I'm now six weeks postpartum and I want to write an update for many reasons. Those of you who have had babies know what this time is like, but to those of you pregnant or wanting to get pregnant - let me tell you that this period is very often overlooked. No one talks about the "fourth trimester". It's far less interesting to hear about the changes going on with mom once the baby is out. However, there are a ton of changes still going on for mom. Not just emotionally as many people point out, but physiologically too. In my job I have to memorize/understand the physiologic changes after a person has a baby - and these changes last months after delivery.
First, it's a tad unfair that as a woman, a baby rips your insides apart and then your body releases a hurricane of emotions from extreme sadness to joy to anxiety to depression and then you are sleep deprived day after day after day and - oh by the way- you are also responsible for keeping this little creature alive. This means the little cutie sucking your sore nipples 8-12 times a day - or more!
Rest assured that all of these things get better in time, but that doesn't mean it's not hard or emotional or frustrating sometimes. *I want to remind anyone that it's ok to discuss the postpartum emotions including anxiety and depression with their doctor - call if this doesn't get better. Or call if it's impacting your daily life caring for your little. Emotional health is so important to take care of a baby.
Recovery
You need some things postpartum. I thought I'd just spoil the baby and save the money by just getting through the postpartum period without many supplies. I mean, it only lasts a month right? A few days after we got home, I sent Jake to Target and told him to come home with pads/witch hazel wipes/ anything they had stocked in the postpartum section. As the saint he is, he came home with one of everything. Yes the hospital gives you some things, but some things you need to buy. It's ok to budget the cash for these things, baby can have a few less onesies.
Here's what you need at baseline postpartum :
disposable underwear for a few days (hospital provided ours)
perineal squirt bottle (hospital provided one, we got another for the second bathroom)
witch hazel wipes (feels amazing! used for weeks while I healed)
maxi pads (hospital gave us some, you need more!)
full coverage underwear (these are really good!)
nursing bras (in a larger size than you are prebaby) I like these affordable ones
Ibuprofen and Tylenol
Gel Breast Soothies - they are reusable (Medela or Lansinoh)
Not necessary but very helpful was this perineal donut . Did you know it hurts to sit on harder surfaces for a few weeks?
Weight
I was under the impression that I would have lost a lot of weight by six weeks postpartum. My Lily is worth every pound gained, and I'm not in a hurry to lose it all quickly, but I just had a skewed view of the weight loss process. I had assumed my weight would fall off easily with breastfeeding . I think I'm one of those people that breastfeeding causes the body to hold onto the fat. You either hold onto it due to the hormones or you lose it due to the calories burned - there are scientific articles about how women respond differently. I knew I had to add in some exercise for my mental sanity as well so I started doing light walks and light ab exercises at four weeks postpartum. The intensity of course was based on how I was feeling, and I definitely stopped if I started hurting. Now I try to work out five times a week, of course it's still modified as my abs are still separated! Exercise is an important part of my life - mentally and physically. I truly believe that my prepregnancy and pregnancy strength training workouts were the best thing I did to have a healthy pregnancy and easy labor and delivery so I am making it a priority postpartum.
Breastfeeding
Fed is best - I'm not here to shame anyone who doesn't breastfeed. I just knew it was important for me to make a strong effort with it. Breastfeeding is full of hundreds of amazing things that formula can't provide, so to me it was important. However, I also told Jake before baby that if it mentally caused me a lot of distress and we kept failing and failing then he needed to remind me it was ok to stop. Luckily, Lily knew how to latch well and eat from hour zero. I was in a poor medical state for 48 hours so Jake literally laid her on me and she ate and then he picked her up and cared for her the rest of the time while we were in the hospital. She continues to do well, and so far my body has done a good job giving her what she needs. The only (minor) complaint I have is that I am extremely nauseous whenever I feed her. I usually eat or drink something during the feed to try and take my mind off it. Since week four, I have introduced one pumping session after the morning feed to help store milk for when I return to work and also at that time Jake started feeding her a night bottle. So I pump while he does that as well. I want her to get used to him feeding and comforting her at night because I will soon be back working 24 hour shifts and will be away from home.
*Pacifers - yeah they told us not to give her one until four weeks - after discussing with other moms I decided no thanks she can be soothed by one and she started "accepting" the pacifier week 2. Also pacifiers decrease the risk of SIDS.
Stretch Marks
Throwing this topic in here as an update to my stretch mark routine post. There is nothing wrong with stretch marks, carrying a baby is a true miracle and every scar is worth it. Stretch marks are likely mostly genetic, and very few topical skincare ingredients have any scientific backing them for prevention. As I wrote in that post, those ingredients that have some evidence for stretch mark prevention include Vitamin E, hyaluronic acid, and centella asiatica.
I used those three ingredients every morning during my pregnancy, and then used regular coconut oil or any other type of oil at lunch and at night. I applied all of those over my breasts, belly, sides, back, butt, and thighs. I also drank collagen daily - there's not really any scientific evidence for this I just thought it could help. I do not have any stretch marks, and do continue to apply the oils once a day while my body shrinks. I apply the Vitamin E, hyaluronic acid, and centella asiatica to my breasts while postpartum to prevent stretch marks there, otherwise just oils for the rest of the areas.
Specific products I used (they don't cost a fortune and all last a long time):
Vitamin E Oil - any brand but mine came from Trader Joe's
Coconut Oil - any brand and "virgin unrefined" is best for skin
Marine Collagen Powder (instead of the bovine, this went on sale a lot on amazon)
Randomly used This Oil and Belly Balm (you don't need this)
Sleeping
"Sleep when the baby sleeps" during the day is a load of crap unless you can actually get your newborn baby to sleep nicely in a bassinet from the beginning. Lily, like most newborns I imagine, likes to be held, likes to sleep upright, or likes to sleep on her stomach. I believe that you can't spoil a newborn so we have been holding her for some naps, sometimes she sleeps supervised in the boppy lounger, and sometimes she sleeps in her bassinet (although those naps are shorter). The naps that are not in her bassinet all carry a risk of infant death, so she is supervised for all of those naps, so no I'm not sleeping. At night she sleeps in the Snoo on her back, strapped in, and swaddled. I'll review the Snoo at another time, but for six weeks it's worked well for us. We took the Taking Cara Babies course, which apparently is a mixed method of the Ferber Method and Dr Karp's 5 S's (you can probably google those for free), but we learned a lot and will continue to implement her practices as we move forward.
One of the best things we started was shift work at night. Jake "works" 8pm to 1am (sometimes 2am) and will watch her or respond to her while I sleep in another room. When he started the bottle session he would feed her when she woke up otherwise I get up and feed her and he finishes the burping and rocking back to sleep. I take over after until 7:30 and then nap for an hour or so in the morning. At six weeks, she "can" go six hours once between feeds. She does sometimes, normally she does not go the full six hours. I wake up usually 2-3 times to feed her at night.
Another normal thing no one discusses is newborn grunting! Totally normal between the hours of 4-6am and she is a loud one! We are talking farm animals meet Jurassic Park noises, and random shouting baby "Waas" mixed in. This started from the first week and I would continually picked her up thinking she was distressed (maybe she was?) and tried to feed or soothe her. Plus I didn't want to wake Jake up by letting it go on for hours (this was before he slept in the other room during those hours). After reading multiple posts in the physician mom Facebook group I'm in, I realized it's normal and baby is still asleep. Apparently baby bowels kick in during those hours and things start moving, and supposedly grunting resolves as they get bigger and more developed. So I stayed up from 4-6am one night and just watched her from my bed over the side of the bassinet and it did indeed appear she was sleeping, I let her sleep/groan with her eyes shut and then would get 3+ hour stretches in between wake ups. This gave me the confidence to kick her out of my room! We did that at four weeks and it was the best thing for all of us (she was still ten steps away). It was much easier to sleep through after that.
So far the postpartum period has been a ton of work. There are no patterns to newborn behaviors. They just came from the womb and are completely random. Also, if anyone things maternity leave is all snuggling the baby on the couch watching TV and relaxing, they are totally wrong! She is a totally normal behaved baby, and I have enjoyed so much time spent with Lily, but I'll be honest working 80 hours a week in residency is much easier than maternity leave. I have six more weeks of leave and I'm so fortunate for all of the extra cuddles, laughs, and snuggles I'll get with her. It makes all of the other work worth it. I can't wait to watch her personality develop even more!
*all photos in this post from Muller Photography
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