1. Good nutrition: A pregnancy diet high in protein, healthy fats, and lots of good fruits and veggies is associated with lower rates of postpartum depression. Doing the same after birth can help too. You’ll also probably sleep better and feel better if you keep things like caffeine and sugar to a minimum.
2. Exercise: Pregnancy exercise is also associated with lowered risk.
3. Sleep: Good sleep may lower your risk.
4. Breastfeeding and skin-to-skin contact: Breastfeeding can be associated with lower rates of postpartum depression. When things are going well, and especially when a person is exclusively breastfeeding, there are some protective hormonal changes that can improve moods. It’s important to remember though, that if breastfeeding is very complicated and difficult, please seek help. If you are experiencing a lot of distress caused by breastfeeding, you need to assess how it is affecting your mental health and what you can do about it. A lactation consultant may be able to help you find a solution that works for you and your family, even if that means you don’t breastfeed at all or provide breast milk in a different way.
5. Support: Having a supportive network of helpers is associated with better mental health. It’s so important to accept help or ask for it. If you can set this up while you’re still pregnant, that’s best! You’ll probably feel better knowing you have some help after your baby comes, and then you get to benefit from it when the time comes.

Your good mental health is critical. It should not be ignored or set aside for later. You deserve to feel better, and your family will benefit from having you healthy and more present.

I took a wonderful workshop on the topic of The Sitting Month recently with Jane Yu, L. Ac. She is an acupuncturist and doctor of Chinese medicine specializing in pregnancy, birth, and postpartum. I teach birth classes, have had a couple of babies of my own, and I even teach a class all about postpartum recovery. I understand at a personal level how important and delicate the postpartum period can be, and I try to give my birth class students useful information regarding their recovery.

Unfortunately, our current healthcare system is not well-equipped to properly support families in this recovery, which includes the big transition into parenthood too. We don’t get enough support for our physical healing, and almost none to support the emotional upheaval and social, mental, logistical changes that occur in a person’s life after bringing a baby into the family.

In many Asian countries, there is a more holistic approach to managing postpartum recovery. It is treated with a lot more reverence and special attention. The more I learn, the more I recognize that these ancient traditions should probably be upheld, even if they could use a little updating so that more people would be open to the treatment.

What is the Sitting Month?

The Sitting Month has different names in different cultures. What is common among traditions is that it’s a period of about 40 days, or six weeks. That is also similar in the United States.

Our final (and often first) follow up visit with the obstetrician is scheduled for about 6 weeks postpartum. It’s done that way because most people have healed well enough to be cleared for normal activity at that point.

The Sitting Month also recognizes a similar timeframe for healing. What’s very different is how those 6 weeks are managed. The traditional care during The Sitting Month requires a lot of special attention from people who are familiar with the special practices and foods, usually a mother, grandmother, and/or other family members. The new mother in recovery has very little to do besides eat, rest, and care for her baby.

When you look at the results, this kind of care makes sense. It makes it much more likely that they will recover quickly and completely. It also allows them to take the time needed to bond and transition more gently into parenthood.

Sitting Month care usually involves a community. Mothers, aunties, other family members, friends and neighbors may all pitch in to help out the new family. It’s less about the baby, and more about the new mother and the new family. It is recognized that the person who just went through 9 months of pregnancy and birthed a baby needs support and special attention.

I don’t think we do a good job of this in our culture. Instead it tends to be about three things:

1. The baby
2. Productivity
3. The body bouncing back

Mother Care over Baby Enthusiasm

The baby DOES deserve care, but the focus should maybe be on helping the new mother more easily provide care to her baby instead of having other people come look at the baby and pass the baby around and give the baby gifts. Sitting Month traditions are mostly about mothering the new mother.

Healing over Productivity

Our definition of Productivity definitely takes a back seat with Sitting Month care. It’s important to recognize that healing is critical AND productive, and that means giving recovery full focus for a temporary amount of time. Being productive in the more modern and visible sense shouldn’t be happening yet. Healing first, then a person can be even more “productive” later.

Whole Self Recovery over Bouncing Back

The idea of “bouncing back” shouldn’t be all negative, but I do think that emphasis is usually placed on the wrong things. Losing weight, fitting into skinny jeans, being able to do vigorous exercise and activity are the main focus in our culture. Instead, in traditional Asian cultures, the focus is on nourishing the body so it can regain full function.

The body changed dramatically during pregnancy, and birth is an extremely physically demanding event too. The body lost a lot of fluid, shape, hormonal, soft tissue, and organ stability. It needs support to be able to recover from all of this, but when it’s done well, the weight loss and beauty and fitness will come back eventually. It’s a gradual process that starts with very simple and nourishing things.

Sitting Month Traditions

Something that most or even ALL Sitting Month traditions have in common is the focus is on three different priorities.

1. Warmth
2. Rest
3. Relaxation

Avoid Cold

This might be handled differently in different cultures, but the basic idea is to stay warm. Warm helps the body heal and keeps the energy moving in that direction. The “rules” around this can be very strict and difficult to adhere to when done traditionally. For the sake of this article, I’m going to focus on the basics and some ways to get the benefits without going too far outside your comfort zone.

• Avoid drinking iced beverages and eating frozen foods
• Have lots of warm teas and soups
• Keep your thermostat a little higher than usual
• Stay out of drafts or direct airflow from the A/C vent
• Bathe less, and be sure to take only very warm baths and showers. Also make sure your room is warm especially while you dry off and dress. Blow dry your hair after a wash so you don’t get a chill from having wet hair.
• Eat warm foods in the literal sense. Well-cooked soups, broths, slow cooker meals served warm are great meals. The food should be well cooked and warm so it’s easier to digest. Your organs will be out of place for a little while after birth and digestion can sometimes be tricky. Until things are well healed, you can benefit from eating easily digestible foods. Some examples are bone broth, chicken and rice soup, and light risottos. It’s also best to avoid very rich, heavy, or filling foods. It’s also easier to maintain good digestion when you eat more small and light meals throughout the day.
• Also avoid energetically “cold” foods. In Asian traditions these might include raw foods, seafood, and warm weather type foods that people eat because they feel cool or refreshing.

Avoid Physical Stress

Getting plenty of rest is key to good recovery. Your body is healing many injuries caused by pregnancy and birth, even though you can’t see most of them. Muscles, ligaments, tendons, organs, hormones and even skin may be affected.

Resting can help those injuries heal well and completely. When healing is complete, you are ensuring a better future. When healing is incomplete, people might deal with issues down the line related to future pregnancies, issues with pain or incontinence, and even during menopause and perimenopause. The most important point is that you just rest comfortably most of the time. Your main concerns are rest and taking care of your baby. Some tips to help you avoid physical stress:

• If you have more than one floor in your home, try to have a “hangout spot” on each level so you can avoid going up and down stairs more than once per day. You might spend a few hours in your bed, then move to a couch or comfy chair in another room for another part of the day. If you have all of your necessities at a “station” near your hangout space, you’ll minimize the amount of moving around you need to do. You can walk and do some things for yourself, but stairs are considered heavier physical stress and should be minimized.
• Have helpers. Some people have many helpers, and others don’t. If you have anyone offering to help, take advantage of it! It’s great to have someone who might be able to stay with you for any amount of time, but even if it’s just having a friend drop by for a couple of hours a day, that can be helpful. You can organize your day and save some of the heavy lifting tasks for when you have a helper around.
• Baby showers are usually a time to get lots of baby gear, but consider asking for some things to help you in your postpartum recovery. Some ideas are massage, Bengkung belly binding services, acupuncture, hiring a postpartum doula, or hiring someone to prepare meals, do house cleaning, yard work, or anything else you need help with!

Avoid Emotional Stress

Your emotions will likely be all over the place for a while. It makes perfect sense. There is SO MUCH going on including some sleep loss and hormone swings. You should expect to have some ups and downs. It’s also important to recognize that postpartum moods can become a bigger problem. When you’re caring for yourself well, you lower your risks for postpartum mood disorders like postpartum depression and postpartum anxiety. Sitting Month care puts a lot of focus on your emotional health. Relaxation is important. Avoiding big swings is key. Some ideas for keeping you relaxed:

• Avoid too much reading, especially social media. There is a lot of evidence showing that engaging with social media too much can lead to emotional stress.
• Sleep whenever you can. Being sleep deprived magnifies negative emotions.
• Minimize visitors if that causes stress.
• Visitors should bring something or be helpful when they visit.

Although the last two points above mention minimizing visitors, it’s also important to have help. That might mean more visitors! As long as those visitors are helpful and don’t cause stress, then they are contributing to your good health. Sitting Month care usually does involve the community. Family and friends become helpers and carry out the practices that will help you recover. These traditions are usually passed down through generations of helpers. If you’re trying to integrate some of these practices, but want to modify some of the more strict rules, it’s important to communicate with your helpers ahead of time so they can be aware and sensitive to your requests. That can also keep the stress levels down.

You might see some of these recommendations and feel overwhelmed or turned off by the idea of The Sitting Month. It might seem boring or tedious. Remember that a person in postpartum recovery is probably processing things in a very different way. The hormones required to nurse a baby and bond are very powerful.

You may feel very motivated to give all of your focus to your baby and it might feel easier than you think to let other people help you and follow some of these rules. Remind yourself that this is very temporary. Remind yourself that this kind of care will help you heal fully, and be more ready to take on your new life as a parent successfully and with more grace and ease.

Below is an interview I did with Jane Yu about the Sitting Month.

You’ve probably seen a lot of lists to help you pack for birth at a hospital or birth center. It’s great to be prepared! What a lot of people don’t prepare for is the after part. If you’re having a hospital birth, you’ll likely stay there for 2-3 days of recovery time. They will probably provide you with a lot of the basics you’ll need for your recovery including menstrual pads for you and diapers for your baby.

But it’s a good idea to prepare ahead of time for your return home. You’ll still be in recovery for several more weeks, and there are some supplies that can help you be more comfortable as you recover. If you get some of these things ahead of time, you’ll probably be glad you did!

Supplies For Everyone

Everyone will need the things shown on this list. It doesn’t matter if you’re having a quick or slow or complicated or uncomplicated recovery. It doesn’t matter if you had a cesarean birth or a vaginal birth. These are the basics for everyone.

• Menstrual pads or adult diapers: Everyone will have vaginal bleeding after birth. Your placenta has to detach from the uterus and that leaves a big wound. It will bleed until it’s fully healed over. NO tampons or cups for this kind of bleeding. It’s good to have some heavy absorbency pads or diapers at first, but also other sizes all the way down to light absorbency options. The bleeding will gradually lessen over time, so make sure to have some of each size pads. Some people bleed for just a couple of weeks, but most people will bleed for 4-6 weeks. Some people can even continue to bleed for 12 weeks. Since it’s such a big range, you can probably just plan to have enough pads or diapers for 2 weeks and then get more as needed. The bleeding is usually heavy for the first 7-10 days.
• Comfortable clothes: Most people are going to prefer loose fitting clothes. A lot of people like gowns or loose dresses. Bellies will be a strange size and shape for a while after birth, so waistlines could be uncomfortable. If you have a cesarean, you especially might not like having anything around your waistline.
• Good food: You might make and store some freezer meals before you go into labor. You can also have people ready and waiting to bring you meals after you get home. You might even have someone at your home to cook for you. However you go about it, it’s great to make some plans for food! Consider setting up a Care Calendar to organize meal deliveries or use other helpful sites such as Lotsa Helping Hands, or Meal Train.
• Convenience stations: It’s best to rest. That means that you will be laying down a lot, especially in the first two weeks. To keep you from having to run around too much, stock a couple of baskets or bins with important supplies and have one at each of your favorite resting areas. You might have one near your bed and another next to the couch or anywhere else you are spending a lot of your time. You might include:
  • Diapering supplies: a few clean diapers, a container of wipes, a changing pad or towel to put the baby on, a change of clothes for the baby in case of leakage, and plastic bags (it’s great to save your bread or produce bags from the grocery store for this!) for dirty stuff. If your baby has a diaper rash, you might also want to include cream and a clean towel to dry the baby’s bottom with before you apply the cream.
  • Device chargers
  • Remote controls
  • Snacks
  • Water
  • Hair ties
  • Cloths for catching leaks or wiping up spills
  • Lip balm
  • Lotion
  • Glasses
  • Medications/Vitamins/Supplements
  • Journal or notebook and pen/pencil
  • Headphones/earbuds
  • Books
  • Entertainment
  • Hand sanitizer
  • Extra pillows for comfort

Supplies For Some People

Not everyone will be sore or need to recover from stitches. Not everyone will have a cesarean incision to worry about or need pain medication. But things happen! If you have a more complicated recovery in front of you, or some special circumstances related to breastfeeding or baby care, consider some of the following supplies. Since you likely won’t know ahead of time if you need them, these purchases can probably wait until after you get home with your baby.

• Belly band or wrap: These are usually given to you after a cesarean birth, but some people like to have them after a vaginal birth too. A comfortable wrap can feel like a nice supportive hug around your belly if it doesn’t feel normal. Your organs are moving back into place and your belly can feel strange for a little while. This kind of support can be very comforting and possibly help with healing. Make sure not to use these if you have symptoms of pelvic organ prolapse.
• Perineal healing products: If you don’t have stitches or a tear that is healing, you may not need to stock up on these products, so it’s best to wait until you know. There are some products that can help with soreness and swelling or with the healing of a tear.
• Nipple healing products: These might include balms or ointments, or an actual device such as a gel pack or silver nipple cup. If your nipples get damaged by breastfeeding or pumping, these might be helpful for healing. But remember, the first step is to find out WHY your nipples are damaged by visiting a lactation consultant so you can correct the problem and heal completely.
• Breast pump: Not everyone needs to pump, especially during postpartum recovery. Most of the time, breastfeeding works just fine and pumping is not necessary to improve a milk supply or store milk. It’s actually most often recommended that you NOT pump, at least in the first couple of weeks after birth. For the best milk supply and breastfeeding success, it’s better to have the baby attach as much as possible, and sometimes pumping can interfere with direct breastfeeding. In some cases, pumping on a particular schedule might be recommended if there are issues with milk supply or if the baby is having trouble getting milk out of a breast. In that case, having your pump ready to go is great. If you know you’ll need one eventually anyway to go back to work, go ahead and order it through your insurance or through a Durable Medical Equipment (DME) provider who works with insurance. You can do this while you’re still pregnant so you won’t have to worry about it after the baby comes.
• Breastfeeding supplies: There might be some products that will make breastfeeding easier or more convenient for you. Not everyone will need these things, but here is a list of things that can be useful in some situations.

Getting Rest and Help

It might seem really overwhelming to imagine the kind of recovery that could require so many different things, but most of these things are optional and can just make things a little more comfortable for you even though they’re not actually necessary for your health and healing. In my opinion, the most important things to load up on for healthy recovery are REST and HELP.

Spend as much time as you can lying down with your baby skin-to-skin. It will literally help your body recover in so many amazing ways, and you’ll be bonding with your baby and helping to ensure a good milk supply too! You’ll be so glad you did once you’re fully healed and back to normal functioning. When full healing doesn’t happen, it can mean months or even years of discomfort and special care or treatment. Give your body the best chance to do it correctly the first time.

Asking for help can be really hard for some people, but well worth the effort. Asking for help is an important life skill. A lot of times we never learn to request help, or only learn when we’re desperate and have no other options. Don’t wait till then. Be proactive now and find ways to let your family and friends help you in small ways. Let them use their special skills to do something for you while you’re recovering. When you can be thoughtful about it and get it set up ahead of time, things will likely feel much more relaxed and enjoyable after your baby comes.

It would be incredibly rare to NOT be sore and swollen “down there” after a vaginal birth. For some people, this is minimal and passes quickly. For others it can be very uncomfortable and last for many days or even weeks.

Why does this happen?

The perineum is the wall of skin and soft tissue between the vagina and the anus. I don’t usually like to get too graphic, but picture this with me.

A 7.5 pound baby wiggles and squirms lower and lower in your body until the big 13.5 in diameter head is resting on your pelvic floor. The pelvic floor is the muscles and ligaments and tendons just on the other side of that perineum. That baby is a large weight that is more than that part of your body is used to supporting.

And then the baby moves even lower. The head begins to move into the vaginal canal and the opening widens. For the vaginal opening to widen, the perineum has to stretch. It continues to stretch and sometimes even tears to open wider and accommodate the large head. This might take minutes, or it might take hours. Either way, there is a lot of pressure and strain there.

The perineum is being pushed very far outside its normal ranges. How do your other body parts feel when pushed outside normal ranges? Have you ever worked out a little too hard at the gym? Or decided it was time to learn how to swim or bike or run? After going through that, those muscles will be overworked, overstretched, and overtired. They get sore.

So even if you don’t have any tearing while giving birth, you will probably be sore from the extra weight of pregnancy, stretching, and hard work. Most often, the skin also responds to the stress with some swelling. You might even have stitches or a tear that is healing without stitches.

You may have some vaginal soreness and swelling after a cesarean too! Most everyone has a little swelling down there at the end of pregnancy. Then if you labored or pushed at all before having a cesarean, that can add to it. It won’t be as much as if you had a vaginal birth, but it does happen sometimes.

And finally, a lot of people aren’t prepared for this, but your literal bottom might also be sore and swollen from hemorrhoids which can be caused by pregnancy or birth.

What can you do about it?

There are a lot of great tips to help you feel better. If you have stitches or hemorrhoids, that will be a different kind of discomfort, but sometimes that can make the soreness and swelling worse. Most of the things you would do to help your stitches heal are also good for the soreness and swelling in all the parts. Before trying any kind of medication or new product, make sure to talk to your care provider about it. Even with a very natural product, there could be some contraindications you should know about depending on your circumstances.

Some of these things might not work for you, so just focus on the things that do!

• Cold: Ice packs can be very helpful. You will probably be offered these at the hospital. You can also make your own to have at home. A fun tip is to soak big menstrual pads in water and freeze them. Then you have an ice pack that is also absorbent for the postpartum bleeding! Some people use bags of frozen veggies or other cold packs. Make sure they are cleaned often, and that you cover it with a cloth before putting it onto your skin.
• Rest: Resting is generally good for everything while you’re recovering postpartum. The more you are standing and walking, the worse the swelling and soreness will be. So put your feet up!
• Pillow: Sitting on your bottom might be uncomfortable. If it is, sometimes a donut-shaped pillow can make you more comfortable. You can get an inflatable pillow at a local drugstore or online. I had an extra breastfeeding pillow that was about the right size and shape, and that worked for me!
• Topical products: You might want to try a balm, salve, ointment, spray, or lotion. There are a lot of options out there, and one of these might be very helpful for you. It’s hard to know until you try. Some people don’t like the idea of putting something “down there”. If you have very heavy bleeding, these products might also not provide relief for very long.
• Analgesics: You will want to ask your doctor about safe medication options before trying something, but you can often use these to help. Most of the time, an over the counter medication like acetaminophen or ibuprofen is enough to provide the relief you need.
• Sitz bath or a soak in the tub: Some people get a lot of relief from soaking in water. A sitz bath is a small plastic tub designed to fit in your toilet. You can also just get in the bathtub. Epsom salts can be added to the water and can be good for soreness and healing. Epsom salts are easy to find at any grocery store or pharmacy.
• Witch hazel: You can buy pre-soaked pads or buy a bottle of witch hazel and some cotton pads. Witch hazel can help reduce swelling and it’s antibacterial. This can also be a little harsh for some people. Be sure to get alcohol-free witch hazel and talk to your care provider before using.
• Rinse, don’t wipe: Wiping just won’t feel good for a while. You also don’t want toilet paper lint sticking to your stitches or tear site! You might also just like to rinse the area occasionally because blood on your stitches can be irritating. Your hospital or birth center will probably provide you with some kind of spray bottle for this. Peri-bottles can be purchased if you’d like something that’s a little easier to spray while you’re sitting on the toilet. Once you’re home, hand-held toilet sprayers or a bidet can be handy for rinsing. Gently pat dry or you can even use a hair dryer on a cool setting if you really want to stay hands off!
• Really good nutrition and hydration: Most people won’t tell you this but just about EVERYBODY will be a little freaked out when it’s time to pee and poop after giving birth. It might hurt, or it might just feel weird and a little out of your control. It’s best to make sure this process is as easy as possible. When you’re well-hydrated, your urine will be less concentrated and sting less coming out. When you’re well-hydrated AND are eating your fruits and veggies and lots of great high-fiber foods, you are more likely to have regular and easy bowel movements. This is especially helpful if you have a lot of soreness from a significant tear and stitches.

Discomfort Will Pass

It’s hard to know how uncomfortable you’ll be “down there” until the time comes. Some people will hardly notice a difference, but most people will have at least a few days of discomfort. Remember that it will pass!

Also know that if you get the “all clear” for normal activity at your 6-week checkup but things don’t feel quite right to you, you’re probably right. Trust your intuition and consider seeing a specialist. It’s not supposed to hurt forever.

A urogynecologist or colorectal surgeon might be needed if you had a complex tear or even just a tear that didn’t heal quite right. A pelvic floor physical therapist might be helpful in some situations too. Your body went through a lot during pregnancy and birth. It’s very important to treat it kindly so you will heal quickly and THOROUGHLY. Get the help that you need so you can rest and heal for those first few weeks postpartum. You’ll be glad you did.

Last week was the first week of National Breastfeeding Month. The theme was “Enabling Breastfeeding: Making a Difference for Working Parents.” I was very fortunate to stay home with my babies for a pretty long time, so I didn’t have to experience some of the struggles that people often go through to maintain breastfeeding while working. This is a HUGE issue for most people and an important one to address.

How to Prepare

If you know you will be going back to work at a certain point, and want to continue breastfeeding, there are some things you can do to prepare to make this transition.

• Take a breastfeeding class and maybe even a pumping class! You can do this before the baby comes, and it can help you know how to be best prepared.
• Order your breast pump. Insurance should cover the purchase of your pump. If you are told that they can’t send you the pump until after your baby is born, you can push back or consider using a service like Aeroflow, Babylist, or Yummy Mummy to help you get your pump easily and quickly. They do not charge you for the service. They are usually an in-network supplier of breast pumps and parts, and do the work of getting the pump covered for you by your insurance. Make sure to ask to upgrade to a particular pump that you want, even if it’s not on the list of covered pumps. Sometimes they will agree,if you’re willing to cover the price difference.
• Practice using your pump! Read the directions and just look over all the pieces of the unit. It will seem a lot less intimidating when it’s actually time to use it if you’ve gotten familiar with it first.
• Talk to your employer about your intention to breastfeed and find out about how they can support you.

It takes most people several weeks to feel comfortable with breastfeeding and to have a good reliable milk supply. What I mean by “reliable”, is that your milk supply won’t be so easily affected by changes in routine.

At first, going too long without breastfeeding can make a significant difference in the amount of milk you make. Newborn babies are designed to eat OFTEN, and when you respond to their hunger cues quickly and reliably, you can usually create a good milk supply. After a few weeks of this, babies will start eating a little less often, and you can sometimes stretch the time in between feedings without doing harm to your milk supply.

Pumping Milk

If you get a couple of months off work, that might mean you don’t have to do too much pumping to have milk for your baby while they’re with a caregiver. You may only have to pump once or twice while you’re at work, and maybe another time in the morning before you go or at night before you go to sleep. With a good pump, you might be able to express enough milk with these 2-3 pumping sessions to feed your baby while you’re at work the next day. That might also be enough to maintain a good milk supply, as long as you’re also breastfeeding plenty when you’re with your baby.

A good pump means it works for you! For a lot of people that means an electric pump that allows you to extract milk from both breasts at the same time. Some are battery powered or easy to use even if you have to be moving around or working at the same time. It’s also important to get the correct flange size so you’re sure to get the most milk for your effort. A lactation consultant can help you be sure you’re using the right one, or try using our sizing guide.

After a few weeks of this schedule, you might be able to pump a little less. You might not need that steady routine of breast stimulation to maintain your milk supply. If pumping at work is really hard, you may be able to do less or even eliminate those pumping sessions. You might instead choose to pump more on the weekends. You can stock up on milk that way, and have enough to send with your baby during the week. As long as you are breastfeeding often when you are with your baby, your milk supply will likely adjust to this new routine.

If pumping feels manageable to you and it is working, keep doing it! It’s a great way to maintain your milk supply AND feed your baby when you go back to work. Pumping at work should not be impossible. We have laws to protect parents who need to express milk at work for their babies, including the most recent PUMP ACT.

You should be provided with some break times for pumping, and a decent place that is private and NOT a bathroom to do the pumping. Even if pumping is not IMPOSSIBLE for you, it can sometimes be too hard and people wonder if they’ll be able to keep it up. A lot of people do not keep it up. It’s just not worth it.

Your good mental health is extremely important to your whole family. If pumping is causing you a lot of stress, you might have more problems at work and at home, and it might even mean that you can’t produce enough milk. High levels of stress are shown to decrease milk production. If this is the case for you, there are other options too.

Breastfeeding Does NOT Have to be an “All or Nothing” Option

There are a lot of different ways to handle breastfeeding and work. The key to maintaining a good milk supply is making sure you are removing enough milk from the breast every day. Pumping at work as often as you were feeding your baby at home is the best way to guard your milk supply and make sure you always have enough to feed your growing baby. Adding one pumping session at home, in addition to pumping at work, is an even better option for guaranteeing a great milk supply. If this can’t work for you, it doesn’t mean you can’t continue to breastfeed! There are other options:

• You could pump often at work AT FIRST, then gradually do it a little less so you won’t be as likely to experience some of the negative effects of stopping abruptly like engorgement, leaking, mastitis, and clogged ducts. Maybe you pump 3-4 times per shift at first, then you take away one of those sessions per week until you’re down to just one time. If you are exclusively pumping, you might not want to taper off as quickly. If you can do this gradually enough and you had a very reliable supply to begin with, you might not need to supplement with formula.
• You could pick a work pumping routine and just stick to it for a few months. You could choose to have as many pump breaks as you can comfortably manage. Maybe you have one, two or three pumping breaks per work day and stay consistent with it. It’s possible that if you’re very consistent, and you continue to feed your baby often or pump regularly at home, your milk supply can adjust. In that case you won’t need to supplement with formula.
• Depending on when you have to go back to work and how reliable your milk supply is, some people are able to stop pumping at work completely after just a few weeks without too much consequence. If you have three months of maternity leave, and you pump at work for another six or eight weeks, you might be able to not pump at work at all. If you pump some breast milk in the mornings before work, and some on the weekends, that might be enough to get your baby through without needing to supplement your feedings with formula.
• If you need to go back to work quickly and/or pumping at work will be too difficult, you might choose to provide your baby’s caregiver with formula for the time you’re at work, and then breastfeed and/or pump at home. Any amount of breast milk is beneficial. Even if you can’t provide breast milk exclusively to your baby for one or two years, your baby will benefit greatly from the breast milk they receive. Even if all you can manage is a few months, weeks, days, or even just a few drops, that amount of breast milk will also benefit your baby. Most people don’t think to try a hybrid option like this.

A lot of people believe that if pumping at work is too hard, you just have to stop breastfeeding completely. This doesn’t have to be the case. Sometimes when people stop pumping, the milk supply will dwindle until it’s gone. But even if that does happen, you were able to offer the milk until it was gone, if you continue to breastfeed when you’re home. You also likely won’t have to deal with issues of engorgement or pain while you wait for the milk to dry up. It will just gradually lessen until it’s gone.

On the other hand, it might not go away at all. You might have less milk than before, which means you might need to continue to use formula even on days when you’re not at work, but you can also breastfeed as often as you want and continue to provide breast milk.

These hybrid strategies can be a great solution for a lot of families. You still get to breastfeed, but you don’t have to deal with the stress of maintaining a very full milk supply while trying to work. However you choose to do it, you are still doing an amazing thing by providing any amount of breast milk for your baby.

Last week’s article was about breastfeeding after a cesarean birth. This is really important information because about 1 in 3 births are cesareans in the United States. It is a very common surgery, but most people go into it without much understanding about what it might be like and might feel overwhelmed and stressed before, during, and after the birth because they are unprepared.

It’s true that most people feel overwhelmed about birth regardless of how the baby gets out! Birth preparation is very important for everyone, but it often leaves out the full experience of cesarean birth. In my standard birth classes, I don’t get to spend enough time talking about cesarean birth. The majority of people DO have a vaginal birth, so it makes sense to put most of the focus there. Also, even more people PLAN to have a vaginal birth and a lot of those people don’t really want to think about cesareans. It can feel too overwhelming and even scary. But I do teach a separate two-hour long class about cesarean birth, because there is so much information that I think expectant parents should have.

Planning for a Cesarean

Most often, people come to this class because they find out ahead of time that they will need to have a cesarean. Sometimes people who are planning a vaginal birth come because they want to feel fully prepared for all the possibilities, but that’s a lot more rare. I haven’t personally experienced cesarean birth, but I’ve been able to hear the stories of so many people who have, and it’s clear that there are some things that could have helped them have a better experience if they had been informed and prepared.

The same is true for cesarean recovery. Preparation and information can make all the difference in how the experience goes for you and how you FEEL about it.

Cesarean Options

First, it’s essential to understand that if a cesarean becomes the path that your birth needs to take, it does not mean that you no longer have options.

Just as in vaginal birth, there is a lot of variation in how a cesarean is done, how a cesarean is experienced, and how people recover. There are many different ways to do the surgery, and all doctors are different. Hospital facilities are different, and may or may not offer certain options. What matters is that you know what the options are for your cesarean birth so that you can request and choose the best ones for you and your family.

It’s also important that you know what is happening along the way and can understand the needs you and your baby might have for health, safety, and recovery. If you can take a C-section class to help you prepare, it might help you feel more confident and less worried.

Recovering from a C-section

While cesareans are common and even routine, they are far from simple. A C-section is major abdominal surgery. It’s critical to treat it as your birth and not just a medical procedure, but also to recognize that it’s a big deal for your body. When you can go into it with that mindset, you will take good care of your body afterward and hopefully have a complete and problem-free recovery.

Remember to be very gentle with yourself, and recognize that if there are problems with your recovery, you did have major surgery! Understand that everyone’s recovery journey will look different.

Take it slowly and ask for help. Having supportive people around to help you with daily living after a cesarean is a critical piece of a healthy recovery. Getting the rest that you need and having the time to take care of your healing body are key to recuperation.

I also love to recommend seeing a pelvic floor physical therapist. These providers can help you prepare to have a great recovery and also help you if you have problems later. Don’t think that you have to be doomed to long-term or permanent pain and discomfort because you had surgery. There are things that can help. If you have trouble accessing pelvic floor physical therapy or just prefer to learn on your own, I love to recommend this online course.

It’s also important to prepare yourself emotionally. No one wants to have a “bad” childbirth experience. Everyone’s definition of good or bad is different. Some people have wonderful cesarean births and are able to think about, talk about, and even share the birth story with others. Other times, the experience feels very stressful and is something they would rather forget. What makes the difference? In a lot of cases, just preparing for a cesarean makes all the difference. Even if your plan is to have a vaginal birth, can you consider what a cesarean might be like? Can you think about the options and have a Plan B birth plan? When you can set up the expectation that a cesarean is possible and develop some informed preferences, you might be better able to stay present during your birth experience if a cesarean does become necessary. When you can stay present and continue to feel like you are participating in the process, you will be more likely to have good feelings about the birth.

During the Cesarean Birth

During the birth, you’ll benefit when you can shift gears and consciously decide to let go and follow this new plan. This is how your baby will come to be with you, and it will help if you can accept that peacefully. This is your birth story now, and you want to embrace the experience mindfully. Here are some things that might help you achieve this:
You can keep your focus on the fact that you will meet your baby very soon (cesareans are fast!).
You can focus on the fact that you are receiving great care and support so you will both be safe.
Rather than focusing on the experience as a surgery while it’s happening, recognize that THIS IS BIRTH! There are some differences from a vaginal birth, but there are also a lot of similarities. It’s great to keep the focus on the similarities.

• Accept comfort and encouragement from your partner and/or doula during the birth. Keeping your focus there might help you too. You are receiving love and support.
• Have other comforting things to focus on. You might like to have music or other soothing sounds playing on a speaker or headphones, or you might like to have your baby’s ultrasound picture to look at for comfort and motivation! Having some essential oils with nice smells on a tissue to focus on can sometimes help with relaxation as well.
• Some people like to talk to their babies or sing a lullaby. They can hear you, and babies can recognize their parents’ voices. It might be soothing for both of you.
• Other people like to visualize being home with their babies. Picturing all the snuggles and good moments you are about to have can remind you of why you are there.
• Remind yourself that your body has done a lot of amazing things. Just because a cesarean became necessary does not mean that your body has failed. Things just happen sometimes. Your body did a lot of work to get this far, and it will continue to do so after. It’s important to appreciate and nurture your amazing body.

A Positive Birth Experience

Having a positive birth experience is associated with better recovery, lower rates of postpartum depression, better breastfeeding, better parenting, and better relationships. That’s a lot to put on one experience, but it is a very big experience for everyone. A positive birth experience does not mean it HAS to go a certain way, it just means that you interpret it as positive. For most people, that means they were prepared for detours and were able to shift gears quickly, and they felt supported and heard by their care team.

It’s worth spending some time and focus on that emotional preparation. When you’re prepared, you are less likely to get swept up into a birth experience that you did not plan. That can feel very chaotic or even scary. Through preparation, you do have the power to have a positive birth experience regardless of the directions you end up taking to get to the finish line.

Watch the video below with Dr. Rebecca Maidansky of Ladybird PT clinic in Austin, TX to hear more about preparation for and recovery after a cesarean. And use the discount code BFSUCCESS for 25% off the Managing C-section Scar Pain & Recovery course.

If you are currently pregnant, it might surprise you to hear that you should probably start thinking about choosing a pediatrician for your baby now. Babies born at a hospital usually get their first checkup with a pediatrician the day after they are born. That checkup is most often provided by the hospital’s staff pediatrician and you don’t need to worry about it. In some cases, your own family’s pediatrician may be the one to perform this exam in the hospital and you’ll need to provide contact information for your doctor. Be sure to find out what you need to do by asking your care provider or hospital maternity unit.

After that initial checkup, the standard schedule for doctor visits in the first year goes like this:

• First doctor visit happens when your baby is about one week old.
• One month
• Two months
• Four months
• Six months
• Nine months
• One year

That’s seven visits just for check-ups and vaccinations! If your baby needs to see the doctor because they are sick or have something else going on, you get to add to that number of visits. Because you will be seeing this care provider so often, it’s a great idea to choose well and to choose now. Some doctors have very full schedules and it can be hard to get the appointment times and days that you prefer, so finding that person now and getting your appointments scheduled is smart.

How Do You Choose a Pediatrician

Depending on where you live, there may be a lot of doctors to choose from and it can be difficult to sort through the options and pick the right one for you and your baby.

I like to recommend that people start by deciding on what kind of doctor they want to see. Most people choose a pediatrician. Pediatricians specialize in working with young people from birth through adolescence. There are only children being seen at a pediatrician’s office, so they have all the right small equipment for the job and often staff who are especially good with kids. A bonus is that they are usually fun and have cute decorations and toys for the benefit of the little people.

Other people might choose a family practice doctor. These providers work with people from birth through death. They often have children as patients, but see people of all ages. Their offices might not be geared towards children, but they do have everything they need to provide care to your young ones. Another benefit of establishing a relationship with a family practice doctor is that your whole family can see the same provider.

I personally started out with a pediatrician for my children, but when I had to choose a new practice because of a change in insurance, I decided to switch us all to a family practice. I really enjoy this, because our doctor knows us all, and everything is in one place. That makes things simpler for me.

Whatever you decide, the next step would be to find out who is in network with your insurance company. That will ensure that you get the best coverage.

Once you have that list, you may still have a lot to sort through, so think about these things:

• Where is the office located? When you have to make so many visits, it can start to feel inconvenient to drive across town, especially if you have a baby or toddler who doesn’t love being in the car for long periods of time.
• How is the parking situation? Is getting in and out of the office convenient and simple? It can be extra frustrating to have to park far away or in a big garage when you’re lugging around a big diaper bag, a baby, a stroller, etc.
• Are they taking new patients? Finding out now is a great idea because if you wait to establish care until your baby is born, you might be told that they are not taking new patients and you’ll need to start over.
• How far ahead do you have to schedule visits? If you’re a long distance planner, this might not matter to you. If you sometimes wait until later to schedule things, you might get disappointed when you’re told you’ll have to wait a month or more to be seen.
• Will you be able to see YOUR chosen doctor for most visits? Even sick visits? Some practices are small and it can be easy to schedule with your favorite provider, but others are very large and you may never get to see the doctor you thought you were choosing.
• Does your doctor have a partner for coverage when they’re away? If you need to see a doctor while your doctor is not available, who is there?
• Do they have in-house diagnostics? If your child needs something like an x-ray or blood work, are they able to handle that in the office or would you need to be sent somewhere else?
• Do they have long waiting room waits? Some care providers do a great job of ensuring that you rarely have to wait much before your appointment time, but others are chronically behind. This might start to matter a lot when you’re spending a lot of time there with a baby!
• Do they have separate waiting rooms for sick visits and well visits? If you’re just there for a check-up and a vaccination, it might be uncomfortable to be in a waiting room full of sick kids.
• How are you treated while you’re there? You should feel comfortable with the staff at your doctor’s office. Are people friendly? Do they listen well? Do you feel like they are knowledgeable and competent? Are they also flexible and willing to seek outside advice when they’re not sure about something? Do they take your concerns seriously? I definitely switched away from a doctor who made me feel like I was a silly and overly worried first time mom. I wasn’t, and I found a doctor who took my concerns seriously. Your parental intuitions matter, and you and your doctor can be a great team when you can work together!
• Do your philosophies align? You don’t have to agree on everything, but there are often many different ways to handle issues with your children. You might not feel comfortable giving certain medications or agreeing to certain procedures if there are alternatives. You can find a doctor who will either agree with you or at least respect your preferences. That’s important.

When my first baby was about 9 months old, our pediatrician started asking me when I would begin weaning her off of breastmilk. She was doing great, I was very comfortable with breastfeeding at that point, and I knew the latest recommendations said that breastfeeding for two years is ideal! When I told her that I didn’t intend to stop breastfeeding anytime soon, I felt very judged, so I found a new doctor who celebrated my choices and made me know that I was doing a great job.

Doctors are Not Always Experts in Parenting

It’s also important to remember that although doctors are very important for your child’s health, they are not necessarily the right person for every job. They are not necessarily parenting experts who can tell you the best ways to get your child to sleep better or eat better or to ask about discipline. They often get asked for this kind of advice, however, and will probably try to do their best to help. But it’s good to remember that they are offering opinions and that there are many right ways to parent a child. It can be reassuring when you and your doctor are on the same page.

It is very appropriate to call different providers and ask these questions. Doctors often get requests for appointments for interviews or a call for general information about their practice. You will not be the first parent to do this. It’s a great way to find the right care provider on your first try, and could potentially save you time and frustration in the future.

I like to think of it like choosing a stylist to cut my hair. There are so many ways to cut and style hair well, but only a few that I like for myself! If I get a haircut that I don’t like, or have a hard time getting an appointment time, or don’t like the smell in the salon, I find someone else to do it next time. I consider the whole experience when choosing a professional for this job, and we should do the same when making decisions about healthcare.

Complete healing after pregnancy and birth is CRITICAL! And for the most part, it’s the same conversation whether you have a vaginal birth or a cesarean birth.

We focus a lot on having a healthy pregnancy. We watch what we eat, we try to rest and exercise, take our vitamins and have lots of visits with our care providers. Most people then take some time to prepare for birth. It’s a big deal.

We may have very important ideas about birth, and want to do whatever we can to help make that happen. We also will probably give a lot of thought to taking care of a baby. We may take a newborn care or breastfeeding class, we prepare a room, and we collect lots of STUFF. We may even set up childcare while we’re still pregnant! Unfortunately, the preparation usually stops here.

Create a Postpartum Self Care Plan

Postpartum is a word that simply means after birth. This is a very special time that should be handled carefully and thoughtfully. You not only need to recover physically from pregnancy and birth and take care of a baby, but it is also the first part of your parenting journey. Becoming a parent for the first time is a rite of passage. You may need to do a lot of shifting and transforming physically, emotionally, personally, professionally, socially, and even spiritually as you start your parenting journey! There is SO much going on at this point.

My favorite two pieces of advice for this POSTPARTUM period are:

1. Rest.
2. Clear your expectations.

You may get some advice from friends and family about how to handle this transition. They might tell you to breastfeed plenty so you can lose the baby weight faster (not true for everyone). They might tell you not to hold the baby too much or you may spoil them (not true AT ALL). Most of the time, the advice is not very helpful. Consider taking a little time to think about how you want to spend your time in recovery and make a plan of action.

Take Time for Recovery

We live in a country where the postpartum period is not handled with the care and reverence that it deserves. In some cultures, a lot of time and attention are given to a woman in the postpartum period. They receive a lot of support and tenderness from family and their community. Significant time off from work outside the home is encouraged. The general idea is that this is a time to rest and recuperate.

In the United States, unfortunately, the predominant message is that we should “bounce back” as quickly as possible. I’m pretty sure there is an award given for people who can get their pre-pregnancy body right back, go right back to working effectively outside the home, and can go right back to having a vigorous sex life and social life. Well no, there actually isn’t an award for that, but doesn’t it seem like people are competing for one? Listening to other people and the media can give us the mistaken idea that this is the way it’s supposed to be. It is not supposed to be this way!

Because of these unhealthy but widely held beliefs, we might enter the postpartum period with the expectation that we need to hurry up and get back to life as it was. I think you should clear your expectations about this. You DON’T need to rush ‘back’. There is no ‘back’ and there shouldn’t be!

You are supposed to be different. You’re a parent now, and that’s a really big deal. You were a caterpillar, and then your pregnancy was the time you wrapped yourself into a cocoon, a chrysalis. You give birth and emerge a butterfly. A butterfly has to give itself time for its wings to dry before it can fly. Your DNA is the same, but your cells and self get to reform into something new, different, and probably better. I hope that you can embrace this idea because it makes this transition feel very different.

Some Good Evidence that we Need to Do Things Differently

1. It is an indisputable fact that breastfeeding is healthy, but breastfeeding rates in the U.S. are low compared to many other countries. Some of the main reasons for this are minimal parental leave policies and lack of social support during pregnancy and postpartum.
2. Up to 50% of women will experience pelvic organ prolapse after birth. This is when our bladder, uterus, or rectum end up lower in our pelvis because of soft tissue injury or improper healing. When this happens, you might feel a bulging sensation in the vagina, heaviness, pain with sex, bladder or fecal incontinence, or trouble controlling gas.
3. Up to 40% of women will experience diastasis recti after birth. This is when the abdominal muscles don’t heal back together after pregnancy. Everyone’s abdominal muscles separate during pregnancy. They have to in order to make room for the huge uterus! Sometimes, they don’t rejoin and heal properly. This might cause back pain, weakness in the core, and a belly pooch that looks like a small pregnant belly.
4. Approximately 20% of people experience postpartum depression after birth. This is a lot, and this can really interfere with your physical and emotional recovery. It can interfere with breastfeeding, parenting, self-confidence, and your ability to go back to work. One major common factor among people with postpartum depression is a lack of support.

The important thing to remember is that these things can be significantly improved if you take the time and rest you need to HEAL COMPLETELY. When employers support you by giving you more time at home, you can do a great job of establishing breastfeeding, and that means you can continue it more easily even after you go back to work. When you have help at home, you can spend more time in bed, allowing your body to heal. There is a lot of evidence that shows decreased rates of pelvic organ prolapse and diastasis recti when people rest for an appropriate amount of time.

When new moms stay in bed more, breastfeeding rates also improve. Spending time with your baby on your body in bed allows you to bond and produce the hormones your body needs to establish a great milk supply and give you protection against postpartum depression.

You can see how it all works better when we can change our expectations and get plenty of rest. The more you do this, the better chance you have of making this an empowering transition, but you can only rest and recover when you have support.

A Few of my Favorite Postpartum Tips

• After a vaginal birth, there will most likely be vaginal swelling and soreness! Ice packs help. You can buy special ice packs for this purpose OR you can make your own by soaking a menstrual pad in water and putting it in the freezer.
• Peeing and pooping might be really intimidating and even painful at first! Wiping is not recommended, and instead, you’re supposed to rinse with water. You might use an irri-bottle provided by the hospital, a peri-bottle that you might like to purchase yourself, or you might like to buy and install a handheld bidet sprayer for your toilet like this one which can make the rinsing much easier!
• Eating well will help you feel better and heal faster. It can also make peeing and pooping less problematic and uncomfortable. This article by registered dietician, Lily Nichols, has some great recipes to help you nourish your body best after birth. The book The First Forty Days: The Essential Art of Nourishing the New Mother is another great resource.
• Consider seeing a pelvic floor physical therapist. You can get some good ideas by meeting with someone during pregnancy to help you prepare to have a better birth and recovery, or you might see someone after you give birth if things aren’t feeling or working quite right.
• Many experts agree that staying in bed a lot can help you heal and prevent problems. A general guideline offered by some experts is:
• • One week IN THE BED. The first week you are mostly horizontal. Of course, you get up to use the bathroom, have a shower, and get a glass of water, but mostly you are in the bed lying down.
  • One week ON THE BED. In the second week, you can be more upright. You’re sitting up more, and maybe getting up for simple things more often. But you’re not doing chores, taking long walks, or staying on your feet for long.
  • One week AROUND THE BED. The third week you’re spending more time out of the bed, but you’re not taking big excursions out. You are “around the bed” so you can get in it if you feel a little drained if you start bleeding more, if you feel some heaviness in the pelvis, or if you get a chance for a nap.
• Set up help for yourself now. When you have supportive people helping you with baby care, food, and household duties, you’ll be better able to take the time you need to rest and recover. These might include family, friends, or people you hire! Postpartum doulas can be another great way to get the help you need. They can give the kind of support you need to heal. In my area, postpartum doulas are in short supply, so be sure to schedule someone as soon as possible!

There is a lot more to know about healthy recovery in the postpartum period! To learn more about this topic, consider taking our live-taught online classes called What Happens After Birth? Postpartum Recovery, Healing & Restoration and Take It Easy: The Importance of Self-Care in Pregnancy & Postpartum.

And if you have any issues at all, please contact your medical professional

It can feel very surreal to be sent home from the hospital or birth center with your brand new baby. I remember feeling amazed that they let me do that! I didn’t really know what I was doing, or what to expect. The staff at my birth center had been helping me with my own physical recovery, and they were also helping me feed, diaper, clean, and clothe my baby. When it was time to go home, it was hard to imagine how I’d be able to manage!

It’s very normal to feel this way, and it will get easier. Your confidence will build as you get through each day, and each challenge. You will learn skills from others, and you will develop your very own methods and hacks for taking care of your baby. But the first 24 hours, even if you feel unsure, insecure, exhausted, or possibly downright freaked out, is a special time. It might also feel like a very long day.

Know that you aren’t alone. There have been MANY mothers, many parents, before you who have had the same experience and many of the same feelings. They got through it, and so will you.

Here are a few things that might help you prepare for this time and maybe ease through it a little more gracefully:

1. Set up some help. This matters A LOT. Having supportive people around you makes a big difference, and it’s smart to set that up ahead of time instead of trying to do it when you’re just getting home with a new baby!

1. • Have someone come stay with you. Maybe a mom or sister would be available to spend a little time at your house while you recover and get things figured out. If not, consider hiring a postpartum doula to come to your house to provide the support you need. A postpartum doula is someone who provides physical, emotional, and informational support to a woman and her family during the postpartum period.
   • Before you go into labor, create a Meal Train or a Care Calendar, or something similar to help with meal preparation and other tasks during your first days at home. You can share the link with friends and family who want to help. There are probably a lot more people than you think. Friends and family can sign up to help you on the days that you request it.
2. Have an “on-call” advice-giver ready to answer your questions. Do you have a family member, friend, or co-worker who you consider extremely WISE? Is this person also a parent? If you have someone like that in your life, ask them if they’d consider keeping their phone on 24/7 so they can take your call if you’re having a tough time or just have a question. It can feel really good to know you have sound advice if you need it.
3. Have some great nourishing foods ready before your due date, or at least have some recipes chosen so you can recruit someone else to make them for you! Nutrition is key to a great recovery. When we eat nourishing foods we feel better, we heal better, and we can even make milk better! I love Lily Nichols’ books and posts. She’s a registered dietician and nutrition expert. See her post about REAL FOOD POSTPARTUM RECOVERY MEALS for some recipe ideas.
4. Take opportunities for sleep WHENEVER POSSIBLE. If you need to fall asleep with your baby sleeping on your chest, that’s OK! Can your partner or another helper keep an eye on you while you do that? Babies take a while to catch on to the idea that nighttime is the best time to sleep, so rest when your baby does or you might get WAY behind in your sleep!
5. Put a favorite fun or relaxing thing on the schedule for your first day home. Do you love to play UNO or video games? Is there a book you’ve been dying to read? Do you love foot rubs? Think of something that’s easy to do in bed and put just that one thing on the schedule! You’ll have something to look forward to that can make you feel a little more normal while you’re getting the hang of having a baby.
6. Focus on lots of skin-to-skin snuggles with your baby. This benefits everyone. Your baby benefits from being on your body, your milk supply benefits, and YOU will feel better and recover more quickly. Babies are little oxytocin makers. This natural chemical helps you feel good, helps you make milk, and literally helps your uterus recover from pregnancy and birth.
7. Recovery takes priority. Remind yourself often that there is nothing else you “should” be doing. You are doing very important work by staying off your feet and focusing on your baby and your healing. A few weeks and months down the road, when you don’t have any recovery complications, you’ll be so grateful that you gave yourself the time to rest. You also don’t need to be hosting visitors. Your job is to recover, not to entertain.
8. Your breasts might get very swollen and uncomfortable as your milk comes in. It can take some time for your body to regulate the amount of milk that is needed. Expressing milk may be helpful and can be saved for later. Our Breastfeeding 101 class can help you learn more about breastfeeding and hand-expressing milk. Our pumping class is great for learning more about expressing and pumping milk.

Here are a few things to know about BRAND NEW babies in their first 24 hours at home:

1. Their bellies are TINY! They need to eat OFTEN and if it seems your baby is eating ALL THE TIME, it’s probably a good thing! It means your milk production is getting a good foundation. Most newborns will need to eat 8-12 times in a 24-hour period. Some may eat more or less often.
2. They have black or greenish/black poo for a little while. This is called meconium and it’s normal. Once they’ve been getting milk for a few days it will look more normal. In the meantime, cleaning their bottoms with warm soapy water and a washcloth might make those diaper changes a little easier. You also might want to apply diaper cream or coconut oil after a diaper change so clean up is easier next time.
3. How many wet and dirty diapers should you expect? On your first day back home, most babies will be 3 days old and you can expect 2-3 dirty diapers and 3-5 wet diapers. Sometimes a diaper will be dirty AND wet. You can definitely count both.
4. They might be very sleepy at first. Sometimes they are so sleepy that they might need to be woken up to eat. This might be hard, especially if you’re getting a nap too. But you might want the baby to eat frequently because you may have a lot of milk building up, making your breasts feel uncomfortable.
5. Your baby will have a pretty fresh umbilical cord stump. After the umbilical cord is clamped and cut right after birth, the part connected to your baby’s belly will remain until it dries up and falls off. This usually takes 1-3 weeks, but they occasionally fall off a little more quickly. You mainly just need to make sure it stays outside the diaper, that it stays dry, and that it doesn’t smell bad. You will also want to watch the skin around it to make sure it doesn’t look red or swollen, and that there’s no oozing. If it starts to look or smell iffy, call your pediatrician.

TAKE SOME DEEP BREATHS, RELAX, LISTEN TO YOUR BODY AND LISTEN TO YOUR BABY.

Your baby got a checkup before you got home. You and your baby had to be healthy to be discharged. Take a deep breath, and know that for at least this first day, you’re in pretty good shape. So just tune in to your body’s needs and your baby’s signals to help you know what’s next. There are no schedules or routines needed. I promise that will come later. Right now is just the time to rest and respond to needs.

You are all going to need some time to figure out life together, but in those first few days and weeks, set VERY low expectations. This can be really hard for most of us! It’s a challenge to be able to let go when we’re used to having very predictable and structured adult lives and routines. Consider this a retreat from the normal. This is your chance to practice zen principles and live in the moment.