Pregnancy week by week

Baby

Toddler

First few weeks after birth





















                                            Your changing body

Your tummy is wrinkly and soft now. Your breasts will get bigger as they produce milk. You will continue to bleed for two to three weeks or more. Your pelvic floor may feel very saggy; practise your pelvic floor exercises regularly.

Lochia

After the baby is born, you will have a discharge called lochia, which is a bit like period. It will be heavy at first but gradually get lighter and stop after about 14 days. You may need to use two maternity sanitary pads for the first few hours, then just one at a time. The loss is bright red to begin with, then pinkish for a week, then yellowish white. If you pass clots of blood bigger than a coin, tell your doctor. It may be possible that some remnants of placenta are still left behind.

If you suddenly start having bright red bleeding again, after the lochia loss has stopped, you could have started regular periods again. If the discharge smells or is greenish in colour as well, let your doctor know.

After pains

You may feel “after pains”, a bit like period pains, caused by contraction of the uterus as it shrinks after birth. These can be particularly strong after second and subsequent babies. They only last for a few days and are a good sign that your uterus is shrinking back to its usual size. Your doctor will prescribe you some pain killers.

Perineal pain

Even if you haven’t had a tear or a cut, your perineum may feel very bruised and sore. If you find it uncomfortable to sit down, your doctor can recommend  you a support cushion, or offer paracetamol, to ease the discomfort. You will be encouraged to keep the area clean, and to get up and move around as soon as possible, especially if you have had a caesarean; being active leads to a quick recovery. If your stitches are smelly or seem to be oozing, ask your doctor to check them. There could be an infection and you might need antibiotics.

Feeling blue

It is common to feel weepy and depressed in the first few days after birth. This is often referred to as “third day blues” or “baby blues”.  Symptoms can include feeling emotional and irrational, bursting into tears for no apparent reason, feeling irritable or touchy or anxious and depressed. These symptoms are probably caused by the sudden hormonal and chemical changes that happen after child birth. They are perfectly normal and usually last for only a few days. Give yourself some time, deal with the physical problems and gradually things will settle down. If you find your mood swings do not settle, see your doctor. A few women do develop postnatal depression in the weeks after the birth and they need support and help. If this happens to you, visit your doctor-don’t struggle alone.


Sex and the new mum

Don’t worry if you don’t feel like making love for quite a few weeks after your baby’s birth. All sorts of things can stop you:

    You will probably feel tired
    
    Opportunities for sex may be limited with the new baby

    You might feel sore and be frightened that love-making will hurt

    You might be worried about getting pregnant again.

Your hubby will probably also be feeling tired, and he may well be frightened of hurting you when you have sex. So, for a while you might both not be interested. That’s fine! Make sure you are using a contraceptive. If you find painful after the first few times, see your doctor. You might have stitches, or a scar, that haven’t healed properly.
 
Little leaks

If you notice a small amount of wee leaking out when you laugh, cough or sneeze, this is because your pelvic floor muscles have been weakened during pregnancy and labour. The pelvic floor muscles hold the bladder, uterus, and bowels in place. After having a baby, many women find that these muscles are weaker than before. To prevent leaks happening, practise your pelvic floor exercises as these will help to strengthen your muscles. If the problem is still there by the time you have your six- week check, mention it to the doctor, you can have special physiotherapy to help

Constipation

If you have stitches, a perineal tear during birth or developed haemorrhoids (piles) during pregnancy, you might be very frightened of opening your bowels. You can hold a folded clean sanitary towel on the stitches while you go. You may need to soften your bowel motion for the first few days. Your doctor will probably prescribe you a laxative such as lactulose.

It will also help to:

    Drink plenty of fluids – water is best
    
    Eat foods that are high in fibre- especially fruit and vegetables

    Get up and about- moving around will get your system into action


                                              Getting back into shape

After you have given birth, it is natural for you to devote all your time to your new baby. Even so, it is important to take a little time for yourself. Although you cannot expect to return to full pre-pregnancy fitness immediately, there is lot you can do now to help get yourself back into shape. By regaining your fitness, you will feel good and have more energy to look after your baby.
 
Making yourself comfortable

After having your baby it is vital to have sufficient rest to recover. Use a method of relaxation if you have learnt one whilst your baby sleeps.

While lying down, lie on your side and make yourself comfortable by placing pillows under your abdomen and between your knees. This position is comfortable for most women, especially if you have had painful stitches in your abdomen, or bottom and/or piles. You can also use this position for feeding your baby.


To get out of bed

Bend both knees, keeping your feet on the bed and roll on to your side moving your shoulders and knees together. Push your body up by pressing down onto the mattress with your upper hand, allowing your feet to go down to the floor. Sit on the side of the bed for a few moments, and then stand by leaning forwards and pushing up with your hands and legs. Try not to stoop; stand tall.


To get into bed

Stand with the back of your knees against the bed. Support your abdomen with one hand and put the other hand on the bed behind you. Bend forwards slowly as you sit on the bed. Lower your head and shoulders sideways down onto the pillow, keeping your knees bend and together, lift your legs up at the same time.

Sitting and feeding

Always sit well back in the chair or bed. A small pillow or folded towel placed behind your waist will support you and may help to relieve backache; your feet should reach the floor. Pillows on your lap will bring the baby up to the level of your breasts for a comfortable feeding position. Rest back as you feed making sure that your shoulders are relaxed.

Remember, you can also feed your baby whilst lying down on your side in the good resting position as described above.

Exercise

There are many good reasons for exercising once your baby is born. You should return gradually and always listen to your body. The effects of the hormones can still affect your joints up to 6 months after the birth, or for as long as you are breastfeeding. Hence, care should be taken not to start high impact activity too soon.  Brisk walking is an excellent way to exercise. Gradually increase the time and pace of your walking every day during the first six weeks. You can start swimming once your vaginal bleeding or discharge stops. If you have had a Caesarean delivery, you may prefer to wait until you have your 6 weeks check up.

Many women feel extremely tired after child birth so do not over do it, pace yourself, limit your visitor and have plenty of rest. Accept offers of help and do not try to be a super mum.

Remember to do your pelvic floor muscle exercises as described below in this section.


                                                         Eat healthy

Life will become very busy once your baby arrives and it can take time to adjust to new, often exhausting routines. Physically recovering from the birth itself and sleepless nights can take their toll on a new mum but it is still important that you continue to look after yourself. One way to do this is to eat small, nutritious snacks whenever you can, keeping meals simple, quick to prepare and healthy.

After pregnancy, the body needs time to recover but many new mums are keen to regain their pre-pregnancy weight and figure. The best way to lose any excess weight is to allow at least six weeks for your body to recover and then start taking some gentle exercise.

If you are breast feeding:
  • It is important to continue eating a varied, balanced diet that includes plenty of fruit, vegetables, starchy foods, fibre and protein.
     
  • Eating fish is good for your health and the development of your baby. Oily fish is important as it is a good source of fatty acids, which help the development of the baby’s nervous system.
     
  • Drink plenty of fluid. Try to drink at least six to eight glasses of fluid a day.
     
  • Regular intakes or large amounts of alcohol or caffeine should be avoided as this will affect your baby.
     
  • Weight reduction diets are not recommended when breast feeding as cutting back on food can reduce the quality of your milk.

Stay comfortable: pregnancy hormones and pressure on your organs can lead to heartburn, haemorrhoids and constipation. Making small lifestyle changes can alleviate or prevent these problems. Avoid spicy meals or late-night meals to prevent heartburn.

Your growing baby depends on you for nutrition. Therefore, eating well is vital. You may feel that you are eating well; however, some diets can leave you low in energy and important nutrients. Women who eat a balanced diet are more likely to have healthy babies. Remember, normal weight gain is one of the most positive signs of a healthy pregnancy. So what if you are getting bigger! Just relax and enjoy your pregnancy!
 
Important:

    Avoid crash and fad diets
    
    Eat well and choose high fibre, low fat foods

    Don’t skip meals

   Cut back on fatty and sugary foods and replace cakes and biscuits with snacks such as fruits.

The most important thing you can do to help your baby’s development is to take care of yourself because, by doing so, you are also taking care of your baby. And the best ways you can do this is to ensure that you eat a healthy, balanced diet. As your body changes to accommodate a developing baby, nutrition becomes very important.


                                    Helpful tips on organising your busy day

Most mums would agree: there simply is not enough time in the day. Whether you are a mum with a career outside the home or a stay-at-home mum, taking care of your household demands and meeting the needs of your family can become overwhelming. By following a few simple organising tips, however, you can make each day a little less stressful.

1) Developing a routine

It may seem difficult to stick to a routine, but it will pay off when your children know what to expect each day and how they can help make the day go more smoothly

2) Stop racing around:

3) Streamline house work: keep your living space clutter-free by only keeping out the things you use everyday

4) Make a weekly meal plan: Find time to unwind; this one is hard, but it’s important to have a fresh mind so you think more clearly and as a result your day will go more smoothly.

 
                                   Activity in the early days after delivery

Being active is good for you. Get out of bed and walk around as soon as possible unless you are advised otherwise.

Changing your baby


The surface on which you change your baby should be at waist level so that you do not have to bend forward, risking backache. It is also easier to lift your baby from this height.

Bathing

Avoid bending forward and straining your back, by kneeling down if you are washing your baby in the bath. If you are standing, make sure that the baby bath or sink is at waist level.

Circulation

  If your ankles are swollen, put your feet up with your knees supported

  • When you are resting in bed or sitting on a chair, bend your feet and ankles up and down briskly for 30 seconds every hour

  • Avoid sitting or lying with your legs or ankles crossed as this may restrict the blood flow

  • Avoid standing still for long periods.

Posture

Regaining good posture after you have had a baby is important; this will help the way that you look and feel. Standing, sitting, lying or being active with good posture may help to avoid future aches and pains.

Sore nipple fix

What you can do...
  • Try and improve the way your baby attaches to the breast

  • Bathe your breasts with plain water (soap can remove natural oils and contribute to cracking)

  • Never pull your nipple out from your baby’s mouth like a cork from a bottle; put your finger gently into the side of her mouth to break the suction.

  • Express a little milk onto your nipples after feeds and let it dry.

  • If you are using breast pads, use one without plastic backing to let the air in, and make sure that your bra is not too tight.

  • Remember, once your baby is attached correctly, the pain will fade. It will get better.

  • Ask your doctor on the correct way to attach your baby and some remedy to help the healing in the meantime.

Emotional rescue

Even if you are still full of joy and delight at your baby’s arrival, parenting is a 24- hour responsibility, and some days it can feel overwhelming.

While new babies sleep a lot, they need very frequent feeding in the first few weeks. Gradually, babies will sleep for longer at night, will be able to take more milk at a feed and feed less frequently. Until then, though, your own sleep is bound to be disturbed; broken nights and lack of sleep are a fact of life for new parents.

Here are some ways of coping:

  Put on hold everything that doesn’t absolutely have to be done and simply enjoy your baby.

  • Get as much help as possible, from your hubby, mother, or friends. Ask people

  • Try to use some of the time when your baby is asleep to catch up on sleep yourself

  • Get a little exercise everyday; take your baby for a walk and get the benefits of fresh air.

  • Don’t let visitors overwhelm you; tell people when they can visit and when they can’t

  • Accept that this phase of your baby’s life won’t last forever. It may seem like it will never end, but it will. Things will gradually settle into more of a pattern.

                                                After Caesarean delivery

You should follow all the above advice. However, because you have had an abdominal operation you will be more tired; do not expect too much too soon. There are several layers of stitches in your lower abdomen that will take time to heal so increase your activities gradually as you feel able.  
  • Take regular pain relief for as long as you require it.
     
  • In the early days if you need to cough, sneeze or laugh, lean forwards, supporting your wound- with your hands, a pillow, or small towel.

  • When you return home, accept all the help that is offered.

  • Try to avoid any activity that causes strain for the first 6 weeks such as prolonged standing or carrying heavy grocery bags.

  • Try not to lift anything heavier than your baby for at least 6 weeks. If you have a toddler, encourage him/her to climb up to you while you are sitting down rather than bending forward to pick him/her.

                                        Pelvic floor muscle exercises

The pelvic floor muscles are at the bottom of your pelvis, supporting the pelvic organs. These muscles have been stretched in pregnancy and during vaginal delivery, which may cause problems. These exercises are needed to improve muscle strength so that you can control your bladder and bowel and help prevent prolapse of the pelvic organs.

Remember to:  
  • Start the pelvic floor exercises as soon as possible after you have had your baby
     
  • Do gentle, rhythmic tightening and relaxing of the muscles which will help ease discomfort, pain and swelling, and will aid healing if you have a tear or stitches

  • If you have a urinary catheter inserted, wait until it is removed and you are passing urine normally before starting these exercises.

How to exercise your pelvic floor muscles

  • Imagine you are trying to stop yourself passing urine or wind. Try and “squeeze and lift” the pelvic floor muscles, closing and drawing up the 3 passages. Start gently and rhythmically. Hold the squeeze for a few seconds; do not hold your breath.
     
  • Gradually increase the hold time and the number that you do until you can hold the squeeze for up to 10 seconds and repeat up to 10 times

  • Try exercising in different positions (standing, sitting, lying) and establish a routine, such as every time you feed your baby.

 Remember it can take several months for the pelvic floor muscles to return to their previous strength. Pelvic floor muscles exercises are important for life for all women.


Getting ready for exercise

Physically, your body will not return to its pre-pregnant shape immediately. But don’t rush to get back to normal; it took you nine months to reach that shape. Crash diets will interfere with breast feeding and may make you feel tired at a time you need all your energy. A sensible diet and graded exercise programme is the best way to lose weight.

Around six weeks you will have your six week check. It’s a useful opportunity to discuss any worries and queries you may have about your baby or yourself. The six week check marks the official discharge from the maternity services, provided there are no complications which need further visits.

Exercise may be the last thing you are thinking of when you are already so tired all the time. But exercise can help you recover quickly from child birth, and also help you cope both physically and emotionally with becoming a parent. Exercise helps your tummy muscles become strong again; too, and helps you lose the weight gained during pregnancy.

Try:
  • Swimming
     
  • A brisk walk

  • A tone-up; try a videotape aimed at postnatal women.
 You need to continue to do your pelvic floor exercises even if you are unable to manage anything more physical. These will strengthen your pelvic floor and reduce your risk of leaking.

Back care

Your pelvic joints will take 3-6 months to return to their pre-pregnancy state. You can easily strain your back during this time so try not to lift anything heavier than your baby for as long as you are able. If you do have to lift:  
  • Always try to bend your knees
     
  • Hollow your abdomen

  • Tighten your pelvic floor muscles

  • Breathe out as you lift

If you have a toddler, try and avoid lifting him or her for the first few weeks and try not to lift anything heavy. If you have to lift, follow the correct technique as described above.

 

 



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