INITIAL POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE: PART ONE

POSTPARTUM CARE AT HOME: YOUR COMPREHENSIVE GUIDE TO THE FIRST FEW WEEKS - PART ONE

Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. And do see the Postpartum Guide to Breastfeeding Postpartum, for initial issues specific to that.

The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you. 

After the first week or so, but before your memory of details fades, it is a wonderful experience to reflect on your pregnancy and birth with heartfelt honesty, and write your pregnancy memories and childbirth story down in a bump to birthday journal. This is something special to share with your child one day, and it is also a wonderful gift to yourself. It can be especially helpful for healing if things were difficult, or your labor and birth did not go as planned or as you hoped. Journaling will help you express, later process, understand, come to terms and make peace with any painful feelings that come up more deeply. 

Below are some helpful hints to make the next few weeks easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal, as you are perfectly designed to do, given the proper care and support. 

Nutrition for Postpartum Care

Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily. 

Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs. 

Herbs and Supplements

Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic. 

Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:

1. Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips. 

2. Add a pinch of Comfrey to help with healing. (optional) 

3. Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.

4. Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.

5. Enjoy hot or cold, up to 4 cups per day.

 You can make it in larger quantities and store in the fridge.

Other herbal tonics for new moms to promote general physical and emotional postpartum recovery and healing include Ashwagandha and Gotu Kola (½ -1 tsp each twice daily), and Milky Oats (1/1-1 tsp 1-3 times daily), in addition to herbs mentioned below as appropriate for each specific issue.

To promote healing after birth, take 3-4 pellets of homeopathic Arnica 30 c under your tongue every few hours for the first 3 days, then three times daily for a week. You can also dissolve the pellets in a clean unused bottle of water, shake vigorously a few times, then gargle a mouthful before swallowing, which increases the strength of the remedy.

Treatment for Afterpains

Periodic cramping, known as afterpains, commonly occur as your uterus muscle fibers contract around the blood vessels that supplied the placenta. This is your body’s natural defense in order to minimize excessive bleeding and return to its non-pregnant size. They can be quite painful, and can occur with increasing intensity after each subsequent baby.  

Breastfeeding can temporarily increase the severity of these pains, which is actually helping your body heal and prevent excess blood loss. Afterpains should gradually subside over the next week and lessen significantly over the first 3 days after birth. 

Below are some suggestions to lessen the discomfort.

• Frequently empty your bladder, even though you don’t feel like you need to pee, as is common from the swelling after childbirth.

• Especially during the first 24 hours, check the top of your uterus several times per hour to make sure it is nice and firm like a hard nectarine or knuckle. Massage the top of your uterus gently when it begins to soften or feels boggy.

• Lie on your stomach with a pillow under your lower abdomen.

• Apply warm moist towel compresses, hot water bottles, hot herbal packs or rice packs heated with a few drops of essential oil of Lavender, or a heating pad to your lower abdomen. 

• Practice your breathwork, deep breathing and conscious relaxation exercises during the afterpains, dropping your focus right down into them, relaxing with surrendering to the intense sensations as you did in labor.

• Try soaking in a well-cleaned, warm bath with drops of Lavender or Chamomile.

• For an effective herbal infusion: 

  • Mix a large pinch of Chamomile blossoms and/or Catnip in 1 cup boiling water.

  • Brew covered for 10-20 minutes.

  • Strain in a glass canning jar.

  • Add honey to taste (optional).

  • Drink very warm, 1-4 cups daily.

• Take a dropperful of Motherwort herbal tincture up to 4 times daily. If without relief, try Cramp Bark herbal tincture, 1 dropperful every 30 minutes to 2 hours, then 2-3 times daily. You can add a dropperful of Black Haw tincture 3 times per day. You can make your own cramp bark infusion by steeping a handful of Cramp Bark and Black Haw with a pinch of Hops and generous pinch of Blue Cohosh root in a quart mason jar overnight.

• Take Wish Garden AfterEase herbal tincture as directed

• Take 3-4 pellets homeopathic Chamomilla, Arnica, or Caulophyllum 200 c. Try one remedy under your tongue. If no relief try the other. If the remedy works, repeat daily as needed.

• Try Moxibustion treatments by an acupuncturist.

• Try additional suggestions and remedies mentioned here for aches and pains in pregnancy. They work!

• If the pain is too much for you and interfering with your ability to breastfeed, rest and sleep, you can take ibuprofen (up to 800 mg every six hours) OR acetaminophen (up to 650 mg every four hours) ½ hour before nursing for the first several days only, as needed. But before reaching for these medications, try 1-2 grams of Curcumin (Turmeric), a natural herb studied to be as effective for pain relief than most over the counter synthetic analgesics without their associated potential risk of toxicity. 

Consult your practitioner for severe cramping or cramping that lasts longer than 1-2 weeks, or if accompanied by uterine tenderness, fever or foul smelling discharge.

Home Remedies for Bleeding

During the first two to five days, bleeding is no more than a heavy period with an occasional clot the size of a 50 cent piece or egg, dark red in color with a fleshy smell. It tends to be less after cesarean birth. Clots are simply congealed blood mostly that pools in the vagina when you are reclining, and can occasionally be as long as the vaginal canal. Sometimes bleeding increases with nursing, strenuous activity, heavy lifting and pushing motions, full bladder, and as you rise from a lying down position. 

During the next week or so, the bleeding becomes paler pink or brownish, and it lessens in amount so that you only need to change sanitary pads several times per day. Over the following two to four weeks, discharge becomes creamy white or yellow and even less in amount, but usually returns to red bleeding or spotting for a day or two around the second postpartum week.  

Some women occasionally spot on and off for longer periods of time or throughout breastfeeding. Suggestions for keeping clean and comfortable are:

• Take a daily bath in a well-cleaned tub (add Calendula tincture and Lavender oil to water if desired) or shower.

• Change disposable organic sanitary pads or herbal infused natural pads every four to six hours, and after going to the bathroom. Do not use tampons, menstrual sponges, or menstrual cups. The first day or two, especially at night, consider wearing adult diaper type pads simply because it is just easier, as bleeding can be heavier than common postpartum maxi pads can accommodate, and can leak onto your clothes and sheets. Use them with a smile.

• Wash hands before and after changing pads.

• Remove pad from front to back, squeeze a peri-bottle of warm water over perineum. If you had tearing with or without repair, you can also add 1 tsp Calendula tincture and Lavender oil to the water. Pat dry.

• Do not douche.

• Check the top of your uterus for firmness several times per hour when awake for the first 24 hours, then several times per day for three days. It should feel as firm as a hard nectarine. If it feels soft, massage it firmly so it re-contracts.

• To prevent excessive bleeding, take homeopathic Arnica 30 c as described in the supplement section.

• Take herbal Shepherd’s Purse, 1 dropperful of the tincture three times daily for the first 3-5 days.

• Wear an abdominal binder or Bellefit’s postpartum support girdle. You get a $20 off with code: ANNE20 at checkout.

• Continue your herbal iron dose until your bleeding stops in 4-6 weeks, which may need to be increased per your practitioner if there was hemorrhage. Eat foods high in iron, like red meat, dark turkey meat, eggs, dark leafy green veggies, and dried fruits.

• If bleeding becomes heavy (you are saturating more than a large maxi pad every half hour):

  • Try herbal Shepherd’s Purse tincture (1 dropperful under your tongue), repeat every few minutes as needed)

  • Add 3 dropperfuls tincture of Cotton root, 2 dropperfuls each of Lady’s Mantle, Witch Hazel and Blue Cohosh, and 1 dropperful Yarrow. Take them every 10 minutes under your tongue until the heavy bleeding resolves, but only up to an hour. 

  • If heavy bleeding persists, take 2 dropperfuls of HerbPharm Erigeron/Cinnamon tincture of Erigeron and Cinnamon  under your tongue every 20 minutes for no more than 2 hours, and add 1 dropperful of Angelica if without relief.

Report to your practitioner if you’re saturating more than one pad an hour for more than a few hours not relieved by the other suggestions above, especially if you are starting to feel lightheaded, weak, disoriented, cold and clammy with rapid shallow breathing and heart pounding. Contact them also if you’re experiencing large clots, foul-smelling vaginal discharge, severe lower abdominal pain, temperature over 100.4 after the first few days, and deviation from the described pattern of bleeding.

Perineal and Vaginal Discomfort

After delivery, your perineum and vaginal area may feel sore, swollen and uncomfortable. Any pain or tenderness should gradually lessen over the next several weeks, or longer if you had a large tear. 

Suggestions are:

• Practice good perineal hygiene as previously described in the section on bleeding.

• Don’t forget to take the homeopathic remedy Arnica 30c as directed above, in the first few weeks to support healing after giving birth, which definitely helps your perineal and vaginal areas.

• For a small tear that did not need stitches, using a peri-bottle, squeeze warm water with several drops of Calendula tincture and Lavender oil over the area as you urinate to reduce stinging. Squirt Vitamin E oil a few times daily on the tear to promote healing. Motherlove and Earth Mama make wonderfully soothing and healing herbal combination perineal sprays.

• Apply a perineal ice pack or frozen maxi pads saturated with Witch Hazel for the first 24 hours (with 30 minute respite each hour) or as long as you feel it is soothing.

• Periodically sit in a cool sitz bath during the first 24 hours or as long as you feel it is comforting.

• After the first 24 hours, take a warm sitz bath, or warm shallow bath 2-3 times per day. You can also add tea tree oil, tincture of calendula, garlic, ginger and/or lavender, or try herbal sitz bath combinations with Uva Ursi, Comfrey and Sage or Calendula and Oatmeal (both combos have Witch Hazel, Yarrow and Plantain). You can also try herbs with Epsom and Dead Sea salt or herbal salt soaks and see which feels best for you. You can use any leftover unused liquid for compresses or your peri bottle rinse.

• Use a pillow or cushion when you need to sit.

• Contract your pelvic muscles (Kegels) or even better, engage your mula bandha (all of your pelvic floor muscles) when changing positions.

• Take the homeopathic Arnica 30 c as directed above for general recovery.

Report pain that worsens or does not improve over time, an increased area of redness, swelling or pus-like discharge.

If You Have Difficulty Urinating

During the first four hours after birth, many women have trouble urinating such that they feel no urge, feel the urge but cannot urinate, or feel burning after the urine comes out. It is essential that you urinate within eight hours after birth as difficult as it may be, to prevent infection and excess uterine bleeding.  

Suggestions to help you urinate are:

• Listen to running sink water.

• Squeeze warm water over your perineum with your peri-bottle, infused with a few drops of oil of Peppermint.

• Dabble your fingers in water.

• Apply light pressure to the area above your pubic bone.

• Put oil of Peppermint in the toilet.

• Sit in a sitz bath with several drops of the oil of peppermint.. 

• Take a bath or shower.

• Blow your thumb.

• Concentrate on relaxing and opening your pelvic floor muscles while imagining the urine flowing out.

• Drink eight glasses of water per day.

• Try homeopathic Arsenicum or Causticum both at the 30 c dose.

Report inability to urinate more than eight hours after the birth, burning pain before or as the urine is coming out, feeling the urge to urinate frequently but little urine comes out, fever, or back flank pain.

Cesarean Birth 

If you birthed your baby by c-section, it will take more time to heal physically, and psychologically - especially if unexpected and unplanned, or traumatic. Trust that you will get back to your new mama self. The scar will be there but will eventually fade. Allow for at least 3 months recovery for your body from major abdominal surgery, possibly longer to heal the mind and heart. Homeopathic remedies help tremendously and definitely speed and enhance your recovery safely and naturally.  If your cesarean is planned, start Arnica 200 c three times daily the day before and continue through 3-4 days postpartum. 

Other remedies helpful to have on hand are Aconite 30 c for intense fear and panic before surgery, Bellis Perennis 200 c post cesarean to boost healing after you finish the Arnica, Staphysagria 200 c for incisional pain and healing, and Hypericum 200 c for shooting nerve type pain from the spinal anesthesia (only if needed). Use one remedy at a time and take it three times daily until you feel improvement. Consult your classical homeopath for more personal guidance.

The first week is the hardest in terms of postoperative pain, so take ibuprofen or acetaminophen if absolutely needed, then switch to more natural pain relief remedies like ginger or turmeric that are safe for you and your breastfeeding baby, but still effective. 

Use the skills from breathwork and mindfulness to center and ground yourself, stay present one breath at a time, surrender, lean into and embrace the temporary painful sensations you feel, without the story, with love and compassion towards yourself. Whenever you feel overwhelmed or stressed, take a few minutes to simply breathe, keeping your focus softly on a distant nonmoving object (drishti) or close your eyes and internally gaze between your eyebrows, relaxing deeper with each exhale. Send your love and breath (divine life force) and imagined light to areas of pain. Use visualization to support you as you desire. This is powerfully healing.

While in the hospital, it is important to take deep abdominal breaths also to keep your lungs fully expanding (use the incentive spirometer many hospitals give you), and to get up and walk within 12-24 hours after birth for 10 minutes each waking hour, especially to prevent serious blood clots and painful abdominal gas buildup. The more you walk, the sooner you pass gas and get your bowels moving, and you keep your blood flowing rather than stagnating from immobility.

Ask to be progressed from a clear to regular diet within this time, and choose healthy foods and bottled spring water from the hospital menu (if that even exists!) or have your family and friends bring you more wholesome real food meals and snacks. For gas and bloating, limit:

• Gluten containing foods found in wheat, spelt, rye, barley and some oats

• Some fresh fruits and veggies

• Cow dairy if lactose intolerant

• Carbonated liquids

• Chewing gum. 

Eat slowly, chewing thoroughly and mindfully. Natural remedies for gas and bloating include chewing Fennel seeds, drinking Fennel tea, or taking 2-4 ml of the tincture three times per day, taking Slippery Elm lozenges 3-4 three times daily, and a high quality multi species probiotic twice daily on an empty stomach. Eat and drink more fermented foods like kefir. For bad gas and abdominal pain, take 1 dropperful each of Chamomile and Passionflower, ½ dropperful each of  Hops and Lemon Balm, and ¼ dropperful of Lavender tinctures every four hours.  

The dressing over your incision should be removed within 12-24 hours, so your incision is kept clean and dry to prevent infection. You can apply a clean maxi pad over the incision if your belly is folding over it, so it does not stay warm and moist, inviting bacterial growth. You have been sewn back together in many layers, and the skin is brought together by a glue like substance, absorbable stitches or staples, or removable metal staples. While it takes time to heal, when all is proceeding normally, it is unlikely to open as commonly feared. 

Sometimes they use steri-strips over the incision which will come off eventually or you can remove them in a few days. You can definitely shower, but do not use soap initially on the incision. Dry the area gently. A little oozing of blood is common to see on the dressing, as is a tiny amount of clear, white, or yellowish fluid, as long as it is not pus- like discharge. Look at your incision so you can monitor its healing as well as work on acceptance and appreciation for the journey you and your baby needed, made especially for you both. Once you go home, you can apply herbs for perineal and vaginal tears mentioned above to soothe and enhance healing. Earth Mama makes a lovely herbal balm specific to healing a cesarean scar and there are other organic balms that also help the scar fade. 

Make sure to keep Baby skin to skin in dim quiet as much as you can, bonding and soothing baby with your love, telling Baby all is well, Baby is safe and acknowledge that was a tough journey for both of you. Get help with breastfeeding as soon as possible. Baby may be sleepy from the medications, and it takes longer for the full breast milk to come in, but you will get the breastfeeding going with excellent support and patient perseverance. 

I encourage you to love, be proud and grateful for your cesarean scar. This may take time to cultivate, but is a worthwhile goal. Do not be shy to ask for extra needed help, and get support processing and healing emotionally. For online and local group support and advocacy, there are many wonderful resources like ICAN, but you may want to consider breathwork to release the strong stuck emotions and trauma energy in your body if it is interfering with your well-being. If you are suffering from birth trauma or you suspect your baby has it as well - as is common after cesarean birth - there are resources for healing for you and for your baby.

Consult your practitioner with:

• For fever over 100.6 with general muscle aches and chills

• Persistent or worsening pain

• Area of tenderness/foul smell/pus/redness/swelling by your incision

• Area of leg swelling, redness, warmth and pain worse when you flex your foot

• Unusually frequent, urgent or painful urination

• Heavy or foul smelling vaginal bleeding

• Vision changes, nausea, vomiting, chest pain and/or headache, especially if you had high blood pressure

• Anything unusual you are concerned about. 

Obviously, if you have problems breathing, feel weak, disoriented and faint, call 911.

Constipation and Your First Bowel Movement

It is normal to go a few days after delivery without having a bowel movement. Many have loose stools before labor and pooped during pushing, and those who birthed in hospitals who don’t allow eating in active labor probably did not eat much, if at all, in labor, unless they (hopefully!) respectfully challenged that outdated policy, or simply sneaked it. So you have a few days leeway. Some mothers are afraid that a bowel movement will be painful or open their tear more or stitches if they had them. Other women are too busy and preoccupied with all that is involved postpartum to even think about taking the time. Do rest assured that although the first few bowel movements may be uncomfortable, they will not open your tear or effect the stitches. Even if you had a large tear, it’s extremely rare for them to be torn by a BM.

Suggestions to limit your discomfort and prevent constipation are similar to remedies in pregnancy with some additions:

• Replace refined highly processed foods with whole grains, lots of fresh fruits with the skin, and vegetables (especially green leafy salads).

• Drink at least 64 ounces of fluid each day, preferably filtered, spring or well water, or herbal tea. Consume between meals, at least 20-30 minutes before or 2 hours after eating.

• Do Kegels and abdominal muscle toning exercises.

• Drink warm prune juice or a cup of tea or coffee on an empty stomach.

• Drink Smooth Move Tea, which tastes yummy and works like a charm.

• Mix 2-3 Tbsp oat or wheat bran, or ground flax seed, in your hot cereal or apple sauce. Or, mix with stewed prunes or dried figs. 

• Try raisin bran muffins with black strap molasses (ask someone to make you a batch, with whole grains, or Paleo - gluten, sugar and dairy free).

• You can take these remedies in these doses for preventing and treating constipation which include Magnesium or the powdered liquid equivalent in Natural Calm, herbal Floradix liquid Magnesium, Triphala, Psyllium seed husks, or homemade Dandelion and Yellow Dock root infusion. 

• Use Colace (stool softener) as directed if your bowel movements are getting hard despite these above suggestions, and you are on opioid pain medication after a cesarean birth.

• If you are taking iron, use alternative sources of iron other than ferrous sulfate, such as ferrous fumarate, ferrous gluconate, or herbal iron.

• Do not ignore the urge to have a bowel movement, which usually occurs ½ hour after breakfast.

• Take an interesting book or magazine into the bathroom with you to enjoy some relaxing time on the toilet.

• While on the toilet, rest your feet on a low stool and avoid straining. Support your perineum by applying counter pressure with a folded tissue if needed.

• If it hurts while having the first few bowel movements, do some relaxation and deep breathing exercises, relax into the discomfort instead of fighting it and tensing up, or try splinting the perineum with your hands to provide extra give to the area.

• Avoid relying on enemas and laxatives on a regular basis.

• Ask your classical homeopath, or refer to books like Homeopathy For Pregnancy, Birth and Your Baby’s First Year by Miranda Castro, for a homeopathic remedy specific to your unique symptoms.

Consult your practitioner if there is no bowel movement by the end of the fourth postpartum day, or you experience unusual pain or bleeding.

Treating Hemorrhoids

Hemorrhoids are varicose veins of the rectum, and are a common postpartum occurrence. They resemble a pile of red grapes or marbles just outside the anal area, but they can be internal as well. They can itch, bleed and be quite painful during the first 2-3 days, before gradually becoming smaller. Refer to the suggestions for natural remedies for hemorrhoids in pregnancy as many still apply now.

Suggestions for relief are:

• Herbal sitz baths as mentioned above for your perineum, with Epsom salts, Witch Hazel, and/or Comfrey.

• Use a pillow or cushion when you need to sit on a chair.

• Sleep on your side.

• Lie down several times each day with your hips and legs elevated with pillows.

• Try gently placing the hemorrhoids back inside your rectum with a lubricated finger, and then tightening your rectal muscles around them for 2 minutes.

• Natural remedies with dosing are here for internal and topical use, and include applications of already made Witch Hazel compresses (known as Tucks in the pharmacy) or make your own by pouring Witch Hazel onto round cotton pads, plantain, pure Aloe Vera gel, clove of garlic insert, and homeopathic Hamamelis and herbal combinations in a salve or ointment.

• Shine a red heat lamp on the affected area.

• Avoid constipation and straining.  See above.

Report if pain, swelling or bleeding worsens or becomes severe.

Postpartum Dizziness or Faintness

It is very common to feel dizzy, light-headed or faint the first few times that you get up from a lying or sitting position, especially after a long, hard exhausting labor with a large amount of blood loss.  

Suggestions are:

• Make sure you are eating well and drinking enough water as described in nutrition and constipation sections. 

• Have someone assist you the first couple of times that you have to rise.

• Rise from lying down gradually. First sit, then stand slowly.

• If feeling lightheaded or woozy while standing, lie down with your feet elevated or sit down with your head between your knees. Ask for someone to bring you a few large glasses of juice, as well as a high quality whole carbohydrate, fat and protein meal. For example, a nut butter and jelly sandwich on sprouted multigrain bread, or yogurt with fruit and granola.

• If you feel faint or do faint, sniff ammonia or smelling salts. This is an important first aid item to have, especially if birthing at home.

• Open windows to get fresh air.

• Splash water on your face.

Contact your practitioner with dizziness that lasts longer than the first few days or any actual fainting.

CONTINUED NEXT MONTH….STAY TUNED!

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POSTPARTUM CARE AT HOME: YOUR BREASTFEEDING GUIDE

POSTPARTUM CARE AT HOME: YOUR BREASTFEEDING GUIDE

Congratulations to you and your family on the birth of your baby! You did it!! You are a rockstar, superhero, however and wherever you birthed. Now it is time for some postpartum care. But through it all, do what you can to go with the flow. Tune into your body and your baby’s natural rhythms. Embrace it all as a normal healthy phase of your life as a new mama, shared with mamas around the world since the beginning of time. Try to have fun with it and keep your sense of humor. 

Welcome to the postpartum period, the fourth trimester, a period of healing and adjustment, of getting to know and comfort your baby, and mastering breastfeeding. All your baby needs now is love and breast milk. If you are unable or choose not to breastfeed, consider feeding baby pumped breast milk, or donor breast milk from registered milk banks. Breast milk is the ideal food for your baby, although organic goat milk formula is most similar to human milk and you can discuss best alternative options with your pediatrician. 

The rest will follow naturally, as you learn on the job, take guidance from wise experienced others, and let Baby be your teacher. As in pregnancy and birth, trust your instincts and your heart. But, do not hesitate to ask for help and support as needed. Hopefully you prepared in your pregnancy so that you are well supported during this sensitive time, as it has always taken a village to raise a baby as well as new parents. A postpartum doula is a must if you do not have family and friends to help you. 

Below are some helpful hints to make the next few weeks of breastfeeding easier and more comfortable, so you are more able to heal, enjoy and reflect upon your extraordinary new miracle. The most important advice is to slow down, stay in the moment, try to resist the temptation to do, do, do...and just be, be, be. Trust that you will heal and get into your breastfeeding routine, as you are perfectly designed to do, given the proper care and support.  Do not hesitate to reach out to an IBCLC lactation consultant sooner rather than later if there are breastfeeding issues beyond what your midwife or doula can help you with.

Nutrition for Postpartum Care & Breastfeeding

Maintain at least the same healthy nutrition as you did in pregnancy, especially now for recovery after birth, and during breastfeeding. This will help you to make good quality milk, and nourish your baby as well as yourself. Make sure to eat at least three whole food varied healthy meals and snacks, and even a little bit more than you would normally consume. And keep well hydrated with at least 64 ounces of water daily. 

Traditional foods for the early postpartum weeks across cultures typically include soups and stews with a lot of vegetables, including the starchy ones like sweet potatoes and winter squash, stew meat or chicken, and whole grains like barley and oats. Also, do eat plenty of eggs, seasonal fruits and vegetables. Much nourishment can be added to fruit/veggie smoothies, soufflés, whole grain hot cereals, and breads/muffins like zucchini-apple, banana-date or carrot-raisin, enhanced with almond flour or chopped nuts and seeds, nut milk, and eggs. 

Herbs and Supplements

Make sure to supplement your diet as in pregnancy, with herbs, vitamins, minerals, omega threes and probiotics to complete nourishment not supplied by diet alone. This will aid in your recovery and help supply all of your and your baby’s nutritional needs. Do increase iron foods and take an herbal iron, especially if you were anemic in pregnancy, have low iron stores, lost a lot of blood at birth, gave birth by cesarean, and/or are still anemic. 

Do continue your nourishing pregnancy herbal infusion to your diet but add alfalfa and red clover. You can have a support person make this by:

1. Blending a handful of dried Nettle leaf, a handful of dried Red Raspberry leaf, a pinch of Alfalfa, large pinch of Red Clover, and several Rose Hips. 

2. Add a pinch of Comfrey to help with healing. (optional) 

3. Brew in a mason quart glass canning jar of boiling water 1-4 hours. The longer the brew, the stronger the taste and effect.

4. Strain, and drink plain or lightly sweetened with Rose Hip infused honey and/or a splash of fresh squeezed lemon or lime juice.

5. Enjoy hot or cold, up to 4 cups per day.

 You can make it in larger quantities and store in the fridge.

There are some nice herbal breastfeeding teas like those made by Earth Mama Organics and Traditional Medicinals. Use two bags per cup of tea to get the benefits. You can have your special someone make your own delicious, nourishing combination of herbs that helps with breastfeeding and enhances the nutritional content of your breast milk: 

1. Mix a handful each of dried Chamomile blossoms, Catnip and Blessed Thistle, a pinch each of Fennel seeds and Fenugreek powder or seeds, and a few dried Lavender flowers.

2. Put 1 tablespoon of the mix in a cup, fill with boiling water, and steep for 10-15 minutes.

3. Strain in the glass mason jar, and drink plain or lightly sweetened with Rose Hip infused honey, and a dash of anise. 

4. Drink 1-3 cups daily.

Breastfeeding

Note ways to prepare for breastfeeding and common myths to be busted, as well as  5 essential tips to get the breastfeeding going.

Your newborn baby’s stomach is tiny, like the size of a cherry the first few days, a small apricot at one week, and a large egg at one month of age. Only tiny amounts of milk are tolerated initially. Expect your baby to drink about 1-1 ½ tsp per feed on the first day, 1½-2 ounces by one week, and 2 ½-5 ounces per feed by one month of age. This is just what you have to give. 

The liquid gold colostrum that your breast produces makes no more than a few teaspoons per feed, but when your full breast milk comes in, you will have more than enough to accommodate. Often women have a misconception that they do not have enough milk when they have exactly what baby needs, and they get into a tension and supplemental feeding cycle that actually does decrease supply. 

If you had labor or birth complications, needed epidural or spinal anesthesia, baby was birthed by cesarean or had to be in the intensive care, establishing breastfeeding can be more challenging at first but you can do it. Get help by a certified lactation consultant (IBCLC) as soon as possible if there is any difficulty. Baby-friendly hospitals should all have them on staff, or you can ask your midwife, pediatrician or local La Leche leader for recommendations. If you need additional guidance to boost low milk supply first follow these steps. All you may need to do is keep nice and calm with baby skin to skin and nurse more frequently, avoid formula and glucose water, and do not use pacifiers until your breastfeeding is well established. 

You can increase emptying if needed, which boosts your supply, by using a double electric breast portable Willow pump every 2-2½ hours for 15-20 minutes, but know that a healthy baby is the best breast pump. If you do pump, freeze the milk for later use, like when you need to go out or want a break from a nightly feed. Take herbal combinations like More Milk Special Blend, drink non alcoholic beer or Hops tea and several cups Sesame milk daily. You may need to add increased amounts of the individual herbs like Goats Rue, Blessed Thistle and Fenugreek, 2-3 capsules each up to 3 times per day, or add the tincture of More Milk Special Blend, 2 ml 4 times per day to increase your supply. 

Treating Breast Engorgement

Your breasts will begin filling with milk and can become engorged by the third or fourth postpartum day whether or not you are breastfeeding. Initially, you may notice that your breasts become larger, fuller, heavy, lumpy, slightly tender and warm. They may leak milk and you may notice a short-lived low grade fever. The skin of the breasts may be pulled tight and become shiny, hard, painful and throbbing, and the baby might be less able to grasp the nipple.  

Suggestions to minimize discomfort with breastfeeding include:

• Practice early, frequent breastfeeding (on demand or every 1½-3 hours) without supplemental bottles for at least the first month. The breasts will learn to replace only what baby takes. (This is a good reason not to pump significantly in addition to nursing initially, as breasts will replace that too). Allow the milk to run freely into a bottle from one breast as the baby nurses on the other side. The bottled milk can be frozen for a later nighttime feed your partner can give Baby to give you some needed sleep once engorgement resolves.

• If Baby is having a hard time latching, try manually hand expressing a small amount of milk before nursing. You can also do so afterwards if still uncomfortably full after each feeding.

• Rub Arnica oil gently over breasts, except nipples, then apply a comfortably hot washcloth/compress or stand under a warm shower 5-10 minutes before nursing.

• Gently massage breasts downward while nursing using Arnica massage oil or lotion.

• If you are uncomfortable between feedings, you can let comfortably hot shower water run over your breasts and massage them downwards using a fine tooth comb dipped in soap, or gently hand express just a small amount, or soak your breasts into a sink full of comfortably hot water. If engorgement is severe add 1-2 ounces of Marshmallow root tincture to the water. 

• For severe engorgement, apply cold packs just during the short term period of extreme discomfort. Ideally, make these by defrosting frozen cabbage leaves rolled over with a rolling pin.

• Apply cold compresses of Comfrey (soak washcloths with the tincture and store in the fridge). You can try comfortably hot Comfrey compresses and add Parsley tincture.

• If you are not nursing and need help drying up your breastmilk, drink lots of Sage tea and do not pump. 

Report any areas of increased heat, redness, swelling and severe pain; fever over 100.4 after the first few days; and chills, headache and generalized aches like you have the flu.  

Sore Nipples

Your nipples may be tender or downright sore during the first week or so of getting accustomed to breastfeeding your baby, whether you are a first time mom or have nursed successfully before. You may also feel some pain, usually lasting no longer than one minute, each time the baby latches onto the breast in these early weeks, which lessens as baby nurses. If your baby is improperly sucking, or incorrectly positioned, your nipples can become very sore and the pain is intense the entire feed.

Suggestions to minimize nipple soreness are:

• Remember this pain is temporary as your nipples adjust to normal healthy breastfeeding, and use your tools from labor and breathwork to breathe and relax into the sensations rather than to fight them. This actually helps tremendously.

• Have an experienced person observe for proper positioning, latch and sucking during breastfeeding from the beginning, especially if you have severe nipple pain during the entire feed and your nipples are very sore.

• Release the baby’s suction with your finger before removing the nipple from the baby’s mouth anytime you need to stop the sucking, especially when the latch is shallow.

• Soak nipples in a cup of 0.9% physiologic saline solution, then expose breasts to fresh air 20 minutes after each feeding, ideally in the sun, in front of a 60 watt light bulb, or a blow dryer. Yes, spend some time topless.

• Apply some breast milk to the nipple.

• Avoid synthetic breast creams and nipple shields.

• If mild, massage plain organic Cocoa Butter, Almond oil or Vitamin E onto the nipples after each feeding. If without relief, apply homeopathic calendula cream or herbal salve made with Calendula, Marshmallow,  Aloe Vera, and Chamomile, or Lanolin designed for sore nipples after each feed and gently remove any residue before nursing. Apply pure Aloe Vera gel to the cracks and cuts, as well as Comfrey, but wipe off before nursing so baby does not ingest it. Try several formulas and see what feels best for you.

• Nurse more frequently for shorter periods of time.

• Alternate positions of nursing each feeding to vary pressure points on the nipple.

• Initiate nursing on the least sore side. You can nurse only one breast a day to allow the other to heal, pumping the sore breast to relieve engorgement during each nursing session. Then nurse the alternate breast the next day (pumping the other), and continue this until nipples have recovered.

• Take a daily bath or shower, washing nipples with water only (no soap).

• Wear all cotton bras, avoid tight bras, and minimize the use of breast pads. If breast pads are occasionally needed, use organic bamboo or cotton washables or nontoxic disposable breast pads without plastic, changing when wet to keep nipples dry.

Report to your practitioner if your soreness lasts longer than a week or is getting worse, if your nipples are cracked and bleeding, or severe nipple pain persists during entire feed indicating a latch issue.

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Need more help from me?

Check out my insider’s Guide to the joys and challenges of recovering from birth and getting the breastfeeding in these modern times created by a seasoned holistic nurse midwife who has seen everything! Learn simple tricks of the trade to make the journey to motherhood more holistically healthy and fulfilling.
You will have direct access to me through the Guides and I can help you:

• Help yourself breastfeed healthfully and successfully

• Get the support and guidance you need to answer all of your questions to create a breastfeeding experience you love and treasure forever

• Understand holistic modalities on breastfeeding issues

• Get the support and tools you need for stress reduction

• Answer questions and make informed decisions

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If you need more personal guidance, schedule a consultation with me.

My Natural Birth Secrets book 2nd edition has helpful tips as well, and is an excellent resource in adjunct to the Guide.

5 Essential Tips for Breastfeeding Newborns

Are you prepared to ‪breastfeed your baby? Here are the first 5 tips to get you started.

1) Prepare in advance with education and 2) Get support

Whether you are expecting one baby, multiples, or plan to tandem nurse, the best way to prepare to breastfeed is the same as the best way to have the most positive birth outcome: through education during pregnancy when you do not know about it! More and more mamas today approach their birth full of information and support, which is great! But many mamas do little to prepare themselves for ‪‎breastfeeding their precious little ones ‪‎before they are faced with it postpartum.  In addition, It is much easier when you are determined, surrounded by breastfeeding mamas and support - which you can seek out while pregnant, and have a natural unmedicated birth. It is harder without all that, but absolutely doable. My Love Your Birth online course goes into much more detail about breastfeeding and preparing yourself in advance with knowledge and support, the hows and whys, and what you can do to prevent potential common breastfeeding breastfeeding and set yourself up for optimal success.  

Photo of @mamacarlock is by @kindredphotographer

Breastfeeding is a magical experience for the entire family, and it's one I am proud to support whole heartedly - especially as it's so incredibly beneficial for mamas and babies, on many levels. I am determined to help mamas and babies get the support they need so their breastfeeding journey is a successful one. I have helped thousands of mamas on their breastfeeding journeys, and am happy to share the wisdom from my education and those experiences with you.

Breastfeeding is a natural process healthy mamas and babies know how to do. But it’s not always easy. Natural unfortunately doesn’t necessarily equal easy, especially in the beginning, and for first timers! It is a learned instinct, but once you and baby get it, it can be so easy, even pleasurable and incredibly worth it. While many do get it right away, for others there is a learning curve that takes a few weeks to get into your groove, and sometimes extra support is needed - especially if its your first experience and you are not surrounded by mamas breastfeeding, as women were throughout history since the beginning of time, and still are in many parts of the world.  It is the way all mammals naturally feed their babies. 

This mama pig is so full of the oxytocin and prolactin hormones, she is completely relaxed and in pig mama bliss. Animals just know what to do. In unusual cases, if a baby animal is having difficulty in the wild, they did not survive. And that is simply part of wildlife reality. If an animal is owned by a person, they usually help the rare little one that is having trouble. Humans who are passionate about breastfeeding but facing challenges are fortunate to have all sort of lactation support, wet nurses, donor milk banks, pumping, storage and alternative feeding methods to get babies breastmilk.

3) Start breastfeeding within the first hour postpartum, or as early as possible by 4) placing skin to skin and allowing for the breast crawl

The first hour after postpartum is an ideal time to start breastfeeding as babies are naturally wide awake, alert, and have strong suck, root and crawl reflexes - from the hormones of undisturbed childbirth.  Make sure the lights are dim and the room is quiet. Place baby skin to skin on your abdomen or chest.

Photo by @senhoritasfotografia

Healthy babies have reflexes to actually crawl up and find their way to the breast, find the nipple and start sucking on their own. It takes patience but there is no rush - and it's truly amazing to watch. Check out movies like "The Breast Crawl."  There are plenty like this on you tube. Healthy postpartum mamas have a huge heart, the maternal instinct to love and care for their babies enhanced by the hormonal cocktail circulating in the body after undisturbed birth; and their breasts are filled with colostrum  - commonly referred to as liquid gold, that transitions in a few days to breast milk which completely meets your babies' needs at least for the first 6 months and beyond.

5) Make sure baby's latch is wide

It's optimal for them to be allowed and encouraged to do their crawl up to your breast, but yes, there are times when some assistance is needed. But don't give up. If baby is falling asleep and you efforts to wake baby have not worked, or baby does seem frustrated and is starting to get fussy trying to find your nipple, there are things you can do to help. You will have an easier time getting her to breastfeed before the crying starts. Sit up and get yourself comfortable with pillow support as needed, cradle hold your baby in one bent arm so his face is directly in front of your breast a tad below your nipple, leaving your other arm free. 

When your baby is held close, facing your nipple, wait for baby to open his or her mouth wide enough to get a good latch to breastfeed. A good latch includes as much of your areola as possible - the darker circular area surrounding your nipple, where the breastmilk is contained, as well as your nipple, where the milk is released into baby's mouth. Baby needs to compress and squeeze the milk out of your milk sinuses in the areola prior to sucking - which are all part of the breastfeeding process.

Sometimes baby's latches are occasionally shallow in the early learning stages, which usually means baby is sucking mostly on the nipple; this not only feels painful, but also baby is not getting the proper amount of milk needed. If that happens, press down on the nipple with your finger to release baby's strong latch and try again. Until you both get the hang of it, you may need to hold your breast as this mama is doing, and slide the nipple up and down against baby's lips. This will stimulate baby to open wide and then you bring baby to your breast to feed. Practice and patience do make perfect and are well worth it. 

It is crucial to have lactation support available. Sometimes all you need is some wisdom from other seasoned breastfeeding moms or your local La Leche leader. Often guidance from your midwife does the trick. If not, and more extensive assistance is needed, do not hesitate to contact your local lactation consultant. Make sure to ask that needed help right away, as the earlier breastfeeding is established the better for both you and baby.  It does take a village of love. We must bring back that village. 

The newborn baby has only three (main) demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three." ~ Grantly Dick-Read. 

Let Me Help You Not only Rock Your Breastfeeding, but also....Create The Happiest Birth Experience Of Your Life.

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You are supplying your baby's complete nutrition and hydration requirements, as well as your own. It is difficult to get everything you need even from the best of whole food varied organic diet. Do you need supplements? Here are some of my favorite I recommend to mamas in my practice.