Fred Creutzmann, MD - 972-394-7277 - www.DrCmd.com

INFORMATION FOR THE NEW MOTHER

1. ACTIVITY - Avoid heavy lifting the first two weeks. The ligament relaxing hormones of pregnancy are still active. Avoid driving, as your reflexes will be slowed. REST!!! Take naps when the baby sleeps and have only helpful visitors the first weeks, no “guests.”

2. HYGIENE - Until the 4-6 week check up, no swimming pools, hot tubs or douching, as this can cause infection. Sitz baths are beneficial for episiotomy healing as well as reducing hemorrhoid discomfort. Tylenol and ice packs are also helpful.

3. HEMORRHOIDS - These are quite common and are akin to varicose veins of the legs. They are aggravated by hard stools so have roughage, (fruits, vegetables, bran, etc.), with meals. Keep well hydrated with water every day. If this does not help, call me.

4. BREAST FEEDING - First milk (colostrum) is present in small concentrated amounts the first 3-4 days, gradually changing into the mature milk. With the increasing quantity of milk, mothers begin to feel fullness in their breasts. Watch your baby for cues he or she is hungry, i.e. fist in the mouth, rooting, or loud sucking sounds. Crying is a late sign of hunger. Allow baby to empty one breast, before burping the child and offering the other breast. This will help to avoid engorgement and will allow baby to get the “hind” milk, which is higher in fat and calories. If you are still feeling uncomfortably full when baby is done nursing, you may pump or hand express enough milk until you are comfortable. Label with date and store in freezer. Express some colostrum or breast milk after each feeding and spread it over your nipples. Allow to air dry. If sore, dry or cracked, you may also apply Lansinol cream in a thin layer. You should be breast-feeding about 8-10 times each 24 hours. If baby has not awakened in 4 hours, wake him and feed him. Fill out your breast-feeding record each day for the first 2 weeks and call your pediatrician or lactation consultant if there is insufficient output or too few feedings. Keep well hydrated and avoid overly spicy foods or excessive amounts of caffeinated drinks, (more than 2 or 3 a day), as this may make baby jittery. Check with your pediatrician before taking medications as some are secreted in the breast milk.

NON-NURSING MOTHERS- Wear a snug sports bra until breast engorgement is gone. Avoid stimulation to breasts, including water from the shower. If uncomfortably full, you may apply ice packs to breasts or use refrigerated cabbage leaves inside of bra.

5. MENSTRUATION -­ Flow usually returns within 6-8 weeks if you are not nursing. If you are nursing, menses may return in as early as 2 months, but typically does not resume until the fourth month. YOU CAN BECOME PREGNANT BEFORE YOU HAVE A PERIOD! Use precautions. I once had a patient who pregnant again at her six weeks check-up!

6. SEXUAL INTERCOURSE­ - This is not recommended until your 4-6 week check up to avoid infection and injury to healing pelvic structures. If you are breastfeeding, prolactin, a hormone that is elevated by this process, suppresses estrogen secretion. Without estrogen, the lining of the vagina becomes thin and does not secrete lubrication very well. You may need a water-soluble lubricant such as K-Y for the first four post-partum months; at that time prolactin returns to lower levels even if you are still breastfeeding. This is also why menses returns later in breastfeeding women.

7. POST-PARTUM BLUES -­ You have just been through a remarkable experience. You have a beautiful baby after 9 months of waiting. There is frequently an emotional high following the delivery, but then you may feel a bit of a let down. You are likely tired from being up with the baby and the new responsibilities of motherhood can seem overwhelming. There is a drastic change in your body chemistry with an abrupt drop in the hormone levels of pregnancy. You may feel a little let down, but you feel like you really shouldn't be. THIS IS NOT UNCOMMON! This is universally accepted as a normal response to childbirth and usually passes in 2-3 days. If, in the remote possibility, you continue to feel poorly and especially if you are troubled with insomnia, call and we can talk about it.

8. ADDITIONAL INFORMATION – This handout and others are on my website DrCmd.com

WHEN YOU SHOULD CALL THE DOCTOR

If you have an elevated temperature 100.5.

Increasing pain

Burning with urination.

Increased vaginal bleeding.

Drainage from an abdominal incision.

Foul odor of vaginal discharge.

Shortness of breath or leg pain.

Swelling, unrelenting headache or visual changes.

Anything that does not seem normal to you.

Congratulations on your new baby!
May you be a blessing to each other through the years.