Post-Delivery Instructions San Diego Perinatal Center 8010 Frost Street, Suite 300 San Diego, CA 92123 ACTIVITY: Physical activity folate and iron. from the shower run over should be as you can tolerate. them for a long time. Allow for rest periods, NURSING MOTHERS: If Stimulation of any kind especially the first 2 weeks. If nipples become sore or cause more milk production. you would like to exercise - cracked: It can produce temporary walking is recommended. 1. Expose nipples to air as relief but not long term Jogging and swimming are much as possible. The flaps relief. If breasts become okay after 6 weeks. Do not of your nursing bra can be painful and firm: return to full activity left open when leaking is not 1. Decrease your fluid (aerobics, tennis, a problem. intake. employment) until after your 2. Wash nipples only with 2. Apply an ice bag wrapped postpartum check-up -- and water. Other cleansing in a thin towel to the no sit-ups or weight lifting for products are unnecessary, breasts. at least 3 months after a and may taste bad leading to 3. Two Aspirins or Advil cesarean, until your scar has improper suckling. may be taken very 4 hours if healed to a thin white line. 3. Use breast milk to needed. lubricate nipples after 4. Cold cabbage leaves (not SLEEP: Make sure to get feeding. cooked) tucked inside bra. adequate rest. Your baby 4. A commercial product will wake you a lot at night, such as unmedicated lanolin BREAST INFECTION so try to nap while baby is should be used (Mastitis): Can occur sleeping during the day. only when the nipple is during breastfeeding, or Don't be afraid to ask for cracked (e.g. lansinoh). If after you stop nursing. help from your partner, you have breastfeeding Typically an area on the family and friends. questions, the Lactation breast will be red, hard and Team at the Hospital can be hot to touch and you will DIET/VITAMINS: Continue very helpful. Their phone have a fever over 100.5 to eat well-balanced meals number is: (858) 939-4127. degrees. If this happens, as you did during your please call! pregnancy. Prenatal BOTTLE-FEEDING CONSTIPATION: Eat foods vitamins and iron MOTHERS: rich in fiber and increase supplements should be After delivery until breasts your fluid intake. Bulk continued until your return to normal you should forming laxatives such as postpartum check-up or as wear a tight bra, (a jogging Metamucil® are very long as you are breast- bra is best) even at night. An helpful. Milk of Magnesia at feeding. Even after ACE wrap, instead of bra bedtime may be used as a completing breast-feeding, may be helpful. Do not laxative. To make stools we recommend a multiple express milk from your softer use Colace or vitamin containing both breasts, or let hot water Pericolace 100mg two or instructions postdel REFORMATTED 2011.doc three times a day. These are after delivery. They will Provera (the birth control available over the counter. usually stop within a few days. shot), this can be given two Make sure to check your weeks after delivery for HEMORRHOIDS: temperature if they persist. most women. Use the sitz bath 2-3 times a day. Apply an over the AFTER PAINS: These occur DRIVING: Driving may be counter hemorrhoid as the uterus contracts and resumed when the preparation such as Anusol- returns to a pre-pregnant size. discomfort from your C- HC, Preparation H, Tucks, or They usually last 4-7 days. Section incision or ice packs as needed. Make Breast-feeding will intensify episiotomy has decreased sure to keep bowel the cramping. Tylenol or enough to allow you to movements soft. If the Advil, 1-2 tablets, every 4 quickly and firmly apply the hemorrhoids become hard hours may be used to relieve brake. You should not drive discolored (purplish) or discomfort. until at least two weeks after extremely painful, call. a cesarean, and do not drive INTERCOURSE: Intercourse while you are taking Vicodin, VAGINAL BLEEDING: It is may be resumed after the Tylenol with Codeine, or any normal to have a bloody bleeding has completely other narcotic medication. vaginal discharge after stopped and your stitches are delivery, and you may pass healed, but not before 4-6 EPISIOTOMY CARE: It is blood clots for several days. weeks after delivery. The important to practice good The amount may increase hormonal changes after hygiene to prevent infection. with breast-feeding or with delivery may make the 1. The stitches will dissolve increased activity. Overall, vagina seen dry, especially if by themselves within a you will bleed off and on for you are breastfeeding. This couple of weeks. Tiny pieces 6 weeks and some women sensation often lasts until of suture, like thread, may up to 12 weeks. It is not regular periods start up. come out of the vagina as unusual for it to stop and Astroglide or a similar water- this occurs. This is normal. then start again. It will soluble lubricant may be 2. Do not be afraid to look at gradually change from red to used. Remember to use your vaginal area. If you are a yellow-grey. Heavy contraception! experiencing increased pain, bleeding is described as You can get pregnant even check for redness, increased saturating a Maxi Pad (one if you are breast-feeding! swelling, or drainage from an hour) of bright red blood. DOUCHING: Not safe until 8 your episiotomy site. If this occurs, you need to weeks after delivery or 3. Showers are encouraged. call. cesarean. 4. Change your sanitary napkin every 4-6 hours. MENSTRUATION: This CONTRACEPTION: The Make sure it's secured varies from woman to possibility of becoming properly to avoid sliding woman. Periods might not pregnant exists after back and forth. return until breast-feeding is delivery whether your 5. Remove your sanitary stopped. Most breastfeeding periods have returned or pad from front to back to moms have a period within not, even when nursing. keep germs from the rectum about 6 months. For the Breastfeeding does not from entering the vagina. bottle feeding mother 6-10 prevent pregnancy. 6. Continue to use the spray weeks is the usual. If you have intercourse bottle on your perineum before your check-up, use after urinating. Pat dry and HOT FLASHES AND NIGHT foam and condoms. If you always from front to back. SWEATS: These are common would like to use Depo- For comfort, warm sitz baths instructions postdel REFORMATTED 2011.doc may be done 2-3 times a 3. Showers are OK, but mildest form is called the day. Avoid long periods of avoid prolonged exposure of "baby blues". This is caused sitting or standing. Local the incision to moisture that by your body's hormones anesthetic sprays may be could increase the risk of dropping back to a pre- used on your stitches (e.g. infection. Let the water run pregnancy level and is Epifoam, Dermaplast). over the incision, but DO normal. However, a few NOT scrub it for 14 days. women will have more C-SECTION INCISION: 4. If steri-strips were used, severe mood swings or Use the prescription given to they will eventually start depression. Even though you on discharge from the peeling off. Trim them with this is also caused by a hospital for severe pain. scissors, but do not pull change in hormones, it may Plain Tylenol or Advil may them off. They will usually require treatment. If you be used for lesser pain. come off on their own within feel the symptoms are Remember that most 2-3 weeks. worsening and affecting how prescribed pain medications 5. Abnormal symptoms you function or feel you are cause constipation, so try include increased swelling, losing control, please call. the Tylenol or Advil first. redness, purulent discharge The level of discomfort you from incision or if the area POST-DELIVERY CHECK- have should decrease daily. becomes hot to touch and UP: Call the office the first 2. You or your partner painful. weekday after you are home should look at the incision to schedule your daily. It should appear to be EMOTIONAL HIGHS AND appointment. It should be 4- healing. A small amount of LOWS/MOOD SWINGS: 6 weeks after delivery or yellowish-red discharge is Many women will cesarean unless you are normal but if continuous experience emotional highs instructed otherwise. drainage occurs, a physician and lows or mood swings should be called. after giving birth. The Please call if you have: 1. FEVER (above 100.4 or greater) OR CHILLS--CHECK YOUR TEMPERATURE BEFORE CALLING. 2. EXCESSIVE OR PROLONGED BLEEDING (more than 1 saturated pad per hour). 3. REDNESS, SWELLING, INCREASE IN PAIN, OR OPENING OF YOUR EPISIOTOMY OR C-SECTION INCISIONS. 4. MARKED DEPRESSION OR ANXIETY. 5. FREQUENCY AND/OR BURNING WITH URINATION. 6. SEVERE ABDOMINAL OR PELVIC PAIN. 7. PAINFUL, REDDENED, HARD AREAS ON THE BREAST Please have your pharmacy’s phone number ready, and have a pencil handy for instructions. Thanks! Holly Casele MD, Val Catanzarite MD PhD, Larry Cousins MD, Sean Daneshmand MD, Wade Schwendemann MD instructions postdel REFORMATTED 2011.doc .